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Syndromes of coronary heart disease with angina pectoris were analyzed to provide guidance for clinical practice and to improve accuracy of traditional Chinese medicine (TCM) diagnoses and efficacy of TCM treatment. A total of 860 cases with coronary heart disease with angina pectoris were selected from TCM Clinical Research Information Sharing System for TCM clinics and research. Syndromes were automatically extracted with the cluster method and were analyzed to provide objective evidence for clinical studies. Final syndrome classifications were recognized and confirmed by clinical experts. Popular syndromes included Qi and blood deficiency, blood stasis and obstruction collaterals, liver depression and spleen deficiency, and Qi stagnation and blood stasis. Syndromes Qi and blood deficiency and blood stasis and obstruction collaterals accounted for 28.61% of total syndromes, whereas liver depression and spleen deficiency and Qi stagnation and blood stasis accounted for 26.44%. The main syndrome elements comprised Qi deficiency, blood deficiency, blood stasis, and Qi stagnation.
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Aged , Female , Humans , Male , Middle Aged , Angina Pectoris , Diagnosis , Therapeutics , Cluster Analysis , Coronary Disease , Diagnosis , Therapeutics , Diagnosis, Differential , Hemostasis , Medicine, Chinese Traditional , SyndromeABSTRACT
<p><b>OBJECTIVE</b>To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) at Hegu (LI 4) and Neiguan (PC 6) on treatment and prevention of postoperative sore throat (POST) after tracheal intubation under general anesthesia.</p><p><b>METHODS</b>One hundred patients who received elective thyroid gland lobectomy with gradeⅠand Ⅱ of American Society of Anesthesiologists criteria were randomly assigned into a TEAS group and an anesthesia group according to random number table method, 50 cases in each group. All the patients were treated with tracheal intubation under general anesthesia. Patients in the TEAS group were treated with TEAS (2 Hz/100 Hz, 8 to 12 mA) at Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of operation. Patients in the anesthesia group were treated with TEAS at the same acupoints but no electrical stimulation was given. The incidence rate, severity and visual analogue scale (VAS) of POST were recorded 1h, 6h, 12h and 24h after tracheal extubation, respectively.</p><p><b>RESULTS</b>The incidence rate of POST was 12.0% (6/50), 22.0% (11/50) and 18.0% (9/50) 1h, 6h, 12h after tracheal extubation respectively in the TEAS group, which was significantly lower than 30.0% (15/50), 42.0% (21/50) and 36.0% (18/50) in the anesthesia group (all<0.05). However, the incidence rate was not significantly different between the two groups 24h after extubation[14.0% (7/50) vs 28.0% (14/50),>0.05]. Moreover, the VAS scores of the patients with POST in the TEAS group at each time point were lower than those in the anesthesia group (all<0.05).</p><p><b>CONCLUSIONS</b>TEAS at Hegu (LI 4) and Neiguan (PC 6) can effectively reduce the incidence rate and severity of POST induced by tracheal intubation under general anesthesia.</p>
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Objective To investigate the effectiveness of target intervention in preventing catheter -related bloodstream infection ( CRBSI ) .Methods The targeted monitoring was launched by changing venepuncture site , reinforcing instructions in aseptic insertion technique and hand hygiene supervision ,avoiding femoral access and remo-ving unnecessary catheters ,venous puncture implemented by high qualification anesthesiologist ,then the incidence of CRBSI before and after the project was compared .Results The incidence of CRBSI after the project decreased signif-icantly from 17.97%to 4.32%,the difference was statistically significant (χ2 =40.82,P<0.05).Chi-square test and logistic regression analysis showed that the incidence of infection was increased in patients with catheter for longer than 10 days (χ2 =4.33,P<0.05),the incidence of CRBSI was decreased in patients that central venous puncture implemented by high qualification anesthesiologist (χ2 =9.21,P<0.05),and patients received catheter indwelling into femoral vein had increased incidence of CRBS (χ2 =7.45,P<0.05).Conclusion Indwelling catheter time, unskilled operator ,catheter site are risk factors in patients with CRBSI .In response to these factors ,we should develop interventions to maximize establish a protective barrier , improve the quality of the medical operation , prevent the occurrence of CRBSI more efficiently .
