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1.
Article in English | WPRIM | ID: wpr-939796

ABSTRACT

OBJECTIVE@#To summarize the medication rules of Chinese herbs to treat heart failure with preserved ejection fraction (HFPEF) based on data mining and to provide references for clinical utilization.@*METHODS@#The China National Knowledge Infrastructure (CNKI), Wanfang database (Wanfang), VIP database (VIP), Chinese Biomedical Literature (CBM), PubMed, Embase, and Cochrane Library databases were searched from inception to October 2021 to identify relevant literature on treating HFPEF with Chinese herbs. Microsoft Excel 2019 was used to set up a database, and then, association rule analysis and hierarchical cluster analysis were performed by using apriori algorithm and hclust function respectively in R-Studio (Version 4.0.3).@*RESULTS@#A total of 182 qualified papers were included, involving a total of 92 prescriptions, 130 Chinese herbs, and 872 individual herbs prescribed, with an average of 9.5 herbs per prescription. The six most frequently prescribed herbs were Astragali Radix (Huangqi), Salviae Miltiorrhizae Radix Et Rhizoma (Danshen), Poria (Fuling), Glycyrrhizae Radix Et Rhizoma (Gancao), Cinnamomi Ramulus (Guizhi), and Ginseng Radix Et Rhizoma (Renshen). There were 35 herbs used more than 5 times, involving 11 efficacy categories. The top three categories were deficiency-tonifying herbs, blood-activating and stasis-removing herbs, and dampness-draining diuretic herbs. The most commonly used herbs were mainly warm and sweet. The primary meridian tropisms were Lung Meridian, Heart Meridian and Spleen Meridian. Association rule analysis yielded 26 association rules, such as Astragali Radix (Huangqi) & Salviae Miltiorrhizae Radix Et Rhizoma (Danshen), Poria (Fuling), Cinnamomi Ramulus (Guizhi) & Atractylodis Macrocephalae Rhizoma (Baizhu). Hierarchical cluster analysis yielded four herb classes, and their functions were mainly qi-replenishing and yang-warming, blood-activating and diuresis-inducing.@*CONCLUSIONS@#HFPEF is the syndrome of root vacuity and tip repletion, and its core pathogenesis is "deficiency", "stasis", and "water", with "deficiency" being the most principal, which is closely related to Xin (heart), Fei (Lung), and Pi (Spleen). The treatment of this disease occurs by improving qi, warming yang, activating blood and inducing diuresis. Astragali Radix (Huangqi) with Salviae Miltiorrhizae Radix Et Rhizoma (Danshen) is the basic combination of herbs applied.


Subject(s)
Data Mining , Drugs, Chinese Herbal/pharmacology , Heart Failure/drug therapy , Humans , Medicine, Chinese Traditional , Salvia miltiorrhiza , Stroke Volume
2.
Article in English | WPRIM | ID: wpr-896273

ABSTRACT

Although the contributions of sitagliptin to endothelial dysfunction in diabetes mellitus were previously reported, the mechanisms still undefined. Autophagy plays an important role in the development of diabetes mellitus, but its role in diabetic macrovascular complications is unclear. This study aims to observe the effect of sitagliptin on macrovascular endothelium in diabetes and explore the role of autophagy in this process. Diabetic rats were induced through administration of high-fat diet and intraperitoneal injection of streptozotocin. Then diabetic rats were treated with or without sitagliptin for 12 weeks. Endothelial damage and autophagy were measured. Human umbilical vein endothelial cells were cultured either in normal glucose or in high glucose medium and intervened with different concentrations of sitagliptin. Rapamycin was used to induce autophagy. Cell viability, apoptosis and autophagy were detected. The expressions of proteins in c-Jun N-terminal kinase (JNK)-Bcl-2-Beclin-1 pathway were measured. Sitagliptin attenuated injuries of endothelium in vivo and in vitro. The expression of microtubuleassociated protein 1 light chain 3 II (LC3II) and beclin-1 were increased in aortas of diabetic rats and cells cultured with high-glucose, while sitagliptin inhibited the over-expression of LC3II and beclin-1. In vitro pre-treatment with sitagliptin decreased rapamycin-induced autophagy. However, after pretreatment with rapamycin, the protective effect of sitagliptin on endothelial cells was abolished. Further studies revealed sitagliptin increased the expression of Bcl-2, while inhibited the expression of JNK in vivo . Sitagliptin attenuates injuries of vascular endothelial cells caused by high glucose through inhibiting over-activated autophagy. JNK-Bcl-2-Beclin-1 pathway may be involved in this process.

