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Objective:To analyze the effects of butylphthalide combined with alteplase on acute ischemic stroke.Methods:A total of 176 patients with acute ischemic stroke who received treatment at The Second People's Hospital of Liaocheng from November 2020 to October 2021 were prospectively included in this study. They were divided into control and combined treatment groups ( n = 88/group) according to hospital registraction number. The control group was given intravenous thrombolysis with alteplase. The combined treatment group was intravenously administered alteplase for 6 hours followed by butylphthalide sodium chloride injection. The two groups were treated for 2 consecutive weeks. The National Institutes of Health Stroke Scale score, clinical efficacy, interleukin-6, tumor necrosis factor-α, and high-sensitivity C-reactive protein levels as well as the incidence of adverse drug reactions were compared between the two groups. Results:After thrombolysis, the National Institutes of Health Stroke Scale score, interleukin-6, tumor necrosis factor-α, and high-sensitivity C-reactive protein levels in the combined treatment group were (4.23 ± 1.75) points, (6.42 ± 2.05) ng/L, (13.42 ± 3.59) ng/L, and (3.17 ± 0.94) mg/L, respectively, which were significantly lower than (7.28 ± 1.93) points, (9.58 ± 2.79) ng/L, (22.28 ± 3.73) ng/L, and (5.23 ± 1.25) mg/L, respectively in the control group ( t = 10.98, 20.29, 16.06, 12.36, all P < 0.001). The total response rate in the combined treatment group was significantly higher than that in the control group [94.32% (83/88) vs. 80.68% (71/88), χ2 = 7.48, P < 0.05]. There was no significant difference in the incidence of adverse drug reactions between the combined treatment and control groups [6.82% (6/88) vs. 11.36% (10/88), χ2 = 0.01, P > 0.05]. Conclusion:Butylphthalide combined with alteplase for the early treatment of acute ischemic stroke can increase therapeutic efficacy, improve neurological function, and reduce inflammatory responses. The combined therapy has a positive clinical value in the early treatment of acute ischemic stroke.
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Objective:To investigate the relationship between serum interleukin-6 and interleukin-10 levels and clinical prognosis in patients with severe acute pancreatitis.Methods:Ninety-two patients with severe acute pancreatitis who received treatment in The Second People's Hospital of Liaocheng from August 2018 to July 2021 were included in this study. Serum interleukin (IL)-6 and IL-10 levels were detected. The Bedside Index of Severity in Acute Pancreatitis (BISAP) score was evaluated. Clinical interventions were performed. The relationship between serum IL-6 and IL-10 levels and the clinical prognosis of severe acute pancreatitis was investigated.Results:Serum IL-6 level [(103.75 ± 15.53) ng/L] was highest in patients who died. Serum IL-10 level [(97.33 ± 13.06) ng/L] was highest in patients with local complications. The highest number of patients with a prognostic outcome of death [26 (37.14%)] was found in patients with a BISAP score ≥ 3. Serum IL-6 level in patients with severe acute pancreatitis was positively correlated with the BISAP score ( r = 0.62, P < 0.05), and serum IL-6 level and BISAP score were negatively correlated with serum IL-10 level ( r = -0.57, -0.61, both P < 0.05). Conclusion:Increased or decreased serum IL-6 and IL-10 levels in patients with severe acute pancreatitis indicate that the patient's condition tends to worsen, and timely intervention according to serum IL-6 and IL-10 levels can improve the clinical prognosis of severe acute pancreatitis.
