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Objective:To analyze the correlation between ambulatory blood pressure variability and the progression of subjective cognitive decline (SCD).Methods:In this prospective observational study, the overall sampling method was used to continuously select 100 patients with SCD in the Department of Neurology, Changshu First People′s Hospital and Changshu Xinzhuang People′s Hospital from January 1 2016 to June 30 2017. The baseline demographic characteristics of the patients were collected. The Chinese version of SCD-Q9 questionnaire was used to self-evaluate SCD, and the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate objective cognitive impairment. All patients received 24 h ambulatory blood pressure monitoring, and 24 h systolic coefficient of variation (SCV) and diastolic coefficient of variation (DCV) were calculated. The follow-up period was 4 years after the first visit, and the MoCA scale was evaluated once a year. Finally, 83 patients completed the follow-up and were included in this study. According to the MoCA score at the end of follow-up (<26 or ≥26), the patients were divided into progression group (39 cases) and non-progression group (44 cases). The difference of MoCA score between baseline and last follow-up was calculated in the progression group. The difference in demographic characteristics between the two groups was compared with χ2 test. The difference of 24 h SCV and 24 h DCV between the two groups were compared by rank sum test. The correlation between 24 h SCV and MoCA score difference or SCD-Q9 score in the progression group were tested by multiple linear regression analysis. Results:The 4-year progression rate of SCD patients was 46.99% (39/83). There was no significant differences in baseline age, gender, education level, medical history, smoking history, SCD-Q9 score and MoCA score between the progressive group and the non-progressive group (all P>0.05). The 24 h SCV in the progressive group was significantly higher than that in the non-progressive group [13.4% (9.9%, 15.6%) vs 10.9% (9.7%, 12.7%), U=594.50, P=0.016]. There was no significant difference in 24 h DCV between the two groups ( P>0.05). In progressive group, the 24 h SCV was negatively correlated with MoCA score difference ( r=-0.368, P=0.021). Conclusion:There is a correlation between ambulatory blood pressure variability and SCD progression, high 24 h SCV may be one of the factors of SCD progression and has certain predictive value.
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Objective:To investigate the therapeutic effects of dialectical addition and subtraction treatment based on self-made Qufeng Zhike Decoction on cough caused by wind dryness invading the lung. Methods:Thirty patients with cough after catching a cold who were admitted by Huainan Hospital of Traditional Chinese Medicine from May 2021 to May 2022 were included in this study. These patients were treated with self-made Qufeng Zhike Decoction (first decocting the ochre for 30 minutes, then decocting inula flower in cloth bags, or traditional Chinese medicine drug granules for drinking with boiled warm water), 1 dose per day, 5 doses in total at first diagnosis. During the follow-up visit, patients were given an dialectical addition and subtraction treatment according to the improvement of cough. Five days of dialectical addition and subtraction treatment were taken as one course of treatment, and two or three courses of treatment were used. Therapeutic effects and adverse reactions were recorded. Scores of cough, expectoration and pharyngeal itching before and 15 days after treatment were recorded. Results:All 30 patients actively cooperated with the treatment. Among 30 patients, treatment was remarkably effective in 19 patients, effective in 9 patients, and ineffective in 2 patients, with a total response rate of 93.33% (28/30). Among 30 patients, two complained of mild stomach discomfort (relieved after taking medicine 1 hour after a meal). No obvious adverse reactions were found in the remaining patients. Compared with before treatment, scores of cough, expectoration and pharyngeal itching were significantly decreased after treatment [cough: (2.38 ± 0.51) points vs. (1.00 ± 0.85) points; expectoration: (0.88 ± 0.54) points vs. (0.29 ± 0.08) points; pharyngeal itching: (0.98 ± 0.67) points vs. (0.65 ± 0.33) points, t = 2.36, 2.98, 2.01, all P < 0.05]. Conclusion:Dialectical addition and subtraction treatment based on self-made Qufeng Zhike Decoction for treatment of cough caused by wind dryness invading the lung has a promising curative effect, without obvious adverse reactions.
