Efficacy and Safety of the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Chinese Patients with Nonvalvular Atrial Fibrillation: A Single-center, Prospective, Observational Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China.</p><p><b>METHODS</b>The clinical data of 106 NVAF patients, who were consecutively underwent LAA closure with the WATCHMAN Device between April 2014 and May 2015, were collected. Patients were followed up at 1, 3, 6, and 12 months after discharge. A transesophageal echocardiograph was performed at 45 days after implantation and repeated in case of an unexpected event during the follow-up period.</p><p><b>RESULTS</b>This study included 106 NVAF patients with a mean age of 64.2 ± 8.6 years (ranging from 50 to 88 years), and the mean CHA2DS2-VASc score of all patients was 3.6 ± 1.6 (ranging from 2 to 9). Among those 106 NVAF patients, 100 (94.3%) patients were implanted with the device successfully. The procedural success rate was 94.3% (100/106), and the occlusion rate was 100.0% (100/100). There were one tamponade, one ischemic stroke, and eight minor pericardial effusions during hospitalization. During 12-month follow-up period, two patients developed a thrombus layer on the device that resolved with additional anticoagulation: one with visible device-thrombus experienced transient ischemic stroke, and one had a hemorrhagic stroke. There were no deaths in this study. The overall survival rate was 100.0%, and nonmajor adverse event rate was 95.0% (95/100). In this study, the expected annual rate of ischemic stroke risk in these patients according to the CHA2DS2-VASc score was 4.0%, while the observed ischemic stroke rate was 2.0% per year.</p><p><b>CONCLUSIONS</b>LAA closure with the WATCHMAN Device was feasible, efficient, and safe for NVAF to prevent the accidence of stroke in Chinese patients. During the 12-month follow-up period, the observed ischemic stroke rate (2.0% per year) in our study was lower than the predicted annual stroke risk (4.0%) using the CHA2DS2-VASc score.</p>

Study on clinical effect enhancement of acupuncture for depression with chronic pain treated with SSRI antidepressants / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the clinical efficacy on depression with chronic pain between the simple medication of selective serotonin uptake inhibition antidepressants (SSRIs) and the combined therapy of acupuncture and SSRIs.</p><p><b>METHODS</b>Ninety cases of depression were randomized into an acupuncture + medication group (combined therapy of acupuncture and western medication) and a medication group (simple medication), 45 cases in each one. In the medication group, the western medicine was adopted. According to the condition of disease, SSRIs was prescribed such as fluoxetine and paroxetine. In the acupuncture + medication group, on the basic treatment of western medication, acupuncture was applied to Baihui (GV 20), Yintang (GV 29), Shenting (BL 24), Fengchi (GB 20), etc. HAMD scale, VAS and SERS were used to evaluate the clinical efficacy in terms of depression symptoms, pain and side reactions of antidepressants before treatment and in the 1st, 2nd and 4th weeks after treatment in the patients and the differences between the two groups.</p><p><b>RESULTS</b>The differences in HAMD and VAS scores were not apparent before treatment between the two groups (P>0.05). HAMD score and VAS score in the 1st, 2nd and 4th weeks of treatment in the acupuncture + medication group were lower apparently than those in the medication group (all P<0.01). SERS score in the 1st, 2nd and 4th weeks of treatment in the acupuncture + medication group was lower apparently than that in the medication group (all P<0.01).</p><p><b>CONCLUSION</b>Acupuncture enhances the clinical efficacy on depression with chronic pain treated with SSRI antidepressants and reduces the adverse reactions.</p>

Relationship of anxiety state with lymphocyte subsets and the effect of Chinese medical treatment on anxiety in patients with chronic hepatitis B / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the relationship of anxiety state with CD4(+) level and CD4(+)/CD8(+) ratio and to observe the effect of Chinese medicine (CM) treatment on anxiety in chronic hepatitis B (CHB) patients.</p><p><b>METHODS</b>The anxiety state of 120 CHB patients was evaluated based on Hamilton Anxiety Scale (HAMA) scoring. According to the scores, 63 patients with scores ≥14 were classified to anxiety and 57 patients with scores <14 to non-anxiety. The differences in CD4(+) cells and CD4(+)/CD8(+) ratio between patients with anxiety and non-anxiety were analyzed. Moreover, 63 patients with anxiety were randomized into two groups: 31 in the control group were treated with lamivudine (100 mg per day) alone and 32 in the observation group were given equal dosage lamivudine combined with CM treatment depending on syndrome differentiation, all for 12 weeks. The effects of treatment on anxiety state and T-lymphocyte subsets as well as its impact on some CHB-related indices were observed and compared.</p><p><b>RESULTS</b>The anxiety state of CHB patients was negatively correlated with CD4(+) and CD4(+)/CD8(+); the level of CD4(+) in patients with anxiety was significantly lower than that in non-anxiety patients (P<0.01 or P<0.05). After treatment, anxiety state in the observation group was significantly improved, with their HAMA scores significantly lowered (P<0.01), and the levels of CD4(+) and CD4(+)/CD8(+) were significantly higher than those in the control group (P<0.05 or P<0.01). Moreover, the alanine transaminase recovery rate and the HBV-DNA-negative conversion rate in the observation group were significantly higher than those in the control group, respectively (P<0.05).</p><p><b>CONCLUSIONS</b>The anxiety state of CHB patients was related to CD4(+) and CD4(+)/CD8(+) levels. CM treatment could improve the anxiety state and showed certain regulatory effect on the patients' immune system.</p>

