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Objective:To evaluate the clinical efficacy of Jianpi-Huazhuo Decoction in the treatment of complication patients with phlegm-dampness in type 2 diabetes mellitus (T2DM) and Diabetic nephropathies (DN). Methods:A total of 72 patients with with phlegm dampness T2DM and DN in Huaibei Traditional Chinese Medicine Hospital of Anhui Province from June 2018 to June 2020 were randomly divided into two groups with 36 in each group. The control group were treated with oral metformin sustained-release tablets on the basis of diabetes propaganda. The observation group was treated with Jianpi-Huazhuo Decoction on the basis of the control group. Both groups were treated for 4 weeks. The blood glucose (plasma, enzyme method), HbA1c (whole blood, high performance liquid chromatography) and fasting insulin (serum, chemiluminescence method) were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Plasma BUN, SCR and urinary albumin excretion rate (UAER) were measured by automatic biochemical analyzer. The plasma laminin (LN), procollagen Ⅲ (PC Ⅲ) and collagen type Ⅳ (Ⅳ-c) were detected by ELISA. The adverse events during treatment were observed and the clinical efficacy was evaluated. Results:The total effective rate was 86.1% (31/36) in the observation group and 58.3% (21/36) in the control group ( χ2 =6.923, P=0.009). After treatment, the levels of FBG, 2 hPG, HbA1c, FINS and HOMA-IR in the observation group were significanlty lower than those in the control group ( t values were 4.242, 2.751, 3.565, 3.613 and 4.512, respectively, all Ps<0.05). After treatment, the plasma levels of LN, PC Ⅲ and Ⅳ-c were significanlty lower than those in the control group ( t values were 3.612, 1.864 and 2.046, respectively, all Ps<0.05). After treatment, the levels of serum creatinine and urinary albumin excretion rate in the control group were significanlty lower than those in the control group ( t values were 5.864 and 3.286, respectively, all Ps<0.05). Conclusion:The Jianpi-Huazhuo Decoction can reduce the blood glucose level and renal fibrosis related factors in patients with phlegm dampness T2DM complicated with DN, improve the clinical symptoms and improve the clinical curative effect.
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Objective To investigate the efficacy of percutaneous transhepatic variceal embolization (PTVE) with Cyanoacrylate (TH glue) in treating large gastric fundal variceal bleeding.Methods PTVE was performed on 24 patients with TH glue injected into the main stem of left gastric vein and its fundic branches.The degree of varices in gastric fundus,rebleeding rate and survival rate after the procedure were compared with those before.Results Varices in gastric fundus were all embolized successfully with TH glue.The diameter of varices was reduced to below 5mm or disappeared in 20 patients (83.3％),and reduced to 5-10mm in the other 4 ( 16.7％ ) During the follow-up period of 3-36 months(mean 16.6 months),the rebleeding rate and mortality were 12.5 ％ ( 3/24 ),and 12.5 ％ (3/24),respectively.One patient died of liver cancer,and two others died of chronic liver failure.Conclusion PTVE with TH glue is of ideal therapeutic effect to block the feeding veins of large gastric fundal varices.
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Objective To compare the degree of pain in patients after radical gastrectomy under different anesthetic regimens.Methods One hundred and two ASA Ⅰ or Ⅱ patients of both sexes,aged 50-75 yr,weighing 45-70 kg,undergoing elective radical gastrectomy,were randomly divided into 3 groups ( n =34 each):general anesthesia (GA) group,combined general-subcostal transversus abdominis plane block (CGTA) group and combined general-epidural anesthesia (CGEA) group.The patients were sent to the postanesthesia care unit (PACU) after tracheal extubation,and the VAS score on arrival in the PACU was recorded.The degree of pain was evaluated by VAS score,and when VAS scores ＞ 3,the patients received intravenous morphine titration.When VAS scores ≤ 3,morphine titration was stopped and all the patients were connected to patient-controlled intravenous analgesia and/or epidural analgesia pump.The total amount of morphine consumed was recorded at the end of titration,and the occurrence of adverse reactions was also observed.Results Compared with groups GA and CGTA,the incidence of moderate to severe postoperative pain was significantly decreased in group CGEA (P ＜0.01).The incidence of severe postoperative pain,the VAS score on arrival in the PACU and the total amount of morphine consumed were decreased gradually in groups GA,CGTA and CGEA ( P ＜ 0.01 ).The incidence of sedation was significantly lower in group CGEA than in group GA (P ＜ 0.01 ).There were no significant differences in the other adverse reactions among the three groups ( P ＞ 0.05 ).Conclusion The degree of pain is reduced gradually in patients after radical gastrectomy under GA,CGTA and CGEA.