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Objective:To explore the protective effect and mechanism of improved St. Thomas solution on canine skeletal muscle ischemia-reperfusion injury (IRI).Methods:Between March 2021 and September 2021, in the experimental operating room at the Air Force Hospital of the PLA Eastern Theater Command, 16 Beagles were randomly divided into control group, IRI group, IRI+NS group, and improved St. Thomas group, 4 in each group. The canine skeletal muscle IRI model was established, and the canine vital signs were monitored by pre-perfusion with improved St. Thomas perfusate [potassium chloride (KCl), magnesium sulfate (MgSO 4), and NaHCO 3 (pH adjusted)]. The pathological damage of canine skeletal muscle was explored by hematoxylin eosin (HE) staining, electron microscope detection and tissue wet/dry weight ratio, and blood vessel density. Hypoxia performances were detected by labeling blood vessels and hypoxia-inducible factor-1α (HIF-1α). The IRI model of L6 rat myoblasts was established, and the components of St. Thomas perfusion solution were pre incubated to explore the effect on the inhibition of cell proliferation. And by detecting reduced nicotinamide adenine dinucleotide phosphate (NADPH), F2 isoprostane (F2-isoprostane), interleukin 1β(IL-1β), tumour necrosis factor alpha (TNF-α), myeloperoxide enzyme (MPO), glutathione peroxidase (GSH-Px), etc. to explore its protective mechanism. Statistical software SPSS 23.0 was used for statistical analysis, A P<0.05 was set as statistically significant. Results:In the improved St. Thomas group, the vital signs of the dogs were relatively stable, the amount of maintained dopamine was less, the histopathological structure of the gastrocnemius muscle tended to be intact, the swelling of tissue cells and mitochondria was significantly relieved, and the tissue wet/dry weight ratio was less than that in the IRI group ( P=0.046). Pre-incubated with therapeutic doses of MgSO 4 or NaHCO 3, the proliferation rate of L6 cells was higher than that of IRI group ( P<0.01, P=0.005), NADPH ( P=0.004, P=0.001), F2-isoprostane ( P<0.01, P=0.01), IL-1β ( P=0.02, P=0.015), TNF-α ( P<0.01, P<0.01), MPO ( P<0.01, P<0.01) were all lower than those in the IRI group, except GSH-Px that was higher than what in the IRI group ( P<0.01). Conclusion:Pre-perfusion of the improved St. Thomas solution can stabilise the vital signs of dogs in a short period of time. The solution can improve the state of skeletal muscle cells, improve tissue hypoxia, and reduce the damage of skeletal muscle tissue cells through anti-inflammatory and anti-oxidative stress.
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OBJECTIVE：To evaluate therapeutic e fficacy and safety of differen t doses of Secukinumab in the treatment of medium and severe ankylosing spondylitis （AS）， and to provide evidence-based reference for clinical treatment of AS. METHODS： Retrieved from Medline ， PubMed， Cochrane Library， Embase， VIP， CJFD， Wanfang database andpu- ClinicalTrials.gov， during the inception to March 2020， xiaofeng1205@outlook.com randomized controlled trials （RCTs）about different doses of secukinumab （75， 150， 300 mg） versus placebo in the treatment of medium and severe AS were collected. After data extraction of clinical studies met the inclusion criteria ，quality evaluation with Cochrane risk bias evaluation tool 5.1.0，Rev Man 5.3 statistical software was used for Meta-analysis of therapeutic efficacy [in the international society for the evaluation of spondyloarthritis scale ，the proportion of 20％ patients improved （ASAS20）；ASAS40；among 6 routine clinical areas related to AS，the scores of at least 5 areas improved by at least 20％，and there was no patients receiving treatment due to deterioration in other areas （ASAS 5/6）；remission value of Bath ankylosing spondylitis disease activity index （BASDAI）from baseline to 16th week，the proportion of the patients with the international society for the evaluation of ankylosing spondyloarthritis （ASAS PR ） score no higher than 2 in the 4 ASAS fields within the specified time] and safety [the incidence of withdrawal from treatment due to ADR，the incidence of serious ADR ，the incidence of general ADR （nasopharyngitis，headache，diarrhea）]. RESULTS ：A total of 5 RCTs were included ，involving 1 624 patients. Meta-analysis showed that ASAS 20 [total：OR＝2.62，95％CI（2.14，3.20），P＜ 0.000 01；75 mg：OR＝2.63，95％CI（1.28，5.40），P＝0.008；150 mg：OR＝2.58，95％CI（2.01，3.32），P＜0.000 01；300 mg：OR＝2.63，95％CI（1.37，5.06），P＝0.004]，ASAS40 [total：OR＝2.82，95％CI（2.13，3.74），P＜0.000 01；75 mg：OR＝ 3.14，95％CI（1.86，5.31），P＜0.000 1；150 mg：OR＝2.79，95％CI（1.85，4.20），P＜0.000 01；300 mg：OR＝2.73，95％CI （1.33，5.58），P＝0.006]，ASAS5/6 [total：OR＝3.82，95％CI（2.61，5.59），P＜0.000 01；75 mg：OR＝5.59，95％CI（3.29， 9.49），P＜0.000 01；150 mg：OR＝3.45，95％CI（2.08，5.70），P＜0.000 01；300 mg：OR＝3.85，95％CI（1.75，8.47），P＝ 0.000 8]，ASAS PR [total ：OR＝4.69，95％CI（3.07，7.16），P＜0.000 01；75 mg：OR＝5.48，95％CI（2.50，11.99），P＜0.000 1； 150 mg：OR＝3.71，95％CI（2.19，6.29），P＜0.000 01；300 mg：OR＝20.0，95％CI（2.58，155.14），P＝0.004] in trial group was significantly higher than control group ；BASDAI improvement [total ：WMD＝－1.15，95％CI（－1.50，－0.79），P＜0.000 01； 75 mg：WMD＝－1.40，95％CI（－2.08，－0.72），P＜0.000 1；150 mg：WMD＝－1.03，95％CI（－1.52，－0.54），P＜ 0.000 1；300 mg：WMD＝－1.20，95％CI（－2.03，－0.37），P＝0.005] of trial group were significantly higher than those of control group ，with statistical significance. The total incidence of nasopharyngitis in trial group [OR ＝1.77，95％CI（1.22，2.57）， P＝0.003] and 150 mg dose subgroup [OR ＝1.84，95％CI（1.18，2.86），P＝0.007] was significantly higher than control group ， without significant difference in other safety indexes among total and different dose subgroups （P＞0.05）. CONCLUSIONS ：75 mg，150 mg and 300 mg of secukinumab are all effective and well tolerated for medium and severe AS patients ，and 150 mg of secukinumab may increase the incidence of nasopharyngitis.
