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Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.
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Objective:To explore the clinical effect of Guige Shujing Decoction combined with acupuncture in the treatment of cervical spondylotic radiculopathy with coldness-blood stasis obstructing meridians.Methods:A total of 86 patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy, who met the inclusion criteria from May 2019 to May 2021, were divided into two groups, with 43 cases in each group, according to the random number table method. The control group was treated with routine basic treatment and acupuncture, and the observation group was treated with routine basic treatment, acupuncture and Guige Shujing Decoction. Both groups were treated for 4 weeks and followed up for 6 months. The scores of TCM syndromes were performed before and after treatment, Clinical Assessment Scale for Cervical Spondylosis (CASCS) was used to evaluate cervical spine function, Visual Analogue Score (VAS) was used to evaluate the degree of pain, Neck Disability Index (NDI) was used to evaluate cervical spine function, and ELISA was used to detect levels of hypersensitive C-reactive protein (hs-CRP), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). The adverse reactions were observed during treatment and the recurrence rate was recorded during follow-up.Results:The total effective rate of the observation group was 95.35% (41/43), and that of the control group was 81.40% (35/43), the difference between the two groups was statistically significant ( χ2=4.07, P=0.043). After treatment, the scores and total scores of shoulder and neck pain, upper limb numbness, neck stiffness, head tenderness and heaviness in the observation group were significantly lower than those in the control group ( t values were 10.66, 12.89, 9.12, 12.27 and 8.75, respectively, P<0.001). After treatment, the CASCS score in the observation group was significantly higher than that of the control group ( t=2.64, P=0.010). After treatment, the VAS and NDI scores in the observation group were significantly lower than those in the control group ( t values were 5.62 and 7.00, respectively, P<0.001). After treatment, the levels of serum hs-CRP, IL-1β and TNF-α in the observation group were significantly lower than those in the control group ( t values were 6.65, 7.52 and 5.08, respectively, P<0.001). There was no significant difference in the incidence of adverse reactions between the two groups during treatment ( χ2=0.73, P=0.393). After 6 months of follow-up, the recurrence rate in the observation group was 2.44% (1/41) and that in the control group was 17.14% (6/35). There was a statistically significant difference in the recurrence rate between the two groups ( χ2=3.89, P=0.048). Conclusion:The Guige Shujing Decoction combined with acupuncture therapy can inhibit the neurogenic inflammatory reaction of patients with coldness-blood stasis obstructing meridians of cervical spondylotic radiculopathy, reduce pain, improve cervical spine function, reduce recurrence rate and improve curative effect.
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OBJECTIVE: To explore the influence of work pressure and psychological capital on job burnout of college teachers. METHODS: A total of 287 teachers from 7 universities in Nanjing City were selected as the research subjects using the convenient sampling method. The Maslach Burnout Inventory, Job Stress Scale for University Teachers and Psychological Capital Questionnaire were used to investigate their job burnout, job stress and psychological capital. RESULTS: The total scores of job burnout and job stress were(42.9±12.5) and(48.5±12.4) respectively, and the occurrence of job burnout was 64.1%. The total scores of psychological capital was(106.7±14.7), and the scores of the four dimensions including self-efficacy, hope, resilience and optimism were(27.6±4.6),(26.7±4.8),(27.0±4.2) and(25.4±3.8) respectively. The total score of job stress was positively correlated with the total score of job burnout [correlation coefficient(r)=0.41, P<0.01]. The total score of psychological capital, self-efficacy, hope, resilience and optimism were negatively correlated with the total score of job burnout(r values were-0.42,-0.28,-0.36,-0.36 and-0.42, respectively, P<0.01). The results of multiple linear regression analysis showed that after adjusting the influence of confounding factors and excluding other confounding factors, the higher the job stress, the higher the job burnout level(P<0.01), the higher the psychological capital optimism dimension score, the lower the job burnout level(P<0.01). CONCLUSION: The job stress and psychological capital of college teachers can independently affect their job burnout level, with a dose-effect relationship.
