Severe diabetic foot repaired by tibial bone transverse transport combined with flap transfer: Report of 7 cases / 中华显微外科杂志

Objective:To investigate the clinical effect of Ilizarov technique of tibial bone transverse transport combined with flap transfer in the treatment of severe diabetic foot.Methods:From April 2016 to March 2020, 7 patients with severe diabetic foot were treated by Ilizarov technique of tibial bone transverse transport combined with flap transfer in the Department of Hand and Foot Surgery of Foshan Nanhai Public Health Hospital. Diabetes Wagner classification: 2 cases were in Grade 3, in which, 1 case was ulcer in right heel and deep plantar with abscess and infection, and 1 case was ulcer in left great toe and phalanx infection; Other 5 cases were in Grade 4, of them, 2 cases were gangrene in proximal and distal of left great toe, 1 case were gangrene and infection in proximal, middle and distal segment of right 2nd toe, 1 case were gangrene and infection in proximal, middle and distal segment of left 4th toe, and 1 case were gangrene in distal segment of left 4th toe. Wound area was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Sural neurouascular flaps were used in 1 case, dorsal plantar artery flaps in 4 cases and medial plantar artery flaps in 2 cases. Size of flap was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Follow-up was conducted regularly by outpatient clinic, telephone and WeChat interviews. Content of the follow-up included foot wound healing, skin temperature of dorsal foot, lower limb paralysis, puncture exudation of external fixation stent, and blood supply of calf skin. Foot function was assessed according to the American Orthopedic Foot and Ankle Association (AOFAS) score.Results:All 7 patients entered the follow-up for 6-28 months, with an average of 8.2 months. All the foot ulcers healed. The pain of affected limbs eased off in 5 patients, and 2 patients had significant pain relief in affected limbs. Foot paralysis significantly alleviated in 7 patients, with calf skin temperature increased (1.81±0.56) ℃, and no recurrence of foot ulcers. According to AOFAS score, 3 cases were excellent, 3 cases were good and 1 case was fair.Conclusion:Ilizarov technique of tibial bone transverse transposition combined with flap transfer in the treatment of severe diabetic foot has a good clinical effect and it could be an option in the treatment of diabetic foot.

Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study / 中华急诊医学杂志

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care / 中西医结合学报

There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO

Effect of Tongguan Capsules () on Restenosis after Coronary Stent Implantation: Study Protocol for A Randomized Controlled Trial / 中国结合医学杂志

BACKGROUND@#Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate.@*OBJECTIVE@#This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation.@*METHODS@#Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months.@*CONCLUSION@#This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407).

Relationship between programmed cell death and myocardial ischemia-reperfusion injury and new perspectives of traditional Chinese medicine intervention / 中国中药杂志

Myocardial ischemia-reperfusion injury(MIRI) is an urgent problem in clinical treatment. As cardiomyocytes are terminal cells, MIRI-induced cardiomyocyte death will irreversibly damage the structure and function of the heart. In previous studies, apoptosis was considered to be the only way to regulate cell death, while necrosis could not be regulated. However, current studies have shown that cell necrosis could also be regulated, which was collectively called programmed cell death(PCD). Regulated cell death is actively mediated through molecular pathways, so there is the possibility of inhibiting this signaling to reduce MIRI. At present, PCD mainly includes apoptosis, autophagy, necrosis, pyroptosis and ferroptosis. As a unique treature in China, traditional Chinese medicine has the advantages of multiple pathways, multiple targets, low toxicity, less side effects and low economic costs. With the in-depth study of the efficacy of traditional Chinese medicine against MIRI, it has been confirmed that traditional Chinese medicine could regulate PCD to reduce MIRI. Therefore, this paper focuses on the relationship between PCD and MIRI, and new studies on intervention with relevant traditional Chinese medicine, with the aim to provide new MIRI prevention and treatment methods from the perspective of "intervention of PCD".

Effect of PI3K/Akt Signal Pathway Crosstalk in Myocardial Ischemia Reperfusion Injury and Prevention and Treatment with Traditional Chinese Medicine Therapy / 中国实验方剂学杂志