3.
Article in Chinese | WPRIM | ID: wpr-879017

ABSTRACT

Chemical constituents of water extracts of Asplenium ruprechtii were investigated. Five compounds were isolated by silica gel, Sephadex LH-20 gel column chromatographies and preparative HPLC, and their structures were identified by various spectral analyses as aspleniumside G(1), trans-p-coumaric acid(2), trans-p-coumaric acid 4-O-β-D-glucoside(3), cis-p-coumaric acid 4-O-β-D-glucoside(4), and(E)-ferulic acid-4-O-β-D-glucoside(5). Among them, compound 1 is a new 9,19-cycloartane glycoside.


Subject(s)
Chromatography, High Pressure Liquid , Glucosides , Glycosides , Triterpenes
4.
Article in Chinese | WPRIM | ID: wpr-910042

ABSTRACT

Objective:To evaluate antegrade interlocking intramedullary nails combined with less invasive stabilization system (LISS) in the treatment of femoral fractures (Lambiris type Ⅲ or Ⅳ).Methods:The clinical data of 27 patients were retrospectively analyzed who had been treated for femoral fractures of Lambiris type Ⅲ or Ⅳ at Department of Orthopedic Surgery, Wuhan Fourth Hospital from February 2015 to May 2019. They were 21 males and 6 females, aged from 22 to 57 years (average, 41.3 years). According to the Lambiris classification, 24 cases were classified as type Ⅲ (17 as type Ⅲa, 5 as type Ⅲb and 2 as type Ⅲc) and 3 cases as type Ⅳ. The time from injury to operation ranged from 2 to 9 days (average, 4.3 days). All the fractures were fixated with anterograde femoral interlocking nails and femoral LISS. Recorded were operation time, intra-operative blood loss, hospital stay, bone healing time, and Harris hip score, Hospital for Special Surgery (HSS) knee score and complications at the final follow-up.Results:In this cohort, operation time averaged 2.1 h (from 1.8 to 2.5 h), intraoperative blood loss 361 mL (from 310 to 480 mL), and hospital stay 15.1 d (from 11 to 18 d). All the 27 patients were followed up for 13 to 38 months (average, 25.3 months) after operation. All the fractures united well after an average duration of 29.2 weeks (from 28 to 36 weeks). By the Harris hip scores at the final follow-up, the hip function was evaluated as excellent in 18 cases, as good in 6 and as acceptable in 3, giving an excellent and good rate of 88.9%(24/27); by the HSS knee scores at the final follow-up, the knee function was excellent in 16 cases, good in 7 and acceptable in 4, giving an excellent and good rate of 85.2%(23/27). Follow-ups observed no fracture nonunion, malunion, refracture, internal fixation failure or other complications.Conclusion:In the treatment of femoral fractures of Lambiris type Ⅲ or Ⅳ, antegrade interlocking intramedullary nails combined with LISS has advantages of rigid fixation, a high rate of fracture union, limited complications, and good functional recovery.