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Objective: To investigate changes of quality of life [QOL] of patients with adenocarcinoma of the esophagogastric junction [AEG] after gastric tube anastomosis
Methods: From January 2009 to December 2011, eighty-seven patients with Types II and III AEG were selected for gastric tube reconstruction after proximal gastrectomy. The QOL of the patients was assessed using the Chinese versions of the EORTC QLQ-C30 and the EORTC QLQ-STO22 preoperatively, as well as one and two years postoperatively
Results: The QLQ-C30 showed that the global health of the respondents decreased at one year after the surgery [P=0.02]. The preoperative score for physical function was significantly better than the one- and two-year post-operation scores. The preoperative scores for pain, nausea and vomiting, and economic difficulties were worse than the one- and two-year post-operation scores [P < 0.05]. Diarrhea was worse at one year post-operation than during pre-operation [P = 0.00], but improved at two years after the operation. The QLQ-STO22 scales showed that the preoperative dysphagia score was better than one-year post-operation, and no significant differences were observed in terms of dysphagia between the preoperation and two-year postoperative periods. Preoperative reflux and taste scores were better than those after the operation [P < 0.05]. The hair loss score at one-year post-operation was worse than at either pre-operation or two-year post-operation
Conclusions: Most QOL scales worsened after surgery, particularly at postoperative year one. However, the scales can be gradually recovered to preoperative levels. The physical function, nausea and vomiting, reflux, taste, and financial difficulties did not fully recover two years after the operation
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This study investigated the expression and clinicopathological significance of CD9 in gastrointestinal stromal tumor (GIST). Immunohistochemistry staining for CD9 was performed on tumor tissues from 74 GIST patients. The correlation with clinicopathological features, risk classification and prognosis was analyzed. CD9-positive staining comprised 59.5% (44/74) of the GIST patients. The CD9-positive expression rate of the sample was significantly associated with diameter (P = 0.028), mitotic counts (P = 0.035), risk classification (P = 0.018) and three-year recurrence-free survival (RFS) (P < 0.001). Cox proportional hazards regression (HR = 0.352; P = 0.015) showed that CD9 is an independent factor for post-operative RFS. The subgroup analysis showed that CD9 expression in gastric stromal tumor (GST) is significantly associated with diameter (P = 0.031), risk classification (P = 0.023) and three-year RFS (P = 0.001). The Cox proportional hazards regression (HR = 0.104; P = 0.006) also showed that CD9 is an independent factor for RFS of GST. However, CD9 expression does not have a statistically significant correlation with clinicopathological features, risk classification, and prognosis in non-GST. In conclusion, CD9 expression in GIST appears to be associated with the recurrence and/or metastasis of GIST patients, especially in GST, which may indicate the important role of CD9 in the malignant biological behavior and prognosis of GST.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Tetraspanin 29/genetics , Disease-Free Survival , Gastrointestinal Neoplasms/metabolism , Gastrointestinal Stromal Tumors/metabolism , Gene Expression Regulation, Neoplastic , Immunohistochemistry , Kaplan-Meier Estimate , Prognosis , Proportional Hazards Models , Risk FactorsABSTRACT
Aim: To preliminarily investigate the antioxidant activity of the acidic exopolysaccharide(EPS-A) from cultivated Cordyceps sisnensis in vitro and in vivo. Methods: PC12 cells were injured by H_2O_2 after the cells were treated with different doses of EPS-A for 6 h, and then the levels of malondialdelyde( MDA) and superoxide dis-mutase (SOD) in PC12 cells were determined. H22 cells were inoculated into the right oxter of each mouse after ICR mice were treated with EPS-A for 7 days, and tumor-bearing mice were treated with EPS-A for 7 days. MDA level and SOD activity in liver, brain and serum were assayed, and tumor weight of each mouse was measured as well. Results: EPS-A significantly decreased the production of MDA and increased SOD activity in H_2O_2-injured PC12 cells. Moreover, EPS-A inhibited H22 tumor growth in mice, in which the level of MDA in liver and brain was reduced, and SOD activity in liver, brain and serum was enhanced. Conclusion: EPS-A exhibited antioxidant activity in cell cultures and mice.