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Objective:To explore the therapeutic effect of Xiaochaihu decoction addition and subtraction on cough variant asthma(CAV) based on the theory of " Shaoyang as the pivot" .Methods:From May 2018 to May 2019, 23 patients with CAV were selected in the Traditional Chinese Medicine Hospital of Huainan, all of whom were diagnosed as CAV by bronchodilation test.The patients were first treated with Xiaochaihu decoction addition and subtraction, 7 doses, decocting in water, oral, 1 dose per day.Add and subtract the prescriptions according to the changes of the condition.The curative effect and adverse reactions were observed, and the recurrence was observed for half a year.Results:Of 23 patients, 11 cases were obviously effective, 9 cases were effective and 3 cases were ineffective, the total effective rate was 87.0%(20/23). Course of treatment: of the 11 cases with obvious effect, 4 cases were treated for 3 weeks, 5 cases for 4 weeks, 2 cases for 5 weeks, and 9 cases with effective effect were treated for 5 weeks.It was suggested to use other treatment for 3 cases with ineffective effect after 6 weeks of treatment.No obvious adverse reactions were found in 22 patients, one patient had slight nausea, which was relieved by himself.All 23 cases were followed up for half a year, 3 cases recurred, the recurrence rate was 13.0%(3/23).Conclusion:Based on the theory of " Shaoyang as the pivot" , the treatment of CAV with Xiaochaihu decoction addition and subtraction has high clinical effective rate, low recurrence rate and no obvious adverse reactions.
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Objective: To explore the association between excite seeking personality and alcohol use, and provide reference basis for intervention measures of drinking behavior. Methods: Totally 5966 college students in 8universities [2180 males, mean age (20 ± 1) ] were selected from Hunan province by using multi-stage stratified cluster random sampling method. We Chat-based anonymous questionnaire survey was conducted by using general questionnaire, excite-seeking personality scales, alcohol questionnaire, and alcohol use disorders identification test. Results: The rate of 12-month alcohol drinking, binge drinking, hazardous and harmful drinking among college students were 47. 5％, 24. 5％, 7. 4％, respectively. High degree of excite seeking personality had more likelihood to having had alcohol drinking, binge drinking, hazardous and harmful drinking (Ps ＜ 0. 01). Excite seeking personality was an independent risk factor of 12-month alcohol drinking, binge drinking, hazardous and harmful drinking. Conclusion: It suggests that excite-seeking personality may be a related factor of alcohol drinking behavior.
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Objective@#To analysis the incidence and relevant clinical factors of colorectal polyps and adenomas in population of health examination.@*Methods@#Colonoscopy results and clinical data of 615 cases undergoing health examination from January 2018 to March 2019 were analyzed retrospectively in International Medical Center, Beijing Friendship Hospital, Capital Medical University.There were 436 males and 179 females, average age 47.38 years, aged 18-81 years. The clinical data contained sex, age, smoking history, drinking history, body mass index.Chi-square test and trend chi-square test were used to compare the differences of polyp detection rate and adenoma detection rate in different populations. Multivariate Logistic regression analysis were applied to explore the potential factors associated with the polyp detection rate and adenoma detection rate.@*Results@#Two hundred and forty cases(39.02%) with colorectal disease were checked out, include 206 cases(33.50%) with colorectal polyps and 138 cases(22.44%) with colorectal adenomas. In the detection rate of colorectal polyps, male were higher than female[36.70%(160/436) vs 25.70%(46/179), χ2=6.89, P<0.05], smokers were higher than non-smokers[42.35%(108/255) vs 27.22%(98/360), χ2=15.34, P<0.001], and drinkers were higher than non-drinkers[40.67%(109/268) vs 27.95%(97/347), χ2=10.98, P<0.05]. With the increase of age, the detection rate of colorectal polyps increased significantly(χ2=24.19, P<0.001). With the increase of body mass index, the detection rate of colorectal polyps increased significantly(χ2=16.88, P<0.001). In the detection rate of colorectal adenoma, smokers were higher than non-smokers[28.24%(72/255) vs 18.33%(66/360), χ2=7.31, P<0.05], and drinkers were higher than non-drinkers[27.61(74/268)% vs 18.44%(64/347), χ2=7.30, P<0.05]. With the increase of age, the detection rate of colorectal adenoma increased significantly(χ2=15.87, P<0.001). With the increase of body mass index, the detection rate of colorectal adenoma increased significantly (χ2=13.30, P<0.001). There was no significant difference in the detection rate of colorectal adenomas between male and female[24.31%(106/436) vs 17.88%(32/179), χ2=3.02, P>0.05]. Multivariate Logistic regression analysis showed that age increasing, body mass index increasing, smoking and alcohol consumption were risk factors for colorectal polyps and adenomas.@*Conclusions@#The detection rate of colorectal polyps and adenomas are related with sex, age, smoking, drinking and body mass index. Age increasing, body mass index increasing and smoking are the risk factors for colorectal polyps, age increasing and body mass index increasing are the risk factors for colorectal adenomas.
