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In this study, the evidence mapping methodology was used to systematically retrieve and sort out the clinical research evidence of Chinese patent medicines in the treatment of tension-type headache(TTH), and to understand the distribution of evidence in this field and the basis and quality of evidence. Chinese and English articles on the 28 Chinese patent medicines for TTH, which were recorded in National Essential Medicines List(2018), Medicine Catalogue for National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance(2020), and Chinese Pharmacopoeia(2020), were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, China Biology Medicine disc(CBMdisc), PubMed, EMbase, and Cochrane Library from the establishment to June 2021, followed by descriptive analysis. Then, tables and bubble charts were plotted to analyze the distribution characteristics of evidence. A total of 129 eligible articles were yielded: 126 randomized/non-randomized controlled trials, and 3 systematic reviews. The functions, indications, and composition of the 28 medicines, as well as the proportion of related articles, publication trends, intervention measures, and outcome indicators were compared and analyzed. The results showed that the 28 Chinese patent medicines, composed of 128 Chinese medicinals, can be classified into six categories in terms of function: reinforcing healthy Qi, tranquilizing mind, dispelling stasis, regulating Qi, treating wind, and resuscitating. There are ongoing efforts to study the treatment of TTH with Chinese patent medicine in China, despite of little evidence. The clinical positioning of Chinese patent medicine for TTH is not clear, and clinical research fails to highlight the advantages of Chinese medicine. In addition, the outcome indicators have not been standardized and unified, and there is a lack of evidence on the long-term efficacy of Chinese patent medicine for TTH. This study is the first exploratory application of evidence maps to compare the characteristics and clinical research progress of 28 Chinese patent medicines for TTH, which can provide a reference for research on the optimization of Chinese medicine strategies for TTH.
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Female , Humans , Pregnancy , Asian People , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Medicine, East Asian Traditional , Nonprescription Drugs , Tension-Type HeadacheABSTRACT
Object To develop an easy-assembled and-disassembled image diagnostic module to solve the problems of the tent-form field medical system in size, weight, mobility, accessories, protection and etc, which is of high references for combination and integration scheme of large-scale digital imaging equipment by adopting box instrumentation.Methods The module had its design executed with system modeling, structure simulation and CAD after its service requirements were analyzed. The design fell into the ones for overall framework, combination mode, packaging and buffer vibration isolation, ergonomics, box instrumentation, radiography accessories for vertical and horizontal positions, protection device and etc.Results The module was gifted with radiodiagnosis-related performances such as digital radiography, digital diagnosis,diagnosis reporting, compatibility to vertical- and horizontal- position radiography, and radiation protection during war conditions.Conclusion The module developed gains advantages in power, continuous radiography, assembling and disassembling, accessories and protection, and thus meets the requirements of the tent-form field medical system in mass casualties imaging diagnosis.
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Object To design a casualty sorting unit with chest integrated with table in the tent-form field medical system.Methods The unit was designed with virtual prototype simulation and CAD, which took considerations on the service orientation, the types and quantity of equipment and devices as well as the requirements for packaging box's size and dimensions of the tent-form field medical system.Results The unit had a size of 1795 mm ×600 mm ×600 mm when deployed, and could be used as the field diagnostic and treatment table; the size was 800 mm ×600 mm ×600 mm when withdrawn, when the module met the requirements of the tent-form field medical system for the packaging box and could be used to hold valuable devices such as color Doppler ultrasound and ECG machine. Finite element simulation and check verified that the module had shape and stress changes due to austere force satisfy the desired requirements.Conclusion The unit gains advantages in deployment and withdrawal, materials, mechanical structure and ergonomics-based operation, accords with the requirements for modularity and multi function integrated into one decice, and enhances the efficiency of casualty sorting in the tent-form field medical system.