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Objective:To analyze the value of cytotoxic T lymphocyte and natural killer cell levels in prognosis evaluation of patients with ST-elevation myocardial infarction (STEMI).Methods:A total of 158 patients with STEMI who underwent percutaneous coronary intervention in The Second People's Hospital of Liaocheng from September 2020 to August 2021 were included in this study. The ratio of cytotoxic T lymphocytes to natural killer cells was measured immediately after admission and 48 hours after surgery. These patients were followed up for 1 month after treatment. They were divided into the adverse cardiovascular event group (occurrence group) and no adverse cardiovascular event group (non-occurrence group) according to the occurrence of cardiovascular adverse events. The influential factors of the prognosis of STEMI and the correlation between the influential factors and STEMI were analyzed.Results:Among 158 patients with STEMI, 27 patients had adverse cardiovascular events, accounting for 17.09%. There were significant differences in systolic blood pressure, left ventricular ejection fraction, and low-density lipoprotein levels between the occurrence and non-occurrence groups ( t = 2.82, 4.27, 2.32, all P < 0.05). At 48 hours after surgery, the levels of cytotoxic T lymphocytes [(22.75 ± 8.39)%, (29.23 ± 4.61)%] and natural killer cells [(13.73 ± 4.64)%, (20.64 ± 4.52)%] in the peripheral blood in the occurrence and non-occurrence groups were significantly decreased compared with before surgery [ t = -5.05, -83.68, -142.71, -7 084.80, all P < 0.001]. Before and 48 hours after surgery, the levels of cytotoxic T lymphocytes [(27.47 ± 3.35)%, (22.75 ± 8.39)%] and natural killer cells [(21.42 ± 4.36)%, (13.73 ± 4.64)%] in the peripheral blood in the occurrence group were significantly lower than those in the non-occurrence group ( t = 7.68, 13.10, 4.16, 5.76, all P < 0.001). Univariate analysis showed that preoperative cytotoxic T lymphocytes < 27.47%, preoperative natural killer cells < 21.42%, left ventricular ejection fraction, and low-density lipoprotein may be the risk factors that affect the prognosis of patients with STEMI ( P < 0.000, 0.012, 0.019, 0.033). Cox regression analysis showed that preoperative cytotoxic T lymphocytes < 27.47% and preoperative natural killer cells < 21.42% were independent risk factors affecting the prognosis of patients with STEMI (both P < 0.001). Conclusion:Reduced levels of baseline cytotoxic T lymphocytes and natural killer cells in patients with STEMI suggest an increased risk of poor prognosis.
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Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.
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Objective:To investigate the effect of oxygen-driven aerosol inhalation of anti-asthmatic drugs in the treatment of elderly patients with chronic bronchitis and its influence on the quality of life.Methods:From January 2015 to January 2018, 68 elderly patients with chronic bronchitis in Zhejiang Xin'an International Hospital were randomly selected and divided into control group and observation group according to different treatment methods, with 34 cases in each group.The control group was given anti-infective, relieving cough and asthma, ultrasonic atomized inhalation and other treatments, meanwhile oral health education and routine care were also given.The observation group was implemented oxygen-driven aerosol inhalation of anti-asthmatic drugs based on the control group.The phlegm quantity of the two groups was recorded on the 1st, 2nd, 3rd, 4th and 5th day of treatment.The respiratory rate, heart rate and SpO 2 were measured during the treatment period.The improvements of clinical symptoms and signs were compared.The anxiety, depressive symptoms, treatment adherence, subjective well-being and quality of life of the two groups before and after intervention were evaluated. Results:The amount of sputum in the observation group was significantly higher than that in the control group on day 1, 2 and 3[(18.53±2.96)mL vs.