5.
Chinese Journal of Trauma ; (12): 926-931, 2021.
Article in Chinese | WPRIM | ID: wpr-909958

ABSTRACT

Objective:To investigate the effect of robot-assisted percutaneous retrograde screw fixation in the treatment of acetabular fractures involving the posterior column.Methods:A retrospective case series study was conducted to analyze the clinical data of 13 patients with acetabular fractures involving the posterior column admitted to Wuhan Fourth Hospital from January 2019 to December 2020. There were 8 males and 5 females,aged 62-78 years[(69.7±1.5)years]. According to Judet-Letournel classification,fractures involved the posterior column in 4 patients,anterior column plus posterior semi-transverse column in 3 and double column in 6. According to AO classification,type 62-A2.1 was found in 2 patients,62-A2.2 in 2,62-B3 in 3 and 62-C in 6. All patients were treated with retrograde percutaneous screws assisted by orthopaedic surgery robot. The operation time,intraoperative blood loss,length of hospital stay and time of bone healing were recorded. The incision healing and complications were detected. Matta reduction standard was used to evaluate the fracture reduction quality at 2 days after operation,and Majeed function score was used to evaluate the functional recovery preoperatively,at 3 months after operation and at 6 months after operation.Results:All patients were followed up for 6-12 months[(9.3±1.7)months]. The operation time was 1.1-1.5 hours[(1.3±0.2)hours]. The intraoperative blood loss was 110-200 ml[(161.3±21.1)ml]. The length of hospital stay was 8-13 days[(10.7±1.3)days]. The time of bone healing was 14-18 weeks[(15.4±1.1)weeks]. All incisions were healed by first intention. One patient with sciatic nerve injury was treated with mecobalamin and recovered 3 months later. One patient with advanced heterotopic ossification had no obvious clinical symptoms. All patients had no complications such as incision infection,deep venous thrombosis of lower limbs,fat embolism,screw penetration into hip joint,fracture displacement after failure of internal fixation,traumatic arthritis,or necrosis of femoral head,etc. According to Matta reduction standard,there were 10 patients with anatomical reduction and 3 with satisfactory reduction. Majeed function score was(15.0±1.3)points before operation,(76.5±2.0)points at 3 months after operation and(85.1±1.9)points at 6 months after operation( P<0.01),and there were 9 patients with excellent results,2 with good results and 2 with fair results,showing the excellent and good rate of 85%. Conclusion:For acetabular fractures involving the posterior column,robot-assisted percutaneous retrograde screw fixation has advantages of less surgical trauma,higher fracture healing rate,fewer complications,satisfactory anatomical reduction and good functional recovery.

6.
Article in Chinese | WPRIM | ID: wpr-906038

ABSTRACT

Paeoniae Radix Rubra is a traditional Chinese medicine commonly used in clinical practice, it is mostly wild and widely distributed in different areas of China. In addition, the plant of Paeoniae Radix Rubra also has ornamental value. Modern phytochemical researches showed that the chemical constituents of Paeoniae Radix Rubra were complex. Up to now, more than 300 chemical constituents have been found, mainly including monoterpene glycosides, triterpenoids, flavonoids, tannins, phenolic acids, saccharides, steroids, volatile oils and so on. Among them, the content of monoterpene glycosides was the highest, and the types of volatile oil were the most. Paeoniae Radix Rubra has a wide range of pharmacological effects, exerting different curative effects in multiple systems such as blood, cardiovascular, nervous and digestive system. It can protect myocardial cells and nerve cells, stabilize microcirculation, anti-endotoxin, anti-atherosclerosis, reduce pulmonary hypertension, anti-depression, protect liver, anti-gastric ulcer, anti-tumor, slow down aging, treat Parkinson's syndrome and diabetes and its complications, anti-radiation, anti-inflammatory, anti-virus and so on. Through reviewing the literature on chemical constituents and pharmacological effects of Paeoniae Radix Rubra, it was found that total glycosides and monomers such as paeoniflorin, albiflorin, benzoylpaeoniflorin and gallic acid may be the main active components of Paeoniae Radix Rubra. At present, the research on Paeoniae Radix Rubra mainly focused on monoterpene glycosides, while the research on flavonoids and volatile oil in Paeoniae Radix Rubra was less. It is suggested that research on these two components should be strengthened in the future.

