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Objective:To compare the effects of deep anesthesia extubation with sugammadex and neostigmine on perioperative respiratory adverse events (PRAE) and the duration of anesthesia recovery room (PACU) in children undergoing adenoidectomy.Methods:The clinical data of 470 children with adenoidectomy who underwent deep anesthesia extubation from February 2021 to April 2022 in Shenzhen Hospital of Southern Medical University were retrospectively analyzed. According to the use of muscle relaxant, they were divided into sugammadex group (group S) and neostigmine group (group N). Group S was intravenously injected with sugammadex 2 mg/kg after operation, and group N was intravenously injected with neostigemine 0.05 mg/kg combined with atropine 0.02 mg/kg when the train-of-four (TOF) value was >25%. The extubation time and PACU residence time of the two groups were recorded. Changes of heart rate (HR) and mean arterial pressure (MAP) immediately after surgery (T 0), within 1min after extubation (T 1), 5 min after extubation (T 2), and 20 min after extubation (T 3). PRAE was record. Results:There were 138 cases of propensity score matching in group S and group N respectively. The extubation time and PACU residence time in group S were shorter than those in group N (all P<0.05). At T 1, T 2 and T 3, HR and MAP in group S were significantly lower than those in group N (all P<0.05). The incidence of persistent cough and decreased blood oxygen in group S was lower than that in group N (all P<0.05). Conclusions:Compared with neostigmine, postoperative deep anesthesia extubation with sugammadex antagonistic residual muscle relaxant can shorten the duration of extubation and PACU retention after adenoidectomy, accelerate the recovery of children, make the peri-extubation cycle more stable, and reduce the occurrence of PRAE.
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Objective:To explore the effect of Toll-like receptor 9 (TLR9) signaling pathway activation on the transcriptome in the renal tubular cells.Methods:Mouse primary renal tubular epithelial cells were extracted and cultured. When the degree of cell fusion reached 80%, they were divided into two groups, which were added with 10 μL phosphate buffered saline (PBS, PBS control group) and TLR9 activator cytosine phosphate guanidine oligodeoxynucleotide (CpG-ODN) with a final concentration of 5 μmol/L (CpG-ODN treatment group). The RNA sequencing was performed on the Illumina platform after extraction. DEGseq software was used to analyze the differential expression of genes between the two groups. Goatools and KOBAS online software were used to analyze the differential genes involved signal pathways. Homer software was used to predict transcription factors.Results:Compared with the PBS control group, there were a total of 584 differentially expressed genes in the CpG-ODN treatment group, of which 102 were up-regulated and 482 were down-regulated. The most significantly enriched gene ontology (GO) terms of differentially expressed genes included response to interferon-β, defense response to virus and other inflammatory pathway. The most significantly enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways included 2'-5'-oligoadenylate synthase activity, regulation of ribonuclease activity, negative regulation of virus life cycle, cellular response to interferon-βand defense response to protozoan. The results of transcription factor prediction showed that interferon regulatory factor 3 (IRF3) was the most significantly enriched transcription factor in the promoter sequence of differential genes; the most significant transcription factor downstream of TLR9 was IRF3, and other predicted transcription factors such as transcription factor 21 (TCF21), zinc finger protein 135 (ZNF135), and PR domain containing 4 (PRDM4) might be new candidates for TLR9 signaling pathway.Conclusion:CpG-ODN activates TLR9 signaling pathway, and primary renal tubular epithelial cells can directly respond to CpG-ODN stimulation and undergo transcriptome changes, which provides a basis for further research on the molecular mechanism of TLR9 pathway in sepsis induced acute kidney injury.
