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This paper systematically summarized related literature on the treatment of atherlsclerotic occlusive disease of the lower extremities (ASO-LE) in recent years from three aspects, including internal treatment, external treatment , internal and external treatment, which shows that TCM treats ASO-LE mainly by activating blood circulation to dissipate stasis, warming Yang, smoothing meridian. TCM treatment could improve clinical symptoms and quality of life of ASO-LE patients. Futurestudies should pay attention to TCM advantage of "Preventing Diseases" and explore the effective ways of integrating prevention and treatment.
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Objective:To explore the relationship between residual collateral vessels in uterine arterial embolization (UAE) and the risk of bleeding during the operation of curettage for cesarean scar pregnancy.Methods:A total of 499 patients who underwent preventive UAE before curettage for scar pregnancy in Shandong Provincial Hospital from January 2012 to June 2019 were included. Clinical data of the patients were retrospectively collected and analyzed. In patients with uterine collateral circulation, collateral vessels were embolized as much as possible. Angiography was performed after UAE. All the cases were divided into 3 grades according to residual staining in middle and lower part of corpus uteri as follows, grade A: no or mild staining, grade B: moderate staining, grade C: intense staining. Blood loss of the patients during curettage was recorded, and the incidence rate of minor hemorrhage (<50 ml) and massive hemorrhage (>500 ml) of the 3 grades were calculated respectively. The results of three grades groups were compared with those of control group (patients without collateral circulation) by using Chi-square test or Fischer exact probability.Results:According to angiogram acquired after UAE, collateral vessels were found in 53 patients, with 25 cases in grade A group, 15 cases in grade B group, and 13 cases in grade C group, respectively. Thirty-six patients underwent transcatheter embolization of collateral vessels. The incidence rate of minor hemorrhage in type B and C [60.0% (9/15), 46.2% (6/13)] was lower than that in control group (87.9%, 392/446), with significant difference found (χ2=9.972, P=0.002, χ2=19.090, P<0.001). Significant difference was found in the incidence rate of massive haemorrhage between group C (23.1%, 3/13) and control group (2.2%, 9/446) (χ2=14.480, P=0.001). Conclusion:As for cesarean scar pregnancy cases with uterine collateral vessels, embolization of collateral vessels may reduce the amounts of bleeding during curettage. Residual staining of middle and lower part of corpus uteri may be helpful in predicting the risk of massive haemorrhage during curettage.
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This paper systematically summarized related literature on the treatment of atherlsclerotic occlusive disease of the lower extremities (ASO-LE) in recent years from three aspects, including internal treatment, external treatment , internal and external treatment, which shows that TCM treats ASO-LE mainly by activating blood circulation to dissipate stasis, warming Yang, smoothing meridian. TCM treatment could improve clinical symptoms and quality of life of ASO-LE patients. Futurestudies should pay attention to TCM advantage of "Preventing Diseases" and explore the effective ways of integrating prevention and treatment.
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Objective To investigate the risk factors for postoperative deep wound infection after open reduction and internal fixation for closed calcaneal fractures.Methods From January 2014 to January 2017,190 patients with closed calcaneal fracture were treated at Department of Traumatic Orthopaedics,Taihe Hospital.They were 118 males and 72 females with an average of 39.8 years (range,from 18 to 73 years).They were divided into a deep infection group and a non deep infection group according to the presence or absence of deep wound infection in the follow-up period.The 2 groups were compared in the general clinical data.In statistical analysis,the related risk factors were first screened by single factor analysis and followed by multivariate logistic regression analysis to identify the independent risk factors associated with the postoperative deep wound infection in patients with closed calcaneal fracture.Results The 190 patients were followed up for an average of 21.3 months(range,from 13 to 31 months).Postoperative deep wound infection occurred in 11 patients,giving an overall incidence of 5.7％ (11 / 190).The single factor analysis showed that the deep infection group incurred significantly longer time for tourniquet and used significantly more conventional extensile lateral approach than the non deep infection group (P ＜ 0.05).There were no significant differences between the 2 groups in general data,injury cause,fracture type,drainage,or incision closure technique (P ＞ 0.05).The multivariate logistic regression analysis revealed that tourniquet time ＞ 80 min (OR=5.949,95％ CI:1.216～ 29.108,P=0.028) and conventional extensile lateral approach (OR =5.414,95％ CI:1.507 ～ 19.452,P =0.01) were independent risk factors fo r the postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Conclusions Tourniquet time and conventional extensile lateral approach may be the independent risk factors for postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Therefore,it is important to adopt the sinus tarsi approach and control tourniquet time within 80 minutes for prevention of deep wound infection as long as the surgical quality is ensured.