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Object To design a mobile class 1000 laminar flow clean field surgery unit to provide a clean space to facilitate the mobile medical rescue team to execute emergency operations in the field tent, private house and etc.Methods The principle of positive pressure isolation and finite element simulation were involved in the design of two-way air intake channel on the top, flexible isolation laminar flow clean module which could be constructed rapidly, three-stage composite clean air supply module and integrated surgery module with box instrumentation.Results The field surgery unit had all its performances meet the desired requirements, of which, the ventilation rate was 24 times per hour, the relative positive atmospheric pressure value was higher than 5 Pa in the surgical unit, and the cleanness reached level 6 at the operating and surrounding areas.Conclusion The field surgical unit can be deployed rapidly, and has the key indexes accord with the desired requirements for cleanness, ventilation rate and positive pressure difference, and thus can be used for the surgery support of the mobile medical rescue team during wartime operations and emergency medical rescue.
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Object To develop a box-type medical operation module based on analyses on missions and equipment requirements of the commanding group in the medical service facilities so as to facilitate the organization, coordination and information acquisition in the tent-form field medical system.Methods The medical operation module was designed with the analyses on the service orientation of medical commanding and operation as well as the requirements for functions and technical indexes, the thoughts and technical forms of modularization, integration and vibration isolation, and the methods of system modeling, structural simulation and CAD.Results The medical operation module was gifted with the functions of medical operation, communication, broadcasting, network and etc, and gained advantages in box instrumentation, multi-function eqipment, easy deployment, withdrawal, transport and storage.Conclusion The medical operation module behaves well in structure, multi function, layout and operation, and thus can be used for medical commanding in the tent-form field medical system.
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Objective To design a multi-function first-aid module integrating instruments with the box to solve the existing problems in integration, operation, deployment, withdrawal, environmental adaptability and etc, so as to realize integrated storage, transport and operation of the instruments. Methods The module had its structure, modes of deployment and withdrawal, instruments buffering and vibration isolation, ergonomics and etc designed with the technologies of integrating box and instruments, integration, buffering and vibration isolation, centralized oxygen and power supply as well as the methods of system modeling,structure simulation and CAD.Results The first-aid module was gifted with the functions of respiratory and circulatory rehabilitation,vital signs monitoring,emergency treatment of complex and multi injuries, which could be used as a 2 000 mm×800 mm×600 mm emergency treatment platform when deployed. There were 4 angles for adjusting the backboard to form anti-shock positions for the severe casualties.The module had the time for deployment and withdrawal not more than 5 min,and was easy to deploy,withdraw,transport and store.Conclusion The module behaves well in structure,function,layout,operation and military service when used for the treatment of the severe casualties in the tent-form field medical system,which contributes to enhancing the casualty treatment efficiency and prognosis.[Chinese Medi-cal Equipment Journal,2018,39(5):12-16]
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Objective To develop a set of field tent hospital system to further enhance campaign-level medical support service. Methods The system had its service orientation, functional requirements, component unit and modular elements determined with system analysis. The technical architecture was realized with tent combined with boxes, and the system modules were designed with the method of integrated box and instruments.Results The system had its design executed from the aspects of layout,composition of grid tent,medical functional units,support unit and packaging unit,which was applied in a series of military medical support operations in foreign countries and China as well as in the construction of national medical emergency rescue forces. Conclusion The system gains advantages in modularity, integration, completing, informatization and standardization,and thus greatly enhances the military medical support ability and national emergency medical rescue ability in China.[Chinese Medical Equipment Journal,2018,39(5):1-6,16]
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Objective To design a whole process management information system of the field medical equipment.Methods According to the problems found in the management of medical equipment, the functional requirements of different user systems were determined.The system was developed with combined Java and C languages,Eclipse and Visual Studio 2012, and was connected into military integrated information network according to security requirements.Results By applying the whole process management system of the field medical equipment, all process data could be managed from purchasing, warehousing,distribution,use,maintenance,R&D and so on.Conclusion By applying this system,the management of the field medical equipment is improved, functional requirements are met of all levels of health equipment management, the platform for data sharing among relevant departments is set up,and the static mode is transformed into a real-time,dynamic and whole process one for field medical equipment management.
