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Objective To observe the effect of Xuebijing on coagulation function in patients with sepsis. Methods Sixty-two patients with severe sepsis were admitted to Department of Emergency and Intensive Care Unit (ICU) of Kunming Municipal Hospital of Traditional Chinese Medicine from February 2015 to June 2017, and they were divided into Xuebijing group and routine treatment control group according to the random number table method, 31 cases in each group. Both groups were treated with symptomatic supportive therapy, and the Xuebijing group was treated with Xuebijing injection 50 mL intravenous drip on the basis of routine treatment, twice a day for consecutive 7 days. The differences in platelet count (PLT), 5 items of coagulation: D-dimer, fibrinogen (Fib), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score were compared between the two groups before and after treatment. Results After treatment, in both groups, the levels of PLT and Fib were significantly higher than those before treatment, the level of D-dimer, APACHE Ⅱ were obviously lower than those before treatment, APTT, PT and TT were significantly shorter than those before treatment, and the changes in Xuebijing group were more marked than those in the routine treatment control group [PLT (×109/L):186.63±45.29 vs. 119.96±59.76, Fib (g/L): 3.88±1.82 vs. 2.33±1.33, D-dimer (mg/L): 0.40±0.11 vs. 0.65±0.14, APTT (s): 30.95±8.48 vs. 42.25±7.73, PT (s): 10.97±1.51 vs. 13.16±2.22, TT (s): 16.17±1.28 vs. 18.98±1.12, APACHE Ⅱ score: 6.62±2.91 vs. 12.87±4.54, all P ＜ 0.05]. Conclusion Xuebijing can regulate coagulation disorder in patients with severe sepsis, ameliorate the disease condition of patients, block the deterioration of disease development, and improve the prognosis of patients.
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Objective To investigate the efficacy and safety of ozonated water injection for inflammatory pain of ankylosing spondylitis.Methods Forty patients suffered from inflammatory pain of ankylosing spondylit were admitted at the Xishan Coal Electricity Group Co.,Ltd Workers' General hospital from October 2013 to October 2016,and were randomly divided into Group A and Group B,20 cases in each group.Patients in Group A were treated with ozonated water injection into facet joint and sacroiliac joint,while patients in Group B were treated with diclofenac sodium controlled release table as control.Immunosuppressant was taken by all patients in both groups as the basic therapy.The VAS,ratio of VAS less than 3,Schober,Bath ankylosing spondylitis disease activity index(BASDAI),CRP,ESR and side effects were evaluated before treatment and 1 week,1 and 2 months after treatment.Results Before treatment,1st week,1st and 2nd month after treatment,the VAS in group A were (8.20 ± 0.92) points,(2.60 ± 0.79) points,(2.30 ± 0.67) points,(1.50 ± 0.53) points respectively,the Schober were (2.55± 1.62) cm,(3.10± 1.59) cm,(3.35±1.99) cm,(4.10t 1.37) cm,and the BASDAI were (6.30±0.64),(2.68±0.46),(2.08±0.40),(1.56±0.48).Before treatment,1st week,1st and 2nd month after treatment,the VAS in group B were (8.30± 1.06) points,(4.00± 1.05) points,(2.50± 1.18) points,(1.80± 1.03) points,the Schober were (2.50 ± 1.80) cm,(2.85± 1.49) cm,(3.95 ± 1.19)cm,(4.05±0.89) cm,and the BASDAI were (5.64±0.47),(2.98±0.29),(2.20±0.37),(1.70±0.45).The repeated measured repeated measures analysis of variance showed that among three indexes of VAS,Schober and BASDAI,the difference within group was statistically significant (P ＜ 0.05),but there were no significant difference between groups and interaction (P ＞ 0.05).The VAS and BASDAI of patients in both groups were significantly lower at 1st week,1st and 2nd month after treatment as compared to those before treatment,and the Schober of patients in group A at 1st week,1st month,2nd month and that of patients in group B at 1st month,2nd month significantly higher as compared with that before treatment(P＜0.05).The ratio of VAS less than 3 of patients in group A were 80％,100％ and 100％ at 1st week,1st and 2nd month after treatment,that in group B were 40％,80％ and 90％.The ratio of VAS less than 3 of patients in group A were significant higher than that of patients in group B at 1st week,1st month after treatment(P＜0.05).The CRP in group A were (43.3±12.6)mg/L,(8.46±6.92) mg/L before treatment,1st week after treatment,and that in group B were (43.1 ± 16.9)mg/L,(9.92±6.98) mg/L.The ESR in group A were (38.3±9.4) mm/h,(14.2±5.5) mm/h before treatment,1st week after treatment,and that in group B were (32.0± 10.1) mm/h,(12.8±6.5) mm/h.The CRP and ESR after treatment in two groups significantly lower as compared with those before treatment (P＜0.01),but there was no significant difference between group(P＞0.05).Four patients (20％) in group A and 11 patients(55％) in group B were suffered from gastrointestinal side effects after treatment,the ratio of group A was significant lower than that of group B (X2 =5.23,P＜ 0.05).Conclusion Ozonated water injection into facet joint and sacroiliac joint compound immunosuppressant improved pain and joint function,and exhibited a low gastrointestinal side effects.
