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<p><b>OBJECTIVE</b>To evaluate the efficacy of ropivacaine injection at the acupoints Hegu and Sanyinjiao for labor analgesia and its effects on cortisol level in parturients.</p><p><b>METHODS</b>A total of 120 ASA class I-II nulliparous women undergoing spontaneous term labor (37 to 41 weeks of gestation) with a live, singleton fetus in the occiput anterior position and requiring labor analgesia with acupuncture were enrolled in this study. These women were randomized into study group and control group and received injections of 1 mL of 0.2% ropivacaine and normal saline, respectively, at each of the acupoints of bilateral Sanyinjiao and Hegu in the first stage of labor. The Visual Analogue Scale (VAS) before and at 30, 60 and 120 min after analgesia, the time of labor, delivery outcome and cortisol levels were compared between the two groups.</p><p><b>RESULTS</b>The VAS was significantly lower in the study group than in the control group (P<0.05). At 120 min after injections of ropivacaine or saline, serum cortisol level was significantly higher in the control group than in the study group (P<0.05). The rates of cesarean section and instrumental delivery and the time of labor were all similar between the two groups (P>0.05).</p><p><b>CONCLUSION</b>Ropivacaine injection at Hegu and Sanyinjiao is effective for labor analgesia and does not prolong the process of labor or increase the rates of cesarean section or instrumental delivery.</p>
ABSTRACT
<p><b>BACKGROUND</b>Diabetes mellitus (DM) remains a major health problem worldwide. Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM. This study aimed to evaluate the efficacy of Jinlida (JLD) granule, a Chinese herbal recipe, in the treatment of impaired glucose tolerance (IGT) and its effect on the prevention of DM.</p><p><b>METHODS</b>Sixty-five IGT patients were randomized to receive one bag of JLD granules three times daily (JLD group, n = 34) or no drug intervention (control group, n = 31) for 12 weeks. Oral glucose tolerance test, glycated hemoglobin A1c (HbA1c), body mass index, blood lipids levels, fasting insulin, and insulin resistance calculated using homeostatic model assessment (HOMA-IR) of all the patients were observed and compared before and after the treatment.</p><p><b>RESULTS</b>Sixty-one participants completed the trial (32 in JLD group and 29 in the control group). There were statistically significant decreases in HbA1c (P < 0.001), 2-h plasma glucose (P < 0.001), and HOMA-IR (P = 0.029) in JLD group compared with the control group after 12 weeks of treatment. After 12 weeks of treatment, two (6.9%) patients returned to normal blood glucose, and five (17.2%) patients turned into DM in control group, while in the JLD group, 14 (43.8%) returned to normal blood glucose and 2 (6.2%) turned into DM. There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups (P = 0.001).</p><p><b>CONCLUSIONS</b>JLD granule effectively improved glucose control, increased the conversion of IGT to normal glucose, and improved the insulin resistance in patients with IGT. This Chinese herbal medicine may have a clinical value for IGT.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Blood Glucose , Body Mass Index , Drugs, Chinese Herbal , Therapeutic Uses , Glucose Intolerance , Blood , Drug Therapy , Glucose Tolerance Test , Glycated Hemoglobin , Metabolism , Hypoglycemic Agents , Therapeutic Uses , Insulin , Blood , Insulin ResistanceABSTRACT
Objective To improve the diagnosis and therapy level of the uterine intravenous eiomyomatosis, we reported one case involving the right heart and reviewed the relative literatures.Methods and results The patient is 38 years old, she was admitted to hospital with fever, abdominal pain and chest tightness for one week in July 2010. She had a total hysterectomy owing to hysteromyoma in 2003. In July 2010, because she wanted a baby with the method of surrogate pregnancy, so she was injected medicine to stimulate follicle growth in the USA. The medicine was Li ShenBao injection, the total of 12d daily 3 branch (dose not stated). Afterward she couldn't stand fever, abdominal distension and chest tightness, she returned to China for treatment. After she was hospitalized, for diagnosis she got many image examination done, such as B-scan, CT, MRI and PET/CT. Result All image examination found that a massive solid and cystic tumor in the abdominal and pelvic cavity, left kidney hydrocele, ascites, and tumor embolus in the right atrium, inferior caval vein, left renal vein, also bilateral iliac vein. The thoracic-abdominal surgery was carried out, massive tumor was removed, also the tumor embolus in the right atrium and inferior caval vein. The pathological diagnosis was uterine intravenous leiomyomatosis. Conclusion Uterine intravenous leiomyomatosis is a rare disease, involving to heart case is seldomness. In recent years, the case increasing could be related with the usage count of sex hormone in Assisted Reproductive Technology. The imaging examination can give a confident diagnosis, and the final diagnosis depend on pathology. For treatment, surgery is the first choice, and must be thorough to prevent recurrence.
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Objective: To observe the ultrasound characteristics of galactostasis at various physiological stages, so as to improve the diagnosis of galactostasis. Methods: The ultrasound data of 56 patients with galactostasis were retrospectively analyzed and the ultrasound characteristics were summarized. The ultrasonic manifestations of different physiological stages were compared. Results: During the lactation period,there were extensive mammary duct ectasias and floating weak signals were found in the mammary duct during pure galactostasis; large non-responsive fluid areas exhibited formations of honeycomb-like multilocular fibrous septa; and these cavities ruptured with abscess when secondary infection occurred. During the later lactation period,the dilated galactophores became hypoechoic or anechoic,which,together with the dot-like echoes of residual breast milk or macular strong echoes, formed mixed signals of retention cysts. After menopause, the galactophores atrophy occurred; the accumulation of galactostasis desiccated into patches or powder, which caused thick hyperechoic dots or multiple hyperechoic streaks in the galactophores or parenchyma. Conclusion: Ultrasonic images of galactostasis vary with the physiological and pathological changes of the mammary glands, and are related to the duration of galactostasis, absorption, concentration and desiccation of lactation.
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Objective: To observe the echocardiography characteristics of patients with coronary heart disease (CHD), and to discuss the diagnostic value of their echocardiography for CHD. Methods: From Jan. 2002 to Dec. 2006, a total of 276 patients with suspected CHD were examined by echocardiography; 190 patients also underwent coronary arteriography (CA) and 85 of them served as controls. The consistence between echocardiography results and CA results was analyzed. The abnormal echocardiography manifestations of the rest 105 patients were analyzed based on the stenoses and occlusion degrees revealed by CA. Results: The diagnostic consistent rate of routine echocardiographic examination was 90.6% compared with that of CA. The false positive and negative rates were both 4.7%. The echocardiographic features of CHD included the reduction of left ventricular diastolic function (74.4%), the left ventricle enlargement (23.2%), the left atrium enlargement (16.3%), and the reduction of left ventricular systolic function (9.3%). The echocardiographic features of coronary artery stenosis and occlusion included the reduction of left ventricular diastolic function (92.3%), the left ventricle enlargement (9.5%), the reduction of left ventricular systolic function (8.57%), and the reduction of E/A ratio. More diseased branches was associated with lower E/A ratio. The E/A ratios of patients with 1, 2, 3 and 4 diseased branches were 0.78, 0.66, 0.64 and 0.61, respectively; the difference of E/A ratios of different groups was significantly different (P<0.05). Conclusion: Routine echocardiographic examination has a high consistent rate with CA in diagnosis of CHD, and it is suitable for popularizing in grass-root hospitals. Reduction of left ventricular diastolic function is the main echocardiographic feature of CHD, and more attention should be paid on related parameters, but the influence of arrhythmia and other factors should be ruled out.