Myocardial ischemia-reperfusion injury （MIRI） was originated from the ischemic injury to myocardial cells due to some factors， and the injury will be aggravated after the blood supply recovery. MIRI will cause reperfusion arrhythmia， myocardial stagnation， microcirculation disorders or blood loss reflow， and become a key issue to be solved in the clinical treatment. Therefore， it is of important clinical significance to explore how to improve MIRI. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway has been regarded to be an important cascade signaling pathway to prevent MIRI， which is cross-talked in such mechanisms as oxidative stress， calcium overload， autophagy， inflammation， endoplasmic reticulum stress and mitochondrial dysfunction. This pathway is at the core site and closely related to the severity of MIRI. Meanwhile， traditional Chinese medicine（TCM） has its unique advantages in the prevention and treatment of MIRI， including multiple targets， multiple pathways， fewer toxic and side effect， as well as TCM characteristics of syndrome differentiation treatment and overall concept. A great number of studies have confirmed that this pathway is a common mechanism of action for most TCM compounds， TCM monomers and extracts. In this paper， we clarify the effect of PI3K/Akt signaling pathway crosstalk on the myocardial ischemia-reperfusion injury， with the focus on the relationship between the key targets of PI3K/Akt signaling pathway and MIRI. It will give great insights to the intricate relationship between them and promote the future development of new drugs targeting the PI3K/Akt signaling pathway. Finally， we also summarized the existing findings of TCM on PI3K/Akt pathway， which provides a reference for the treatment and drug development of MIRI.

Application of Free Venous Flap with Tendons and Nerves for Repairing Compound Palmar Tissue Defects / 现代医院

Objective To explore a one-time repairing method for defects in palmar skin soft tissue, proper palmar nerves and arteries, and flexor tendon.Methods From March 2011 to June 2016, the defects in palamar skin, nerves, blood vessels or flexor tendons of 21 fingers in 20 cases were repaired by using the resected superficial veins and tendons and nerves of skin soft tissue on axes of indicis proprius tendon (extensor digiti quinti) or forearm-palmaris longus tendon or foot back short tendons of the first or second toes were cut according to the defects in palmar skin soft tissue, nerves, blood vessels and flexor tendon, Results All the vein flaps of the 20 cases were survived.The patients were followed up for 6 to 24 months.Both the shape and function of the fingers recovered well.The flaps were of good quality, with no obvious pigmentation, and good at sensations (The sensation between two points were 9 mm on average).Conclusion It was a simpler and more convenient way to repair defects in palmar skin soft tissue, nerves, blood vessels and flexor tendons using free venous flap with tendons and nerves for transplantation.It also ensures the blood-supply without sacrificing the main vessels, and thus it is an ideal method for repairing simultaneous defects in skin soft tissue, nerves and flexor tendon.

Analysis of on medication rules for Qi-deficiency and blood-stasis syndrome of chronic heart failure based on data mining technology / 中国中药杂志

To analyze the medication features and the regularity of prescriptions of traditional Chinese medicine in treating patients with Qi-deficiency and blood-stasis syndrome of chronic heart failure based on modern literature. In this article, CNKI Chinese academic journal database, Wanfang Chinese academic journal database and VIP Chinese periodical database were all searched from January 2000 to December 2015 for the relevant literature on traditional Chinese medicine treatment for Qi-deficiency and blood-stasis syndrome of chronic heart failure. Then a normalized database was established for further data mining and analysis. Subsequently, the medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system(V2.5), association rules, improved mutual information algorithm, complex system entropy clustering and other mining methods. Finally, a total of 171 articles were included, involving 171 prescriptions, 140 kinds of herbs, with a total frequency of 1 772 for the herbs. As a result, 19 core prescriptions and 7 new prescriptions were mined. The most frequently used herbs included Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma), Fuling(Poria), Renshen(Ginseng Radix et Rhizoma), Tinglizi(Semen Lepidii), Baizhu(Atractylodis Macrocephalae Rhizoma), and Guizhi(Cinnamomum Ramulus). The core prescriptions were composed of Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma) and Fuling(Poria), etc. The high frequent herbs and core prescriptions not only highlight the medication features of Qi-invigorating and blood-circulating therapy, but also reflect the regularity of prescriptions of blood-circulating, Yang-warming, and urination-promoting therapy based on syndrome differentiation. Moreover, the mining of the new prescriptions provide new reference and inspiration for clinical treatment of various accompanying symptoms of chronic heart failure. In conclusion, this article provides new reference for traditional Chinese medicine in the treatment of chronic heart failure.

Is there an improvement of antibiotic use in China? Evidence from the usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals / 华中科技大学学报（医学）（英德文版）

The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program (NASP), the overall usage and the prophylactic use of antibiotic for type I incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for type I incision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type I incision operations decreased by 16.22% (P<0.05). The usage of combination antibiotic therapy for type I incisions was also decreased. Region and bed size were the main determinants on surgical prophylaxis for type I incision. This national analysis of hospitals on antibiotic use and stewardship allows relevant comparisons for bench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.

Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012 / 华中科技大学学报（医学）（英德文版）

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Is nationwide special campaign on antibiotic stewardship program effective on ameliorating irrational antibiotic use in China? Study on the antibiotic use of specialized hospitals in China in 2011-2012 / 华中科技大学学报（医学）（英德文版）

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly over prescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Effect of clinical pathways based on integrative medicine for patients with chronic heart failure: a multi-center research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess a multi-center study effectiveness of clinical pathways based on integrative medicine (IM) for chronic heart failure (CHF) patients.</p><p><b>METHODS</b>A combined method of historical control study and clinical study on concurrent control was used. After the standard management for clinical pathways was carried out in four hospitals at home, the effects on hospitalization days, medical expenses, clinical efficacy, patient satisfaction, and quality of life were assessed.</p><p><b>RESULTS</b>Results of non-concurrent historical control study showed that: the hospital stay was significantly shorter in the pathways group than in the retrospective group (12.59 days vs 18.44 days), and the total cost of hospitalization was significantly reduced in the pathways group (yen 9 051.90 vs yen 11 978.40), showing statistical difference (P < 0.01). Moreover, the effect on the heart function was better in the pathways group than in the retrospective group (the markedly effective rate: 45.60% vs 21.90%; the total effective rate: 96.80% vs 86.10%), showing statistical difference (P < 0.01). Results of clinical study on concurrent control showed that the hospital stay was significantly shorter in the pathways group than in the control group (11.19 days vs 13.21 days), showing statistical difference (P < 0.05). The average total cost of hospitalization was significantly lower in the pathways group than in the control group (yen 8 656.80 vs yen 11 609.70), showing statistical difference (P < 0.01). As for clinical efficacy of Chinese medical syndrome, the total effective rate was higher in the pathways group than in the control group (97.10% vs 93.62%), showing statistical difference (P < 0.05). The markedly effective rate of heart function was better in the pathways group than in the control group, showing statistical difference (49.30% vs 38.30%, P < 0.05). The overall satisfaction was higher in the pathways group than in the conventional group (P < 0.01). There was no statistical difference in the mortality within 3 months after discharge from hospital, and the readmission rate due to heart failure between the two groups (P > 0.05). But there was statistical difference in the quality of life (P < 0.05).</p><p><b>CONCLUSION</b>The pathway could shorten the hospitalization time, decrease the cost of hospitalization, improve the clinical efficacy, improve patients' quality of life and satisfaction, therefore, it could be spread nationwide.</p>

Clinical epidemiologic investigation on Chinese medicine syndrome laws in patients with chronic heart failure / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the distribution laws of Chinese medicine syndromes in patients with chronic heart failure (CHF) by clinical epidemiologic investigation.</p><p><b>METHODS</b>512 CHF patients were studied, including 168 items of symptoms and 48 items of tongue and pulse pictures. A database of Chinese medicine syndromes was established, and 9 disease nature elements and 5 disease location elements were extracted. Frequency analysis was performed on all symptoms, tongue and pulse pictures. The variables with frequency constituent ratio less than 10.0% were deleted. Then the features of clinical epidemiology, syndrome patterns, syndrome elements, main symptoms, as well as tongue and pulse pictures were analyzed.</p><p><b>RESULTS</b>(1) The disease nature elements of CHF covered qi deficiency, yin deficiency, and yang deficiency (categorized as the essential deficiency), as well as blood stasis, turbid phlegm, and the retained fluid (categorized to the superficiality excess). Among them, frequencies of qi deficiency and blood stasis (both more than 85.0%) were the highest. The disease location elements of CHF were ordered in frequency as Xin (97.9%), Pi (88.1%), followed by Shen (43.0%), Fei (30. 1%), and Gan (7.0%). (2) In the distribution of syndrome patterns in CHF patients, qi deficiency phlegm-stasis syndrome was the most (59.2%), followed by qi-yin deficiency with phlegm-stasis intermingle syndrome (20.3%), Xin-yang decline with phlegm-stasis obstruction syndrome (7.0%), and yang-deficiency with water overflowing syndrome (5.5%). (3) Patients with heart function grade II, III, and IV mainly manifested as qi-deficiency with phlegm-stasis syndrome. Besides, qi-yin deficiency with phlegm-stasis intermingle syndrome could be often seen in those with grade III. And Xin-yang decline with phlegm-stasis obstruction syndrome and yang-deficiency with water overflowing syndrome could often be seen in those with grade IV.</p><p><b>CONCLUSIONS</b>The pathogenesis of CHF is essential deficiency and superficiality excess. The essentiality consists of qi deficiency, yin deficiency, and yang deficiency, and the superficiality consists of blood stasis, turbid phlegm, and retained fluid. The disease was located at the five zang-organs, mainly dominated at Xin and Pi, and associated with Fei, Shen, and Gan. Qi deficiency phlegm-stasis syndrome was dominated in Chinese medicine syndrome patterns. Along with the aggravation of CHF, Chinese medicine syndrome pattern shows certain development laws.</p>