(15.42±2.72)mL, (27.69±7.22)mL vs.(21.52±4.58)mL, (36.11±5.24)mL vs.(25.48±4.57)mL] ( t=4.511, 4.208, 8.915, P=0.000, 0.000, 0.000). At the 4th day after treatment, the amount of sputum had no statistically significant difference between the two groups ( t=0.013, P=0.989). At the 5th day after treatment, the amount of sputum in the observation group was significantly less than that in the control group[(26.62±4.47)mL vs.(33.11±8.74)mL]( t=3.855, P=0.000). The respiratory rate and heart rate had no statistically significant differences between the two groups during treatment (all P>0.05). The SpO 2 level in the observation group was significantly lower than that in the control group[(92.00±3.00)% vs.(95.00±2.00)%]( t=4.852, P=0.000). The cough improvement time, dyspnea relief time and the improvement time of lung wet snoring sound in the observation group were significantly shorter than those in the control group[(2.88±0.55)d vs.(3.91±0.74)d, (3.17±0.62)d vs.(3.96±0.75)d, (3.63±0.61)d vs.(4.08±0.76)d]( t=6.514, 4.734, 2.693, P=0.000, 0.000, 0.001). The treatment adherence and quality of life scores of the two groups after intervention were significantly higher than before intervention (control group: t=7.226, P=0.000; observation group: t=18.073, P=0.000). The scores of treatment adherence and quality of life in the observation group were (93.58±6.25)points and (89.63±9.88)points, which were significantly higher than those in the control group [(82.15±6.33points and (78.93±10.22)points] ( t=7.492, 4.389, P=0.000, 0.000). The subjective well-being scores of the two groups after intervention were significantly lower than before intervention (control group: t=10.338, 4.474, P=0.000, 0.000; observation group: t=16.354, 8.939, P=0.000, 0.000), the decline of the observation group was more significant compared with the control group ( t=13.936, P=0.000). Conclusion:Oxygen-driven aerosol inhalation of anti-asthmatic drugs has good antispasmodic and antitussive effect in the treatment of elderly patients with chronic bronchitis.At the same time, oxygen inhalation can be guaranteed to increase the oxygen partial pressure, accelerate the patients’ condition, stabilize the patients’ mood and improve the patients’ self-confidence, thereby improving its treatment compliance, better control the disease to improve their quality of life and happiness.
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Objective:To investigate the clinical effects of perforator flaps in the repair of limb defects.Methods:Anterolateral thigh perforator flap (ALTP), deep inferior epigastric perforator flap (DIEP), posterior in- terosseous artery perforator flap (PIAP), thoracodorsal artery perforator flap (TDAP), medial sural artery perforator flap (MSAP) and radial collateral artery perforator flap (RCAP) were used to repair 56 cases of limb wounds from Novem- ber, 2016 to October, 2018. The sizes of soft tissue defect were ranged from 1.5 cm×1.5 cm to 10.0 cm×24.0 cm, while the sizes of flap were ranged from 2.0 cm×2.0 cm to 11.0 cm×25.0 cm. The recipient sites were all sutured di- rectly. The flaps survived and wound healing were observed postoperatively. Appearance, texture, recovery of the limb function, shape and function of donor site were followed-up regularly.Results:One case of venous crisis occurred on the 3rd day after inferior epigastric artery perforator flap surgery, and survived after exploratory surgery with the necrosis in the distal part of the flap, which healed after dressing. Other 55 flaps all survived. Both recipient site and donor site healed in primary union. The color of the flaps was normal. The skins were soft, and the functions of the limbs recovered well. Only a linear scar remained in the donor area without dysfunction.Conclusion:The perforator flap surgery is reliable for limbs repair and can be promoted and applied.