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Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin for treatment of recurrent pain after trigeminal radiofrequency thermocoagulation.Methods Forty patients of both sexes suffering from recurrent pain after trigeminal radiofrequency thermocoagulation,who refused surgical treatment,aged 45-80 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with visual analog scale score ≥4,with the course of recurrent pain 0.5-17.0 months,were randomized into 2 groups (n =20 each) using a random number table:gabapentin group (group A) and gabapentin plus rTMS group (group B).The patients were treated with 2 courses of rTMS in total (5 days for 1 course,1 time per day) and with the second course at a 2-day interval in group B.Effective analgesia and pain relief were recorded within 6 months after treatment,and the therapeutic efficacy was evaluated according to the modified Macnab criteria.The daily consumption of gabapentin and development of rTMS-and gabapentin-related adverse reactions were recorded.Results No rTMS-related adverse reactions were found in group B.Compared with group A,the rates of effective analgesia and pain relief were significantly increased,the therapeutic efficacy was enhanced,the daily consumption of gabapentin was decreased,and the incidence of gabapentin-related adverse reactions was decreased in group B (P＜0.05).Conclusion Combination of rTMS and gabapentin produces better efficacy than gabapentin alone when used to treat the recurrent pain after trigeminal radiofrequency thermocoagulation,and the safety is good.
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Objective To evaluate the effect of remifentanil preconditioning on hepatic ischemiarepeffusion (I/R) injury in rats with liver cirrhosis.Methods Healthy male Sprague-Dawley rats,weighing 160180 g,received 40％ tetrachloride carbon 3 ml/kg (in peanut oil) intragastrically twice a week for 8 weeks to induce liver cirrhosis.Thirty-five rats with liver cirrhosis were randomly divided into 5 groups (n =7 each) using a random number table:sham operation group (group S),group I/R,and preconditioning with different does of remifentanil groups (R1,R2 and R3 groups).Hepatic I/R injury was induced by clamping the branches of hepatic artery,portal vein and common bile duct in the left and median hepatic lobes for 30 min followed by 90 min reperfusion in anesthetized rats with liver cirrhosis.In R1,R2 and R3 groups,remifentanil was infused intravenously at 0.4,2.0 and 10.0 μg· kg-1· min-1 for 15 min,respectively,and the rats were exposed to ischemia for 30 min followed by 30 reperfusion starting from 10 min after infusion was stopped.At 90 min of reperfusion,blood samples were collected from the abdominal aorta for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities.The rats were then sacrificed and livers were removed for determination of superoxide dismutase (SOD) activity,malondialdehyde (MDA) content,and expression of activated caspase-3 (using immunohistochemistry and Western blot analysis) and for detection of cell apoptosis in hepatic tissues.Apoptotic index was calculated.Results Compared with group S,the serum ALT and AST activities,MDA content and apoptotic index were significantly increased,SOD activity was decreased,and the expression of activated caspase-3 was up-regulated in I/R,R1,R2 and R3 groups.Compared with group I/R,no significant changes were found in the indexes mentioned above in group I/R,and the serum ALT and AST activities,MDA coment and apoptotic index were significantly decreased,SOD activity was increased,and the expression of activated caspase-3 was down-regulated in R2 and R3 groups.Conclusion Remifentanil preconditioning can reduce hepatic I/R injury in rats with liver cirrhosis,and the mechanism is related to inhibition of the lipid peroxidation and cell apoptosis.