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Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris ( SAP ) and its effect on vascular endothelial function and serum levels of superoxide dismutase ( SOD ), total antioxidant capacity ( TAC ), glutathione peroxidase ( GSH-px ), malondialdehyde (MDA),and lipid peroxide( LPO) . Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group( 75 cases in each group) . Both groups received routine intervention according to the guidelines. The control group was given with intravenous drip of left carnitine(3 g／time and once a day). On basis of the control group,the observation group was treated with regular aerobic exercise therapy. After 8 weeks＇ treatment for two groups,attack frequency degree of angina pectoris,score of life quality of Seattle angina scale(SAQ),and clinical effect were compared between the two groups. And the vascular endothelial function ( plasma endothelin ( ET ) 1, nitric oxide ( NO )), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD,TAC,GSH-px, MDA and LPO) were detected. Results After 8 weeks＇treatment,frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less(( 4. 19± 0. 56) vs. ( 6. 22 ± 0. 89) time, (4. 31±0. 50) vs. (5. 25±0. 71) min),while life quality indexes SAQ score was higher,than those in the control group,and the difference was statistically significant (( 18. 44 ± 2. 30) vs. ( 12. 49 ± 1. 82) score, (56. 31±6. 62) vs. (48. 05± 5. 88) score,(14. 46 ± 1. 99) vs. ( 9. 22 ± 1. 10) score,( 21. 41 ± 2. 95)) vs. (18. 09±2. 26) score,(16. 14±2. 17) vs. (12. 05±1. 82) score,(all P＜0. 01)). The total clinical effective rate of the observation group ( 92%( 69 ／ 75)) was higher than that of the control group ( 80%( 60 ／75)),the difference was statistically significant (χ2＝4. 485,P＝0. 034). After 8 weeks′ treatment,level of ET-1,FMD of brachial artery,MDA,and LPO were lower than those in the control group(( 65. 38± 7. 91) ng／L vs. (77. 12±8. 56) ng／L,( 9. 44± 1. 34)% vs. ( 12. 55± 1. 81)%,(2. 81± 0. 43) μmol／L vs. ( 3. 90 ±0. 50) μmol／L,(3. 14±0. 44) μmol／L vs. (4. 40± 0. 63) μmol／L),while NO,SOD,TAC,GSH-px were higher than control group(( 67. 51 ± 7. 79) μmol／L vs. ( 52. 17± 6. 08) μmol／L,( 85. 25± 9. 67) U／L vs. (76. 01±8. 33) U／L,(12. 79±1. 80) kU／L vs. (9. 64±11. 05) kU／L,(117. 65±15. 03) U／L vs. (111. 76 ±14. 19) U／L),and the difference was statistically significant (all P＜0. 01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients,and improve the clinical effect,which may be related to the improvement of endothelial function and antioxidant effect.
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Objective To analysis the incidence and relevant clinical factors of colorectal polyps and adenomas in population of health examination.Methods Colonoscopy results and clinical data of 615 cases undergoing health examination from January 2018 to March 2019 were analyzed retrospectively in International Medical Center,Beijing Friendship Hospital,Capital Medical University.There were 436 males and 179 females,average age 47.38 years,aged 18-81 years.The clinical data contained sex,age,smoking history,drinking history,body mass index.Chi-square test and trend chi-square test were used to compare the differences of polyp detection rate and adenoma detection rate in different populations.Multivariate Logistic regression analysis were applied to explore the potential factors associated with the polyp detection rate and adenoma detection rate.Results Two hundred and forty cases (39.02％) with colorectal disease were checked out,include 206 cases(33.50％) with colorectal polyps and 138 cases(22.44％) with colorectal adenomas.In the detection rate of colorectal polyps,male were higher than female [36.70％ (160/436) vs 25.70％ (46/179),x2 =6.89,P ＜ 0.05],smokers were higher than non-smokers[42.35％ (108/255) vs 27.22％ (98/360),x2 =15.34,P ＜0.001],and drinkers were higher than non-drinkers[40.67％ (109/268) vs 27.95％ (97/347),x2 =10.98,P ＜0.05].With the increase of age,the detection rate of colorectal polyps increased significantly (x2 =24.19,P ＜ 0.001).With the increase of body mass index,the detection rate of colorectal polyps increased significantly(x2 =16.88,P ＜0.001).In the detection rate of colorectal adenoma,smokers were higher than non-smokers [28.24％ (72/255) vs 18.33 ％ (66/ 360),x2 =7.31,P ＜ 0.05],and drinkers were higher than non-drinkers [27.61 (74/268)％ vs 18.44％ (64/ 347),x2 =7.30,P ＜ 0.05].With the increase of age,the detection rate of colorectal adenoma increased significantly(x2 =15.87,P ＜ 0.001).With the increase of body mass index,the detection rate of colorectal adenoma increased significantly (x2 =13.30,P ＜ 0.001).There was no significant difference in the detection rate of colorectal adenomas between male and female [24.31％ (106/436) vs 17.88％ (32/179),x2 =3.02,P ＞ 0.05].Multivariate Logistic regression analysis showed that age increasing,body mass index increasing,smoking and alcohol consumption were risk factors for colorectal polyps and adenomas.Conclusions The detection rate of colorectal polyps and adenomas are related with sex,age,smoking,drinking and body mass index.Age increasing,body mass index increasing and smoking are the risk factors for colorectal polyps,age increasing and body mass index increasing are the risk factors for colorectal adenomas.
