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ObjectiveTo observe the clinical effect of Qingxin Zishen decoction on hot flashes after endocrine therapy for prostate cancer and explore its therapeutic mechanism. MethodA total of 60 patients who met the criteria and were admitted to Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 were collected and randomly divided into a treatment group and a control group， with 30 cases in each group. The treatment group was treated with Qingxin Zishen decoction， while the control group was only given routine nursing. The observation period of this study was eight weeks. The improvement of hot flash frequency， hot flash degree， hot flash score， ISS score， and TCM syndrome score were observed in the two groups before and after treatment. The changes of serum endothelin-1 （ET-1）， nitric oxide （NO）， calcitonin gene-related peptide （CGRP）， prostate specific antigen （PSA）， and testosterone were detected. ResultIn terms of efficacy， after treatment， the frequency， degree， and score of hot flashes， ISS score， and TCM syndrome score decreased in the treatment group （P<0.05）. Compared with the control group， all indicators were better in the treatment group （P<0.05）. In terms of laboratory indicators， after treatment， the serum NO level in the treatment group was increased. ET-1 level was decreased. The ratio of ET-1/NO was decreased， and the CGRP level was decreased （P<0.05）. However， testosterone and PSA levels were not significantly changed . Compared with the control group， after treatment， the serum NO level in the treatment group was higher， and the level of ET-1 was lower. The ratio of ET-1/NO and the CGRP level were lower （P<0.05）. There were no significant differences in testosterone and PSA levels between the two groups. ConclusionQingxin Zishen decoction can significantly improve hot flashes in patients with prostate cancer after endocrine therapy. The mechanism of Qingxin Zishen decoction may be to improve the vasomotor function by regulating the expression level of vasomotor factors， so as to treat hot flashes.
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Dizziness or vertigo is a common clinical symptom, and its underlying etiology is complex. Many clinicians are confused about its diagnosis and treatment. This article presents a case about chronic vestibular syndrome. And case appreciation and academic discussion are conducted by well-known domestic neurologists and otologists, so as to provide a good thinking model and basic ideas for the diagnosis and treatment of dizziness or vertigo, hoping to further improve the diagnosis and treatment level among clinicians.
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Humans , Dizziness/therapy , Vertigo/etiology , Vestibular Diseases/complications , OtolaryngologistsABSTRACT
Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.
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Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.
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Clinical microbiology examination technology experiment is an important part of clinical microbiology examination technology teaching. In the experimental teaching of clinical microbiology examination technology, the virtual simulation technology was combined with traditional teaching to give full play to the advantages of the virtual experimental platform. As to experimental projects that couldn't be carried out in traditional teaching and some important experimental projects, students could learn on the virtual experimental platform, and after learning, they would participate in the corresponding assessment. The perfect combination of the two can solve the problem of high experimental cost and limited experimental content in the current experimental class, make up for the shortcomings of traditional teaching, realize the sharing of teaching resources. Besides, it can strengthen the students' experimental operation skills and enhance the interest of learning for cultivation of application-oriented medical talents.
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Objective@#To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions.@*Methods@#In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization.@*Results@#The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30).@*Conclusion@#Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.
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The new training standards of medical laboratory technology demand the graduates of medical laboratory technology should have the basic scientific research ability and quality. In order to com-plete the teaching work better and achieve the above training objectives, the members of the research group have made some attempts, adopting PBL, CBL and other teaching methods in theoretical teaching, develop-ing open experiments and comprehensive design experiments in experimental teaching, organizing students to study extracurricular undergraduate subject in spare time, in order to provide some basis for the training of students majoring in medical laboratory technology.
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Objective:To observe and analyze the therapeutic effect and safety of tirofiban combined large dose statin in patients with acute myocardial infarction (AMI),and evaluate its influence on myocardial perfusion and cardiac function.Methods:A total of 97 consecutive AMI patients visited to our hospital from May 2011 to January 2013, who were beyond the emergency PCI time window (≥12h),their chest pain was remissive or not further aggravated were studied.All patients were pumped with tirofiban for 48h continuously;according to combined rosuvastatin dose,they were divided into large dose group (n = 52,20mg,once/d,until one month after infarction,then changed to routine dose of 10mg,once/d)and routine dose group (n=45,10mg,once/d).All patients received se-lective PCI after 7 ~ 10d conservative treatment.Myocardial perfusion level,left ventricular ejection fraction (LVEF)on one week after PCI and 30d after AMI,enzymology changes [creatine (CK),lactate dehydrogenase (LDH)]and major adverse cardiovascular events (MACE)during hospitalization were compared between two groups.Results:Compared with routine dose group,there were significant reductions in thrombus scores in infarct related artery (IRA)[(1.32±1.01)scores vs.(0.81±0.78)scores]and corrected TIMI frame [(32.4±4.73)vs. (26.8±2.34)]in large dose group (P =0.021,P 0.05).There was no MACE in both groups during hospitalization and 30d after PCI.Conclusion:Tirofiban combined large dose statin is safe and effective in patients with acute myocardial infarction,it can reduce intra-coronary thrombus burden,im-prove myocardial tissue perfusion and cardiac function without increasing MACE.