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Objective To investigate the efficacy of flurbiprofen cataplasms to muscle strain in patients with gastrointestinal diseases.Methods Patients with muscle strain were divided into flurbiprofen cataplasms group (with gastrointestinal diseases,20 cases) and flurbiprofen tablets group (without gastrointestinal diseases,22 cases).Before and 1,2,4 and 7 days after treatment,the numeric rating score (NRS) were evaluated and pain relief (PR),effective rate (ER) and satisfied rate (SR) were calculated and side effects were observed.Results There was no significant difference between flurbiprofen cataplasms group and flurbiprofen tablets group at 1,2,4 and 7 days after treatment [ER:80％ (16/20) vs.82％(18/22),90％(18/20) vs.100％(22/22),95％(19/20) vs.100％(22/22),95％(19/20) vs.95％(21/22)；SR:60％ (12/20) vs.82％ (18/22),90％ (18/20) vs.95％ (21/22),90％ (18/20) vs.95％ (21/22),95％(19/20) vs.95％ (21/22),P ＞ 0.05].There was no side effects in two groups.Conclusion Flurbiprofen cataplasms may alleviate the muscle strain effectively,especially suitable for patients with gastrointestinal diseases.
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@#Objective To investigate the changes of morphology of injured nerve after pulsed radiofrequency (PRF) and radiofrequency thermocoagulation (RFTC) on rats. Methods 55 male Wistar rats were selected, in which 5 were allocated to control group (group C) and the other 50 were randomly divided into group PRF (n=25) and group RFTC (n=25). The specimens were analyzed both with light microscopy and electron microscopy at immediate, and 1, 7, 14 and 28 d after operation. Results In group PRF, the nerve function of rats maintained after operation. The edema among nerve fibers was found under light microscope, while myelin lamellar structure disorder and myelin balls shaped, and compensatory hyperplasia of ultrastructure under electron microscopic level. Those effects were more pronounced 1 d after operation. In group RFTC, the nerve function of rats disappeared and autophagy behaviors happened, meanwhile Waller's degeneration and nerve regeneration appeared under both light microscopy and electron microscopy. Conclusion PRF and RFTC can produce destruction of nerve, but PRF was minor and recoverable.
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Objective To investigate the changes in cerebral hemodynamics in different body positions in healthy volunteers.Methods Sixty right-handed healthy male volunteers,aged 22-26,height 167-178 cm,weighing 51-67 kg,were randomly divided into 4 groups ( n =15 each): 15 degrees head-down tilt group (group Ⅰ ),30 degrees head-down tilt group (group Ⅱ ),15 degrees head-up tilt group (group Ⅲ) and 30 degrees head-up tilt group (group Ⅳ ).Blood flow signals of right middle cerebral artery (MCA) and extracranial internal carotid artery (EICA) were detected by transcranial Doppler and systolic blood flow velocity (Vs),diastolic blood flow velocity (Vd ),mean blood flow velocity (Vm),pulsatility index (PI) and resistance index (RI) were recorded at supine position (baseline),immediately,10 and 30 min after body position change(T1-3 ).Lindegaard index was calculated.Results Compared with the baseline,in group [Ⅱ Lindegaard index was increased at T2,while Vs and Vm of MCA were decreased at T2,3,in group Ⅳ Vs of MCA and PI of EICA at T2,Vd and Vm of MCA at T2,3 were decreased ( P ＜ 0.05),while there was no significant difference in the variables mentioned above in the other two groups ( P ＞ 0.05 ).Conclusion In healthy adults,cerebral blood flow velocity decreases in 30 degrees headdown and head-up tilt positions,however there is no change in cerebral blood flow velocity in 15 degrees headdown and head-up tilt positions.