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Objective@#To summarize the measures and experience of treatment in mass extremely severe burn patients.@*Methods@#The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.@*Results@#Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.@*Conclusions@#Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.
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Objective To observe curative effect of Ningdong granules on tourette syndrome (TS) concomitant with sleep disorder in children.Methods Eighty-three cases were diagnosed by diagnosis and statistics of mental-disorder (DSMIV) TS criterion and diagnostic standard of traditional Chinese medicine,and then were divided into 3 groups:tiapride hydrochloride group (n =25),Ningdong granules group (n =30) and tiapride hydrochloride plus Ningdong granules group (n =28).Yale global tic severity scale (YGTSS) and Athens insomnia scale (Athens) were used for rating the clinical efficacy before and after treatment.The enrolled children were treated for a period of three months.Results The therapeutic effective rate of TS in tiapride hydrochloride group,Ningdong granules group and tiapride hydrochloride plus Ningdong granules group was 92.0％,90.0％ and 96.4％,respectively.The therapeutic effective rate of sleep disorder was 84.0％,93.3％ and 96.4％,respectively.Mter treatment,YGTSS and Athens scores were significantly changed in all three groups (P ＜ 0.05).Athens score was significantly different between tiapride hydrochloride plus Ningdong granules group and tiapride hydrochloride group (P ＜ 0.05).The total number of adverse reactions was 16,1 and 8,with significant difference (P ＜ 0.01).Conclusion Curative effect of Ningdong granules is similar to that of tiapride hydrochloride on treating TS,but Ningdong granules is more effective than tiapride hydrochloride on treating sleep disorder with less adverse reactions.Combination therapy of Ningdong granules with tiapride hydrochloride is the better choice for treating TS with sleep disorder,and it can also reduce the incidence of adverse reactions of tiapride hydrochloride.
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Objetive To explore the feature and influence of psychological trauma of severe physical violence (SPV) perpetrators with or without violent pedigree,and to provide theoretical basis in the intervention of domestic violence.Methods The cases of domestic violence were identified based on appeals for help to police stations,local Women' s Federations,Residents' Community Committee,Center of Community Health Services,the judicial branch of city governments.The subjects were screened,recruited and divided into the group of the abusers with violent pedigree(AP,n=136),the group of abusers without violent pedigree (ANP,n =105),the group of non-abusers with violent pedigree(NAP,n=105) and the group of non-abusers without violent pedigree(NANP,n =198).The features and influence of psychological trauma in four groups were compared.Results (1) In AP group,above 6 traumatic events got 66.1 percent.The median of the number of traumatic events in AP group was 7,and outstanding statistical significance existed among four groups(P＜0.01).(2)The scores of avoidance (1.37± 0.79) and intrusion(1.40±0.80) and added scores of IES-R(4.08±2.30) in AP group were significantly higher than the other groups,while the scores of hyper-vigilance (1.31 ± 0.88) were higher than NAP (0.95 ± 0.75) and NANP group(0.94±0.83).The scores of intrusion(1.22±0.83) and hyper-vigilance (1.14±0.85) in ANP group were significantly higher than those in the NANP group(P＜0.05).(3)The scores of witness DV,childhood emotional,physical and sexual abuse and the numbers of traumatic events were positively related with the traumatic symptoms.Conclusion The traumatic experiences are significantly correlated with severe physical violence behavior among violence perpetrator with violent pedigree.Some traumatic experiences may be the protective factors of domestic violence behavior.In the violent pedigrees,abusers have the most severe traumatic symptoms and their traumatic symptoms,especially intrusion and hyperarousal symptoms,are positively correlated with severe physical violence behavior.