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Objective To investigate the effect of acute normovolemic hemodilution (ANH) combined with controlled hypotension (CH) on the extravascular lung water (EVLW) and oxygenation in elderly orthopaedic surgery patients.Methods Forty-five elderly orthopaedics surgery patients,23 males,22 females,aged 65-75 years old,ASA grade Ⅰ or Ⅱ,were randomly divided into 3 groups (n=15 each).Group A,served as control,received regular routine transfusion and intraoperative crystalloid fluids and colloidal liquid to add volume.Group B,namely ANH group,received normovolemic hemodilution till Hct reaching 30% after induction of anesthesia.Group C,ANH combined with CH group,received ANH with Hct reaching 30% after induction of anesthesia,and the patients were continuously pumped nitroglycerin combined with esmolol for controlled hypotension.The target mean arterial pressure controlled and cut by 30% below the basic value.We collected arterial blood for blood gas analysis at 5 points: before before induction of anesthesia (T1),immediately after ANH (T2),30 min after ANH (T3),30 min after CH (T4),immediately after surgery (T5).Meanwhile the MAP,HR,PaO2,SpO2,Hct,HCO3-,pH,cardiac index (CI),stroke volume variation (SVV),stroke volume index (SVI),extravascular lung water index (EVLWI) and intrathoracic blood volume index (ITBVI) were recorded.Blood loss,urine output after surgery and the operation time were also recorded.Results The volumes of autoblood removed had no significant difference between group B and group C,and no autoblood was removed in group A.The volume of blood loss in group C was significantly less than that in group A and group B (P<0.05).Six cases in group A,one case in group B and none in group C needed homologous allogeneic blood transfusion.Compared with T1,MAP,HR,CI,SVI and Hct were significantly decreased at T2-T5 (P<0.05),but all those are stable in the normal range.Compared with T1,SVV was significantly decreased at T2-T4 (P<0.05).Compared with T1,ITBVI,PaO2 and SpO2 were increased at T2-T5 (P<0.05),but all those are stable in the normal range.CI and SVI at T2 in group A was significantly lower than that in group B and C.Compared with group A and B,MAP at T4 in group C were significantly decreased and SVV at T4 in group C were significantly increased(P<0.05).Urine output,the operation time,EVLWI,HCO3-and pH in three groups had no significant difference.Conclusion Acute normovolemic hemodilution combined with controlled hypotension has an effect of saving blood in elderly patients,without any influence on the extravascular lung water and oxygenation,which can be used safely in elderly patients which they are monitored.
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Objective To explore the genetic variation in children patients with esophageal atresia (EA ) to provide a prophase basis for further studying EA pathogenesis .Methods Ten children cases of EA were collected from the neonatal surgery department of our hospital .The high-throughput whole-exon sequencing was used to study the genetic variations ,and their clinical significance was analyzed by the bioinformatics methods .Results In the high quality sequencing data ,the effective clean reads accounted for 85 .36% ,in which 97% of the clean reads could participate in the comparison with the reference genes .The comparison analysis obtained 520541 single nucleotide polymorphism sites ,in which single nucleotide variation(SNV) occurred at 149622 sites ,including synonymous mutation ,nonsynonymous mutation ,stop codon gain ,stop codon loss ,frameshift insertion ,nonframeshift insertion ,unknown mutation ;meanwhile ,598 copy number variation genes were detected .The functional cluster analysis revealed that the mutant genes were closely related to cell biology .Conclusion The SNV occurrence may influence the expression and function of body various proteins and may play an important role in EA pathogenesis .
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Intraventricular hemorrhage (IVH) is a neurological urgency with a high mortality and unfavorable prognosis. Fast removal of intraventricular blood should be considered as a priority. The current treatments of IVH mainly focus on external ventricular drain and endoscopic aspiration, but neither way can remove the blood in the fourth ventricle easily and relieve the compression of brainstem. Here we report a unique procedure to solve this problem. A 41-year-old male patient who had suffered sudden attack of headache and disturbance of consciousness for 2 h was diagnosed as having high density lesion in the whole ventricular system by computed tomographic (CT) imaging. An emergent bilateral ventriculopuncture and intraventricular hematoma removal under non-line-of-sight was performed immediately; the catheter was extended to the fourth ventricle to maximally remove the hematoma. Postoperative CT scan demonstrated total removal of IVH and no sign of extra brain damage.