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Objective:To investigate the effect of ultrasound-guided early removal of indwelling catheter on recovery quality and catheter-related infection of patients with general anesthesia in post anesthesia recovery unit (PACU).Methods:From September 2019 to April 2020, 146 patients with gynecological benign diseases who underwent hysteroscopic surgery in the Department of Anesthesiology, Shenzhen Hospital of Southern Medical University were selected prospectively and randomly divided into two groups, with 4 cases excluded. The function of the bladder was evaluated by ultrasound in the anesthesia recovery room after operation. In the ultrasound group, 71 patients had no abnormality, and the catheter was removed after the residual urine of the bladder was drained. 71 patients in the control group were normal, and the catheter was removed 24 hours after operation. The residual urine volume, urine retention, incidence of restlessness, urinary tract infection rate, time to first walking and hospital stay were observed in the two groups after the first bladder emptying.Results:The incidence of agitation in PACU was 7.0%(5/71) in the ultrasound group and 22.5%(16/71) in the control group, with statistically significant difference ( P<0.01); the first postoperative walking time in the ultrasound group and the control group was statistically significant [(10.5±4.1)h vs (18.9±6.5)h, P<0.05]; the postoperative hospital stay in the ultrasound group and the control group was statistically significant [(3.2±1.3)d vs (5.1±2.5)d, P<0.05]. The incidence of urinary tract infection and urinary tract irritationin in ultrasound group was significantly lower than that in control group (1.4% vs 9.8%, 1.4% vs 14.0%, P<0.05). Conclusions:For uncomplicated patients after gynecological laparoscopic surgery, ultrasound evaluation of bladder function, extraction of residual urine immediately after the removal of catheter, is more conducive to the early recovery of patients than 24 hours after the removal of catheter.
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Objective:To investigate the characteristics and the risk factors of coronavirus disease 2019 (COVID-19) associated acute kidney injury (AKI).Methods:A retrospective cohort study was performed to examine the basic data, clinical characteristics and prognosis of patients with COVID-19 in Zhongnan Hospital of Wuhan University and Wuhan Fourth Hospital from January 1st to February 1st in 2020. According to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO), patients with AKI were included in AKI group and those without AKI were included in non-AKI group. The differences of each index between the two groups were compared. The prognostic value of AKI for COVID-19 was analyzed by Kaplan-Meier survival curve and Cox regression.Results:A total of 394 COVID-19 patients were included, with a total mortality of 5.6%; 37 (9.4%) of them developed AKI. The mortality of patients with COVID-19 associated AKI was 18.9%. There were significant differences in age, gender, smoking history, hypertension history, malignancy history, cardiovascular disease history and cerebrovascular disease history between the two groups. In addition to the difference of serum creatinine (SCr) and blood urea nitrogen (BUN), white blood cell count (WBC), neutrophil count (NEU), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), D-dimer, procalcitonin (PCT) and C-reaction protein (CRP) in AKI group were significantly higher than those in non-AKI group [WBC (×10 9/L): 5.75 (4.13, 7.83) vs. 4.52 (3.35, 5.90), NEU (×10 9/L): 4.55 (2.81, 6.11) vs. 3.06 (2.03, 4.50), AST (U/L): 40.0 (24.5, 69.5) vs. 30.0 (23.0, 42.5), LDH (μmol·s -1·L -1): 5.21 (3.68, 7.57) vs. 4.24 (3.05, 5.53), D-dimer (μg/L): 456 (266, 2 172) vs. 290 (152, 610), PCT (μg/L): 0.33 (0.03, 1.52) vs. 0.01 (0.01, 0.11), CRP (mg/L): 53.80 (26.00, 100.90) vs. 23.60 (9.25, 51.10), all P < 0.05], while lymphocyte count (LYM) and platelet count (PLT) were decreased [LYM (×10 9/L): 0.68 (0.47, 1.05) vs. 0.91 (0.63, 1.25), PLT (×10 9/L): 142.0 (118.0, 190.0) vs. 171.0 (130.0, 2 190.0), both P < 0.05]. The mortality of AKI group was significantly higher than that of non-AKI group [18.9% (7/37) vs. 4.2% (15/357), P < 0.01]. Kaplan-Meier survival curve showed that the 30-day cumulative survival of AKI group was lower than that of non-AKI group (log-rank: P = 0.003). Cox analysis also showed that AKI increased the odds of patients with COVID-19 mortality by 3.2-fold [hazard ratio ( HR) = 3.208, 95% confidence interval (95% CI) was 1.076-9.566, P = 0.037]. Conclusions:The risk of AKI is higher in patients with COVID-19. Early intervention to prevent AKI in patients with COVID-19 is of great significance to improve the prognosis of patients.