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Objective To investigate the correlation between 24-h ambulatory blood pressure variability and the overall burden of cerebral small vessel disease (CSVD) in patients with acute ischemic stroke. Methods From March 2016 to December 2017, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Changshu Hospital of Soochow University were enrolled. The 3. 0 T-MRI was used to assess asymptomatic lacunar infarction, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces within 24 h after admission, and the total CSVD score (0-4) was calculated. 24-h ambulatory blood pressure monitoring was performed 24 to 72 h after admission. Ordinal logistic regression analysis was used to determine the independent correlation between the 24-h ambulatory blood pressure-related index and the total CSVD score. Results A total of 220 patients with acute ischemic stroke were enrolled. The patients were divided into five groups according to the total CSVD score. Univariate analysis showed that there were significant differences in age, homocysteine, the proportion of hypertension, as well as 24 h, daytime and nighttime mean systolic blood pressure (SBP), and coefficient of variation of daytime SBP among the 5 groups (all P < 0. 05). Ordinal logistic regression analysis showed that age (odds ratio [OR] 1. 078, 95％ confidence interval [CI] 1. 051-1. 106; P < 0. 001), 24-h mean SBP (OR 1. 043, 95％ CI 1. 026-1. 060; P < 0. 001), daytime mean SBP (OR 1. 042, 95％ CI 1. 025-1. 059; P < 0. 001), nighttime mean SBP (OR 1. 034, 95％ CI 1. 019-1. 049; P < 0. 001), and coefficient of variation of daytime SBP (OR 1. 129, 95％ CI 1. 052-1. 210; P = 0. 003) were independently correlated with the total CSVD score. Conclusions The elevated 24 h, daytime and nighttime mean SBP levels and coefficient of variation of daytime SBP are independently correlated with the severity of overall CSVD burden in patients with acute ischemic stroke.
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Objective To explore clinical characteristics,diagnosis and treatment method after Peutz-Jeghers Syndrome (PJS) secondary malignant.Methods The clinical date of five cases with malignant tumors associated with Peutz-Jeghers syndrome from June 2014 to January 2017 were analyzed retrospectively in Beijing Friendship Hospital,Capital Medical University.The patients were followed up by phone,outpatient service,and hospitalization.The starting point of the follow-up was the visit date.The patient's death was the end point.The clinical and pathological features,therapy,and postoperative survival were observed.The follow-up deadline was May 2018.Results PJS secondary malignant patients lack clinical specificity.Two cases of five patients accepted endoscopic resection,three cases accepted surgery,and were treated with chemotherapy postoperatively,including 1 case died from tumor progression of 6 months after operation.Tumor recurrence was not found in the rest 4 cases till May 2018.Conclusions Part of the malignant polyp,endoscopic resection is feasible.When endoscopic resection is not feasible,operation treatment is needed;and postoperative adjuvant chemotherapy is needed to improve the long-term prognosis.
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Objective To investigate the correlation between 24-h ambulatory blood pressure (BP) variability and cerebral microbleeds (CMBs) in patients with acute ischemic stroke. Methods Consecutive inpatients with acute ischemic stroke were prospectively enrolled. 24-h ambulatory BP was monitored. Magnetic susceptibility-weighted imaging was used to evaluate CMBs and their locations. Univariate analysis was used to compare the baseline data between the CMBs group and the non-CMBs group. Multivariate logistic regression analysis was used to determine the independent correlation between ambulatory BP related indexes and CMBs. Results A total of 178 patients with acute ischemic stroke were enrolled, including 114 males, aged 67.6 ±10.8 years, and 90 (50.6%) with CMBs. The proportion of hypertension and asymptomatic lacunar infarction, periventricular and deep white matter high signal score, 24-h, daytime, nighttime mean systolic and diastolic BP, 24-h, and daytime systolic BP variability in the CMBs group were significantly higher than those in the non-CMB group (all P<0.05). Multivariate logistic regression analysis showed that 24-h systolic BP variability (odds ratio 1.133, 95% confidence interval 1.023-1.255; P=0.016) and daytime mean systolic BP (odds ratio 1.045, 95% confidence interval 1.022-1.069; P<0.001) had significant independent correlation with CMBs. Conclusion 24-h systolic BP variability and daytime mean systolic BP were the independent risk factors for CMBs in patients with acute ischemic stroke.