Effect of Chinese medicine therapy for strengthening-Pi and nourishing-Shen in preventing lamivudine induced YMDD mutation and its immunologic mechanism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the effect of Chinese medicine therapy for strengthening-Pi and nourishing-Shen (SPNS) in preventing lamivudine induced YMDD mutation and its immunological mechanism.</p><p><b>METHODS</b>One hundred and sixty chronic hepatitis B (CHB) patients with positive HBeAg were equally assigned to two groups at random: the observation group and the control group. Patients in the observation group were treated with lamivudine combined with SPNS, and those in the control group were treated with lamivudine only, with the treatment lasting for 52 weeks in total. Changes in indexes, including liver function, HbeAg, HBV-DNA, YMDD variation, CD(4), CD(4)/CD(8) ratio, interferon-gamma (IFN-gamma), interleukin-4 (IL-4), blood routine, renal function, as well as any adverse reactions that occurred in patients, were observed at different time points.</p><p><b>RESULTS</b>The ALT, AST recovery rate and HBV-DNA negatively inversing rate at the 24th week, the 36th week and the 52nd week were all higher (P<0.05); meanwhile, the YMDD mutation rate at the 36th week and the 52nd week was lower (P<0.05) in the observation group than in the control group. The posttreatment levels of CD(4), CD(4)/CD(8) ratio, IFN-gamma, and IL-4 as well as the pre-post treatment difference of these indexes in the observation group were significantly different from those in the control group (P<0.05).</p><p><b>CONCLUSION</b>Chinese medicine SPNS therapy can significantly reduce the YMDD variation of HBV, and the mechanism may be related to its regulation of the CD(4) level, CD(4)/CD(8) ratio and Th1/Th2 balance.</p>

Effect of Tongxie Yaofang Granule in treating diarrhea-predominate irritable bowel syndrome / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the clinical effect of Tongxie Yaofang (TXYF) Granule in treating diarrhea-predominate irritable bowel syndrome (D-IBS) and its possible mechanism.</p><p><b>METHODS</b>A total of 120 patients were assigned to two groups using stratified block randomization, 80 in the intervention group and 40 in the control group. To the intervention group the TXYF granule was given at one package each time, twice a day; the control group was treated with Miyarisan three times a day, two tablets each time. The course of treatment was 4 weeks for both groups. The total efficacy in them was compared, and data of scoring on stool (Bristol method), abdominal pain, abdominal distension, and mental condition were collected before treatment and 2 and 4 weeks after treatment. The activation of mast cells (MCs) of six patients chosen from each group was detected as well before and after treatment.</p><p><b>RESULTS</b>No significant difference between the two groups in terms of the total efficacy or the scores of symptoms before and after treatment was found (P>0.05). The number of activated MCs was decreased in the intervention group after treatment, showing significant difference as compared with that before treatment as well as with that in the control group after treatment (P<0.01).</p><p><b>CONCLUSIONS</b>TXYF is an effective preparation for the treatment of D-IBS. It can quickly lessen abdominal pain and distention, improve the property of stool, and improve mental tension and depression in patients. Its mechanism of action might be through the adjustment of MCs activation to decrease visceral hypersensitivity.</p>

