Clinical study of Bufei-Huayu-Tongluo Decoction and western medicine for chronic pulmonary embolism / 国际中医中药杂志

Objective:To explore the clinical effect of Bufei-Huayu-Tongluo decoction combined with western medicine on chronic pulmonary embolism (PE). Methods:A total of 120 patients with chronic PE, who met the inclusion criteria in our hospital from January 2016 to May 2019, were randomly divided into two groups, 60 cases in each group. The control group was given conventional western medicine treatment, and the study group was given Bufei-Huayu-Tongluo Decoction on the basis of the control group. Both groups were treated for 4 weeks. The forced expiratory volume in one second (FVE1) and forced vital capacity (FVC) were measured by pulmonary function analyzer; the fibrinogen (FIB) and prothrombin time (PT) were detected by coagulation analyzer; and D-dimer was detected by immunoturbidimetry; high mobility group protein B1 (HMGB-1), troponin (cTnI) were detected by ELISA, adverse reactions were recorded and clinical efficacy was evaluated. Results:The total effective rate of the study group was 93.3% (56/60) and that of the control group was 78.3% (47/60). The difference between the two groups was statistically significant ( χ2=5.551, P=0.018). After treatment, FVE1 (1.74 ± 0.26 L vs. 1.55 ± 0.29 L, t=3.779), FVC (66.73% ± 7.54% vs. 58.69% ± 6.32%, t=6.330) in the study group were significantly higher than those in the control group ( P<0.01); serum FIB level (2.85 ± 0.30 g/L vs. 2.36 ± 0.31 g/L, t=8.798), PT (15.31 ± 0.73 s vs. 11.27 ± 0.52 s, t=34.915) were significantly higher than those in the control group ( P<0.01); serum D-dimer (0.66 ± 0.23 mg/L vs. 1.18 ± 0.32 mg/L, t=9.447), HMGB-1 (3.59 ± 0.75 μg/L vs. 6.14 ± 1.28 μg/L, t=13.280) and cTnI (0.62 ± 0.26 μg/L vs. 1.02 ± 0.26 μg/L, t=8.896) were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions in the control group was 13.3% (8/60) and that in the study group was 15.0% (9/60). There was no significant difference between the two groups ( χ2=0.069, P=0.793). Conclusion:Bufei-Huayu-Tongluo Decoction combined with conventional western medicine therapy can improve lung function and coagulation function of patients with chronic PE.

Effect of high-flow nasal cannula oxygen therapy on diaphragmatic function in patients with acute exacerbation of chronic obstructive pulmonary disease: a prospective randomized controlled trial / 中华危重病急救医学

Objective To investigate the effect of high-flow nasal cannula oxygen therapy (HFNC) on the clinical efficacy and diaphragm function of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods The patients with mild to moderate AECOPD (clinical classification Ⅰ-Ⅱ) admitted to Huxi Hospital Affiliated to Jining Medical College from January to October in 2018 were enrolled. The patients were divided into HFNC treatment group and routine oxygen therapy control group (each n = 37) by randomly number table method. The two groups were given bronchiectasis drugs, corticosteroids, expectorant, anti-infection treatment, at the same time, the HFNC treatment group was given HFNC with the initial flow rate of 40 L/min. The routine oxygen therapy control group was given low flow oxygen, and the initial flow rate was 3 L/min. General data such as gender, age, clinical grade, acute physiology and chronic health evaluationⅡ (APACHEⅡ) score were recorded. Bedside ultrasound was used to measure the diaphragmatic excursions during quiet breathing (DEq), diaphragmatic excursions during deep breathing (DEd), and diaphragmatic shallow fast breathing index (D-RSBI) before and 2, 24 and 48 hours after treatment in both groups and compared, meanwhile, arterial blood gas analysis was performed, and arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) were recorded. Results Two patients in the HFNC treatment group withdrew from the study because they could not tolerate HFNC, while other patients were enrolled in the analysis. There was no statistically significant difference in gender, age, proportion of AECOPDⅡ grade or APACHEⅡscore between the two groups, indicating that the general data of the two groups were comparable and balanced. There was no statistically significant difference in DEq, DEd, D-RSBI, PaO2 or PaCO2 before treatment between the two groups. After treatment, DEp in both groups was decreased gradually with time, it was decreased earlier in the HFNC treatment group, and it showed significant difference as compared with that before treatment at 2 hours after treatment (mm: 18.3±3.1 vs. 20.1±4.2, P < 0.01), and it was significantly lower than that in the routine oxygen therapy control group (mm: 18.3±3.1 vs. 20.3±3.7, P < 0.05); DEd was gradually increased in both groups, it was significantly increased in the HFNC treatment group, and it was significantly higher than that in the routine oxygen therapy control group at 24 hours and 48 hours after treatment (mm: 55.2±7.6 vs. 50.8±9.2 at 24 hours, 59.4±7.7 vs. 53.6±9.1 at 48 hours, both P < 0.05); D-RSBI was decreased gradually in both groups, it was decreased earlier and more significant in the HFNC treatment group, and it was significantly lower than that in routine oxygen therapy control group at 24 hours and 48 hours after treatment (times·min-1·mm-1: 0.41±0.13 vs. 0.51±0.20 at 24 hours, 0.31±0.12 vs. 0.43±0.17 at 48 hours, both P < 0.05). After treatment, there was no statistically significant difference in PaO2 or PaCO2 between the two groups. Conclusion HFNC can effectively relieve diaphragm fatigue in patients with mild to moderate AECOPD, but it had no effect on carbon dioxide retention.

