ABSTRACT
Diabetic neuropathic pain （DNP） is one of the common complications of diabetic peripheral neuropathy， which is difficult to be cured. The clinical manifestations of DNP include reduced pain threshold， neuropathic pain in extremities， and abnormal pain. Studies have demonstrated that nuclear factor-kappa B （NF-κB）， mitogen-activated protein kinase （MAPK）， Toll-like receptor 4 （TLR4）， nuclear factor erythroid 2-related factor 2 （Nrf2）， and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathways are involved in the treatment of DNP by inhibiting the activation and release of inflammatory cytokines ［e.g.， tumor necrosis factor-alpha （TNF-α） and interleukin （IL）］， regulating inflammation-mediating factors ［e.g.， reactive oxygen （ROS）， inducible nitric oxide synthase （iNOS）， cyclooxygenase （COX-2）， and NF-κB inhibitor （IκB）］， suppressing neurogenic inflammation， destroying the persistent damage of peripheral nerves， and repairing damaged peripheral nerves. The literature of modern medical research has demonstrated that the treatment of DNP with Chinese herbal medicines is associated with the signaling pathways above. They can treat DNP by regulating the expression of key proteins in the signaling pathways to control neurogenic inflammation and repair diabetic peripheral neuropathic damage. By summarizing the available studies， this review aims to provide a reference for the in-depth research on Chinese herbal medicines in the treatment of DNP and give new insights into the protection of diabetic peripheral nerves and the treatment of DNP with Chinese herbal medicines.
ABSTRACT
Objective To study the success rate of ventilator weaning in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients influenced by bobbed endotracheal intubation. Methods One hundred and sixteen AECOPD patients who were given invasive mechanical ventilation and reached the standards of off-ventilator were divided into control group (general endotracheal intubation group) and experiment group bobbed (tracheal intubation) by random digits table method with 58 cases each. The respiratory rate (RR), heart rate (HR), rapid and shallow breathing index (RSBI), oxygenation index (OI), pulse blood oxygen saturation (SpO2), tidal volume and success rate of ventilator weaning were compared. Both groups were implemented of extubation if they reached the standards of the extubation time by observing their ability in spontaneous breathing test (SBT). Results The RR, HR and RSBI before extubation in experiment group were significantly lower than those in control group:(19.7 ± 2.3) times/min vs. (23.5 ± 2.3) times/min, (91.2 ± 6.3) times/min vs. (93.4 ± 8.1) times/min and 80.2 ± 6.7 vs. 90.5 ± 9.6, P<0.05, and the OI, SpO2, tidal volume and success rate of ventilator weaning were significantly higher than those in control group: (269 ± 9) mmHg (1 mmHg = 0.133 kPa) vs. (245 ± 16) mmHg, 0.929 ± 0.014 vs. 0.870 ± 0.037, (6.1 ± 1.2) ml/kg vs. (5.1 ± 0.8) ml/kg and 91.38%(53/58) vs. 77.59%(45/58), P<0.05. Conclusions The bobbed endotracheal intubations can improve the success rate of ventilator weaning in patients with AECOPD.