Double blinded randomized and controlled study on treatment of chronic heart failure by nuanxin capsule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the effect and safety of Nuanxin Capsule (NXC) in treating patients with chronic heart failure (CHF).</p><p><b>METHODS</b>Adopting the randomized, positive controlled, double-blinded design, 150 CHF patients were assigned to the treatment group and the control group equally, they were treated with optimal western medical therapeutic scheme in combining respectively with NXC and placebo for 24 weeks. The indices for effectiveness and safety evaluation, such as Chinese medicine syndrome, grade of heart function, myocardial contraction, as well as the re-hospitalization rate and mortality, were observed.</p><p><b>RESULTS</b>The total effective rate on heart function in the treatment group and the control group was 78.87% and 64.38% respectively, that on Chinese medicine syndrome was 85.9% and 63.0% respectively, comparisons of the two indices between the two groups all showed significant difference (P < 0.05, P < 0.01). And a better efficacy for improving patients' cardiac contraction function and quality of life was shown in the treatment group (P < 0.05, P < 0.01). The re-hospitalization rates in them were 23.9% and 53.4% respectively (P < 0.05), and 22.54% and 42.5% of the re-hospitalized patients had attack of acute heart failure, a significant difference was found between the two groups (P < 0.05). The mortality in them was 2.90% and 8.95% respectively, showing no significant difference between groups (P > 0.05). No obvious adverse effect was found in both groups.</p><p><b>CONCLUSIONS</b>NXC could improve the heart function of patients, it has obvious curative effect and good safety in treating chronic heart failure.</p>

Short-term clinical effects of integrative Chinese and Western medical treatment through "green track" in treating acute myocardial infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To comparatively study the short-term clinical effects of integrative Chinese and Western medical treatment (ICWM) on acute myocardial infarction (AMI) through "Green Track".</p><p><b>METHODS</b>In the 75 patients with AMI enrolled in the study, 42 were hospitalized after (regarding as Group A) and the other 33 hospitalized before the opening of "Green Track" (regarding as Group B). All of them received the same treatment including primary percutaneous coronary intervention (PCI) and followed with Chinese medicines mainly for strengthening vital-qi. The time of symptom-onset-to-door (SOTD), door-to-consult (DTC), door-to-lab (DTL) and door-to-balloon (DTB), the duration and expense of hospitalization, and the incidence of major adverse cardiac events (MACE) occurred in one month after PCI between the two groups were compared.</p><p><b>RESULTS</b>DTC, DTL and DTB in Group A were shorter than those in Group B respectively (P < 0.01). The duration of hospitalization was 7.40 days in group A and 11.83 days in group B, and the expense was RMB 51 384.75 yuan in group A and RMB 61 040.67 yuan in group B, showing a significant difference between groups (P= 0.004, P = 0.022); during the one-month follow-up, no MACE occurred in group A but 5 cases (15%) occurred in group B, with significant difference between them (P = 0.032).</p><p><b>CONCLUSION</b>The opening of "Green Track" and ICWM treatment displays a satisfactory short-term clinical effect on AMI, it could reduce the duration and expense of hospitalization and decrease the incidence of MACE occurred after PCI.</p>

Studies on chemical constituents of Paederia scandense / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of Paederia scandense.</p><p><b>METHOD</b>The constituents were isolated and purified by silica gel and Sephadex LH - 20 column chromatography. Their structures were elucidated by physicochemical properties and spectral analysis.</p><p><b>RESULT</b>20 compounds were obtained and identified as rubiadin-1-methylether (1), diadzein (2), cleomiscosin B (3), cleomiscosin D (4), isolariciresinol (5), linarin (6), isoscopoletin (7), caffic acid (8), coumarinic acid (9), p-hydroxyl-benzoic acid (10), oleanolic acid (11), ursolic acid (12), beta-sitosterol (13), daucosterol (14), paederoside (15), paederosidic acid (16), paederosidic acid methyl ester (17), saprosmoside E (18), paederoscandoside (19), caffeic acid 4-O-beta-D-glucopyranoside (20).</p><p><b>CONCLUSION</b>Compounds 1-10, and 20 were isolated from this plant for the first time.</p>