Correlation between allergic rhinitis and childhood obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation between allergic rhinitis and obstructive sleep apnea-hypopnea (OSAHS) syndrome in children.@*METHOD@#(1) According to medical history, physical signs, skin-prick test, serum sIgE, endoscopic examination and polysomnography, the incidence of allergic rhinitis was confirmed in 574 cases of childhood obstructive sleeping apnea-hypopnea syndrome in our hospital between July in 2008 to June in 2010. (2) Effects of anti-allergic drugs were observed on 78 children with OSAHS and allergic rhinitis meanwhile.@*RESULT@#(1) 258 cases of allergic rhinitis were confirmed in 574 cases of OSAHS, accounting for 44.9% of the OSAHS cases and 50.4% of all cases of allergic rhinitis during the same period. Most of them were perennial allergic rhinitis (223 cases, 86.4%), and 72.5% of them were aroused by fungal allergen. Compared with other allergen, statistically significant difference was found (P < 0.05). (2) After receiving anti-allergic drugs regularly for 3 weeks, 40 cases suffering from mild and moderate OSAHS and allergic rhinitis, 3 cases out of 38 cases suffering from serious OSAHS and allergic rhinitis showed satisfactory results, while other cases had little improvement.@*CONCLUSION@#Allergic rhinitis is closely related to childhood OSAHS, and perennial allergic rhinitis dominates. The most common allergen is fungal allergen, the second is house and flour dust mites. So for patients of mild and moderate OSAHS with allergic rhinitis, regular anti-allergic drugs can lighten OSAHS effectively and may make patients avoid surgery. Severe OSAHS cases can receive surgical intervention if prior anti allergic therapy fails. Anti allergic therapy should be adopted routinely after tonsillectomy and adenoidectomy in case of hypopnea due to hypertrophy of inferior turbinate or tubal torus in allergic rhinitis.

More exploration on endoscopic rhinoplasty and septoplasty / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Exploring a method of rhinoplasty and septoplasty to get better nasal function and aesthetic effect.@*METHOD@#1) Using endoscopic rhinoplasty and septoplasty, separating the joint of quadrangular cartilage and the bones around it, resecting vertical and horizontal strip of the deviated septal cartilage and fracturing the deviated septal bones and reconstructing them with three layers (mucosa-cartilage or bone-mucosa), positing the reconstructed septum in the middle between two lateral walls of nasal cavity, proper space between septum and turbinates was maintained. 2) The caudal part of quadrangular cartilage was resected and placed in the columella pocket between the two medial parts of the alar cartilage and the supporting function of the septal cartilage was maintained.@*RESULT@#Compared with traditional nasal septal reconstruction surgery, our method got better functional and aesthetic outcome.@*CONCLUSION@#The anatomic three layers were preserved in our method, thus it is better than the traditional methods. The caudal septal cartilage should be used as the perfect material in rhinoplasty.