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Adult , Humans , Male , Cerebral Hemorrhage , Therapeutics , Drainage , Methods , Fourth Ventricle , Hematoma , Therapeutics , Punctures , Tomography, X-Ray ComputedABSTRACT
An electrochemical sensor has been developed for the selective determination of chlortetracycline ( CTC) using the molecularly imprinted technique. A molecular imprinted polymer ( MIP) on the surface of a glassy carbon electrode ( GCE ) was prepared by electropolymerization of o-aminophenol ( OAP ) in the presence of CTC in the sodium perchlorate ( NaClO4 ) solution using cyclic voltammetry ( CV ) . The electrochemical performance of the sensor was studied by using differential pulse voltammetry ( DPV ) . A linear relationship between the peak current difference and the CTC concentration was found in the range of 2. 0×10-8-6. 1×10-7 mol/L with the detection limit of 1. 5×10-8 mol/L (3σ). After regeneration by washing with the mixture of methanol and sulfuric acid, the sensor showed excellent reproducibility and good stability. The MIP electrode exhibited almost no response to chloramphenicol and penicillin, and very weak responses to tetracycline and oxytetracycline, proving a good selectivity. Recoveries of standard addition measured in the actual samples of milk and chicken meat were between 86 . 4% -96 . 9%. Compared with the reported methods, this sensor showed a low detection limit, simple operation without derivatization, rapid response and low cost.
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<p><b>OBJECTIVE</b>To explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.</p><p><b>METHODS</b>Fifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypotensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi (LI 11), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hematoma volume and neurological deficit score were compared at different time points between the two groups.</p><p><b>RESULTS</b>(1) Blood pressure: from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [(164.3 +/- 21.6) mmHg vs (158.6 +/- 21.5) mmHg] and MAP [(113.4 +/- 4.9) mmHg vs (106.7 +/- 6.1) mmHg] were significant between the two groups (both P < 0.05). From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [(147.3 +/- 21.6) mmHg vs (158.4 +/- 23.5) mmHg, (97.2 +/- 5.3) mmHg vs (106.6 +/- 5.1) mmHg, both P < 0.05)]. (2) Hematoma volume: from the admission to 6 h after disease onset, the volume was increased by (4.15 +/- 0.73) mL in the convertional treatment group and (2.67 +/- 0.33) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). From the admission to 24 h after disease onset, it was increased by (5.57 +/- 1.26) mL in the convertional treatment group and (3.14 +/- 1.18) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). (3) Neurological deficit score: the score was increasing gradually in first 3 days after disease onset in the two groups. The score (38.39 +/- 6.84) in the acupuncture group on the first day was different significantly as compared with that (42.37 +/- 7.46) in the conventional treatment group (P < 0.05). On the 10th days, the score (24.68 +/- 5.42) in the acupuncture group was different significantly from that (29.74 +/- 7.36) in the convertional treatment group (P < 0.05).</p><p><b>CONCLUSION</b>There is no peak of blood pressure rising, and the continuous hemorrhagic volume is less in 24 h and neurological deficit score is improved in the acupuncture group. Acupuncture brings the positive significance in the treatment of cerebral hemorrhage at the early stage.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Blood Pressure , Cerebral Hemorrhage , Therapeutics , Hematoma , TherapeuticsABSTRACT
Objective To preliminarily screen the neoplastic stem cell (NSC) related surface markers combination and to under-stand the NSC distribution in hepatoblastoma(HB) .Methods The children cases of HB undergone the surgical therapy in the Jian-gxi Provincial Children′s Hospital were selected .The immunohistochemical method was adopted for observing the expression and distribution of NSC-related markers CD34 ,Thy-1 ,c-kit ,CD56 and stem cell factor(SCF) in the HB tissue and the normal hepatic tissue away from the edge of tumor tissue 3cm outside .Results Thy-1 and c-kit were sporadically distributed in the HB tissue and mainly focued on the portal area ,but did not exressed in the normal liver tissue ;the expression of CD34 and SCF in HB was signifi-cantly higher than that in the normal liver tissue(P0 .05) .Conclusion The different NSC related surface markers are distributed in the HB tissue and focus on the specific areas .The positive cells of Thy-1/c-kit expression may play a role in the HB occurrence .