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Objective To investigate the effect of potassium sodium dehydroandroandrographolide succinate injection on helper T cells in peropheral blood and the content of products of oxidative stress in patients with pulmonary infection.Methods 80 community patients with acquired pneumonia in our hospital were selected as the research subjects.They wererandomly divided into observation group and control group,40 cases in each group.The control group was treated with routine treatment of community-acquired pneumonia,patients in the observation group were given conventional treatment combined with potassium sodium dehydroandroandrographolide succinate injection.The peripheral blood T cell subsets,inflammatory cytokines and oxidative stress were compared in two groups.Results After treatment,malondialdehyde,advanced oxidation protein products of the observation group were (14.61 ± 1.65)U/L,(42.67 ± 5.62)μmol/L,respectively,which were lower than those of the control group.Glutathione peroxidase,superoxide dismutase of the observation group were (243.57 ± 33.64) μg/mL,(21.63 ± 3.78) μg/mL,respectively,which were higher than those of the control group,the differences were statistically significant(t =15.155,15.432,7.651,4.726,all P ＜ 0.05).After treatment,Thl7 of the observation group was (1.03 ± 0.15) ％,Thl7/Treg was (0.21 ± 0.03),which were lower than those of the control group,and Treg was higher than that of the control group,the differences were statistically significant (t =7.315,14.805,4.541,all P ＜0.05).The total effective rate of the observation group was 87.50％,which was significantly higher than 77.50％ of the control group (x2 =2.385,P ＜ 0.05).Conclusion Potassium sodium dehydroandroandrographolide succinate injection can contribute to the improvement of community acquired pneumonia in patients with peripheral blood T cell subpopulation structure,reduce the level of oxidative stress,improve the therapeutic effect,it is worthy of clinical application.
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Objective:To prepare ketoprofen-loaded solid lipid nanoparticles ( SLN) and evaluate the properties. Methods: The formula was optimized by orthogonal experiments with the encapsulation efficiency as the index. The optimal preparation was investiga-ted by the morphology, particle size, zeta potential and drug forms. The release property was characterized by a dialysis method and the release process was fitted. Results: The best formula was as follows: poloxamer 0. 1g, Tween-800. 2g, lecithin 0. 15g, glycerol monostearate 0. 05g and ketoprofen 50mg. The particles were spherical in shape with the encapsulation efficiency of 61. 95%, the par-ticle size was 151. 7 nm and the zeta potential was-30. 2 mV. The result of DSC indicated the drug dispersed in the lipid matrix was a-morphous and molecular state. The in-vitro release curve showed the release was rapid at the early stage and then slowed down with the accumulated amount up to (85. 11 ± 7. 62)% in 12h. The drug was released slowly from SLN with the matrix erosion. The release pro-file fitted well with a Higuchi equation. Conclusion: The solid lipid nanoparticles containing ketoprofen exhibit good quality and the preparation method is simple and feasible, therefore, it is valuable to be further studied.
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Objective:To prepare ketoprofen-loaded solid lipid nanoparticles ( SLN) and evaluate the properties. Methods: The formula was optimized by orthogonal experiments with the encapsulation efficiency as the index. The optimal preparation was investiga-ted by the morphology, particle size, zeta potential and drug forms. The release property was characterized by a dialysis method and the release process was fitted. Results: The best formula was as follows: poloxamer 0. 1g, Tween-800. 2g, lecithin 0. 15g, glycerol monostearate 0. 05g and ketoprofen 50mg. The particles were spherical in shape with the encapsulation efficiency of 61. 95%, the par-ticle size was 151. 7 nm and the zeta potential was-30. 2 mV. The result of DSC indicated the drug dispersed in the lipid matrix was a-morphous and molecular state. The in-vitro release curve showed the release was rapid at the early stage and then slowed down with the accumulated amount up to (85. 11 ± 7. 62)% in 12h. The drug was released slowly from SLN with the matrix erosion. The release pro-file fitted well with a Higuchi equation. Conclusion: The solid lipid nanoparticles containing ketoprofen exhibit good quality and the preparation method is simple and feasible, therefore, it is valuable to be further studied.