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Objective To investigate the relationship among the plasma levels of fibrinogen and the lung cancer,and its clinical significance.Methods From 2011 to 2013,121 cases newly diagnosed lung cancer patients(lung cancer group) and 37 cases healthy individuals(control group) were evaluated.The patients had no history of coagulation system disorders or anticoagulant therapy.Plasma prothrombin time (PT), activated partial thromboplastin time(APTT), thrombin time (TT), fibrin original (FIB), platelet (PLT) of the patients were obtained.The relationship between the plasma levels of fibrinogen and clinical characteristics, therapy modalities (surgery, chemotherapy and radiotherapy), therapy outcomes and survival durations of the patients were analyzed.Results (1) Serum levels of fibrinogen at stage Ⅱ A, stage Ⅱ B, stage Ⅲ A, stage Ⅲ B, stage Ⅳ were (2.001±0.813) g/L, (2.191±0.827) g/L, (3.121 ±2.016) g/L, (4.174±0.595) g/L, (4.332 ± 1.534) g/L, a significant difference was observed between the fibrinogen levels of patients with stage Ⅱ A and those with stage Ⅳ disease (P＜0.001), and there were no significant differences among other stages (P＞0.05).(2)The mean fibrinogen level was significantly higher in the patient group with ECOG performance status 2 than in the other groups(r=0.613,P＜0.05).The mean fibrinogen level was (3.780±1.731) g/L (95％CI,3.122-4.439,P＜0.001) in the group with ECOG 0, (4.182 ± 1.661) g/L(95％CI 3.583-4.781 ,P＜0.001) in the group with ECOG 1 ,and (4.725±2.153) g/L(95％CI,4.007-5.443,P＜0.001) in the group with ECOG 2.(3) The treatment responses of 81 patients who received chemotherapy and/or radiotherapy without surgical intervention were evaluated, serum levels of fibrinogen in 39 patients with partial remission (PR) were (4.005 ±1.177) g,/L,42 patients with stable disease(SD) were (3.192±0.479) g/L, 17 patients with progressive disease(PD) were (7.530± 1.885) g/L,fibrinogen levels were found to be significantly higher in cases with progression,and the difference was significant(P =0.015).(4)Correlation analysis on fibrinogen and chnical indicator: clinical stage (r =0.529, P =0.008), ECOG score (r =0.273, P =0.031), therapy response (r =0.529, P=0.012) were positively correlated with fibrinogen levels.(5)Fibrinogen levels in patients with lung cancer were higher than those of the control group ((2.891 ± 0.484) g/L vs.(3.586± 1.692) g/L, t =-4.620, P ＜0.05), and the difference was statistically significant (P＜0.01).(6)The survival duration was significantly longer in patients with lower fibrinogen levels(321 d vs.435 d,P＜0.05).The mean fibrinogen concentration in patients who were still alive at the end of a 2-year follow-up was (3.531 ± 1.482) g/L, whereas the meanfibrinogen level of patients who died was (3.725± 2.063) g/L, and the difference between the two groups was significant(P =0.015).Conclusion The results suggest that Fibrinogen plasma levels might be useful to predict the clinical outcome and survival of patients with lung cancer.