Influence of TCM therapy for supplementing Pi and nourishing Shen on dendritic cell function in patients with chronic hepatitis B treated by lamivudine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the influence of traditional Chinese medicine (TCM) therapy for supplementing Pi () and nourishing Shen (, SPNS) on dendritic cell function in patients with chronic hepatitis B (CHB) treated by lamivudine.</p><p><b>METHODS</b>Sixty CHB patients with positive HBeAg were equally randomized by digital table into two groups: the observation group and the control group. Patients in the control group were treated with lamivudine only, while patients in the observation group were treated with lamivudine combined with SPNS fomula, for 12 weeks. The phenotype and function of dendritic cell, as well as its secretion factor interleukin 12 (IL-12) in all patients were determined after termination of therapy and the impacts on alanine transaminase (ALT) and HBVDNA were observed.</p><p><b>RESULTS</b>The phenotypes of dendritic cells such as CD1a, CD80, CD86, human leukocyte antigen (HLA-DR) and intercellular adhesion molecule-1, as well as the levels of stimulation index (SI) and IL-12 were higher in the observation group than those in the control group (P<0.05 or P<0.01). Meanwhile, signififi cant difference between the two groups was also shown in the normalizing rates of ALT and HBV-DNA (P<0.05).</p><p><b>CONCLUSION</b>TCM therapy for SPNS can signifificantly improve the function of dendritic cells in patients with CHB treated by lamivudine and enhance the early stage response of patients to the treatment.</p>

Protection of extract from Cuscuta japonica on human sperm acrosome and ultrastructure / 中国中药杂志

<p><b>OBJECTIVE</b>To study the oxidation damage of active oxygen (ROS) to human sperm acrosome and ultrastructure, and study the function mechanism about Cuscuta japonica treating male's infertility and asthenoospermia.</p><p><b>METHOD</b>By using the Percoll gradient centrifugation, the sperm with normal physiological function were selected for the normal sperm model, and the sperm suspension were divided into the normal group, the model group, the positive control group (Vitamin C group), and the lugh, the median and the low dose gvoups of C. japonica. The ROS made from hypoxanthine-xanzine xanzine(HX-XO) and different content (0.125, 0.25, 0.5 g x mL(-1)) of extract were incubated with sperm in the oxygen environment. The acrosomic integrity rate were calculated and the sperm acrosome and ultrastructure were observed.</p><p><b>RESULT</b>The content (0.125, 0.5 g x mL(-1)) of extract had no obvious difference as compared with Vitamin C (0.25 mg x mL(-1)) in protecting the acrosome and ultrastructure, but the content (0.25 mg x mL(-1)) of extract was significantly better than Vit C (P < 0.001).</p><p><b>CONCLUSION</b>The suitable content of extract from C. japonica can significantly protect the sperm membrane, the acosomic structure and the mitochondrion function from the damage caused by ROS.</p>

Protective Effect of Extract from Morindae Officinalis on the Oxidative Injury of Human Sperm Motility / 中国康复理论与实践

@#ObjectiveTo observe the protective effect of extract from Morindae officinalis on the oxidative injury of human sperm motility.MethodsThe sperm specimens were cultivated in vitro, the reactive oxygen species (ROS) was made from hypoxanthine-xanzine xanzine (HX-XO), and sperm specimens were co-incubated with ROS and different dosages of extract and oxygen. The motor parameters were evaluated, the motility were analyzed by the test of capillary tube penetrating, and compared with the control group.ResultsThe sperm function were injured, the motility and penetrating ability decreased evidently under the action of ROS, and with a significant difference compared with the normal group ( P<0.001). The sperm motility and penetrating ability could be improved by all of the small, medium and massive extract compared with vitamin C, especially 0.25 and 0.5 g/ml Morindae officinalis had more evident action in the rate of progressive motility and vitality exponent.ConclusionThe ROS can injury the sperm motility and penetrating ability, the appropriate content of extract from Morindae officinalis can significantly intervene peroxidation in sperm by the ROS, and protect the sperm motility.

Extract from Morindae officinalis against oxidative injury of function to human sperm membrane / 中国中药杂志

<p><b>OBJECTIVE</b>To study the intervention of Morindae officinalis extract in human sperm membrane, and to study the treatment of male infertility and asthenoospermia by M. officinalis.</p><p><b>METHOD</b>To select sperm with normal physiological function using the Percoll gradient centrifugation for the normal sperm model. Then separating the sperm suspension into the normal, model, and control group (Vitamin C group), and the large, medium and small dose of M. officinalis. The ROS was made from hypoxanthine-xanzine xanzine (HX-XO), and ROS, different concentrations (0.125, 0.25, 0.5 mg x mL(-1) of the extract were hatched with sperm in the oxygen environment, the sperm membrane Lipid peroxide injury were analyzed, and the function of sperm membrane were analyzed by sperm Hypoosmoticswelling (HOS) and compared with the controlled group.</p><p><b>RESULT</b>In the same conditions, all the small, medium and large extracts of M. officinalis (0.125, 0.25, 0.5 g x mL(-1)) improved SOD vitality of sperm suspension, reduced the content of MDA, intervened in the injury of sperm membrane by ROS to some extent and protected some function of sperm membrane. The 0.125 mg x mL(-1) extract had no obvious difference (P > 0.05) with Vitamin C in it, but the (0.25, 0.5 mg x mL(-1)) concentration of the extract is significantly better than control Vitamin-C (P < 0.01, P < 0.001). Furthermore, there was a dependence on the dosage, the large dose (0.5 mg x mL(-1)) of M. officinalis especially protected the function of sperm membrane.</p><p><b>CONCLUSION</b>The extract from M. officinalis can significantly intervene in lipin peroxidation in sperm membrane by guarding against oxidation, and protect the structure and function of sperm membrane, that is one of the mechanisms for treating male's infertility and asthenoospermia with M. officinalis.</p>