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Objective To compare the therapeutic effect of percutaneous transhepatic variceal em-bolization (PTVE) with Cyanoacrylate(TH glue) with that of endoscopic variceal ligatien (EVL) in the treatment of esophageal varlceal bleeding. Methods In this prospective randomized controlled trial, cirrhot-ic patients with acute or recent esophageal variceal bleeding were assigned randomly to PTVE (n = 52) or EVL (n=50) groups. Variants including upper gastrointestinal (UGI) re-bleeding, esophageal variceal re-bleeding, relapse of esophageal variees and survival were evaluated. Results During the follow-up (median 24 and 25 months in the PTVE and EVL groups, respectively), UGI re-bleeding developed in 8 patients (15. 4%) in PTVE group and in 21 (42%) in EVL group (X2 =8. 87, P=0. 005). Recurrent esophageal varices bleeding occurred in 3 patients (5. 8%) in FIVE group and 12 (24%) in EVL group (X2 =5.38, P =0. 012, relative risk 0. 24, 95% confidence interval 0. 05 -0. 74). Reccurent rates of esophageal vari-ces in two groups were 17.3% (9/52) and 52% (26/50), respectively (X2 =13.61, P<0.001). There was no significant difference in survival rate between two groups (X2 = 3.30, P = 0. 054). Conclusion With sufficient embolization of lower esophageal and pefi-esophngeal varices and/or the cardial submucosal and perforating vessels, PTVE was more effective than EVL in the management of esophageal varices recur-rence and re-bleeding.
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Objective To evaluate the efficacy of percutaneouse trans-hepatic Cyanoacrylate (TH glue) embolization for gastric varices. Methods TH glue was injected into the gastric varices and its feeder veins in 30 patients. The endoscopy was performed at 1 week and every 3 months after the procedure, while the CT and portal vein angiography were performed at 3 months and every 6 months after the procedure to e-valuate the oblitazation results. Results The effective rate of treatment was 100%. A total of 21 patients were followed up in a mean period of 27.9 months (11-33 months) with a recurrence rate of varices at 14. 29% (3/21). Portal hypertensive gastropathy was observed in 17 patients (80. 95%), and to-bleeding occurred in 2 patients (9. 52%) due to portal hypertensive gastropathy. CT and portal vein angiography dis-played TH glue in fundic peripheral veins, perforating veins in the gastric wall and other feeding veins with-out re-ciroulation or new branches after embolization. Conclusion Peroutaneous trans-hepatic TH glue is a-ble to embolize the gastric varices and its feeding veins, which is feasible and effective in treatment of gastric varices.
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Objective To investigate the clinical value of micro-array technique in the detection of HBV pre-core and basic core promoter region variants. Methods Four spot mutations of A1896(nt1896G→A) and A1899( nt1899G→A) in precore region and T1762A1764(nt1762A→T,nt1764G→A) in basic core promoter region in 46 patients of acute and chronic liver diseases were detected by gene chips to investigate the clinical value of micro-array technique. Results Micro-array technique had a high specificity in the detection of specific mutation, and the positive rate was 87.0%. A1896 mutation was found in 18 cases (45.0%), A1899 mutation in 10 cases (25.0%), T1762 and A1764 double variants in 30 cases (75.0%), and poly-sites variants in 14 cases (35.0%). Significant difference in liver functions was found between each mutation group and non-mutation group (P
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Influenced by the intensity, volume of exercise, the basic metabolic features of skeletal muscle are changed to such structural and functional adaptations as there are increases in the amount of contractile components, muscle glycogen and myoglobin, in the volume and quantity of mitochondria and in the density of capillary in skeletal muscle, which result in enhanced aerobic metabolism, contraction efficiency and prolonged time defore failure. It is also pointed out that the structural changes and decrease of function of sarcoplasmic reticula during acute exercise are important reasons for skeletal muscle fatigue , whereas, high- intensity training can improve sarcoplasmic reticulum function and its Ca2＋ -intake rate, so that to improve the physiological efficacy of excitation- contraltion coupling. So it is put forward that anti- resistance training, as a means of exercise therapy, can efficiently increase muscle strength and prevent muscle atrophy. Keywords：exercise;muscle metabolism;contractile protein;sarcoplasmic reticulum;mitochondria;oxygen restore;exercise therapy
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Bioeleotrical activities of human cerebral cortex which control and regalate movements get to increase during voluntary movements, the metabolic level of the cells of motor areas change at the same time,and consequently regiond cerebrd blood flow (rCBF)changes. Different changes of rCBF indicate the range of motor areas with which the relavant movemats are involved.And studies of this take great significance in finding out the basic active regalarity and features of human brain. In this artide motheds of the determination of rCBF an introduced briefly, and changes and distribution of rCBF of rCBF of each cortical moter area during different types of volantary movements are discribed. Keywords：regional cerebral blood flow; voluntary movements; cerebral corrical motor areas