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Objective To research the anesthetic effect of ropivacaine compounding with dezocine on brachial plexus block.Methods From January 2011 to September 2013,180 cases upper extremity surgery patients were selected and divided into group A,group B and group C in Nanyang Central Hospital.Patients in group A received 25 mL 0.4%ropivacaine injection for brachial plexus block;based on group A,group B was injected 10 mg dezocine to assist anesthesia;group C received a mixture of 25 mL 0.4% ropivacaine and 10mg dezocine injection.The anesthetic effect and adverse reactions of the patients in three groups were recorded and compared. Results The onset of anesthesia of group C was(17.43 ±1.53)min,which was the shortest of three groups,but there were no significant differences.The duration of sensory blockade and duration of analgesia was(8.22 ±1.63)h and (11.33 ±1.90)h,which were all longer than group A and group B,and there was significant differences(P<0.05);the visual analogue scale(VAS) scores of group C at each time before surgery was the shortest,but there were no significant differences.The VAS scores of group C at 1 h,6 h,12 h and 24 h after surgery were all lower than group A and B,and there were no significant differences.Conclusion Ropivacaine compounding with dezocine on brachial plexus block can improve the effect of anesthesia,extend the duration of analgesia.
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Objective To investigate the effect of Tongqiao Yinao decoction ( TYD) on postoperative cogni-tive dysfunction in elderly patients and its underlying mechanisms .Methods 100 anesthetic patients for orthopedic surgery were randomly divided into the TYD-treated group and control group ,50 patients in each group .In TYD-trea-ted group,patients received 150mL TYD orally,twice daily for constitutive 15 days,beginning from the day of admis-sion in addition to conventional symptomatic and supportive treatment .While patients in control group received no TYD.Mini-mental state examination ( MMSE) was used to evaluate the patients′cognitive function before and after anesthesia.Meanwhile,blood samples of patients were also collected to test the expression levels of IL -6.Results There was no significant difference between the two groups before operation .However ,TYD-treated patients had signif-icantly lower incidence rate of POCD than the controls ( 20% in the control group , and 12% in the TYD-treated group;χ2 =4.332,P=0.037) 7 days after operation.The incidence rates of POCD in the TYD-treated group and control group were 30%and 38%1 day after operation ( P>0.05),28% and 20% 3 days after operation ( P>0.05),respectively.Compared with that before operation ,the blood levels of IL-6 in the two groups significantly increased 3 days after operation (control group,t=2.412,P=0.009;TYD-treated group,t=1.429,P=0.039).In contrast to the control group,the level of IL-6 in TYD-treated group declined to the baseline (the control group,t=0.851,P=0.049;TYD-treated group,P=0.404).Interestingly,compared with the controls,the TYD-treated patients had a significant lower level of IL-6 after operation (t=1.198,P=0.035).Furthermore,Pearson correlation analysis showed that change of IL-6 level in blood was negatively correlated with MMSE score (r=-0.782,P=0.022). Conclusion TYD can improve postoperative cognitive dysfunction in elderly patients ,presumably through decreasing the level of IL-6 in blood.
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Objective To analyze the correlation between clinical compliance and peritoneal dialysis treatment outcome and quality of life on end-stage renal disease patients with high and low clinical compliance.Methods Total of 137 continuous ambulatory peritoneal dialysis (CAPD) patients of end-stage renal disease were collected in second-class hospital in Weifang by convenience sampling,and divided into high and low clinical compliance group (68 patients in each)according to ESA score.SF-36,dropout rate,fatality rate,infection rate and rehospitalization rate were used to estimated,and Cox multi-factor regression model was used to analyze correlation between therapy outcome and risk factors.Results 61 CAPD patients (44.52％) were dropout,with 23 cases (37.70％) by death.The dropout rate without death(11.8％,44.12％),fatality rate (7.4％,26.5％) and infection rate(8.8％,38.2％)had significant difference between high and low clinical compliance group (P＜0.05).The SF-36 scores of 8 dimension also had significant difference between the two groups.Cox multi-factor regression model showed that clinical compliance was an important risk factor of therapy outcome and death(HR =1.68,P＜0.05).Conclusion Clinical compliance is an important risk factor of therapy outcome,and should be listed as efficacy monitoring index of peritoneal dialysis and the target of improving the curative effect of the intervention.