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Objective To establish a new method for quantitating leukocyte fragments (LFs) in apheresis platelet concentrates (AP-PCs) by using real-time quantitative polymerase chain reaction (RQ-PCR) and flow cytometry(FCM) and discuss the factors influencing LFs concentrations such as storage time, filtration and PLT concentration. Methods 67 qualified donors were selected. Each of them donated one therapeutic dose of AP-PCs. AP-PCs samples were collected as soon as possible and divided into si xfractions. One was analyzed by hematology analyzer. For the Others, DNA was extracted under differen tconditions (filtrated or unfiltrated, before or after centrifugation) at 4 hours, 24 hours, 48 hours, 72 hours, 96 hours after blood draw, respectively. Then the amounts of albumin gene of the AP-PCs and the cell-free DNA in supematant were quantitatively determined using RQ-PCR and the results were calculated into leukocytes equivalent(WBCs/μl). Intact leucocytes were counted by FCM. The concentrations of LFs were calculated by subtracting cell-frce DNA and intact leucocytes from the total DNA amount. Then the differences of LFs concentrations among groups with different storage time were compared and the differences of LFs concentrations between unfihrated and filtrated groups were also compared. After grouping all the AP-PCs according to their PLT concentrations, LFs contents of AP-PCs before filtration among groups were compared. Meanwhile, bivariate correlation analysis between PLT concentrations and LFs contents was carried out. ResultsLFs contents of all the AP-PCs samples were quantitated successfully.The concentrations of LFs in AP-PCs before filtration in 4 hours,24 hours,48 hours,72 hours , 96 houres after blood draw were(31.4±17. 6), (47.5±25.3), (100.7±53.5), (89.5 ±47.2) and (16.1±7.8) WBCs/μl ; After filtration the results were (16. 9±8. 7), (24. 3 ± 12. 2), (83. 1±42. 6), (78.2 ±40. 2) and (13.6 ± 6. 6) WBCs/μl respectively. There were statistically significant differences among groups of different storage time (Fwithin subjects = 472. 756,P < 0.01). The concentrations of LFs kept on increasing within 48 hours after collections, and then decreased gradually. The peaks appeared between 48 hours and 72 hours after collections. The differences of LFs contents between unfiltered and filtered AP-PCs in 4 hours, 24 hours, 48 hours, 72 hours, 96 hours after collections were 14. 5, 23. 2, 17. 6, 11.3 and 2. 5 WBCs/μl, respectively.There was statistically significant difference between unfiltered and filtered samples (Fbetween subjects=9. 216,P < 0. 05). The differences were considerable within 48 hours, and then declined gradually. The results of bivariate correlation analysis showed that there were no statistically significant correlation between PLT concentrations and LFs contents (at 4, 24, 48, 72, 96 hours after collections the correlation coefficients rs were -0.002, 0.015, 0.027, 0.042 and 0. 037,respectively,P2-tailed>0.05). ConclusionsRQ-PCR and FCM can be used to quantitate LFs in AP-PCs. The concentration of LFs in AP-PCs is influenced by storage time and filtration, but it is not affected by PLT concentration.
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OBJECTIVE: To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction, and to explore the rational period of conservative therapy before operation. METHODS: Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed. The etiology of the obstruction was categorized, and the correlation of mortality and time interval between conservative therapy and operation was analyzed. RESULTS: There were 705 patients with acute intestinal obstruction included. There were 71.1% of the obstruction lesions located on the small bowel, and 82.6% of the patients experienced simple obstruction. The most frequent cause was adhesions (62.0%), and next was neoplasms (23.7%). There were 57.6% of the patients underwent the surgical treatment. The overall mortality rate was 1.6%, and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively. The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation, and the death might occur 24 hours after strangulation. CONCLUSION: The epidemiological transition to adhesive obstruction still exists in China, and it is similar to that in Western countries. In our experience, near half of the patients with simple obstruction may achieve palliation by conservative therapy. Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction, or strangulation disease within the first 24 hours.
