Value of bedside high-flow continuous blood purificationcombined with Xuebijing in the treatment of severe sepsis / 中国医师进修杂志

Objective:To investigate the effect of bedside high-flow continuous blood purification (CBP) combined with Xuebijing in the treatment of severe sepsis (SS) and the influence on the patient′s coagulation-fibrinolysis index, immunity index and expression of peripheral blood Toll-like receptor 4 (TLR4).Methods:Ninety-three patients with SS who were admitted and treated in the Lianyungang First People′s Hospitalfrom January 2017 to October 2019 were selected. They were divided into the combined group (51 cases, treatment with bedside high-flow CBP and Xuebijing injection based on bundle therapy) and the control group (42 cases, treatment with Xuebijing injection based on bundle therapy). The changes in coagulation and fibrinolysis index, immunity index, biochemical index such as TLR4 before treatment and after 1 week of treatment were compared between the two groups. The incidences of complications in both groups were statistically analyzed, and the discharge time from ICU, mechanical ventilation time and 28-day mortality were recorded.Results:After 1 week of treatment, the levels of prothrombin time (PT) and activated partial thromboplastin time (APTT) in the two groups were shortened, D-dimer (D-D) and fibrinogen (FIB) were decreased ( P<0.05); and the levels of PT and APTT in the combined group were shorter than those in the control group, the levels of DD and FIB were lower than those in the control group, there were statistical differences ( P<0.05). After 1 week of treatment, the levels of CD 4+ and CD 4+/CD 8+ ratio in both groups were increased ( P<0.05), and the levels of CD 4+ and CD 4+/CD 8+ ratio in the combined group were higher than those in the control group ( P<0.05). After 1 week of treatment, the levels of TLR4, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), blood lactate (Lac), blood urea nitrogen (BUN) and serum creatinine (Scr) in both groups were decreased ( P<0.05), meanwhile, the above indexes in the combined group were lower than those in the control group ( P<0.05). The incidence of multiple organ failure and the 28-day mortality rate in the combined group were lower than those in the control group: 3.92%(2/51) vs. 19.05%(8/42), 13.73%(7/51) vs. 30.95%(13/42), there were statistical differences ( P<0.05). The discharge time from ICU and mechanical ventilation time in the combined group were shorter than those in the control group: (12.35 ± 2.14) d vs. (14.17 ± 3.36) d, (7.12 ± 2.23) d vs. (8.51 ± 2.39) d, there were statistical differences ( P<0.05). Conclusions:Bedside high-flow CBP combined with Xuebijing injection in the treatment of SS can improve the patient′s condition, regulate the balance of coagulation and fibrinolysis, avoide the activation of coagulation, inhibite inflammatory response, reduce the expression of TLR4 in peripheral blood, improve immune function, protecte kidney function and promotethe patient′s recovery.

Clinical observation on severe acute pancreatitis treated with electroacupuncture at Dachangshu (BL 25) and Shangjuxu (ST 37) combined with ulinastatin / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effects on severe acute pancreatitis (SAP) treated with electroacupuncture (EA), sparse-dense wave and 2 Hz/15 Hz, at Dachangshu (BL 25) and Shangjuxu (ST 37) assisting ulinastetin and explore the effective therapeutic method for SAP.</p><p><b>METHODS</b>A total of 120 patients of SAP were randomized into an observation group and a control group, 60 cases in each one. In the control group, the routine western medicine was adopted with the intravenous drip with ulinastatin. In the observation group, on the basis of the treatment as the control group, EA was applied at Dachangshu (BL 25) and Shangjuxu (ST 37). The treatment was given once every day, 20 min each time. The treatment was 2 weeks in the two groups. The recovery time of defecation, the recovery time of bowel sound, the remission time of abdominal pain and the hospitalization time were recorded in the patients of the two groups. The changes in the tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) and amylase, as well as the scores in the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) were compared in the patients of the two groups before treatment, and on the 3rd, 8th and 14th days of treatment. The therapeutic effects, the cases of surgical transfer or the cases of the transfer of intensive care unit (ICU) were compared between the two groups.</p><p><b>RESULTS</b>The recovery time of defecation, the recovery time of bowel sound and the remission time of abdominal pain, as well as the hospitalization time in the observation group were shorter than those in the control group (all<0.05). The levels of TNF-α, IL-6 and amylase, as well as the scores of APACHE Ⅱ on the 3rd, 8th and 14th days of treatment were all reduced as compared with those before treatment in the two groups (all<0.05). The results in the observation group were lower than those in the control group (all<0.05). The total effective rate was 95.0% (57/60) in the observation group, better than 81.7% (49/60) in the control group (<0.05). There were 1 case of surgical transfer and 0 case in ICU transfer in the observation group, 3 cases of surgical transfer and 2 cases in ICU transfer in the control group, indicating the significant differences between the two groups (both<0.05). .</p><p><b>CONCLUSION</b>EA at Dachangshu (BL 25) and Shangjuxu (ST 37) displays the satisfactory accessory therapeutic effects on SAP treated with ulinastatin.</p>