7.
Article in English | WPRIM | ID: wpr-903977

ABSTRACT

Although the contributions of sitagliptin to endothelial dysfunction in diabetes mellitus were previously reported, the mechanisms still undefined. Autophagy plays an important role in the development of diabetes mellitus, but its role in diabetic macrovascular complications is unclear. This study aims to observe the effect of sitagliptin on macrovascular endothelium in diabetes and explore the role of autophagy in this process. Diabetic rats were induced through administration of high-fat diet and intraperitoneal injection of streptozotocin. Then diabetic rats were treated with or without sitagliptin for 12 weeks. Endothelial damage and autophagy were measured. Human umbilical vein endothelial cells were cultured either in normal glucose or in high glucose medium and intervened with different concentrations of sitagliptin. Rapamycin was used to induce autophagy. Cell viability, apoptosis and autophagy were detected. The expressions of proteins in c-Jun N-terminal kinase (JNK)-Bcl-2-Beclin-1 pathway were measured. Sitagliptin attenuated injuries of endothelium in vivo and in vitro. The expression of microtubuleassociated protein 1 light chain 3 II (LC3II) and beclin-1 were increased in aortas of diabetic rats and cells cultured with high-glucose, while sitagliptin inhibited the over-expression of LC3II and beclin-1. In vitro pre-treatment with sitagliptin decreased rapamycin-induced autophagy. However, after pretreatment with rapamycin, the protective effect of sitagliptin on endothelial cells was abolished. Further studies revealed sitagliptin increased the expression of Bcl-2, while inhibited the expression of JNK in vivo . Sitagliptin attenuates injuries of vascular endothelial cells caused by high glucose through inhibiting over-activated autophagy. JNK-Bcl-2-Beclin-1 pathway may be involved in this process.

8.
Article in Chinese | WPRIM | ID: wpr-888120

ABSTRACT

The study aims to investigate the effect of the compatibility of paeonol and paeoniflorin(hereinafter referred to as the compatibility) on the expression of myocardial proteins in rats with myocardial ischemia injury and explore the underlying mechanism of the compatibility against myocardial ischemia injury. First, the acute myocardial infarction rat model was established by ligation of the anterior descending branch of the left coronary artery. The model rats were given(ig) paeonol and paeoniflorin. Then protein samples were collected from rat cardiac tissue and quantified by tandem mass tags(TMT) to explore the differential proteins after drug intervention. The experimental results showed that differential proteins mainly involved phagocytosis engulfment, extracellular space, and antigen binding, as well as Kyoto encyclopedia of genes and genomes(KEGG) pathways of complement and coagulation cascades, syste-mic lupus erythematosus, and ribosome. In this study, the target proteins and related signaling pathways identified by differential proteomics may be the biological basis of the compatibility against myocardial ischemia injury in rats.


Subject(s)
Acetophenones , Animals , Glucosides , Monoterpenes , Myocardial Ischemia/genetics , Myocardial Reperfusion Injury , Proteomics , Rats , Rats, Sprague-Dawley
9.
Article in Chinese | WPRIM | ID: wpr-888045

ABSTRACT

Lycii Cortex, the dry root bark of Lycium barbarum(Solanaceae), is rich in chemical compositions with unique structures, such as organic acids, lipids, alkaloids, cyclopeptides and other components, and plays an important role in traditional Chinese medicine. It has the effect of cooling blood and removing steam, clearing lung and reducing fire. It is mainly used in the treatment of hot flashes due to Yin deficiency, hectic fever with night sweat, cough, hemoptysis and internal heat and diabetes. Modern pharmacological studies have shown that the crude extract or monomer of Lycii Cortex has a variety of pharmacological activities, such as hypoglycemic, hypotensive, hypolipidemic, antibacterial, and antiviral effects. In this paper, the chemical constituents and pharmacological effects of Cortex Lycii were reviewed in order to further clarify its effective substances, promote the development of medical undertakings, and ensure the "Healthy China" plan.


Subject(s)
China , Hypoglycemic Agents , Lycium , Medicine, Chinese Traditional , Plant Bark
10.
Acta Physiologica Sinica ; (6): 423-432, 2021.
Article in Chinese | WPRIM | ID: wpr-887678

ABSTRACT

Chronic pain of knee osteoarthritis (KOA) greatly affects the quality of life and functional activities of patients. It is important to clarify the underlying mechanisms of KOA pain and the analgesic effect of different therapies. Neuroimaging technology has been widely used in the basic and clinical research of pain. In the recent years, neuroimaging technology has played an important role in the basic and clinical research of KOA pain. Increasing evidence demonstrates that chronic pain in KOA includes both nociceptive and neuropathic pain. The neuropathic mechanism involved in KOA pain is complex, which may be caused by peripheral or central sensitization. In this paper, we review the regional changes of brain pathophysiology caused by KOA pain based on magnetic resonance imaging (MRI), electroencephalogram (EEG), magnetoencephalogram (MEG), near-infrared spectroscopy (NIRS) and other neuroimaging techniques. We also discuss the central analgesic mechanism of different KOA therapies, with a focus on the latest achievements in the evaluation and prediction of pain. We hope to provide new thoughts for the treatment of KOA pain, especially in the early and middle stages of KOA.


