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Adhesive intestinal obstruction is the most common type of ileus, and conserva-tive treatment serves as its preferred treatment option. In the course of conservative treatment, gastrointestinal decompression will relieve symptoms, prevent ileus progression and promote gas-trointestinal function recovery, which has significant clinical effects. Currently, decompression effects of nasointestinal tubes and nasogastric tubes are controversial. There is a previous Meta-analysis evaluating decompression effects of these two methods, but this analysis includes non-randomized controlled trial and lacks research about Chinese patients. Therefore, the authors con-duct a Meta-analysis to evaluate decompression effects of nasointestinal tubes versus nasogastric tubes for adhesive intestinal obstruction.
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Background@#The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. @*Methods@#A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. @*Results@#Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). @*Conclusion@#LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.
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Background@#The influencing factors of diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM) were explored to develop and validate a DKD diagnostic tool based on nomogram approach for patients with T2DM. @*Methods@#A total of 2,163 in-hospital patients with diabetes diagnosed from March 2015 to March 2017 were enrolled. Specified logistic regression models were used to screen the factors and establish four different diagnostic tools based on nomogram according to the final included variables. Discrimination and calibration were used to assess the performance of screening tools. @*Results@#Among the 2,163 participants with diabetes (1,227 men and 949 women), 313 patients (194 men and 120 women) were diagnosed with DKD. Four different screening equations (full model, laboratory-based model 1 [LBM1], laboratory-based model 2 [LBM2], and simplified model) showed good discriminations and calibrations. The C-indexes were 0.8450 (95% confidence interval [CI], 0.8202 to 0.8690) for full model, 0.8149 (95% CI, 0.7892 to 0.8405) for LBM1, 0.8171 (95% CI, 0.7912 to 0.8430) for LBM2, and 0.8083 (95% CI, 0.7824 to 0.8342) for simplified model. According to Hosmer-Lemeshow goodness-of-fit test, good agreement between the predicted and observed DKD events in patients with diabetes was observed for full model (χ2=3.2756, P=0.9159), LBM1 (χ2=7.749, P=0.4584), LBM2 (χ2=10.023, P=0.2634), and simplified model (χ2=12.294, P=0.1387). @*Conclusion@#LBM1, LBM2, and simplified model exhibited excellent predictive performance and availability and could be recommended for screening DKD cases among Chinese patients with diabetes.
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Objective:To explore the influence of rivaroxaban on vascular endothelial function and p38MAPK/NF-κB pathway in the rats with arteriosclerosis obliterans. Methods:The rats were divided into the sham operation group,the model group,rivaroxaban low dose group,rivaroxaban medium dose group and rivaroxaban high dose group. The contents of nitric oxide (NO) and endothelin (ET-1) in serum were detected, the number of endothelial cells in serum was studied, and the expression level of p38MAPK, p-p38MAPK and NF-κB were measured. Results:Compared with that of the model group, the number of endothelial cells in venous blood of rivaroxaban groups decreased. The content of NO in serum of rivaroxaban groups was significantly higher than that of the model group,and the content of ET-1 was significantly lower than that of the model group(P<0.05). The expression level of p-p38MAPK in arterial vessels of rivaroxaban groups was significantly lower than that of the model group,and the expression level of NF-κB was sig-nificantly higher than that of the model group(P<0.05),and the effects were all in a dose-dependent manner. Conclusion:Rivarox-aban can improve vascular endothelial function in the rats with arteriosclerosis obliterans,and the effects may be achieved by modula-ting the p38MAPK / NF-κB pathway.
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Objective To investigate the clinical application of nasal-insertion type ileus-tube in the treatment of adhesive small intestinal obstruction. Methods A total of 221 patients with simple adhesive small intestinal obstruction, who were admitted to authors’ hospital during the period from January 2010 to Aug. 2014, were enrolled in this study. The patients were randomly divided into nasal-insertion type ileus-tube group (n=111) and nasogastric tube group (n=110). After the procedure, the patients were kept under close observation, focusing on the abdominal distention, gastrointestinal decompression amount, the recovery time of anal exhaustion and defecation, the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film, etc. The cure rate, effective rate and transit-operation rate were calculated. The results were compared between the two groups. Results The tube placement operation was successfully performed in all patients. Compared with the nasogastric tube group, in the nasal-insertion type ileus-tube group the recovery time of abdominal distention, anal exhaustion and defecation and the vanishing time of intestinal air-liquid plane on erect abdominal X-ray film were obviously shorter, and the gastrointestinal decompression amount was larger. In the nasal-insertion type ileus-tube group the cure rate and effective rate were significantly increased, while the transit-operation rate was decreased; the differences between the two groups were statistically significant (P<0.05). Conclusion For the treatment of adhesive small intestinal obstruction, the placement of nasal-insertion type ileus-tube is effective and reliable. This technique can strikingly improve the clinical symptoms, therefore, it is worthy of promotion and application in clinical practice.
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Objective To evaluate the clinical therapeutic effect of Shenfu injection (参附注射液) on patients with chronic obstructive pulmonary disease at acute exacerbation stage (AECOPD) and approach its therapeutic mechanism. Methods Fifty-eight patients with AECOPD were divided into a Shenfu group (30 cases) and a control group(28 cases); the Shenfu group received 50 ml Shenfu injection and 5% glucose 250 ml intravenous drip once a day at the base of conventional therapy,while the control group received conventional therapy only. The therapeutic course of both groups was 14 days. The clinical therapeutic effects of both groups were observed, the serum levels of tumor necrosis factor-? (TNF-?), interleukin-2 (IL-2) were measured by enzyme-labeled immunosorbent assay (ELISA), and the lung function of both groups was measured before and after the treatment. Results The total effective rates was 93.3% (28/30) and 85.7% (24/28) in the treatment group and the control group, respectively. In the comparison before and after treatment, the levels of TNF-? in both groups were decreased obviously (both P0.05). Conclusion Shenfu injection has a definite clinical curative effect in the treatment of AECOPD, it may decrease obviously the serum level of TNF-?, increase the level of IL-2 and improve the lung function in the patients with AECOPD.