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OBJECTIVE To investigate the prevalence of DHA AmpC ?-lactamases mediated by plasmid in Klebsiella pneumoniae in China.METHODS Antimicrobial susceptibility test was conducted by the methods of double agar dilution and ESBLs confirmatory in K-B method according to the criteria of guidelines of CLSI.AmpC ?-lactamases were detected on the basis that AmpC ?-lactamases could be inhibited by 3-aminophenylboronic acid(APB).Gene chip technology and PCR were used to detect ESBLs and AmpC gene.RESULTS Among total 34 isolates of K.pneumoniae 32(94.1%) produced AmpC ?-lactamases and ESBLs.The most common(38.3%) were types DHA and TEM and SHV.MIC50 and MIC90 of all strains to all tested antimicrobial agents were lower than 34 strains tested 0.25?g/ml and 0.5?g/ml.Fourteen strains AmpC and ESBLs were conjugated successfully.CONCLUSIONS DHA AmpC ?-lactamases mediated by plasmid are the most common in K.pneumoniae in General Hospital of PLA of China.The most common(38.3%) are types DHA and TEM and SHV.Fourteen(41.2%) strains can be spreaded by plasmid.
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Objective To study the clinical therapeutic effect of Yifumin Capsule in treating type 2 diabetic insulin resistance and its effect on relevance indexes.Methods Two hundred and forty cases of type 2 diabetic insulin resistance with deficiency of qi-yin and stagnation of phlegm and toxin were divided randomly into two groups,120 cases in each group.The treatment group was given orally Yifumin Capsule,and the control group was given orally pioglitazone.The treatment course of the two groups was 12 weeks.Clinical symptoms,blood glucose,blood lipid,CRP,ISI,FINS,HOMA-IR,liver and kidney function were detected respectively.Results Chinese medicine symptoms and signs were all improved.The total effective rate of clinical effect was 88.1% in treatment group and 52.9% in control group.The clinical therapeutic effect of the treatment group was obviously better than the control group.Both groups had a notable seducement in HOMA-IR,FINS,FPG,2 h PG,HbA1c,TG and LDL-C with an obviously improvement in ISI after the treatment.Compared with the control group,the treatment group had a significant decrease in TC and CRP with notable difference.Conclusion Yifumin Capsule can effectively improve the insulin resistance of type 2 diabetic patients.
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Objective To explore the Activation function of the bifidobacterium adolescence cell wall(BCW)on macrophage in abdominal cavity of mice and tumor-inhibition of BCW on human transitional cell carcinoma of bladder(BTCC)in vitro.Methods ①Twenty KM mice were randomly divided into two groups:control group(n=10)and BCW injection group(n=10).BCW was distilled by ultrasonic cell disintegrator.Then the BCW was injected into abdominal cavity of the BCW injection group mice,physiological saline was injected into the control group mice,then all the mice were killled,macrophage in abdominal cavity was collected under the condition of asepsis,the level of IL-2 and IFN-? which produced by macrophage was determined by ELISA reagent box;②The role of tumor-inhibition of BCW on human transitional cell carcinoma of bladder(BTCC,T24)in vitro was determined by MTT method:The cell of T24 in the stage of logarithmic growth was digested,inoculated in cell raise board,cultivated after 24 hours,different concentration of BCW were added into each hole,cultivated continually,replaced nutrient fluid on 1th day,3th day,5th day,MTT was added into each hole too,cultivated continually,DMSO was added into each hole,vibrated,shaked up,determined the A value at 490nm by ELIASA,calculated the tumor-inhibition rate;Observed the growth state under microscope:The cell of T24 in the stage of logarithmic growth was inoculated in cell raise board that comprise microscope slides,cultivated after 24 hours,BCW were added into each hole,cultivated continually,took out two slides after 24 hours,72 hours,120 hours,stained,observed the change of the shape of T24 under microscope,changed the culture liquid only on control group.each time.Results The level of IL-2 and IFN-? of BCW injection group was higher than of control group(P
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Objective To explore the immunologic regulation of the bifidobacterium adolescence cell wall(BCW) on function of macrophage in mice and tumor inhibition of BCW on human transitional cell carcinoma of bladder(BTCC) outside of body.Methods BCW wereinjected into abdomen of KM mice,the level of IL-1,IL12 and TNF-?which produced by macrophage was determined by ELISA reagent box.The role of tumor inhibition was determined by MTT method.Results The level of IL-1,IL12 and TNF-?of BCW injection group was higher than of control group(P