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Objective:To analyze multiple factors that may affect renal function in septic shock patients with acute kidney injury (AKI) in the intensive care unit (ICU), in order to find factors of predictive value for renal function change in those patients.Methods:Septic patients with AKI admitted to department of critical care medicine of Wuhan University Zhongnan Hospital from January 2017 to June 2019 were enrolled, and the patients were divided into renal function improvement group and renal function non-improvement group according to their renal function change. Baseline, laboratory and clinical indicators of them were collected to conduct retrospective analysis. Comparing the difference of each index between the two groups, the statistically significant indexes in the univariate analysis were selected to perform ridge regression analysis. The receiver operating characteristic (ROC) curve and its 95% confidence interval (95% CI) were used to analyze the predictive value of each influencing factor on the recovery of renal function in patients. Results:A total of 323 patients met the inclusion criteria, and 195 of them were divided into renal function improvement group while the other 128 of them into the renal function non-improvement group. Univariate analysis showed that, there was significantly difference in acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), sequential organ failure assessment (SOFA), Glasgow coma score (GCS), heart rate (HR), serum creatinine (SCr), blood urea nitrogen (BUN), potassium (K +), white blood cell count (WBC), maximum central venous pressure (CVP max), maximum-minimum central venous pressure distance (ΔCVP), fluid balance, maximum lactic acid (LAC max), and maximum norepinephrine infusion speed (NE max) between the renal function improvement group and the renal function non-improvement group. Ridge regression analysis of those indexes found that APACHEⅡ, SOFA, SCr, BUN, HR, WBC, fluid balance, and NE max were influential factors of non-improvement renal function ( t values were 5.507, 3.690, 2.026, 4.815, 2.512, 2.114, 3.532, 3.735, all P < 0.05). ROC analysis found the predictive value combining the APACHEⅡ, SOFA, BUN, NE max was the highest [the area under ROC curve (AUC) and 95% CI: 0.863 (0.821-0.899)], which had a higher AUC than any of APACHEⅡ, SOFA, BUN, SCr and NE max [AUC and 95% CI: 0.863 (0.821-0.899) vs. 0.755 (0.705-0.801), 0.722 (0.670-0.770), 0.738 (0.686-0.785), 0.743 (0.692-0.790), 0.748 (0.697-0.794), all P < 0.01], and so did it when compared to APACHEⅡ, SOFA, SCr and NE max combination [AUC and 95% CI: 0.863 (0.821-0.899) vs. 0.825 (0.799-0.865), P < 0.01]. Conclusions:APACHEⅡ, SOFA, SCr, BUN, HR, WBC, fluid balance, and NE max are the positive influencing factors for patients without renal function improvement. The combination of APACHEⅡ, SOFA, BUN, and NE max had a relatively high predictive value for renal function recovery.