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<p><b>OBJECTIVE</b>To investigate the bleeding points and the management of post-therapy nasopharyngeal carcinoma intractable epistaxis.</p><p><b>METHODS</b>The bleeding points, treatment as well as its effects were studied retrospectively in 16 cases of post-therapy nasopharyngeal carcinoma intractable epistaxis. Among them 7 cases had been treated once, 9 cases recurred and received second treatment. Nasopharynx area had received radiotherapy from 70-160 Gy. Nasopharyngeal carcinoma intractable epistaxis occurred in 1-204 months (median time 13 months) after radiotherapy.</p><p><b>RESULTS</b>The bleeding points were found in the following different sites: internal carotid artery 8 patients, the internal maxillary artery of external carotid artery 7 patients, the arteriae pharyngea ascendens of external carotid artery 1 patient. All patients were tally by oronasal packing or intranasal balloons, 9 cases were carried out emergency tracheotomy. Post-therapy nasopharyngeal carcinoma intractable epistaxis was well controlled by transcatheter internal carotid artery balloon embolization in 1 case, transcatheter maxillary artery embolization in 6 cases, external carotid artery ligation in 1 case. Voluntarily stopping bleeding in 1 case. Seven cases among internal carotid artery 8 patients died, 1 case recovery. Seven patients of the internal maxillary artery of external carotid artery and 1 patient of the arteriae pharyngea ascendens of external carotid artery was recovery. There were no complications during a followed-up for 1-3 months after treatment.</p><p><b>CONCLUSIONS</b>After determined the points of post-therapy nasopharyngeal carcinoma epistaxis by angiography mainly the key factors in treatment of epistaxis of post-therapy nasopharyngeal carcinoma were vigorous applicated intractable endovascular treatment, nasal packing and tracheostomy. Internal carotid artery bleeding of post-therapy nasopharyngeal carcinoma still have the high mortality rate at present.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angiography , Carcinoma , Embolization, Therapeutic , Epistaxis , Diagnosis , Therapeutics , Nasopharyngeal Neoplasms , Therapeutics , Retrospective Studies , TracheotomyABSTRACT
<p><b>OBJECTIVE</b>To investigate the three-dimensional reconstruction methods of the portal vein using 64-slice spiral CT data and the anatomical variation of the portal vein.</p><p><b>METHODS</b>Three-dimensional reconstruction of the portal vein was performed using Mimics software based on the 64-slice spiral CT data of 64 cases. Each model of the portal vein and its branches was evaluated according to the presentation rate, depiction quality and anatomic variation.</p><p><b>RESULTS</b>The reconstructed model showed a depiction rates of 100% for the 4-grade branches of the portal vein. The stem of the portal vein and the left and right branches of the level III or above were all displayed, but in 2 cases the superior mesenteric vein and in 1 case the spleen vein was displayed only to the level IV. Of the 64 cases, 50 (78.1%) had normal portal vein and 14 (21.9%) showed anatomical variations.</p><p><b>CONCLUSION</b>The 3D model vividly mimics the anatomic variations of the portal vein to provide valuable information for surgical plans.</p>
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Methods , Portal Vein , Diagnostic Imaging , Tomography, Spiral Computed , MethodsABSTRACT