Clinical observation of acupuncture at Zhiyang (GV 9) points combined with pantoprazole for gastroesophageal reflux cough with damp-heat type / 中国针灸

<p><b>OBJECTIVE</b>On the basic treatment, to observed the effect difference between acupuncture at Zhiyang (GV 9) points combined with pantoprazole and simple pantoprazole for gastroesophageal reflux cough with damp-heat type.</p><p><b>METHODS</b>A total of 102 patients were randomly assigned into an observation group and a control group, 51 cases in each group. The patients in the two groups were given domperidone tablets (10 mg each time, 3 times a day). The patients in the control group were treated with pantoprazole capsule (40 mg each time, once a day). On the basis of the control group, the patients in the observation group were treated with Zhiyang (GV 9) points, once a day, 5 times a week. All the treatment was given for 8 weeks. The indexes were observed before and after treatment, including cough symptom at daytime and nighttime scores, TCM symptom (heartburn, acid regurgitation, chest pain, epigastric pain, throat discomfort) scores and quality of life scores of cough questionnaire in Leicester (physiological, psychological and social aspects). The clinical effects were compared.</p><p><b>RESULTS</b>After treatment, the daytime and nighttime cough scores, TCM symptom (heartburn, acid regurgitation, chest pain, epigastric pain, throat discomfort) scores were lower, and the quality of life scores of cough questionnaire in Leicester (physiological, psychological and social aspects) were higher than those before treatment in the two groups (all <0.05), with better results in the observation group (all <0.05). The total effective rate of the observation group was 94.1% (48/51), which was better than 80.4% (41/51) of the control group (<0.05).</p><p><b>CONCLUSION</b>On the basic treatment, acupuncture at Zhiyang (GV 9) points combined with pantoprazole can improve TCM symptoms, such as cough, of the patients with gastroesophageal reflux cough with damp-heat type, and improve their quality of life.</p>

On the depth of needle insertion / 中国针灸

The statement on the depth of needle insertion is collected from Neiiing (nternal Classic) and Nanjing (Classic of Medical Problems) and the relationship of it is discussed with meridians, diseases, symptoms, location of sickness, qi and blood changes in human body, time, layers of needle insertion, reinforcing and reducing of acupuncture, etc. The factors are explored for the determination of the puncture depth, which provides the important guidance for the depth of insertion, needling sensation, reinforcing and reducing manipulations, acupuncture effect and the improvement of acupuncture efficacy. The complex and mystery of acupuncture technique focus on the control of insertion depth. In clinical practice, the increase of needle insertion depth may not induce the equal increase of efficacy. The depth of needle insertion is rather relevant with stimulation at the effective acupoint in the effective layer.

Effect of Acupuncture on the Quality of Life in Patients with Irritable Bowel Syndrome Discussed Based on Brain-gut Interaction / 上海针灸杂志

ObjectiveTo testify the therapeutic efficacy of acupuncture in treating diarrhea-predominant irritable bowel syndrome (D-IBS) based on brain-gutinteraction.MethodEighty D-IBS patients were randomized into brain-gut interacted acupuncture group (treatment group) and a group with acupoints selected based on conventional syndrome differentiation (control group), 40 in each group. The treatment group was intervened by acupuncture by selecting the thirteen ghost acupoints (invented by SUN Si-miao) plus Tianshu (ST25), Dachangshu (BL25), etc., while the control group was by acupuncture based on conventional point selection, including Zusanli (ST36),Tianshu (ST25), Dachangshu (BL25), Ganshu (BL18), Pishu (BL20), etc., three times a week, and 10 sessions as a treatment course. The clinical efficacies were evaluated after 2 treatment courses.ResultThe two groups were generally equal to each other incomparing each dimension of the Short-form Health Survey (SF-36) before treatment, while the scores were increased after treatment in both groups; the treatment group was significantly superior to the controlgroup in comparing the scores ofrole-physical,bodily pain, general health, vitality, social role functioning, and reported health transition from the SF-36 (P<0.05).ConclusionAcupuncture based on brain-gut interaction can produce a more significant effect in treating D-IBS compared to conventional acupuncture.

