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Objective To explore the effects ofBuzhong Yiqi Pills on HBV-related decompensated liver cirrhosis patients.Methods A total of 176 patients of HBV-related decompensated liver cirrhosis were enrolled in the study from January 2007 to January 2010 and were divided into treatment group (82 cases) and control group (94 cases) according to patient's wishes. Patients in both groups were given antiviral therapy. According to the liver function and complications, patients were given glycyrrhizin to protect liver, Kuhuang Injection to treat jaundice, and spironolactone and furosemide for diuretic treatment. Patients in the treatment group receivedBuzhong Yiqi Pills, one bag for each time, twice a day, four weeks as a treatment session, three sessions each year, with five-year follow-up. Effects ofBuzhong Yiqi Pills on the hepatorenal function, blood coagulation, blood routine, complications and survival rate in patients with decompensated liver cirrhosis were observed.ResultsBuzhong Yiqi Pills could effectively improve the hepatorenal function, blood routine and coagulation disorders of HBV-related decompensated liver cirrhosis patients (P<0.05,P<0.01). The rate of complications with hydrothorax and ascites (46.34% vs. 88.30%), upper gastrointestinal hemorrhage (39.02% vs. 69.15%), infection (31.71% vs. 57.45%), hepatic encephalopathy (23.17% vs. 54.26%), hepatorenal syndrome (6.10% vs. 18.09%) and chronic hepatic failure (9.76% vs. 25.53%) in the treatment group and the control group were with statistical significance (P<0.05,P<0.01). The five-year survival rates were significantly higher in the treatment group (79.27%) compared with the control group (64.89%), with statistical significance (χ2=5.353,P=0.021).ConclusionLong term use ofBuzhong Yiqi Pills can significantly decrease the complications of HBV-related decompensated cirrhosis and improve survival rate of patients.
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Objective To explore the clinical significance of the serum brain?derived neurotrophic factor( BDNF) level in severe neonatal hyperbilirubinemia. Methods One hundred and twenty term and birth weight>2500 g infants admitted to the Neonatal Intensive Care Unit of Bethune nternational Peace Hospital of People Liberation Army were divided into severe hyperbilirubinemia group and control group according to their total bilirubin concentration. Total bilirubin( TBIL) concentration,BDNF and albumin in serum were determined in two groups. In addition, craniocerebral MRI was performed in severe neonatal hyperbilirubinemia before discharge. The correlation of the BDNF, TBIL, B/A, MRI results between severe hyperbilirubinemia group and control group were compared. Results The serum BDNF levels in severe hyperbilirubinemia group was ( 8. 84 ±3. 26) μg/L,significantly higher than that in control group((6. 24±1. 71) μg/L,t=3. 88,P0. 05). The serum BDNF level with craniocerebral MRI abnormal was ( 9. 53 ± 2. 77 ) μg/L, higher than that with craniocerebral MRI abnormal ((7. 81±3. 76) μg/L),but there was no statistical difference between them(t=1. 439,P>0. 05). Conclusion In severe neonatal hyperbilirubinemia, the body can secrete BDNF increasely. BDNF level is positivelycorrelated with B/ A level. As a marker of brain damage,BDNF is sensitive than craniocerebral MRI.
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Objective Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia,but active cooling with whole body surface or head cooling is both complex and expensive.The clinical feasibility of passive cooling in treatment of full term infants with severe asphyxia was investigated.Methods Thirty-two severe asphyxiated term newborns treated with hypothermia were analyzed,who were randomly divided into 2 groups:passive cooling group(n =17) and active cooling group(n =15).Active cooling group adopted MTRE ALLONTM-thermo regulatory systems,passive cooling group using natural cooling method.Hypothermia treatment time was 72 hours.At the end of treatment,the clinical manifestations,biochemical parameters and clinical efficacy of infants between the 2 groups were compared.Results During treatment all infants had no cardiac arrhythmia,hypoglycemia,sustained metabolic acidosis,blood-borne infections,local cold injury or bleeding.Infants in passive cooling group had a relatively wide range of rectal temperature fluctuations[average (33.47-0.71) ℃] and infants in active cooling group had a relatively narrow range of rectal temperature fluctuations[average (33.66 ± 0.29) ℃],but there was no statistically significant difference in their mean rectal temperature(t =1.941,P =0.055).One patient died in active cooling group,but there were no significant differences in suckling age,length of hospital stay,neonatal behavioral neurological assessment score,abnormal cranial ultrasound and MRI between the survivors of the two groups(all P ＞0.05).Conclusions In NICU,environmental temperature is relatively stable,passive cooling for asphyxiated newborns appears to be feasible for maintenance of hypothermia with a lower risk of adverse reactions.