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Objective: To investigate the mechanism of curative effects of Guben Fangchuan capsule (固本防喘胶囊) on chronic obstructive pulmonary disease(COPD). Methods: Using double blind control method , 86 elderly COPD patients in in acute exacerbating stage were divided into treatment group and control group (n=43 in each group). The conventional treatment of the two groups was the same. Additionally, the patients in the treatment group were given Guben Fangchuan capsules orally. The levels of interleukinCD*28 (ILCD*28) and eotaxin in phlegm were detected by enzyme linked immunoadsorbent assay (ELISA). Chymase activity in phlegm was determined by spectrophotometry. They were compared before and after treatment. Results: ①The activity of chymase, the levels of ILCD*28, eotaxin, neutrophil (NEU) and eosinophil (EOS) in phlegm in patients with intermediate and severe COPD patients were lower after treatment in treatment group than those of the patients before treatment and control group (all P
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Objective To discuss the therapeutic strategy and the clinical efficacy of percutaneous cholecystostomy in treating high-risk patients with acute cholecystitis. Methods During the period of Jan. 2006-June 2008,percutaneous cholecystostomy was performed in 27 high-risk patients with acute cholecystitis,consisting of lithic cholecystitis (n = 21) and non-lithic cholecystitis (n = 6). Of 27 patients,percutaneous cholecystostomy via transhepatic approach was performed in 22 and via transperitoneal approach in 5. The 7 F drainage catheter was used. Cholecystography was conducted before the drainage catheter was extracted. Results Percutaneous cholecystostomy was successfully accomplished in all 27 cases,with a technical success rate of 100%. Postoperative patency of gallbladder drainage was obtained in 25 patients,with the relieving or subsiding of abdominal pain and the restoring of temperature and leukocyte account to normal range within 72 hours. In one patient,as the abdominal pain relief was not obvious 72 hours after the procedure,cholecystography was employed and it revealed the obstruction of the drainage catheter. After reopening of the drainage catheter,the abdominal pain was relieved. In another case,cholecystography was carried out because the abdominal pain became worse after the procedure,and minor bile leak was demonstrated. After powerful anti-infective and symptomatic medication,the abdominal pain was alleviated. The drainage catheter was extracted in 25 patients 6-7 weeks after the treatment. Of these 25 patients,12 accepted selective cholecystectomy,7 received percutaneous cholecystolithotomy and 6 with non-lithic cholecystitis did not get any additional surgery. The remaining two patients were living with long-term retention of the indwelling drainage-catheter. Conclusion Percutaneous cholecystostomy is a simple,safe and effective treatment for acute cholecystitis in high-risk patients. This technique is of great value in clinical practice.
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Objective To study the mechanism of traditional Chinese medicine Compound Xueniaoting (CXNT) in treating glomerulus diseases with the main pathological changes of proliferation in mesangial cells. Methods CXNT and rat liver microsomes were incubated together, and then the incubated CXNT was added into cultured glomerular mesangial cells (GMC) in vitro. The proliferation of GMC was observed by MTT assay, the levels of interleukin-6 (IL-6) and endothelin-1 (ET-1) were determined by radioimmunoassay, and content of lactic dehydrogenase (LDH) was determined by velocity assay. ResultsCXNT (2, 4, 8 mg/mL) metobolized by rat liver microsomes could all inhibite the proliferation of GMC and production of IL-6 and ET-1 in a dose-dependent manner. Conclusion CXNT can inhibite the proliferation of GMC and restrain the secretion of IL-6 and ET-1, this function may be one of CXNT mechanisms in treating some mesangial proliferative glomerulonephritis.
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Objective: To study the function of Leshibao Capsule (Radix Ginseng, Rhizoma Atractylodis, Sea cucumber, etc.) on stomach and intestines. Methods: Gastrointestinal function was measured by small intestine driving test, gastric juice quantity, pepsin activity and gastric emptying time. Results: Leshibao Capsule could increase gastric juice, enhance pepsin activity. It could adjust function of gastrointestine in two ways that showed gastrointestinal movement fasted by neostigmine and inhibited gastrointestinal movement slowed by diphenoxylate and morphine hydrochloride. Conclusion: Leshibao Capsule can adjust gastrointestinal function and facilitate digestive function.
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AIM: To explore the anti-low-grade-inflammation mechanisms of Shenqi Compound Recipe(SQCR) in GK rats. METHODS: Specefic pathogen free(SPF) GK rats were divided randomly according to blood glucose level into four groups:Model,Ramipril,SQCR low dosage,SQCR high dosage group and normal Wistar rats(normal control group).GK rats were injected N-?-nitrol-L-arginine methyl ester(L-NAME) intra-peritoneally and took high-fat diet and Wistar rats were injected saline intra-peritoneally and took common diet freely,respectively.In the experiment periods,each group was administrated correspondent substance respectively for 32 days.Serum concentrations of C reactive protein(CRP) and adiponectin were determined by ELISA.Adiponectin mRNA expressions in white adiposed tissue were measured by real time reverse transcriptase PCR. RESULTS:Concentrations of CRP all decreased(P