Subject(s)
Chronic Pain/diagnostic imaging , Humans , Neuroimaging , Osteoarthritis, Knee/diagnostic imaging , Quality of Life , Technology
11.
Article in Chinese | WPRIM | ID: wpr-882345

ABSTRACT

Kawasaki disease is a systemic inflammatory disease of small and medium vessels in children under 5 years of age, which is also one of the most common causes of acquired heart disease in children.Stem cells are a kind of multipotential cells with the ability of self-renewal, self-replication and multi-differentiation.They are important biomaterials in modern regenerative medicine and tissue engineering.So far, substantial studies have found that stem cells such as endothelial progenitor cells, induced multifunctional stem cells, adipose-derived stem cells and so on are involved in the regulation of the pathogenesis of Kawasaki disease and play an important role in anti-inflammation and protection of the vascular endothelial cell damage.The potential of stem cells is gradually being developed and applied to the diagnosis and treatment of Kawasaki disease.However, the pathogenesis and treatment of stem cells in Kawasaki disease are not fully understood, and more basic and clinical trials are still needed.

12.
Article in Chinese | WPRIM | ID: wpr-879827

ABSTRACT

OBJECTIVE@#To study the clinical features of sleep-disordered breathing (SDB) in children with neuromuscular disease (NMD).@*METHODS@#A retrospective analysis was performed on the medical data of 18 children who were diagnosed with NMD and underwent polysomnography (PSG) (NMD group). Eleven children without NMD who had abnormal sleeping habit and normal sleep structure on PSG were enrolled as the control group. The two groups were compared in terms of the daily and nocturnal symptoms of SDB, incidence rate of obstructive sleep apnea (OSA), pulmonary function, end-tidal partial pressure of carbon dioxide (PetCO@*RESULTS@#In the NMD group, 16 children (89%) had related daily and nocturnal symptoms of SDB, and the youngest age was 1 year at the onset of such symptoms. Compared with the control group, the NMD group had significant reductions in total sleep time and sleep efficiency (@*CONCLUSIONS@#There is a high proportion of children with SDB among the children with NMD, and SDB can be observed in the early stage of NMD, which results in the damage of sleep structure and the reduction in sleep efficiency. Respiratory events are mainly obstructive events, and oxygen reduction events are mainly observed during REM sleep.


Subject(s)
Child , Humans , Neuromuscular Diseases/complications , Polysomnography , Retrospective Studies , Sleep , Sleep Apnea Syndromes/etiology
13.
Article in Chinese | WPRIM | ID: wpr-879430

ABSTRACT

OBJECTIVE@#To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment.@*METHODS@#Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L@*RESULTS@#There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling (@*CONCLUSION@#Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.


Subject(s)
Animals , Calcitonin , Calcitonin Gene-Related Peptide , Low Back Pain/therapy , Male , Nerve Growth Factor/genetics , Rats , Rats, Sprague-Dawley
14.
International Eye Science ; (12): 449-454, 2020.
Article in Chinese | WPRIM | ID: wpr-798275