Investigation of GSTT1, GSTM1 and NQO1 genes polymorphisms in myelodysplastic syndromes / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between GSTM1, GSTT1 and NQO1(C609T) genotypes and myelodysplastic syndromes (MDS) susceptibility and chromosome abnormalities.</p><p><b>METHODS</b>GSTT1, GSTM1 and NQO1(C609T) genotypes were detected in 52 MDS patients and 241 unrelated controls by PCR or PCR-RFLP.</p><p><b>RESULTS</b>The incidence of GSTT1 and GSTM1 null genotype was significantly increased in MDS patients as compared with controls (P = 0.001 and P < 0.001, respectively). In individuals with GSTT1 and GSTM1 null genotype, the odds ratios for MDS risk were elevated to 2.873 (95% CI: 1.491-5.537) and 3.591 (95% CI: 1.717-7.508), respectively. A significantly increased frequency of GSTT(1) null genotype among MDS patients with normal karyotype and increased frequency of GSTM1 null genotype among MDS patients with chromosome abnormalities were found as compared to controls (OR = 5.336, P = 0.005 and P = 0.003, OR = 3.740, respectively). There was no difference in the incidence of NQO1(C609T) genotypes between MDS patients and controls.</p><p><b>CONCLUSION</b>Determination of the GSTM1 and GSTT1 genotypes may be used as a stratification marker to predicate high-risk individuals for MDS.</p>

Applied anatomy study related to implants in the temporal bone region / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the bone anatomic structure of the temporal bone region and provide reference in implant surgery in this region.</p><p><b>METHODS</b>Manual quantitative measurements of the bone structure were performed in 73 skull specimens (38 from male and 35 from female).</p><p><b>RESULTS</b>In the area of 8:00-11:00 (right ear) and 16-22 mm from center of the external auditory canal in the temporal bone region, the minimum bone thickness is as follows: 11:00: 6.77 mm in male, 5.18 mm in female; 10:00: 8.60 mm in male, 6.77 mm in female; 9:00: 9.85 mm in male, 7.30 mm in female; 8:00: 14.50 mm in male, 10.80 mm in female.</p><p><b>CONCLUSION</b>(1) In the temporal bone region, the area of 8:00-11:00 (right ear) and 16-22 mm from center of the external auditory canal offers sufficient bone for implants. The length of implants should be as follows: 11:00: 4-5 mm in male, 3-4 mm in female; 10:00: 4-7 mm in male, 4-5 mm in female; 9:00: 4-8 mm in male, 4-6 mm in female; 8:00: 4-12 mm in male, 4-8 mm in female. (2) Towards the external auditory canal and from 12:00 to 11:00, 10:00 to 8:00, the bone became thicker, so, if no ample bone is available in the initial site, the location should be shifted anti-clockwise in right side (clockwise in left side) and closer to the external auditory canal. (3) The differences between male and female are statistically significant in the temporal bone region, so they should be treated distinguishingly during the clinical practices.</p>

Re-evaluation of Diagnostic Value of Electrocardiography for Coronary Heart Disease by Coronary Arteriography / 广州中医药大学学报

[Objective] To re-evaluate the diagnostic value of electrocardiogram (ECG) for coronary heart disease (CHD) by coronary arteriogram (CAG). [Methods] ECG and CAG in 375 cases preliminarily diagnosed as having CHD were analyzed. [Results] ECG was abnormal in 252 cases and normal in 123 cases; 278 cases were diagnosed as having CHD and 97 non-CHD by CAG. CHD was confirmed in 205 cases from 252 with abnormal ECG and in 73 cases from 123 with normal ECG. The sensitivity of ECG for CHD was 73.7% and the specificity was 51.5% , indicating that the changes of ECG having different diagnostic value for CHD (P

TCM Syndrome Analysis of Restenosis after Percutaneous Transluminal Coronary Angioplasty / 广州中医药大学学报

One hundred and twenty cases of restenosis after percutaneous transluminal coronary angioplasty (PTCA) were subjected to TCM syndrome analysis.PTCA and support implantation were performed by routine method. The standard of TCM syndrome differentiation is subordinated to Professor Deng Tietao. The results showed that 78 cases (65%) were differentiated as Qi deficiency with phlegm-blood stasis, 13(11%) as yin deficiency with phlegm-blood stasis and 29 (24%)as phlegm-blood stagnation. It is indicated that Qi deficiency with phlegm-blood stasis is the main syndrome and reinforcing Qi dissipating phlegm and activating blood-flow may be a reasonable way of preventing and treating restenosis.