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Objective To study the expression of aquaporin-4 (AQP-4) in core and marginal region of the contusion brain tissues from patients with severe traffic brain injuries. Methods Thirty patients with severe traffic brain injuries (frontal-temporal brain contusion) admitted into our department from January 2007 to July 2009 were enrolled in the study and divided into three groups according to the period from injury to operation, ie, 0-4 hours (Group A), 5-8 hours (Group B) and 9-12 hours (Group C). The tissue was collected from core and marginal regions of brain contusion in each group. Ten parts of normal brain tissues obtained from the cerebellum to gain good exposure of CPA region tumors were used as control. The expression of AQP-4 in the normal brain tissues and in the tissues from core and marginal region of brain contusion, with GAPDH used as a control. Results The expression of AQP-4 in the marginal region was distinctly higher than that in normal tissues and in the tissues from core region. The AQP-4 expression in the tissues of the core region was lower than that in normal tissues. Conclusions AQP-4 is highly expressed in the tissues from the marginal region early after injury in a time-dependent fashion. Low expression level of AQP-4 in the core region is possibly correlated with early damage of blood brain barrier and peripheral structures.
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Objective: To study the optimal combined ratio of baicalin, icariin and Astragalus saponin I from a Chinese herbal compound Biminne. Methods: Firstly, a mouse model of allergic rhinitis was established by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel suspension, and the effective dose range of baicalin, icariin and Astragalus saponin I was detected by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt method. Secondly, 10 groups of combinations of baicalin, icariin and Astragalus saponin I assembled by U*(10)(10(8)) form were employed to determine the optimal combination by means of analyzing of the inhibitory effect on the splenocyte proliferation. Finally, the effects of each effective ingredient and the optimal combination were compared by observing the splenocyte proliferation, the contents of interleukin-4 (IL-4), IL-5, interferon-gamma (IFN-gamma) in supernatant of the splenocyte cultures and the ratio of IL-4 to IFN-gamma in order to verify the result. Results: Baicalin or icariin at concentrations ranging from 2 to 10 mumol/L, and Astragalus saponin I from 1 to 10 mumol/L effectively suppressed the splenocyte proliferation. When the proportion of baicalin, icariin and Astragalus saponin I was 1:2.14:2.65, the inhibitory effect was most remarkable. Further research confirmed the rationality of the optimal combination. Conclusion: An optimal combination of the major effective ingredients from Chinese herbal compound Biminne most effectively suppresses the proliferation of splenocytes from sensitized mice and regulates the cytokine secreting.
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Objective To study the effects of pulsed radiofrequency(PRF)and radiofrequency thermocoagulation(RFTC)in the treatment of idiopathic infraorbital neuralgia.Methods 16 patients suffering idiopathic infraorbital neuralgia were randomly divided into PRF(n=8)and RFTC(n=8).Numeral rating scale(NRS),pain relief(PR)and effective rate of treatment was performed before operation and at 1 hour、1 st day、7th day、15th day、1 st month、3rd month and 6th month after operation.Results The preoperative and postoperative impedance of thefirst,second and third operation in RFTC group were(490±86)Ω and(424±82)Ω,(492±90)Ω and(432±84)Ω,(481±98)Ω and(409±85)Ω respectively and the postoperative impedance was significantly decreased(P＜0.05).The preoperative NRS in group PRF and RFTC were 9(7～10)and 8.5(7～10)respectively and the postoperative NRS at all points in two groups were significantly decreased as compared with the preoperative NRS(P＜0.05).The PR at 7 and 15d in group PRF were 3(0～4)and that in group RFFC were 4(3～4)(P＜0.05).There were no significant differences in effective rate of treatment at each time between two groups(P＞0.05).Numbness appeared after operation in group PRF and disappeared in a week,however,that was persistent and all sense disappeared in group RFTC.Conclusion Curative effect of PRF for idiopathic infraorbital neuralgia is as well as RFTC and it is a kind of safe and effective technology that causes less side effects.