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Objective To investigate the analgesic effect of ultrasound-guided vertical spinal block (ESPB) in elderly patients after thoracoscopic surgery.Methods 40 elderly patients,aged 60-75 years,were selected for selective thoracoscopic surgery.Patients were randomly divided into two groups,ESPB group (E group) and paravertebral block (PVB) group (P group).In the E group,0.33％ ropivacaine 30 ml was injected between the T5 vertebral body transverse and the erector spines before surgery,and 0.33％ ropivacaine 30 ml was injected into the thoracic paravertebral space of T5-T6 in the P group.Patients in both groups were treated with sufentanil for postoperative patient controlled analgesia (PCA).The dosage of remifentanil intraoperative and sufentanil postoperative,remedial cases recorded in post anesthesia care unit (PACU),numeric rating scale (NRS) score at postoperative 1 h,6 h,12 h and 24 h were recorded,and intraoperative hypotension,postoperative nausea and vomiting cases,and operation time were documented.Results There was no significant difference in remifentanil dosage between the two groups (P ＞ 0.05).The total consumption of sufentanil in group E 24 hours after operation was higher than that in group P (P ＜ 0.05).The operation time of ultrasound-guided nerve block in group E was shorter than that in group P (P ＜ 0.05).The number of PACU remedial cases in group E was higher than that in group P (P ＞ 0.05).The NRS score recorded at postoperative 1 h,6 h,12 h and 24 h show no difference.There was no significant difference in the incidence of nausea and vomiting and intraoperative hypotension in the two groups.Conclusions Ultrasound-guided single ESPB block provides postoperative analgesia,which is similar but weaker compared with PVB and easy to operate.
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Objective To analyze the risk factors of in-hospital mortality in patients with intracerebral hemorrhage (ICH) in the intensive care unit.Methods Patients with intracerebral hemorrhage were retrospectively collected from January 2013 to January 2018 in the Department of Intensive Care Unit,Zhongnan Hospital of Wuhan University.Patients were excluded aged less than 18 years,pregnant women,the onset time of more than 7 days,the length of hospital stay of less than 48 hours,lack of renal function outcomes within 24 hours after admission,the glomerular filtration rate (eGFR) of lower than 15 mL/(min.1.73 m2),the history of chronic kidney disease,regular dialysis and renal transplantation,and incomplete data.Clinical data were collected from baseline characteristics,past history,and laboratory examination.The included patients were divided into the in-hospital non-survival group and the survival group.SPSS 20.0 software as used for statistical analysis,the binary Logistic regression analysis was performed to evaluate risk factors of in-hospital mortality with intracerebral hemorrhage,the prognosis was assessed by receiver operating characteristic (ROC) curve and survival curve (Kaplan-Meier).A P＜0.05 was considered statistically significant.Results In this single-center retrospective study,a total of 300 patients were enrolled,including 96 patients in the hospital nonsurvival group and 204 patients in the survival group.The incidence of in-hospital death in patients with intracerebral hemorrhage in ICU was 32％.Multivariate analysis demonstrated that the risk factors of inhospital mortality were lower GCS score (OR=0.629,95％CI:0.523-0.757,P＜0.01),higher APACHE Ⅱ score (OR=1.590,95％CI:1.369-1.847,P＜0.01),elevated leukocytes (OR=1.082,95％CI:1.028-1.139,P=0.002) and the incidence of acute kidney injury (AKI) (OR=6.978,95％CI:3.381-14.405,P＜0.01).The ROC curve demonstrated that the area under curve (AUC) of APACHE Ⅱ score was the largest with a sensitivity and specificity of 73.96％ and 75.98％,respectively,which can better predict the mortality of patients with cerebral hemorrhage.Kaplan-Meier survival curve showed that in-hospital survival rate of non-AKI patients were higher than that of AKI patients (P＜0.01).Conclusions Lower GCS score,higher APACHE Ⅱ score,elevated white blood cells and AKI are risk factors for predicting in-hospital mortality in patients with intracerebral hemorrhage in the ICU.Therefore,early identification and treatment should be adopted in these high-risk populations.