ABSTRACT

@#AIM: To analyze the correlation between tear film lipid layer thickness(LLT)and macular microvascular parameters in diabetic retinopathy. <p>METHODS: Totally 60 eyes of type 2 diabetes patients with non-proliferative stage(NPDR group)and 60 eyes of proliferative stage(PDR group)with diabetic retinopathy diagnosed in our hospital from 2018-01/12 were selected, and 60 eyes of healthy volunteers with appropriate age and gender were selected as the normal control group. The tear film lipid layer thickness(LLT)was examined by Lipiview eye surface interferometer, while the foveal avascular zone(FAZ), superficial capillary layer(SCL)vessel density and deep capillary layer(DCL)vessel density were measured by optical coherence tomography angiography(OCTA)in three groups. The differences and correlations between the parameters were compared. <p>RESULTS: LLT(69.87±11.401nm)in normal control group was higher than that in NPDR(54.87±7.453nm)and PDR group(42.67±5.246nm), and FAZ(0.312±0.021mm2)was lower than that in NDPR group(0.389±0.037mm2)and PDR group(0.437±0.032mm2). The vascular density of SCL(51.977%±4.164%)was significantly higher than that of NPDR(47.067%±4.757%)and PDR(41.865%±5.512%), and that of DCL(49.578%±2.619%)was higher than that of NPDR(46.032%±2.622%)and PDR(40.598%±2.671%)(all <i>P</i><0.01). There was no correlation between LLT, FAZ, SCL and DCL in normal subjects. LLT was negatively correlated with FAZ in both NPDR group and PDR group(<i>r</i>=-0.922, <i>r</i>=-0.923, all <i>P</i><0.01), positively correlated with SCL(<i>r</i>=0.798, <i>r</i>=0.902, all <i>P</i><0.01), and had no correlation with DCL(<i>r</i>=0.140, <i>r</i>=0.073, <i>P</i>=0.285, <i>P</i>=0.581).<p>CONCLUSION: In diabetic retinopathy, the lipid layer of tear film is lower and the stability of tear film is decreased, and there is a correlation between diabetic dry eye and macular microvascular changes.

15.
Article in Chinese | WPRIM | ID: wpr-799566

ABSTRACT

Objective@#To investigate the surgical options for splenic lymph node dissection in patients with advanced gastric cancer undergoing radical total gastrectomy, and to evaluate the sentinel effect of No. 4s lymph node on splenic lymph node metastasis.@*Methods@#A prospective, single-center, randomized and controlled study was carried out (Trial registration, No.NCT02980861). Enrollment criteria: (1) >18 years old and <65 years old; (2) gastric adenocarcinoma locating in the proximal or corpus; (3) preoperative clinical staging as cT2-4aN0-3M0; (4) D2 radical total gastrectomy feasible judged before operation; (5) physical ability score 0 to 1; (6) I to III of ASA classification. Pregnant or lactating women, patients with severe mental illness or previous history of upper abdominal surgery, those suffered from other malignant tumors in the past 5 years, or heart and lung system diseases judged to affect surgery before operation, those receiving preoperative chemotherapy, radiotherapy or targeted therapies, and distant metastases being found during surgery were excluded. According to above criteria, 222 patients at The First Medical Center of Chinese PLA General Hospital from December 2016 to December 2017 were enrolled prospectively and were randomly divided into the laparoscopic splenic hilar lymph node dissection group (laparoscopic group, n=114) and the open splenic hilar lymph node dissection group (open group, n=108). The result of rapid frozen immunohistochemistry of harvested No.4s lymph nodes was used to evaluate the sensitivity and specificity of sentinel effect on splenic hilar lymph node metastasis. The surgical parameters, postoperative recovery parameters, and complication rates were compared between the two groups.@*Results@#There were 80 males and 34 females in the lapascopic group with a mean age of (56.1±10.2) years, and 69 males and 39 females in the open group with a mean age of (58.4±10.9) years. There were no significant differences in baseline data between the two groups (all P>0.05). Total blood loss was less in the laparoscopic group [(96.3±82.4) ml vs. (116.6±101.9) ml, t=1.124, P<0.001], and the amount of bleeding from the splenic hilar lymph nodes dissected was also less than that in the open group [(25.3±17.8) ml vs. (59.5±36.4) ml, t=1.172, P<0.001]. However, the operation time, the time of splenic hilar lymph node, the number of lymph node dissected and number of splenic hilar lymph node dissected were not significantly different between the two groups (all P>0.05). As compared to the open group, the laparoscopic group had shorter time to the first flatus [(1.3±1.2) days vs. (1.6±1.5) days, t=1.665, P=0.021], shorter time to fluid diet [(4.6±1.4) days vs. (4.9 ± 1.6) days, t=1.436, P=0.007], shorter time to remove nasogastric tube [(3.9±2.6) days vs. (4.3±2.4) days, t=0.687, P<0.001] and shorter hospital stay [(10.3±6.6) days vs. (12.1±7.2) days, t=0.697, P<0.001]. Complication rate was 14.0% (16/114) and 12.0% (13/108) in the laparoscopic group and the open group, respectively, without significant difference (χ2=6.723, P=0.331). The sensitivity of the No. 4s lymph node for the prediction of splenic hilar lymph node metastasis reached 89.5%, and the specificity reached 99.6%.@*Conclusions@#Laparoscopic technique is safe and feasible in the treatment of splenic hilar lymph node dissection in advanced gastric cancer. The No.4s lymph node examination has good sentinel effect on predicting the metastasis of splenic hilar lymph nodes.