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Objective To observe the clinical therapeutic effect of Danhong injection combined with edaravone for treatment of patients with acute cerebral infarction. Methods A prospective study was conducted. Two hundred and ten patients with acute cerebral infarction admitted to Traditional Chinese Medicine Hospital of Qinghai Province from June 2008 to January 2014 were divided into control group and observation group according to random number table method, 105 cases in each group. The conventional routine treatment and edaravone injection were given to the two groups, and additionally in the observation group, intravenous drip of Danhong injection 30 mL, once a day was applied, the therapeutic course in the two groups being 14 days. The changes of blood rheology, blood fat, the United States National Institutes of Health Stroke Scale (NIHSS) scores before and after treatment and clinical curative effect were observed in two groups. Results Compared with those before treatment, plasma viscosity, fibrinogen (Fib), erythrocyte hematocrit (HCT), total cholesterol (TC), triacylglycerol (TG),and NIHSS scores were decreased in the two groups after treatment, the decrease of the above indexes in observation group being more marked [plasma viscosity (mPa·s): 1.54±0.62 vs. 3.10±0.58, Fib (g/L): 3.87±0.91 vs. 4.81±1.31, HCT: 0.46±0.04 vs. 0.54±0.05, TC (mmol/L): 4.97±1.73 vs. 6.65±1.62, TG (mmol/L): 5.01±1.25 vs. 7.53±1.23, NIHSS scores: 2.31±1.15 vs. 10.23±2.21, all P<0.05];the statistical significant differences were found in the above indexes between observation group and control group after treatment [plasma viscosity (mPa·s ):1.54±0.62 vs. 3.01±0.72, Fib (g/L):3.87±0.91 vs. 4.68±1.37, HCT:0.46±0.04 vs. 0.52±0.04, TC (mmol/L):4.97±1.73 vs. 6.34±1.71, TG (mmol/L):5.01±1.25 vs. 7.51±1.30, NIHSS score:2.31±1.15 vs. 3.75±1.73, P<0.05 or P<0.01]. The total effective rate in observation group was obviously higher than that of control group [97.14%(102/105) vs. 74.29%(78/105), P<0.01]. Conclusion The therapeutic effect of Danhong injection combined with edaravone for treatment of patients with acute cerebral infarction is significantly better than the treatment of edaravone injection alone.
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Objective To investigate the effect of Ningdong granule on 5-hydroxytryptamine metabolism and 5-HT2AR of Tourette’s Syndrome(TS) rat models. Methods 32 SD rats were divided into 4 groups randomly, the control group, the model (Apo) group, the low dosage NDG (NGL) group, and the high dosage (NGH) group. TS rat models were induced by intraperitoneal injection (i.p.) with Apo (2 mg/kg) in the experimental groups last 4 weeks. Rats in the control group were injected with normal saline (0.9%) (3 ml/kg, i.p.). Then, the rats were treated by intragastric administration (i.g.) with ND granular at 1.8g/(kg?d)in NGL group, with ND granular at 3.6 g/(kg?d)in NGH group, with distilled water at equal Volume in Control group and Apo group respectively for 12 successive weeks. Analysis the striatum 5-HT2AR protein expression by Immunohistochemical method;Determination of the content of 5-HT and 5-HIAA in striatum by Enzyme linked immunosorbent assay (ELISA). Results The level of 5-HT and 5-HT2AR protein expression in the model group [(1.98±0.14)ng/ml and(143.10±8.01)], compared with the control group[(1.78±0.10)ng/ml and(127.43±6.72)], was up-regulated (P<0.01 or 0.05). The levels of 5-HT and 5-HT2AR protein expression in NGH group[(2.20±0.14)ng/ml and(166.33±9.21)ng/ml] were further up-regulated, and the levels of 5-HIAA in NDH group [(0.58±0.08) ng/ml] became lower, compared with the control group(P<0.01 or 0.05). Conclusion Activity of 5-HT system enhanced in Apo-induced TS rat model. However, the enhanced activity may still be relatively insufficient. The mechanism of ND granulear treating TS was associated with depression of the 5-HT metabolism, up-regulation expression of 5-HT2AR, and improving the activity insufficient of 5-HT system.