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Objective Doppler ultrasonography was used to screen the incidence of central venous catheter (CVC) thrombosis in severe patients to observe the incidences of catheter-related thrombosis (CRT) at subclavian (SC) and internal jugular (IJ) venous insertion sites, and to analyze the factors affecting the thrombosis. Methods One hundred and twenty three adult patients with IJ or SC CVC admitted to the Department of Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University from May to December 2015 were enrolled to be the research objects, they were divided into an IJCVC group (35 cases) and a SCCVC group (88 cases) according to different catheterization sites; they were divided into an operation group (85 cases) and a non-operation group (38 cases) according to whether operation was performed or not; and they were also divided into an anticoagulation group (25 cases) and a non-anticoagulation group (98 cases) according to whether anticoagulation therapy was used or not. Doppler ultrasonography was performed every day to observe the incidences of CRT during ICU stay. Results One hundred and twenty-three patients were included in this study. CRT was detected in 11 (8.9%) patients, with an incidence of 22.1 per 1 000 catheter-days. All the 11 cases with CRT were presented within 3 days after the insertion, with 9 cases (81.8%) on the first day and 2 cases (18.2%) on the third day. The incidence of CRT in SCCVC group was significantly lower than that in IJCVC group [5.7% (5/88) vs. 17.1% (6/35), P < 0.05], with the rates of 12.6 and 59.4 per 1 000 catheter-days, respectively. There were no statistical significant differences in the incidences of CRT between operation group and non-operation group [11.8% (10/85) vs. 2.6% (1/38)], and between anticoagulation group and non-anticoagulation group [8.0% (1/25) vs. 9.2% (2/98), both P > 0.05]. Conclusions The incidence of CRT at IJCVC site is estimated to be 3-times higher than that at SCCVC site, anticoagulants or surgical operation may have impacts on the incidence of CRT, although there were no statistically significant differences. The CRT usually occurs within 3 days after the catheter insertion. Frequent bedside ultrasonography in the first 3 days after catheterization can confirm the diagnosis and guide clinical treatment.
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Objective To investigate the incidence of insomnia and its influencing factors in the outpatients with cardiovascular diseases in a general hospital.Methods A total of 956 consecutive cases of the outpatients was collected from March 2016 to September in the department of cardiology patients in this general hospital.Insomnia was diagnosed with the 2012 Chinese adult insomnia diagnosis and treatment guidelines.All subjects underwent clinical examination,generalized anxiety scale (GAD-7),patient health questionnaire depression scale (PHQ-9),and self-made demographic sociology information questionnaire.Results A total of 925 patients with completed data was included in the analysis data.The insomnia incidence rate was 51.4％.The insomnia incidence rates were 57.8％ and 37.6％ in the patients with and without cardiovascular diseases.The difference was statistically significant (P ＜ 0.01) between both groups.The insomnia incidence rates in the patients with hypertension,coronary heart disease,arrhythmia,hypertension combined with coronary heart disease and other cardiovascular diseases were 50.8％,56.3％,53.2％,63.0％,and 54.3％,respectively.There were significant differences between the groups (P ＜ 0.05).The incidence of anxiety or depressive symptoms was 44.5％ in all investigators.Insomnia incidence rates were 75.6％ and 32.0％ in the subjects with and without anxiety or depressive symptoms.The difference was statistically significant (P ＜ 0.01) between both groups.Multivariate logistic regression analysis showed that gender,type A personality,family income satisfaction,cardiovascular diseases and anxiety/depression were independent factors to affect the occurrence of insomnia.Conclusions The insomnia incidence rates was high in the outpatients from the department of cardiology of general hospital.The main factors that affect the occurrence of insomnia include psychological,social aspects,and cardiovascular diseases.