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Objective To study the expression of TrkB and c-fos in rat auditory cortex after long -term ad‐ministration of sodium salicylate and the mechanisms of salicylate ototoxiclty .Methods Normal adult rats were di‐vided into three groups :normal group without any treatment ,long -term treatment group given i .m .injections , 175 mg/kg ,twice daily at 9:00 am and 6 :00 pm for consecutive 14 days and the recovered group using the same method as the chronic group except that they were sacrificed 28 days after salicylate treatment ceased .After the de‐tection of ABR ,rats were sacrificed after deep anesthesia ,and the auditory cortexes were dissected rapidly .Real-time PCR and Western-blot were explored to detect the expression of TrkB and c-fos .Results The average ABR threshold of normal rats was 36 ± 2 .23 dB SPL .The average ABR threshold of long -term group was 41 .3 ± 3 .31 dB SPL ,which was significantly increased than normal group(P0 . 05) .The expression of c-fos mRNA(1 .24 ± 0 .09)and protein(0 .70 ± 0 .12)in the long -term group were signifi‐cantly increased ,when compared with the normal group .The c-fos mRNA(1 .23 ± 0 .04)and protein(0 .68 ± 0 .08) expression in the recovered group were also significantly increased compared with the normal group .The expression of TrkB mRNA(1 .26 ± 0 .10)and protein(1 .85 ± 0 .17)in the long -term group were significantly increased ,when compared with the normal group .The TrkB mRNA(1 .23 ± 0 .07)and protein(1 .80 ± 0 .08)expression in the recov‐ered group were also significantly increased compared with the normal group .Conclusion The inereased expression of c-fos in the long -term group may be related to the enhancement of central auditory function .The inereased ex‐pression of Trk-B in the long -term group might be involved in instability of synaptic plasticity in tinnitus .
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Objective To explore the correlation of the indoor carbon monoxide concentration and chronic diseases by monitoring the indoor carbon monoxide concentration timely.Methods Collected the data of non-traumatic patients(n=80)from July 201 1 to January 2014,and assigned them into the experiment group with carbon monoxide concentration measured and the control group without measured.All the subjects were further divided into one group with complaint of carbon monoxide poisoning and the other one without.For patients exposed to high concentration of carbon monoxide,carboxyhemoglobin was also measured and APACHEⅡ was scaled,and the relationship between them was analyzed.The confirmation and misdiagnosis rate of carbon monoxide poison-ing were calculated.For the patients with acute exacerbation of chronic diseases like chronic cardiac failure,chronic obstructive pul-monary disease,cerebral infarction induced by carbon monoxide poisoning,BNP,CAT and NIHSS were documented on admission and during follow-up with removal of carbon monoxide exposure and compared respectively.Results The relationship between blood carboxyhemoglobin,APACHEⅡ scores on admission and indoor carbon monoxide concentration was linear,and obviously positive.Between the experiment group(n=40)and the control group(n=40),there was significant difference(P <0.05)in confirma-tion rate and misdiagnosis rate with 80.00% vs.55.00% and 6.25% vs.81.80% respectively.For the 54 patients with carbon monoxide poisoning diagnosed,the changes between before and after removal of carbon monoxide exposure of the CAT scores of chronic obstructive pulmonary disease and NIHSS score of CI disease and myoglobin,troponin I,creatine kinase isoenzyme,BNP for chronic cardiac failure were significantly different(P <0.01).Conclusion The indoor carbon monoxide concentration may indicate the severity of carbon monoxide poi-soning,which could increase the confirmation rate of carbon monoxide poisoning,and reduce the misdiagnosis rate.It is helpful to identify carbon monoxide exposure,the common inducing factor,so as to improve the patients′clinical symptoms.
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Objective To analyze the correlative factors of tracheal stenosis after percutaneous tracheostomy,and to explore its contermeasures.Methods Two hundreds and eighty-six patients from February 2006 to June 2012 with percutaneous tracheostomy were selected.Five correlative factors including machinery ventilation time after operation,airway infection repeatedly,irrational use of ghcocorticoid,high position of tracheotomy and operation improper method were analyzed through Logistic regression analysis.Results Tracheal stenosis occurred in 43 cases,and the incidence rate was 15.03％ (43/286).Multivariable analysis results showed that machinery ventilation time after operation for too long (x2 =21.76,P ＜ 0.01),airway infection repeatedly (x2 =18.21,P ＜ 0.01),irrational use of glucocorticoid (x2 =9.65,P ＜ 0.01),high position of tracheotomy (x2 =4.51,P ＜ 0.05) and operation improper method (x2 =4.33,P ＜ 0.05) were associated with postoperative concurrent tracheal stenosis.Conclusions There are many factors coreelate to tracheal stenosis after percutaneous tracheostomy,in which the machinery ventilation time after operation and airway infection repeatedly are the main reasons,and irrational use of glucocorticoid,high position of tracheotomy and operation improper method are secondary causes.