16.
Article in Chinese | WPRIM | ID: wpr-864048

ABSTRACT

Objective:To explore the clinical characteristics, drug resistance and the serotype distribution of the isolates from peadiatric patients with pneumococcal meningitis (PM).Methods:Clinical data, follow-up outcomes, drug susceptibility of isolated strains and serotyping results of 72 children diagnosed as PM and hospitalized in Beijing Children′s Hospital, Capital Medical University, from January 2012 to December 2017 were retrospectively analyzed, and the independent risk factors of mortality in the PM patients were analyzed.Results:There were 46 males and 26 females.In 72 PM cases, with the age ranging from 1 month to 9 years, and hospital stay from 1 to 363 days(median, 22.0 d). A total of 71 cases (98.6%) had community-acquired infections.There were 28 cases (38.9%) with definite underlying diseases, the top 3 of which were cerebrospinal fluid rhinorrhea(6 cases), head trauma (4 cases)and immunodeficiency diseases (4 cases). Fever (72 cases, 100.0%) was the most common clinical symptom, followed by depression of spirit, change of consciousness (46 cases, 63.9%), vomitting (45 cases, 62.5%), convulsion (42 cases, 58.3%), increased tension of anterior fontanelle (27 cases, 37.5%) and headache (17 cases, 23.6%) .There were 44 cases (61.1%) of neurological complications, including 29 cases (40.3%) of subdural effusion.Bacterial meningitis recurred in 2 cases, both of which were recurrent Streptococcus pneumoniae infection.The intracranial infections were divided into meningitis (43.1%, 31/72 cases) and meningoencephalitis (56.9%, 41/72 cases) .The penicillin nonsensitive rate of meningitis isolates was 74.3%, and their resistance rate to Erythromycin, Clindamycin and Tetracycline were 95.7%, 95.7% and 89.1%, respectively.All meningitis isolates were susceptible to Levofloxacin, Vancomycin and Linezolid.The serotypes of 24 cases (33.3%) were identified, among which 8 strains were type 19F (33.4%), 5 strains were type 14, 4 strains were type 23F, 3 strains were type 6A, 2 strains were type 19A, 1 strain was type 1 and 1 strain was type 15B, with a 13-valent protein-polysaccharide conjugate vaccine (PCV13) coverage rate of 95.8%(23/24 strains). Among all children that were followed up, 51 cases got better, 21 cases (case fatality rate was 29.2%) were confirmed dead, and 21 children (29.2%) had sequelae.The multiva-riate Logistic regression analysis suggested that respiratory failure and peripheral blood white blood cell count <4×10 9/L were independent risk factors for death of children with PM(all P<0.05). Conclusions:Most PM cases in this center are children under 5 years old.Cerebrospinal fluid rhinorrhea, head trauma and immunodeficiency diseases are common underlying diseases in children with PM.Respiratory failure or peripheral blood leukopenia during the course of the disease may indicate a poor prognosis.

17.
Article in Chinese | WPRIM | ID: wpr-846403

ABSTRACT

Since the coronavirus disease 2019 (COVID-19) outbreak, National Health Commission of the People's Republic of China and local departments have released a number of diagnosis and treatment plans for COVID-19. One of the recommended prescriptions for severe stage treatment is Huanglian Jiedu Decoction, whose TCM syndrome is corresponding to the severe syndrome of dual blaze of qi and nutrient in the COVID-19 protocol of Diagnosis and Treatment of Novel Coronavirus Pneumonia (trial version 7). Huanglian Jiedu Decoction can be used in the treatment of syndrome of dual blaze of qi and nutrient. Syndrome of dual blaze of qi and nutrient is with consumption of nutrient yin of body fluid, pathogenic qi always triumphing over healthy qi, excessive noxious heat from qi and nutrient, Huanglian Jiedu Decoction has the efficacy of clearing heat and detoxicating. It can achieve the therapeutic purpose of nourishing yin and protecting yin by removing evil spirits. Modern pharmacological studies have shown that Huanglian Jiedu Decoction has potential effects of anti-inflammatory and antipyretic, antiviral, antioxidant, regulating immunity and protecting viscera and tissues in the treatment of COVID-19 with severe syndrome of dual blaze of qi and nutrient. In this paper, the pathogenesis evolution of COVID-19 with severe syndrome of dual blaze of qi and nutrient, the relationship between prescriptions and syndromes of Huanglian Jiedu Decoction and its modern pharmacological effects was analyzed, so as to provide a basis for the effective treatment of Huanglian Jiedu Decoction in COVID-19 with severe syndrome of dual blaze of qi and nutrient.