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Objective To observe the effect of spleen-warming and kidney-tonifying therapy on Toll-like receptor 4 (TLR4) signaling pathway of cerebral infarction sequelae patients. Methods A total of 60 cerebral infarction sequelae patients with spleen and kidney(yang) deficiency were divided into control group and treatment group, 30 cases in each group. The two groups were given function rehabilitation training following by the theory of modern rehabilitation medicine, and additionally the treatment group was treated with spleen-warming and kidney-tonifying herbs orally. The treatment period for the two groups averaged 3 months. Before and after treatment, the scores of traditional Chinese medicine (TCM) symptoms and signs, peripheral blood TLR4 mRNA expression level, and the inflammation-related factors in the two groups were observed, and the observation parameters were compared with 30 healthy volunteers. Meanwhile, the changes of modern rehabilitation evaluation indexes were also evaluated before and after treatment. Results (1) After treatment, the Fugl-Meyer scores for motor function and Modified Barthel Index(MBI) scores for activities of daily living in the treatment group were obviously increased(P 0.05). (2) After treatment, the predominant symptoms and signs of hemiplegia, facial distortion and dysphasia in the two groups were much improved(P 0.05 compared with those before treatment); the treatment group had obvious effect on the above symptoms and signs, and the effect was superior to that in the control group(P 0.05), and TNF-α level in the control group was decreased but did not arrive to the normal level(P < 0.05); levels of interleukin(IL)-1β, IL-6 and TLR4 mRNA in the two groups were decreased but did not arrive to the normal(P < 0.01), and the decrease in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01). (4) During the treatment period, no obvious adverse effect was found in the two groups. Conclusion Oral use of spleen -warming and kidney –tonifying Chinese medicine combined with modern rehabilitation therapy is effective for the treatment of the sequelae of cerebral infarction patients by relieving the clinical TCM symptoms, and one of the therapeutic mechanisms is probably related with the TLR4 signaling pathway through regulating the expression of inflammatory factors.
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Sepsis is a life-threatening organ dysfunction caused by dysregulated immune response to infection, which has high rates of morbidity and mortality.The imbalance between the response to inflammation and that to anti-inflammation is one of the most important pathophysiological processes in patients with sepsis.Despite the variety of its treatment options, their therapeutic effects remain unsatisfactory.Continuous renal replacement therapy (CRRT) is gaining a wider application in critical care medicine, especially in the treatment of sepsis, which can significantly increase the survival rate of sepsis patients by immunity modulation, organ support, and internal environment stabilization, so as to improve the immune disorder, protect the organ functions, and maintain homeostasis in the body.
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Objective The research about the effect of different chemotherapeutic drugs on CD19?CAR?T cells with CCK8 test to provide the theoretical support about the development of chemotherapy for clinical support. Methods Extract T cells from a normal adult peripheral blood and synthesize CD19?CAR?T cell. CD19?CAR?T cells were treated with different doses of chemotherapeutic drugs for 24,48,72 h and(or)96 h,and inhibition rate was calculated. Results First,we observed that the inhibition rates of fludarabine and Mafosfamide for CD19?CAR?T cells were increasing with the time and concentration (P 0.05). Finally ,Cyclophosphamide had no effect in CD19?CAR?T cells in vitro (P > 0.05). Conclusion Mafosfamide and Fludarabine can inhibit the CD19?CAR?T cells. Cyclophosphamide have no activity in vitro.
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Objective To investigate the influence of two general anesthestic modes on postoperative cognitive dysfunction (POCD) in the patients undergoing laparoscopic radical hysterectomy .Methods One hundred ASA Ⅰ‐Ⅱ patients undergoing lapa‐roscopic radical hysterectomy were randomly allocated to the propofol group (group P) and sevoflurane group (group S) ,50 cases in each group .The anaesthesia time ,total dose of sufentanil ,total dose of vecuronium ,recovery time ,recovery time for regaining ori‐entation and complications during anesthetic recovery period were recorded .The cognitive function was assessed by the mini‐mental state examination (MMSE) on preoperative 1 d (T0 ) ,postoperative 1 d (T1 ) ,postoperative 3 d ,(T2 ) ,postoperative 7 d (T3 ) ,post‐operative 1 month (T4 )、postoperative 3 months (T5 ) and the POCD occurrence situation was evaluated by adopting the Z scoring . Results The total dose of sufentanil and vecuronium in the group S was lower than that in the group P (P<0 .05) ,the recovery time and time for regaining orientation in the group S was longer than that in the group P (P<0 .05);the incidence rates of shive‐ring ,dysphoria and upper respiratory tract obstruction in the group S were higher than those in the group P (P<0 .05) .There were no statistically significant difference in the MMSE scores between the two groups (F=0 .14 ,P=0 .709);the MMSE scores in each group had statistical differences among different time points (F=74 .46 ,P<0 .01) .The interaction effect existed between the gen‐eral anesthetic mode and time with MMSE score (F=7 .99 ,P<0 .01);the MMSE scores at T1 ,T2 in the group S were lower than those in the group P (P<0 .05) .The incidence rate of POCD at T1 ,T2 、T3 ,T4 in the group S was higher than that in the group P (P<0 .05) .Conclusion The incidence rate of POCD in the patients undergoing laparoscopic radical hysterectomy by adopting sevoflurane inhalation general anaesthesia is higher than that by adopting propofol anesthesia ,but which has no difference after postoperative 3 months .