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Objectives To investigate the clinical characteristics of hypoglycemic brain damage, and to assess the ifndings of amplitude-integrated electroencephalography (aEEG) and its predictive value in hypoglycemic brain damage. Methods Twenty-four neonates diagnosed with hypoglycaemia were selected. 12-hour continuous aEEG recordings were performed on the day when hypoglycaemia was diagnosed and second aEEG tracings was performed on the same day or the day after. The variability of aEEG background, appearance of sleep-wake cycling, bandwidth span and amplitude of lower border were analysed and compared with the results of brain MRI. Results Different degrees of epileptic seizures were found in neonates with severe hypoglycemic brain damage and were persisted after the blood sugar was corrected. aEEG in hypoglycemic brain damage was characterized by calyptriform or jagged epileptiform activity, disappearance of the sleep-wake cycle, but little impact on amplitude of lower border and bandwidth span. The recovery of sleep-wake cycle was a sign of brain function recovery. The aEEG and MRI had a good consistency in monitoring the hypoglycemic brain damage. Conclusions aEEG have signiifcant changes in hypoglycemic brain damage and can be used to monitor dynamically hypo-glycemic brain damage.
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Objective To prospectively observe the changes of amplitude-integrated electroencephalogram(aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE).Methods Thirty-five HIE neonates with gestational age of 37 ～ 41 weeks were chosen as HIE group,and all of them were hospitalized in neonatal intensive care unit of Bethune International Peace Hospital from Aug 2011 to Jan 2012.At the same time,40 healthy term neonates were chosen as control group.aEEG monitoring was done within 24 ～ 48 hours after birth with cerebral function monitor (CF3000) and each recording last at least 8 hours.The continuity,sleep-wake cycle,voltage of every aEEG tracing were analyzed.Results (1) The maximal voltage of aEEG tracing in control group was 30 μV,while that in HIE group was 16 μV.The minimal voltage of aEEG tracing in control group was 13 μV,while that in HIE group was 7 μV.The aEEG tracing amplitude both in highest and lowest in HIE group were significantly lower than those in the control group.There were significant differences between them (P ＜ 0.05).(2) There was significant difference of sleep-wake cycling between HIE group and control group[20％ (7/35) vs 100％ (40/40),x2 =51.064,P ＜ 0.05].While there was also significant difference of the continuity of the amplitude between HIE group and control group[31％ (11/35)vs 100％ (40/40),x2 =40.336,P ＜0.05].Conclusion aEEG has some specific changes in neonates with HIE,possiblility it can be used for earlier predicting the occurrence of brain damage after asphyxia and provides good evidence for the early diagnosis and treatment of HIE.
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Objective To study the clinic value of brain edema detected by ultrasound examination in high risk term infants. Meth-ods The study group included 140 term infants who were found having brain edema in cranial ultrasound examinations. 152 term infants with normal ultrasound scan were selected as a control group. The risk factors of brain edema were collected, and univariate analysis and multivariate logistic regression analysis were performed. Results (1) There was no difference of incidence of brain edema between the infants with or without maternal ill historys, fetal distress or hypoalbuminemia, with P > 0.05. (2) In the univariate regression model, as-phyxia,hypoxic -ischemic encephalopathy (HIE) ,ventilation and metabolic acidosis were associated with an increased risk of brain ede-ma. In the multivariate logistic regression model, HIE was associated with a greater risk of brain edema and ventilation was possibly asso-ciated with brain edema. Conclusion Brain edema detected by ultrasound examination in high risk term infants has close relationship with HIE. It suggest that there is a consistency between ultrasound results and clinic situation. The detection of brain edema by ultrasound can assist doctor in clinic practice.