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Objective To evaluate intraoperative placement of bile duct decompression drainage tube in CBD primary suture after laparoscopic choledocholithotomy.Methods 152 patients undergoing laparoscopic choledocholithotomy were divided into group A (placement of bile duct decompression drainage tube during operation,82 cases) and group B (no decompression drainage tube placement,70 casas).Results There was no significant difference in operative time and intraoperative bleeding between the two groups (P ＞ 0.05).In group B patients the abdominal drainage tube indwelling time,abdominal drainage volume,peritoneal drainage fluid bilirubin value,postoperative hospitalization time were significantly longer than group A,the difference was statistically significant (P ＜ 0.05).No recurrence of choledocholithiasis and biliary stricture were found in either groups.Conclusions Placement of bile duct decompression drainage tube in laparoscopic choledocholithotomy and CBD primary suture after laparoscopic choledochotomy can significantly reduce the incidence of biliary leakage and shorten the postoperative hospital stay.
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Objective To systematically evaluate the safety and efficacy of probiotics in the treatment of severe acute pancreatitis (SAP).Methods The randomized controlled trials (RCTs) for studying probiotics in the treatment of SAP were retrieved from databases,including PubMed,Embase,Cochrane Library,Medline,Chinese Biomedical Literature Database (CBM),Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfang academic journal fulltext database.The methodological quality of included literatures was evaluated,and statistical analysis was performed via RevMan5.3 software.Results A total of 12 pieces of RCT literatures including 910 cases of patients with SAP were included.The results of meta analysis indicated that no statistically significant difference was found in the mortality [RR =0.97,95 ％ CI(0.63,1.49),P=0.88],the incidence rate of multiple organ dysfunction [RR =0.72,95 ％ CI(0.49,1.06),P=0.10] and the incidence rate of pancreas-related infections [RR=0.76,95 ％ CI(0.54,1.07),P=0.12] between the probiotics group and the control group;while there were statistically significant differences in the length of hospital stay [MD =-3.74,95 ％ CI(-6.37,-1.12),P=0.005] and the incidence rate of intestinal ischemia necrosis [RR=11.39,95 ％ CI(1.5,86.4),P =0.02],Conclusion Probiotics could not improve clinical outcomes of patients with SAP,and may increase risk for intestinal ischemic necrosis.However,it could shorten the length of hospital stay.
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OBJECTIVE:To investigate the role of clinical pharmacists in individualized antiplatelet therapy for a patient with subacute stent thrombosis after PCI.METHODS:Clinical pharmacists participated in the therapy for a myocardial infarction patient with diabetes,and the patient suffered from subacute stent thrombosis at the fourth day after PCI.Clinical pharmacists suggested performing clopidogrel-related gene detection [Cytochrome P450(CYP)2C19] through comprehensively analyzing the complexity of the lesion,the time of stent thrombosis,the number of stent implantations and combined diseases,etc.According to detection result (CYP2C19* 1/*2),clinical pharmacists suggested to additionally use Cilostazol tablets 50 mg,po,bid,on the basis of previous dual antiplatelet therapy;additionally use Alprostadil injection 10 μg,ivgtt,qd to improve microcirculation.Pharmaceutical care as therapeutic evaluation,ADR monitoring were performed,and medication education as medication notes and dietary adjustments were also provided.RESULTS:Physicians adopted the suggestions of clinical pharmacists;the patient was recovered and discharged from hospital.After discharge,the disease condition kept stable due to persistent aspirin+clopidogrel+cilostazol triple antiplatelet therapy.CONCLUSIONS:Drug metabolizing enzyme is an important cause of individual differences in antiplatelet effects and toxicity,and its gene polymorphism is closely related with clinical outcome and terminal event.Clinical pharmacists should play professional skill to assist physician to access and interpret relevant information,and formulate and adjust individualized antiplatelet therapy after considering disease condition,combined diseases and genotypes,so as to guarantee safe and effective drug use.