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Objective To explore the effect of Shenling Baizhu Powder and moxibustion on serum brain-gut peptide in patients with diarrhea predominant irritable bowel syndrome (D-IBS). Methods Sixty D-IBS cases were randomly divided into two groups, 30 cases in the treatment group were given Shenling Baizhu Powder and moxibustion therapy, and 30 patients in the control group were given loperamide hydrochloride capsule. Treatment for the two groups lasted for 4 weeks. Clinical symptoms and serum brain gut peptide (5-HT, VIP and SP) levels of two groups were observed before and after treatment, clinical efficacy were evaluated. Results Markedly effective rate of the treatment group was 66.7% (20/30), better than 33.3% (10/30) in the control group (P0.05), with statistical significance (P<0.01). Conclusion Clinical efficacy of Shenling Baizhu Powder and moxibustion in treating D-IBS is better than that of loperamide hydrochloride capsule, and can significantly improve clinical symptoms and regulate serum brain-gut peptides levels.
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Objective To observe the clinical efficacy of cerebral palsy children with liver strong spleen weak syndrome treated with integrated traditional Chinese medicine therapy. Methods Eighty cerebral palsy children with liver strong spleen weak syndrome were divided into treatment group (40 cases) and control group (40 cases). Patients in control group were treated with conventional therapy (including exercise therapy, occupational therapy, guidance education, physical factors, and psychological therapy), and patients in treatment group were treated with integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) additionally. Three months were set for a course of treatment, and the whole treatment lasted for a total of four courses. TCM clinical symptoms were scored every six months, muscle tone (MAS), gross motor function (GMFM), and daily life activity ability (MBI) were evaluated every three months for both groups. Results There were significant differences in the total scores of TCM clinical symptom, MAS, GMFM, and MBI at different treatment time points in the two groups, compared with that before treatment (P<0.01). There were significant differences in the total scores of clinical symptom for Chinese medicine, MAS, GMFM, and MBI at different treatment time points for treatment group, compared with that of control group (P<0.05). Conclusion Integrated traditional Chinese medicine therapy (acupuncture and traditional Chinese medicine medicated bath) for cerebral palsy children on the basis of western medicine therapy can more effectively improve function and life quality of children patients.
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<p><b>OBJECTIVE</b>To investigate the antioxidant and anti-endotoxin effects of propofol on endothelial cells and the possible mechanisms.</p><p><b>METHODS</b>Cultured endothelial cells were treated with hydrogen peroxide (H(2)O(2)), propofol + H(2)O(2), lipopolysaccharide (LPS) and propofol + LPS, respectively. Endothelial cell damage was monitored for possible lactic dehydrogenase (LDH) release. The transcription and the protein expression levels of endothelial nitric oxide synthase (eNOS) were measured.</p><p><b>RESULTS</b>LDH release was higher in groups treated with H(2)O(2) or LPS than in the control group. After pretreatment with propofol, the effects induced by H(2)O(2) were attenuated, but propofol did not decrease the LDH release induced by LPS. Both H(2)O(2) and LPS significantly increased the eNOS transcript levels and the increases were significantly attenuated after pretreatment with propofol. Both H(2)O(2) and LPS significantly increased the eNOS protein expression and the increase was attenuated after pretreatment with propofol.</p><p><b>CONCLUSION</b>Propofol could protect endothelial cells against oxidative stress by inhibiting eNOS transcription and protein expression, but could not antagonise endotoxin induced cell injuries.</p>