<p><b>OBJECTIVE</b>The choice of surgical approaches for salvage surgery based on the location and invasion of recurrent and residual lesions of nasopharyngeal carcinoma (NPC), surgical results, complications, and survival were assessed.</p><p><b>METHODS</b>Thirty-seven cases with recurrent and residual lesions of NPC underwent salvage surgery between March 1991 and January 2005 were analysed retrospectively. Of 37 patients, 23 were men and 14 women, with a median age of 46.5 years (26 - 57 years); 4 were at stage I, 10 at stage II, 14 at stage III, and 9 at stage IV; 5 cases were with cervical metastasis, including 3 cases of N1 and 2 cases N2. All recurrent and residual lesions of NPC were determined by biopsy. On the location and invasion of recurrent and residual lesions of NPC, 8 cases underwent endoscopic resection of lesions, 12 cases of the palate nasopharyngectomy, 5 cases of maxillary swing, 4 cases of maxillary swing plus prerenal approach, 2 cases of lateral rhinotomy plus coronal flap approach, and 6 cases transfacial plus nasal pyramid swing approach. Five cases with cervical metastasis received neck dissection in addition to the operations for recurrent and residual lesions of NPC. Postoperatively 31 cases received radiotherapy with dosage of 60 Gy, among them 15 cases with concurrent chemoradiation therapy, and 6 cases with clear surgical margin did not received radiotherapy or chemotherapy. The cases were followed up for 12 - 72 months, with a median of 45 months.</p><p><b>RESULTS</b>Total resection for the recurrent and residual lesions of NPC accounted for 91.8% (34/37) and subtotal resection for 8.2% (3/37). The accident of perioperative complications was 24.3% (9/37). The 3- and 5-year overall disease-free survival rates (DFSR) were 62.1% and 43.3%, respectively. The 3- and 5-year overall survival rates (OSR) were 72.9% and 51.3%, respectively. The 5 year DFSR of cases at stage I-IV were 100%, 40%, 28% and 11% (χ(2) = 10.0, P < 0.01), respectively. The 5 year OSR were 100%, 70%, 35% and 28% (χ(2) = 11.5, P < 0.01), respectively.</p><p><b>CONCLUSIONS</b>Salvage surgery is a justified treatment for the recurrent and residual lesions of NPC, by which some patients with recurrent and residual lesions of NPC can be salvaged.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Nasopharyngeal Neoplasms , Pathology , General Surgery , Neoplasm Recurrence, Local , General Surgery , Neoplasm Staging , Neoplasm, Residual , Prognosis , Retrospective Studies , Salvage Therapy , MethodsABSTRACT
<p><b>OBJECTIVE</b>To study the relationship between multidrug-resistant (MDR) expression in nasopharyngeal carcinoma (NPC) and its sensitivity to chemotherapy.</p><p><b>METHODS</b>The specimens of 23 NPC cases were studied by immunohistochemistry with monoclonal antibody of P-glycoprotein (P-gp), multidrug resistance relation protein (MRP), lung-resistance related protein (LRP), topoisomerase II (Topo II), thymidylate synthase (TS), glutathione-S-transferase (GST-pi). Among them, 20 specimens were taken from primary NPC lesion which were treated with two course of cisplatin (DDP) and 5-fluorouracil (5-FU), 3 specimens were taken from cervical lymph-node of recurrent NPC patients who were treated by radical dissection.</p><p><b>RESULTS</b>Various MDR parameters were expressed differently in 22 cases except for 1 clear cell carcinoma case. The difference was statistically significant (P < 0.05). However, there were no significant difference of MDR expression either among various carcinoma pathomorphology cell groups or among different clinical stage groups. Expression of LRP and TS were found in 10 and 14 cases respectively and the chemotherapy responders rates were 20% (2/10) and 28.5% (4/14) respectively. While the chemotherapy responders rates were 70% (7/10) and 5/6 in cases without expression. There was significant difference (P < 0.001, and P < 0.05).</p><p><b>CONCLUSION</b>The NPC patients with LRP and TS expression may be less sensitive to chemotherapy with DDP + 5-FU.</p>