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Objective To observe the change of peripheral blood Th17 cells and relationship between the severity and Th17 cells in patients with acute asthma.Methods We recruited patients with mild acute asthma(n=10) and severe acute asthma(n=10), and healthy volunteers(n=10). T-lymphocytes were collected from the peripheral blood mononuclear cells (PBMC). Flow cytometer (FCM) was used to detect the expression of peripheral blood Th17 cells. IL-17 levels in the peripheral blood were measured by enzyme-linked immunosorbentassay (ELISA).Results The rate of positive Th17 cells of peripheral blood in the severe acute asthma group was higher than that in the mild acute asthma group(P＜0.05) and the rate of positive Th17 cells of peripheral blood in healthy volunteer group were the lowest among all groups (P＜0.05, respectively). The level of IL-17 in the peripheral blood of patients with severe acute asthma increased significantly compared with that in patients with mild acute asthma and healthy volunteers (P＜0.05). The positive Th17 cells of peripheral blood in patients with acute asthma were positively correlated with the severity of acute asthma(r=0.869, P＜0.05).Conclusion The positive rate of Th17 cells in the peripheral blood increases in patients with acute asthma and has positive correlation with the severity of acute asthma.
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Objective To determine the clinical characteristic, main treatment, and prognosis for the sake of more effective treatments for critically ill patients with H1N1 influenza. Methods Eight critically ill patients with H1N1 influenza in intensive care unit were retrospectively studied, including clinical characteristics, indexex of correlation, and prognosis. Results The acute physiology and chronic health evaluationⅡ score was 19.0±7.8. Five patients died, 4 of whom were caused by respiratory failure. The number of platelets in dead patient was lower than that in healing and improved ones(χ2=8.000,P＜0.05).All the 4 patients treated with glucocorticoid died, 5 out of the 6 patients received invasive mechanical ventilation rather than noninvasive mechanical ventilation, and 3 of them who complicated barotraumas in the lung died at last. Conclusion Critically ill patients with H1N1 influenza have high mortality. Respiratory failure is the main cause of death. Critically ill patients with H1N1 influenza should not be treated with glucocorticoid. Patients who need mechanical ventilation should be treated with invasive mechanical ventilation with low tidal volume and low positive end-expiratory pressure.
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Purpose:To study the significance of p53 protein, p53mRNA, and C erbB 2 protein expressions in Africa endemic and AIDS related Kaposi's sarcoma (KS).Methods:Immunohistochemistry and hybridization in situ were performed with p53 and C erbB 2 in 30 cases with endemic and AIDS related KS.The degree of pasitivity of p53 and C erbB 2 in KS tissues were measured with image analysis system. KS was classified into three types, i.e., angiomatous type, spindle cell type, and mixed type according to the proportion of blood vessel components and spindle cells in the lesions.Results:The degree of positivity of p53 protein was stronger in spindle cell type than that in angiomatous type ( P
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OBJECTIVE:To establish HPLC method for determination of the content of paeoniflorin in Weile capsules.M_ ETHODS:Paeoniflorin was separated on Hypersil C 18 column by using acetonitrile-0.1%phosphoric acid(18∶32)as mobile phase and230nm as UV detection wavelength.RESULTS:There was a good linear relationship between the concentration of paeoniflorin and absorption area value in range of0.25?g～2.5?g.The average recovery was97.9%(RSD=1.09%,n=5). CONCLUSION:The method is highly reproducible and accurate.