Acupuncture Treatment Based on Lung-stomach Theory in Treating Post-infectious Cough / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture by selecting points from the Lung and Stomach Meridians based on the theory of accumulation in stomach and connection with lung in treating post-infectious cough.Method Ninety patients with post-infectious cough were randomized into treatment group 1, treatment group 2, and a control group. Treatment group 1 was intervened by acupuncture at points from the Lung and Stomach Meridians, treatment group 2 was by puncturing points from the Lung Meridian, and the control group was by oral administration of Compound Methoxyphenamine Capsule. Leicester Cough Questionnaire (LCQ) was adopted for observation before and after intervention, and the symptom and clinical efficacies were compared between the groups.Result The total effective rate was 90.0% in treatment group 1, versus 83.3% in treatment group 2, and 80.0% in the control group. The total effective rate of treatment group 1 was significantly different from that in treatment group 2 and the control group (P<0.05). Regarding cough during the daytime, the total effective rate was 93.3% in treatment group 1, versus 83.3% in treatment group 2 and 76.7% in the control group. The total effective rate in treatment group 1 for cough during the daytime was significantly different from that in treatment group 2 and the control group, and the total effective rate in treatment group 2 was significantly different from that in the control group (P<0.05). For cough at night, the total effective rate in treatment group 1 was 86.7%, versus 80.0% in treatment group 2 and 80.0% in the control group. The total effective rate in treatment group 1 for cough at night was significantly different from that in treatment group 2 and the control group (P<0.05). The LCQ score in treatment group 1 was markedly different from that in treatment group 2 and the control group (P<0.05).Conclusion Acupuncture based on lung-stomach theory is an effective approach in treating post-infectious cough, and this method has an advantage of general regulation.

Expression, purification and activity analyses of three Bcl-2 family proteins / 生物医学工程学杂志

Bcel-2 family proteins (Bcl-x(L), Bcl-2, Mel-1 etc.) are key regulators of some life processes, including apoptosis and autophagy. They are currently considered as promising targets for developing new anti-tumor therapies. In our study, the human Bcl-2/Bcl-x(L) chimeric gene and the human/mouse Mel-1 chimeric gene were designed and cloned, and the prokaryotic expression vectors for expressing glutathione S-transferase (GST) fusion proteins and histidine tag fusion proteins were constructed respectively. These two proteins as well as the GST-Bcl-x(L) fusion protein were all successfully expressed in E. coli and subsequently purified. In addition, we measured the binding of these Bcl-2 family proteins to the Bid BH3 peptide by fluorescence polarization-based assay. The dissociation constants (Kd) obtained by us were in general agreement with the data reported in literature. The Kd values of all three proteins with or without the GST tag were almost identical. All these results validate the biological functions of these Bcl-2 family proteins obtained by us. These proteins can be used in the experimental screening of small-molecule regulators of Bcl-2 family proteins in vitro.

Empirical Study on the Hepatotoxicity Induced by Rifamycin Sodium Plus Isoniazid in Mice / 中国药房

OBJECTIVE: To compare the hepatotoxicity which induced by rifamycin sodium and isoniazid by alone or combination in mice. METHODS: Forty mice were divided randomly into 4 groups: the sodium chloride group, the rifamycin sodium group, the isoniazid group and the drug - combination group. The drugs were administered to mice by i. p. or i. g. once daily for 8 days. Each mouse was killed by ophthalmectomy. The blood was collected and the liver was excised immediately. The activity of serum ALT and AST was measured and the liver index in mice was calculated. Light microscope was used to observe the histopathological changes of the hepatic cells. RESULTS: The liver index and the activity of serum ALT and AST increased in all groups expect the sodium chloride group( P