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<p><b>BACKGROUND</b>Anticoagulation treatments are an important aspect of hemodialysis; however, few reports have addressed these treatments. This investigation intends to increase the understanding of the current status and improvements of hemodialysis-related anticoagulation treatments in China.</p><p><b>METHODS</b>In this study, an epidemiological investigation was conducted that examined 842 patients in 2007 and 1 175 patients in 2012 who underwent hemodialysis anticoagulation treatments in seven blood purification centers in northern Chinese cities.</p><p><b>RESULTS</b>Heparin was the most commonly used anticoagulant, although the percentage of use of low-molecular-weight heparin (LMWH) increased from 26.5% in 2007 to 42.1% in 2012. In 2007, there were no significant differences in anticoagulant selection among either patients with various primary diseases or patients with hemorrhage, thrombosis, thrombocytopenia, or a low hemoglobin level. However, compared with patients with other diseases, significantly lower doses of LMWH were administered to patients with hypertension (55.5 U/kg vs. 67.3 U/kg, P < 0.05) or diabetes (58.5 U/kg vs. 67.3 U/kg, P < 0.05), and patients with hemorrhage received lower doses of heparin than the other patients (61.6 U/kg vs. 71.8 U/kg, P < 0.01). In 2012, patients with diabetic nephropathy (51.5% vs. 36.5%, P < 0.01), hemorrhage (43.4% vs. 31.7%, P < 0.01), or a hemoglobin level below 90 g/L (57.2% vs. 37.1%, P < 0.01) experienced significantly higher doses of LMWH administration; patients with hemorrhage received significantly reduced LMWH dosages (50.4 U/kg vs. 57.8 U/kg, P < 0.05), and patients with thrombosis received significantly higher doses of heparin (73.8 U/kg vs. 62.1 U/kg, P < 0.01) or LMWH (57.8 U/kg vs. 52.6 U/kg, P < 0.05). Antiplatelet drugs were administered to 20.4% of the examined patients in 2007 and 20.7% in 2012. In 2012, patients with hypertension (25.9% vs. 18.5%, P < 0.01) and thrombosis (36.6% vs. 16.1%, P < 0.01) had a higher rate of using antiplatelet drugs than patients with other primary diseases and complications. Patients receiving antiplatelet drugs also received higher doses of heparin than patients without using antiplatelet drugs (74.4 U/kg vs. 65.9 U/kg, P < 0.01). However, the use of the drugs was not correlated with thrombocytopenia. The rate at which coagulation indices were determined increased from 45.7% in 2007 to 64% in 2012.</p><p><b>CONCLUSION</b>These findings suggested that hemodialysisrelated anticoagulation treatments in China have gradually become more standardized and individualized.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Anticoagulants , Therapeutic Uses , China , Cities , Heparin, Low-Molecular-Weight , Therapeutic Uses , Renal Dialysis , MethodsABSTRACT
Objective To evaluate the clinical value of internal carotid artery occlusion in treatment of intractable epistaxis caused by carotid artery siphon traumatic lesions.Methods A total of 37 patients with intractable epistaxis caused by traumatic carotid artery siphon pseudoaneurysm or carotid cavernous fistula were retrospectively analyzed.All the patients underwent embolization from October 1998 to June 2010,including 34 men and 3 women with the age ranged from 25 to 65 years and a average of 40 years.Only lesions were occlued in 12 cases without involving the internal carotid artery,while occlusions of internal carotid artery were performed in the rest 25 cases.Results Thirty-six patients were cured without recurrent hemorrhage after embolization.Only 1 patient with carotid artery occlusion died 48 hours after operation.Conclusion For patients with carotid arterial intractable epistaxis,if the elimanation of the lesions is not applicable and the collateral circulation of Willis ring has a good compensation,the use of detachable balloon or coil occlusion of ipsilateral internal carotid artery is a quick and easy method to save patients' lives.
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Objective To explore the treatment and efficiency of high blood flow vascular malformations of oral maxillofacial region with super-selective arterial embolization. Methods 18 cases underwent angiography of the head and neck before treatment and then followed by super-selective catheterization with microcatheter to embolize the feeding vessels of the vascular malformations with PVA. 8 cases underwent surgical excision within 72 hours after the embolization and the other 10 cases passed through the arterial radical emboliztion treatment. Results Technical success ratio reached 100% with no complications causing skin necrosis or incorrect arterial embolization else where in the skull. All 8 cases undergone preoperative embolization showed obviously less bleeding, easier removal of the mass and reduction of operation time. 10 cases with radical arterial embolization manifested reduction of swelling and improvement of organ function within 1 to 24 months after the procedure. 5 patients were cured with only once operation, 4 cases with twice operation and 1 with the thrice. Conclusions Aterial embolization is a safe and effective method in the treatment of high blood flow vascular malformations of oral maxillofacial region.