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Objective To investigate the effects of different types of anesthesia on the incidence rates of low-er respiratory tract infections of elderly patients in orthopedic department.Methods Clinical data from 445 elderly patients in orthopedic department were collected and retrospectively analyzed.We also investigated the relationship be-tween the types of anesthesia and the lower respiratory tract infections.Results The incidence rates of lower respira-tory tract infections were 23.08%in 169 cases,12.14%in 173 cases,and 4.85%in 103 cases after general anesthe-sia with tracheal intubation,intraspinal anesthesia,and nerve blocking anesthesia,respectively.There was statistically significant difference in the infection rates among the three groups (χ2 =13.784,P=0.001).Conclusion Different ways of anesthesia is critically correlated with the incidence of the lower respiratory tract infections in elderly patients.
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Objective To summarize the sonographic features of fetal limb deformity. Methods Systematic continuous sequence approach (SCSA) was performed with two-dimensional and three-dimensional ultrasonography(USG) in 28 383 fetuses to observe the fetal limb development, posture abnormality and other accompanied malformations. Compared with the pathological and radiological findings, the characteristics of fetal limb deformity on USG were summarized. Results Among 28 383 fetuses prenatal ultrasound detected 207 cases of fetal malformations (0.7%, 207/28 383) including 29 cases of limb deformities (14%, 29/207). In the 29 cases, there were osteogenesis imperfecta in 2 cases, syndactyly in 1 case, cleft hand deformities in 1 case, uncifom hand in 1 case, clubfoot deformity in 12 cases, cleft foot in 1 case, micromelia in 4 cases, limb body wall complex in 1 case, forearm defect in 2 cases, and radius absence in 4 cases. Chromosome karyotype analysis was conducted in 7/29 cases, of which 6 cases were normal and 1 case was trisomy-13 with syndactyly. In addition, the fetal limb deformities were found at 17-19 weeks of gestation in 4 cases, at 20-24 weeks in 23 cases, and at 25-33 weeks in 2 cases. In summary, 27/29 cases were identiifed at 17-24 weeks of gestation. Conclusions Prenatal ultrasound is the ifrst-choice method for screening of fetal limb deformity. The detection rate of limb deformity could be greatly improved by using SCSA method with the supplement of 3D ultrasound.
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With the development of computing and storage techniques,there are a lot of medical records and clinical data stored.It raises the issue of how to mine knowledge from these records and to promote the development of traditional Chinese medicine (TCM).Several challenging research subjects of Chinese clinical medicine data mining and analysis have been introduced in the framework of disease-symptom-syndrome-formulaeffect,and the corresponding developments have also been reported.The significant meaning of the data mining and analysis to Chinese medicine is discussed.Then,the detailed works and recent achievements of seven subjects are given including:① Analysis of symptoms to obtain the optimal symptom subset for one disease or syndrome.② Symptom-syndrome or disease to obtain models for syndrome differentiation.③ Analysis of syndrome.④Analysis of Core formula as well as drug addition and subtraction.⑤ Formula-symptom-effect.⑥ Computerized symptoms.⑦ TCM knowledge engineering.
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ObjectiveTo disclose the life quality of uremic patients undergoing hemodialysis in several bemodialysis institutions and its risk factors.MethodsLogistic model was applied to analysis between the risk factors and uremic patients by using the universal kidney disease quality of life short form (KDQOL-SFTM).Resuits①The scores of the patients kidney disease target area and short fort health survey questionnaire were worse than those of the common crowd ( RP:39.69 ± 19.56 vs 86.02 ± 18.75 ; BP:66.33 ± 21.65 vs 81.55 ±20.83 ; MH:58.92 ± 15.87 vs 73.23 ± 16.54 et al) ② The main affecting factors of the life quality for uremic patients undergoing hemodialysis was sex ( male group:female group 46.58 ± 21.67:50.37 ± 22.56,P ＜ 0.05 ),age ( ≥55y group:＜ 55y group 38.78 ± 16.78:57.78 ± 20.45,P ＜ 0.05 ),culture (above senior high school degree group:completed and below senior high school degree group 55.64 ± 21.85:42.59 ± 21.65 P ＜ 0.05 ),diabetes ( nondiabetes group:diabetes group 59.47 ± 18.69:47.67 ± 11.33,P ＜ 0.05 ),medical treatment guarantee ( unversichert group:versichert group 43.54 ± 16.85:56.56 ± 19.67,P ＜ 0.05 ),the state of earning and work ( employed group:nonemployed group,72.90 ± 12.56:60.87 ± 11.45,P ＜ 0.05 ) and so on.③The main affecting factors of the life quality for uremic patients undergoing hemodialysis were diabetes,medical treatment guarantee,age.ConclusionThe main affecting factors of the life quality for uremic patients undergoing hemodialysis are diabetes,medical treatment guarantee,age.