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Objective To separate the CD1c+ MDC and CD304 PDC subsets and analyze their immunobiologic properties.Methods MDC or PDC were separated by immunomagnetic beads and then induced by TNF-α or CpG2006 OND.The phenotype of different DC subsets and allogeneic T-cell-stimulating capacity were detected,respectively.Results The purlty of separated DC was about ninety-five percent.MDC expressed HLA-DR,CD11c,CD4 and CD33,PDC expressed HLA-DR,CD4 and CD45RA,and the percentage of CD40,CD80 were up-regulation after induced to mature.The results of mixed lymphocyte reaction(MLR):MDC had strong potential to stimulate allogeneic T lymphocytes proliferation,while PDC had the weak stimslate potential.The supematant IFN-r in all groups was increased.which the groups of MDC and mMDC were more obviously.The supematant IL-10 was increased obviously in groups of PDC and mPDC.The expression of IFN-r in CD4+ cells were increased obviously after stimulated by MDC or mMDC.PDC and mPDC had the effect of inducing of CIM+ CD25high regulatory T lymphocyte in MLR.The expressing of Foxp3 mRNA had no evident difference in all groups.Conclusion Two different DC subsets in the donors peripheral blood which mobilized with G-CSF were in the state of immature and could be induced to mature in the suitable condition.although expressed high constitutive levels of HLA,DR.No matter how MDC was mature or not,they had strong potential to stimulate allogeneic T lymphocytes proliferation.MDC enhanced the production of IFN-r among T lymphocytes,and the increase of IFN-r was probably the result of TH1 polarization.Unlike MDC,PDC was less efficient present antigens and had poor T-cell-stimulating capacity,probably because of their lesser ability to phagocytose,process and present antigens to the MHC molecules.Although PDC could promote the production of IFN-r,it seemed that did not produced by TH 1.PDC could not promote TH2 cells to product IL-4,and the polarization of TH2 probably reflect the production of IL-10.PDC could induce the generation of CD4+ CD25high regulatory T cells.
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0.05).The volumes of PBSC collected each time in the 3 groups were about 60 ml,and there were(3.67—10.25)?1010 erythrocytes per pack in the ABO major incompatible group,and 22—38 ml of plasma in ABO minor incompatible component.All the PBSC were infused to recipients without the removal of erythrocytes or plasma,and no haemolytic reaction was observed in any recipients and all their hematopoietic functions were re-established.Conclusion Enough PBSC can be harvested by using CS-3000 Plus blood cell separator from ABO incompatible allogeneic donors.By modification of separator parameters,the number of erythrocytes in the collects can be reduced.The collected PBSC can be safely infused into the blood group incompatible recipients without removal of erythrocytes or plasma.
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Objective To investigate the significance and surgical skill for lymphadenectomy around common hepatic artery in gastric cancer.Methods Two hundred and fifty-seven cases with undergoing lymphadenectomy around common hepatic artery in gastric cancer between January 2001 and December 2006 were retrospectively reviewed.Experiences and understanding of dealing with this procedure in curative gastrectomy for gastric cancer were concluded.Results The number of dissected No.8 lymph node was 2.2?1.7,and the positive rate of No.8 lymph node was 30.35%.There were no lymphadenectomy related complications,such as anastomotic leakage,lymphatic fistula and postoperative hemorrhage in this series.Dissection around common hepatic artery lymph nodes along artery intrathecal space,division and ligation of left gastric vein at its root,and sufficient exposure of anatomic structures were important to dissection lymph nodes around the common hepatic artery.The exposure of anatomic structures included liberation of common hepatic artery by traction with the band,and the exposure of posterior side of pancreas by Kocher incision.Conclusion Being familiar with the anatomy around common hepatic artery,careful dissection,and attention to the surgical skill of lymphadenectomy are very important to improve the effectiveness of lymphadenectomy around common hepatic artery in gastric cancer.