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Objective To investigate the value of evaluating vertebrobasilar artery atherosclerosis with 3.0 T high-resolution magnetic resonance imaging (HR-MRI) in the progress of posterior circulation transient cerebral ischemia (TIA).Methods From July 2013 to July 2014,30 consecutive patients (outpatients and inpatients) with posterior circulation TIA at the Department of Neurology,the First People's Hospital of Changshu were enrolled respectively.They were all confirmed as the presence of vertebrobasilar atherosclerotic plaques by the head magnetic resonance angiography.The vertebrobasilar artery plaques were examined with 3 T HR-MRI to assess the nature and stability of the plaques.They were randomly divided into either a stable plaque group (n =16) or an unstable plaque group (n =14) according to the results of plaque stability.They were followed up for 24 months.The time and proportion from the first visit to the posterior circulation infarction were recorded and compared between the two groups of patients.Results At the end of follow-up,the time of posterior circulation infarction in the unstable group was significantly shorter than that in the stable group,and the difference was statistically significant (11.5 [7.0,20.0] months vs.24.0[22.5,24.0] months,Z =-2.755,P ＜ 0.05).The ratios of posterior circulation infarction in the stable group and the unstable group were 5/16 and 8/14 respectively.The difference was not statistically significant between the two groups (P ＞ 0.05).Conclusion Evaluating the results of vertebrobasilar artery atherosclerosis plaque with HR-MRI has a certain value for the progression of posterior circulation ischemia disease.
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Objective To evaluate the efficacy and safety of different doses of Ipragliflozin in the treatment of type 2 diabetes patients.Methods The randomized controlled trials (RCTs) about Ipragliflozin in treatment of type 2 diabetes patients were retrieved from the databases,including Cochrane Library,PubMed,Embase,Medline,CNKI,Wangfang,VIP and CBM.The data were extracted and evaluated by two researchers independently,and the Meta-analysis was performed via RevMan5.2.Results A total of 10 RCTs involving 1 928 patients were included.The results of Meta-analysis showed that glycosylated hemoglobin (HbA1c)[12.5 mg/d:MD=-0.46,95％CI (-0.69,-0.23);25 mg/d:MD=-0.97,95％CI (-1.00,-0.94);50 mg/d:MD=-0.94,95％CI (-1.20,-0.69);100 mg/d:MD=-0.93,95％CI (-1.72,-0.15);150 mg/d:MD=-0.57,95％CI (-0.89,-0.26);200 mg/d:MD=-0.74,95％CI (-1.14,-0.34);300 mg/d:MD=-0.64,95％CI (-0.86,-0.43)],fasting blood glucose (FPG) [12.5 mg/d:MD=-1.52,95％CI(-1.58,-1.47);25 mg/d:MD=-1.98,95％CI (-2.04,-1.93);50 mg/d:MD=-2.53,95％CI(-2.59,-2.48);100 mg/d:MD=-3.27,95％CI(-3.32,-3.21);150 mg/d:MD=-1.29,95％CI (-1.90,-0.68);200 mg/d:MD=-3.34,95％CI (-4.78,-1.90);300 mg/d:MD=-1.73,95％CI(-2.28,-1.18)] and body weight [12.5mg/d:MD=-0.92,95％CI(-1.36,-0.47);25 mg/d:MD=-1.30,95％CI (-1.81,-0.79);50 mg/d:MD=-1.58,95％CI (-1.80,-1.35);100 mg/d:MD=-1.31,95％CI(-1.65,-0.97);150 mg/d:MD=-1.51,95％CI (-2.42,-0.60);300 mg/d:MD=-1.73,95％ CI (-2.63,-0.83)] were significantly reduced in the different doses of Ipragliflozin group than that in the placebo group,and the dose of 50 mg/d and 100 mg/d were better.There was no significant difference in the incidence rate of the overall adverse reaction,hypoglycemic events,urinary tract infection and genital infection between the different doses of Ipragliflozin group and the placebo group (P＞0.05),but data showed that dose of 50 mg/d was more security than 100 mg/d (RR:1.02 vs.2.18,1.83 vs.2.88,1.01 vs.1.72,1.85 vs.2.98).Conclusion Ipragliflozin is effective and safe for the patients with type 2 diabetes,which could effectively control the patients' HbA1c,FPG and body weight,and 50 mg/d may be the best dose.