Etiology and treatment of eating disorders in adolescents: a report of 6 cases / 中国当代儿科杂志

The occurrence of eating disorders in Chinese adolescents is increasing. However the cause, diagnosis, treatment and prognosis of this disorder are rarely reported by pediatricians. This paper investigated the cause and treatment of six cases of eating disorders in adolescent patients. The medical data of six cases of eating disorders in the Shanghai Children's Medical Center from January 2003 to September 2005 were retrospectively reviewed. The patients were 5 girls and 1 boy, whose onset ages ranged from 12.4 to 15.8 years. They were initially referred to the clinic between 12.9 to 16.7 years, with a course of disease varying from three to twelve months. The patients' body mass index (BMI) varied from 9.07 to 17.0. Four out of the six patients were hospitalized because of low temperature, low blood pressure, bradycardia, dehydration and multiple systems damages. The other two were treated in the out-patient clinic. Based on the medical history and physical examination as well as laboratory findings, five of them were diagnosed with anorexia nervosa and the other one were bulimia nervosa. All of the patients were under the care of a team consisting of pediatricians, dietitians, psychiatrists and nurses. When the patients whose vital signs were unstable, medical treatment focused on life sustention and they were kept on beds compulsively and given nutrition transfusion. Meanwhile cognition and behavior therapy was administered to help the patients find out the internal and environmental factors related to the development of this disorder, establish a new conception of healthy weight, and correct their abnormal eating behaviors. The patients who had a severe distortion of body image and a big resistance to the treatment were additionally administered with psychiatry drugs. After treatment, three patients set up a healthy eating behavior, their body weights gradually recovered and they had no relapse during a 1-year follow-up. The other three patients retained some abnormal eating behaviors and their body weights were always below normal. It was found that eating disorders in adolescents may be triggered by some environmental factors, such as comments on body shape from their peers, fashion influence, academic pressures, and problems in communication. Since the patients' abnormal eating behaviors were masked or neglected by parents at the early stage of the disease and the clinical presentations were related to multiple systems, it is difficult to make an early diagnosis and treatment. It is important to improve the pediatricians' knowledge of eating disorders of adolescents and perform cooperation between a multidisciplinary team for the early diagnosis and treatment of this disorder.

Micro machining of micro-cantilever probes for efficient deposition for biochips / 生物工程学报

Biochip technology will bring a tremendous revolution to life science and medical research in 21 century. Microarray assays represent an essential technical advance in biomedical research. Recently, the demand for microarray assay technology has spring up. Therefore, low cost and flexible techniques are needed to meet specific requirements for increasingly integrated biochips. Also performance must be improved in terms of speed and sensitivity. To this end, promising approaches, mainly based on micro and nanotechnologies, have been developed. In this paper, the design and microfabrication of a novel type of micro-cantilever probe are introduced. These probes were fabricated using silicon dioxide by Micro-electromechanical System (MEMS) techniques, and they featured one micron split gap, microchannels and self-replenishing reservoirs. All fabricated micro-cantilever probe were tested on Nanoarrayer instrumentation. Cy3-streptavidin was loaded as biological sample and patterned on DSU gold surface. Results showed these probes were capable of generating high quality biological arrays with routine spot sizes of 2 - 3 microns and could deposit at least three thousand spots without reloading. The spot size could potentially achieve sub-micron when probe size was further shrunk down by the high-resolution lithography technique or more precise microfabrication technologies, such as E-beam lithography. To further improve sample loading efficiency, it is needed to modify the cantilever surface in order to better confine sample inside the microchannel and reservoir, which will be researched in the future.

Reduction of Brain Infarct Size and Extracellular Glutamate Accumulation by Dihydrokinate in Spontaneously Hypertensive Rat after Transient Forebrain Ischemia

No abstract available.