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Objective:To investigate the clinical characteristics of renal injury caused by Guanxinsuhe pill(冠心苏合丸,including slander dutchanspipe root(青木香)).Methods:The clinical data of 27 patients with renal injury caused by Guanxinsuhe pill were studied.The clinical characteristics of the renal damage caused by Guanxinsuhe pill and the relationships between duration of illness,duration of taking Guanxinsuhe pill,anemia,renal atrophy and the progression of renal injury respectively were also analyzed.Results:Twenty-seven patients all taken Guanxinsuhe pill for suspicious coronary heart disease(CHD) and were diagnosed as chronic tubulointerstitial nephropathy accompanied with renal tubular acidosis,renal glucosuria and hyposthenuria after admission.Anemia was of more severity than renal dysfunction.Atrophic kidney occurred in 26 patients.The main complains were nonspecific symptoms including fatigue,anorexia,nausea,vomiting,etc.and accompanied with different degrees of chronic renal dysfunction.Twentyfour hours urinary protein excretions were 120-900 mg((490?250) mg).There were few red and white cells in uroscopy.Sixteen patients discontinuously took the Guanxinsuhe pill(one capsule,2-3 times a day) according to the pharmacopoeia for a long period.Ten patients took a dosage(two capsules,2-3 times a day) higher than that limited by the pharmacopoeia.Twenty-six patients took Guanxinsuhe pill discontinuously.One patient continuously took Guanxinsuhe pill until got renal dysfunction.The duration of taking Guanxinsuhe pill was 1-120 months(37.38?31.58),and the amount of 50-43 800 pills(4 576.00?8 830.54) were used,but the amount of pills of 3 cases was uncertain.The renal injury occurred within 30-216 months(95.41?56.74) after initiation of the drug taken.The renal injury obviously correlated with the anemia and the duration of taking Guanxinsuhe pill.Conclusion:Taking Guanxinsuhe pill can cause renal injury.The Guanxinsuhe pill dose indicated in pharmacopoeia also causes renal damage.The onset of renal injury is insidious.Most of the patients have the history of CHD and when the chronic nephropathy in most of such patients is detected,it is advanced to stage 5.The renal injury induced by Guanxinsuhe pill usually presents as chronic tubulointerstitial nephropathy,renal tubular dysfunction and anemia.Anemia is of more severity than renal dysfunction.The 24 hours urinary protein excretions of all the patients are lower than 1 000 mg daily.It is suggested to avoid taking Guanxinsuhe pill,adjust the prescription of Guanxinsuhe pill and do not use slander dutchanspipe root as an ingredient.
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BACKGROUND: Monoamine hypothesis has been demonstrated by researches. However, the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression has less been reported.OBJECTIVE: To study the effect of different drugs on metabolite of plaama monoamine neurotransmitter, and the correlation between the metabolite of plasma monoamine neurotransmitter and anti-depression treatment in patients with depression.DESIGN: Case controlled study.SETTING: Neurological Department and Brain Institute of Nanjing Medical University.PARTICIPANTS: Forty patients with depression hospitalized in Nanjing Brain Hospital (depression group) were diagnosed with the second revised edition of China classification of mental diseases(CCMD-2) and the tenth edition of International classification of diseases. And the total score of Hanmilton rating scale for depression(HAMD) was more than 17. Healthy voluntary blood donators in the control group were from Nanjing Municipal Central Blood Station( n = 20).INTERVENTIONS: Antidepressant was used in the depression for 4 weeks: fluoxetine 20 mg per day; 5-serotonin selective reuptake inhibitor (SSRI) paroxetine 20 mg per day; venlafaxime 50- 100 mg per day;5-serotonin and morepinephrine selective reuptake inhibitor(SNRI) fluvoxamine 50-100 mg per day. High performance liquid chromatograpy(HPLC)was used to measure the level of metabolite of plasma monoamine neurotransmitter in patients with depression before and 42 week after treatment, and the HAMD was used to evaluate clinical effect of the patients.MAIN OUTCOME MEASURES: The levels of metabolites of plasma monoamine neurotransmitters in patients with depression: 