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Objective To assess the characteristics of abdominal hernia and summarize the therapeutic efficacy of mesh plug tension-free hernioplasty in elderly ventral hernia. Methods All 207 elderly patients with abdominal hernia who were admitted to our hospital during January 1999 to December 2001 and received the mesh plug tension-free hernioplasty were analyzed retrospectively. Results There were 405 patients receiving the mesh plug tension-free hernioplasty from 1999 to 2001, in whom 207 had elderly ventral hermia. Among the 207 elderly patients, 144 had inguinal oblique hernia, 38 direct hernia, 11 direct and indirect hernia, 6 sliding hernia, 6 incisional hernia, 1 femoral hernia, and 1 femoral and inguinal direct hernia. Postoperative complications were urinary retention(8 cases), hypoincisional hematoma(4), scrotal hydroceles(1), and incisional infection (1). One hundred eithty-seven patients were followed-up for 4-40 months and no recurrence was found. Conclusions The mesh plug tension-free hernioplasty is of advantages for elderly abdominal hernia, such as simpleness in performance and a good therapeutic effect. It is especially suitable for the elderly patients due to less trauma and low recurrence rate. It is also important to pay attention to the postoperative complications to the elderly.
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Objective To study the clinical findings and audiological characteristics of auditory neuropathy. Methods Clinical findings, pure tone threshold, acoustic impedance audiometry, speech audiometry, auditory brainstem response (ABR) and distortion product otoacoustic emission( DPOAE) were analyzed in 23 cases of auditory neuropathy. Results The patients were predominantly youngster, female more than male. Pure tone audiometry revealed mainly binaural symmetric upward - sloping audiogram with mild and moderate hearing loss at low frequencies. Speech discrimination score was obviously reduced, which was disproportionately to the pure tone threshold. Ipsilateral and contralateral stapedial reflex were absent. ABR was severely abnor- mal. DPOAIE was normal or nearly normal. Conclusion Clinical findings and systemic audiometry revealed the main characteristics of auditory neuropathy, which could be used not only for the understanding, but also for the diagnosis of this disease.
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Objective To explore the characte ristics of pure tone threshold (PTT) in auditory neuropathy. Methods The results of PTT audiometry were analysed in 48 patients with auditory neuropathy and compared with that of cochlear deafness. Results PTT audiograms in auditory neuropathy group r evealed curves including ascending slope, peak, spoon, letter W, lain letter S, flat, gentle slope. Binaural symmetric PTT audiograms were seen in 38 cases and asymmetric in 10 cases. The auditory threshold in auditory neuropathy showed a e levated range from mild to moderate degrees. Elevated degrees of auditory thresh old in left and right ears were consistent. The elevations of low-frequency audi tory threshold or in the main feature of low-frequency auditory threshold were 9 3.75% (90/96 ears) in the PTT audiograms. Conclusion The elevations of biauricular symmetric and ba sic symmetric low-frequency auditory threshold or in the main feature of low-fre quency auditory threshold were important characteristics of auditory neuropathy.
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0.05). Conclusions There is no difference in immune responses to rectal cancer patients undergoing laparoscopic total mesorectal excision with anal sphincter preservation and those having open surgery.
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For the purpose of studying the diagnostic significance of the traumatic perforation of the tympanic membrane by the otologic endoscopy and video tape recording, one hundred and fourteen patients 117 ears, with ear drum injury caused by the head and facial trauma were examined and analyzed by using the Hopkin modle mult angle otologic endoscopy and the video tape recorder. The results showed that the traumatic perforation of te tympanic membrane were found in all four quadrants of the membrane,61 91% of the perforation located in the anteriorinferior quadrant,of the tense part of the membrane. The shapes of the perforation were spindle,triangular,slit, irregular and lune. The nontraumatic perforation of the tympanic membrane often located in the center or the margin of the membrane and were round or oval in shape. The otologic endoscopy and video tape recording can display the morphologic features of the traumatic and nontraumatic perforations of the tympanic membrane objectively and provide reliable diagnostic and investitgative method for the forensic practice.