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BACKGROUND: Polyethylene glycol-polyethyleneimine/ferroso-ferric oxide (PEG-PEI/Fe_3O_4) was selected as drug carders in tumor treatment, which can increase drug loading capacity and targeting capacity.OBJECTIVE: To test the toxicity of PEG-PEI/Fe_3O_4 nano-magnetic fluid in vitro and in vivo. METHODS: When the prepared PEG-PEI/Fe_3O_4 nano-magnetic fluid reached nano level, 7702 and HpG2 cell lines were filtrated and diluted in 5-20 multiple, and detected by in vitro MTT toxicity test assay; in vivo hemolysis test and micronucleus test was used to test the toxicity and biocompatibility.RESULTS AND CONCLUSION: MTT assay results indicated that the toxicity grade of PEG-PEI/Fe_3O_4 nano-magnetic fluid to 7702 cell line was 0-1, which was harmless to natural hepatic cells; however, PEG-PEI/Fe304 nano-magnetic fluid had slight bystander restraining effect to HpG_2 cell line. Maximum hemolysis rate of the matedel was 0.372%, which was far less than 5%. The micronucieus test result indicated that PEG-PEI/Fe_3O_4 nano-magnetic fluid had no teratogenicity or mutagenicity.
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Objective To explore the effects of pretreatment with different doses of curcumm on the expression of p-CREB and PGC-1α in hippocampus after global cerebral ischemia-reperfusion (IR) injury in rats.Methods Three hundred male SD rats weighing 200-250 g were randomly divided 5 groups ( n = 60 each): sham operation group (group S), IR group, low, median and high dose curcumin group (group LC, MC, HC). Global cerebral ischemia was produced by occlusion of 4 vessels (cauterization of bilateral vertebral arteries and 15 min occlusion of bilateral common carotid arteries) according to the method described by Finkbeiner. Bilateral common carotid arteries were only exposed but not ligated in group S. Intraperitoneal curcumin 30, 100 and 300 mg/kg were injected at 1 h before ischemia in group LC, MC and HC respectively. Equal volume of dimethylsulfoxide (DMSO) was injected intraperitoneally in group S and IR. The rats were killed at 2, 6, 24 and 72 h and 7 d after reperfusion (12 at each time point). Brains were immediately removed and hippocampus was isolated. The number of apoptosis neurons was counted using TUNEL. The expression of p-CREB and PG C-1α protein in hippocampus was detected by Western blot. Results The number of apoptosis neurons, p-CREB and PG C-1α protein expression were significantly higher at each time point in the other 4 groups than in group S ( P ＜ 0.05). The number of apoptosis neurons was significantly lower at T2-4 in group LC and MC, while p-CREB and PG C-Ⅰα protein expression wes significantly higher at T1-4 in group LC, MC and HC than in group IR (P ＜ 0.05). The number of apoptosis neurons was significantly higher, while p-CREB and PGC-1α protein expression was significantly lower at T2-4 in group LC and HC than in group MC ( P ＜ 0.05). Conclusion Curcumin can inhibit neuronal apoptosis in hippocampus and reduce global cerebral IR injury by up-regulating p-CREB and PG C-1α expression in rats and the effect was dose-related.
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A new proposed data mining technique, support vector machine (SVM), is used to predict the degree of malignancy in brain glioma. Based on statistical learning theory, SVM realizes the principle of data dependent structure risk minimization, so it can depress the overfitting with better generalization performance, since the prediction in medical diagnosis often deals with a small sample. SVM based rule induction algorithm is implemented in comparison with other data mining techniques such as artificial neural networks, rule induction algorithm and fuzzy rule extraction algorithm based on fuzzy max-min neural networks (FRE-FMMNN) proposed recently. Computation results by 10 fold cross validation method show that SVM can get higher prediction accuracy than artificial neural networks and FRE-FMMNN, which implies SVM can get higher accuracy and more reliability. On the whole data sets, SVM gets one rule with the classification accuracy of 89.29%, while FRE-FMMNN gets two rules of 84. 64%, in which the rule got by SVM is of quantity relation and contains more information than the two rules by FRE-FMMNN. All the above show SVM is a potential algorithm for the medical diagnosis such as the prediction of the degree of malignancy in brain glioma.