5-hydroxyindoleace tic acid(5-HIAA), 3-methoxy-4-hydroxyphenylglycol(MHPG) and homovani llic acid(HVA) were measured before and 4th week after treatment.RESULTS: The levels of 5-HIAA, MHPG and HVA of the metabolites of plasma monoamine neurotransmitters in patients with depression before treatment [ (20.3±14.6), (124.8±103.6), (54.7±32.1) μg/L] were all lower than those in the normal control group[ (39.5±28.4), (334.5 ±107.3), (88.5±37.2) μg/L], with statistically significant differences (P＜0.05). After SSRI treatment, the 5-HIAA content[ (37.1±21.9)μg/L]was significantly increased as compared with that before treatment, whose difference indicated significant meaning ( P＜0.05), but the differences in MHPG and HVA had no significant meaning as compared with those before treatment(P＞0.05) . After SNRI treatment, 5-HIAA and MHPG contents [(35.4±25.2 ), (291.2±120.4) μg/L] both were significantly increased, which indicated significant difference as compared with those before treatment( P＜0.05); but HVA level had no significant changes.CONCLUSION:'The peripheral neurotransmitter metabolites in plasma can reflect their states in brain. The change of neurotransmitter metabolite in plasma can be regarded as an important reference index for the evaluation of depression.
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0.05),while those of the cells treated with 6?10-5,6?10-6,6?10-7 mol/L of exemestane were significantly different from that of controls(P
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Objective To investigate the effect of mifepristone on the activity of proliferation and the apoptosis, the expression of estrogen receptor (ER),progesterone receptor (PR) protein and morphology changes of human ovarian carcinoma cell line 3AO and SKOV3 in vitro. Methods The proliferative activity of 3AO and SKOV3, which were cultured in vitro, was measured by tetrazolium-based colorimetric assay (MTT assay). Flow cytormetry (FCM) was used to measure the expressive rate of ER, PR , p53 protein, bcl-2 protein, cell apoptotic rate and cell proliferative cycle of 3AO cells, which were cultured with different concentration and duration of mifepristone. The morphologic and ultrastructure changes of apoptotic 3AO cells was observed by the light and electron microscopy. Results Mifepristone inhibited significantly the proliferation of 3AO cells in dose-time dependent manner in vitro. The inhibitory rate of 3AO cells growth, which were cultured with different concentration of mifepristone( 5,10,20,40,80 ?mol/L) and duration (24,48,72 h) was from 1.7% to 75.0%(P0.05). 3AO cells apoptosis activity appeared the positive correlation with the dose of mifepristone and cultured duration (P
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Objective To investigate the characteristics of TCM syndromes of Tourette syndrome (TS) to find out the basis for its TCM treatment. Methods Based on the preliminary studies,the TCM syndrome scale of TS is designed to investigate the general data,main symptoms and syndromes of 126 cases of TS children to find out the frequency of each syndrome. Results Of the 126 TS cases,97 were males,accounting for 77%; the average age was 8.31 years; and 32 had a positive family history,accountting for 25.4%. In the tic behavior,the facial twitching and limb twitching occupied 91.6% of the muscular stereotyped tic. In the vocal behavior,the throat and nasal sound occupied 42.1%. In the accompanied symptoms,the inattention occupied 69.8%. In the personality offset,the willfulness occupied 49.2%,irritable hyperactivity occupied 78.6%,and silence occupied 7.1%. More than 50% of the patients had red or dark red tongue with thick or sticky coating. Nearly 70% of them had string-taut or rolling pulse. As for the syndromes,heart-liver deficiency with deficiency wind stirred up,and liver-kidney yin deficiency with yang hyperactivity stirring up wind were common,being 41.3% and 34.1% respectively. Conclusion TS takes the heart-liver deficiency with deficiency wind stirred up and liver-kidney yin deficiency with yang hyperactivity stirring up wind as the common syndromes. The basic treating principle is enriching yin and reducing yang,and smoothing the liver to stop wind. At the same time,reinforcing the spleen and nourishing the heart,and dissolving phlegm and enlightening the brain should be applied for treatment.