Detection of PD4, CD44, PCNA protein and its clinical significance in human laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of PD4, CD44 and PCNA proteins in laryngeal carcinoma and their relationships with the pathogenesis, development and prognosis of laryngeal carcinoma.@*METHOD@#Immunohistochemistry was used to study 140 cases of laryngeal carcinoma tissues, 25 cases of precarcinoma tissues, 36 cases of vocal cord polyps and 13 cases of normal tissues adjacent to laryngeal carcinoma.@*RESULT@#1. The positive rates of PD4, CD44 and PCNA were 45.71% (64/140), 64.29% (90/140) and 77.86% (109/140) in laryngeal carcinoma, which were much higher than in non-carcinoma tissues (P < 0.01). 2. The third and fourth stages laryngeal carcinoma express stronger PD4 and CD44 than those of the first and second stages. Laryngeal carcinoma with cervical metastasis had higher expression than those without cervical metastasis. To 3 and 5 years' survival, PD4, CD44 and PCNA positive cases had lower chance than those negative cases(P < 0.01 or 0.05). 3. The over all positive rate of PD4, CD44 and PCNA was 27.86% (39/140) in laryngeal carcinoma tissues and 5.41% (4/74) in non-carcinoma tissues.@*CONCLUSION@#The high expression of PD4, CD44 and PCNA proteins maybe closely related to the pathogenesis, development and prognosis of laryngeal carcinoma.

Expression of PD4, CD44v6, CD44v9 and its clinical significance in human laryngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Study on the role of mycoplasma infection and expression of CD44v6, CD44v9 protein in the pathogenesis, development and prognosis of laryngeal carcinoma (LC).@*METHOD@#Immunohistochemistry was used to study 137 cases of laryngeal carcinoma tissues, 26 cases of precarcinoma tissues, 34 cases of vocal cord polypus and 15 cases of normal tissues adjacent to laryngeal carcinoma.@*RESULT@#The positive rate of PD4 and CD44v6, CD44v9 was 45.3% (62/137), 72.3% (99/137) and 56.2% (77/137) in laryngeal carcinoma, which are much higher than those in non-carcinoma tissues. (2) The positive rate of PD4 and CD44v6. CD44v9 in the third and fourth stages of LC were higher than those in the first and second stages of LC. Laryngeal carcinoma with cervical metastasis had higher expression than those without cervical metastasis (P < 0.01). To 3 and 5 years survival, PD4 and CD44v6, CD44v9 positive cases had lower chance than those negative cases (P < 0.01 [Chinese character: see text] 0.05). (3) The overall positive rate of PD4 and CD44v6, CD44v9 was 27.7% (38/137) in laryngeal carcinoma tissues and 5.3% (4/75) in non-carcinoma tissues.@*CONCLUSION@#These results implicates that the pathogenesis, development and prognosis of laryngeal carcinoma maybe closely related to the high expression of PD4 and CD44v6, CD44v9 protein.

Role of mycoplasma infection and expression of Ki67 protein in the pathogenesis,development and prognosis of laryngeal carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE Study the role of mycoplasma infection and expression of Ki67 protein in the pathogenesis, development and prognosis of laryngeal carcinoma. METHODS Immunohistochemistry method was used to study 145 specimens of laryngeal carcinoma tissues, 25 specimens of precarcinoma tissues, 31 specimens of vocal cord polyps and 15 specimens of normal tissues adjacent to laryngeal carcinoma. RESULTS ①The positive rates of PD4 and Ki67 were 45.52%(66/145) and 82.76 % (120/145) in laryngeal carcinoma tissue, 16.00 % (4/25) and 32.00 % (8/25) in precarcinoma tissue, 12.90 % (4/31) and 22.58 % (7/31) in vocal cords polyps, 6.67 % (1/15) and 0 (0/15) in normal tissues adjacent to laryngeal carcinoma. ②The positive rates of PD4 and Ki67 were higher in the advanced laryngeal carcinoma cases than that in the early laryngeal carcinoma cases. The positive rates of PD4 and Ki67 were higher in laryngeal carcinoma cases with cervical metastasis than that laryngeal carcinoma cases without cervical metastasis(P