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Objective To evaluate the efficacy and safety of different doses of Ipragliflozin in the treatment of type 2 diabetes patients.Methods The randomized controlled trials (RCTs) about Ipragliflozin in treatment of type 2 diabetes patients were retrieved from the databases,including Cochrane Library,PubMed,Embase,Medline,CNKI,Wangfang,VIP and CBM.The data were extracted and evaluated by two researchers independently,and the Meta-analysis was performed via RevMan5.2.Results A total of 10 RCTs involving 1 928 patients were included.The results of Meta-analysis showed that glycosylated hemoglobin (HbA1c)[12.5 mg/d:MD=-0.46,95％CI (-0.69,-0.23);25 mg/d:MD=-0.97,95％CI (-1.00,-0.94);50 mg/d:MD=-0.94,95％CI (-1.20,-0.69);100 mg/d:MD=-0.93,95％CI (-1.72,-0.15);150 mg/d:MD=-0.57,95％CI (-0.89,-0.26);200 mg/d:MD=-0.74,95％CI (-1.14,-0.34);300 mg/d:MD=-0.64,95％CI (-0.86,-0.43)],fasting blood glucose (FPG) [12.5 mg/d:MD=-1.52,95％CI(-1.58,-1.47);25 mg/d:MD=-1.98,95％CI (-2.04,-1.93);50 mg/d:MD=-2.53,95％CI(-2.59,-2.48);100 mg/d:MD=-3.27,95％CI(-3.32,-3.21);150 mg/d:MD=-1.29,95％CI (-1.90,-0.68);200 mg/d:MD=-3.34,95％CI (-4.78,-1.90);300 mg/d:MD=-1.73,95％CI(-2.28,-1.18)] and body weight [12.5mg/d:MD=-0.92,95％CI(-1.36,-0.47);25 mg/d:MD=-1.30,95％CI (-1.81,-0.79);50 mg/d:MD=-1.58,95％CI (-1.80,-1.35);100 mg/d:MD=-1.31,95％CI(-1.65,-0.97);150 mg/d:MD=-1.51,95％CI (-2.42,-0.60);300 mg/d:MD=-1.73,95％ CI (-2.63,-0.83)] were significantly reduced in the different doses of Ipragliflozin group than that in the placebo group,and the dose of 50 mg/d and 100 mg/d were better.There was no significant difference in the incidence rate of the overall adverse reaction,hypoglycemic events,urinary tract infection and genital infection between the different doses of Ipragliflozin group and the placebo group (P＞0.05),but data showed that dose of 50 mg/d was more security than 100 mg/d (RR:1.02 vs.2.18,1.83 vs.2.88,1.01 vs.1.72,1.85 vs.2.98).Conclusion Ipragliflozin is effective and safe for the patients with type 2 diabetes,which could effectively control the patients' HbA1c,FPG and body weight,and 50 mg/d may be the best dose.
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OBJECTIVE:To observe the effects of Compound biejia ruangan tablets combined Entecavir tablets on liver func-tion and hematoidin of patients with chronic hepatitis B(CHB)blood stasis syndrome. METHODS:Totally 110 patients with CHB blood stasis syndrome were selected from Neijiang Second People's Hospital,the Affiliated Hospital of Southwest Medical Univer-sity and Yibin First People's Hospital during Jan.-Dec. 2015. They were divided into control group and observation group by strati-fied blocked randomitation,with 55 cases in each group. Control group was given Entecavir tablets 0.5 mg,po,qd;observation group was additionally given Compound biejia ruangan tablets 2.0 g,po,tid. Both groups received treatment for 12 months. TCM syndrome scores,the levels of liver function indexes(AST,ALT,ALP,GGT),serum bilirubin(TBIL,DBIL,IBIL),liver fi-brosis indexes(LN,HA,PⅢP,Ⅳ-C)and Fibroscan(FS)were observed in 2 groups before and after treatment. The occurrence of ADR was recorded. RESULTS:In observation group,2 patients withdrew from the study,and 3 patients of control group with-drew from the study. Before treatment,there was no statistical significance in TCM syndrome scores,the levels of liver function in-dexes,serum bilirubin,liver fibrosis indexes and FS between 2 groups(P>0.05). After treatment,TCM syndrome scores,the lev-els of TBIL,IBIL,LN,HA,PⅢP,Ⅳ-C and FS in 2 groups were significantly decreased,while DBIL level was increased signifi-cantly,and the observation group was significantly better than control group,with statistical significance(P<0.05). The levels of AST and ALT in observation group were decreased significantly,while the levels of ALP and GGT were increased significantly, and the observation group was significantly better than control group,with statistical significance(P<0.05). There was no statisti-prove liver function indexes and bilirubin level,and inhibit liver fibrosis with good safety.
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OBJECTIVE:To systematically review the efficacy and safety of ramucirumab in the treatment of adenocarcinoma in stomach or gastroesophagealjunction,and provide evidence-based reference for clinic. METHODS:Retrieved from Wanfang database,CJFD,PubMed,EBSCO,Medline and Cochrane Library,randomized controlled trials(RCT) oframucirumab and (or) other medicines or other chemotherapy (test group) versus placebo or and Clinical Trials. gov other antibiotics(control goroup) were collected with time limit from establishment to Sept. 2015. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic review manual 5.1.0. RESULTS:Totally 3 RCTs involving 1 188 patients were enrolled,including 652 patients in the test group and 536 patients incontrol group. Results of Meta-analysis showed, the overall survival[HR=0.83,95%CI(0.72,0.95),P=0.006] and progression-freesurvival[HR=0.66,95%CI(0.47,0.92),P=0.01] in test group were significantly longer than control group,the difference was statistically significant;there was no significant difference in the objective response rate[RR=1.31,95%CI(0.81,2.11),P=0.28]. The incidence of severe adverse reactions(degree level:3-4 grade) in test group was significantly higher than control group,the difference was statistically significant [RR=1.14, 95%CI (1.00,1.29),P=0.04].CONCLUSIONS:Ramucirumab can extend overall survival and progression-free survival of adenocarcinoma in stomach or gastro-oesophageal junction,but the incidence of adverse reactions should be noticed.