18.
Acupuncture Research ; (6): 587-591, 2020.
Article in Chinese | WPRIM | ID: wpr-844134

ABSTRACT

Acupuncture therapy has been shown to have a positive effect in treating symptoms of patients with traumatic brain injury (TBI) in China. The present paper summarizes findings of recent researches on the underlying mechanisms of acupuncture intervention for improving TBI from 1) inhibiting inflammatory response, 2) regulating neurotransmitters, 3) promoting nerve repair and regeneration, 4) antioxidation, 5) inhibiting intracellular calcium overload, 6) regulating aquaporin content, 7) regulating cellular energy metabolism, 8) improving brain circulation, and 9) inhibiting cell apoptosis.

19.
Article in Chinese | WPRIM | ID: wpr-872941

ABSTRACT

In recent years, with the rapid development of economy and the change of life style, the prevalence rate of diabetes has increased year by year, which has become a worldwide problem threatening the health of all mankind. According to epidemiological studies, most patients with diabetes are mainly type 2 diabetes mellitus(T2DM), accompanied by insulin resistance and insufficient insulin secretion. The interaction of many factors such as inflammation, obesity, oxidative stress and apoptosis leads to the occurrence of insulin resistance. At present, the commonly used hypoglycemic drugs include insulin and related preparations, biguanides, sulfonylureas, α-glycosidase inhibitors, glinids, thiazolidinediones, dipeptidyl peptidase-Ⅳinhibitors and so on. Although appropriate exercise, lifestyle changes and oral hypoglycemic drugs are effective in the treatment of mild T2DM. However, long-term and combined medication is needed for patients with severe diabetes or with related complications, which increases the risk of drug side effects and adverse reactions. Chinese herbal medicine has been used in China for thousands of years, such as Huanglian jiedutang and Yangyin Jianpitang. Similarly, many single traditional Chinese medicines also have their own advantages in the treatment of T2DM, such as Ophiopogonis Radix,Ginseng Radix et Rhizoma,Momordica Charantia,Euodiae Fructus,Alismatis Rhizoma,Astragali Radix,Notoginseng Radix et Rhizoma,Anemarrhenae Rhizoma,Dioscoreae Rhizoma and other traditional Chinese medicines have ideal effects in reducing blood sugar and improving insulin resistance. However, the active substances and targets in a considerable number of prescriptions or single medicines are not clear. Recently, more and more natural products have been proved to have anti-T2DM properties, and their possible therapeutic mechanisms have been explored. The purpose of this paper is to comprehensively review the effects and related targets of natural active substances such as flavonoids, polyphenols, alkaloids, terpenoids, polysaccharides and quinones on T2DM, and to provide theoretical support for better research and development of drugs for the treatment of diabetes and its complications.

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Article in Chinese | WPRIM | ID: wpr-871051

ABSTRACT

Objective:To investigate the clinical characteristics and experience in the diagnosis and treatment of neonatal gastric perforation, and the factors influencing prognosis.Methods:This was a retrospective analysis involving 49 neonatal gastric perforation cases who underwent surgical treatment in the Neonatal Surgery Department of Shanxi Children's Hospital from January 2008 to December 2017. Their clinical data, including manifestations, auxiliary examinations, operations, and prognosis, were analyzed. According to the prognosis, these patients were divided into two groups, survival group, and fatality group. Independent sample t-test or continuity correction Chi-square (or Fisher's exact) test was used for statistical analysis. Results:(1) Of the 49 cases, 29 (59.2%) were boys, and 20 (40.8%) were girls. There were 30 (61.2%) premature and 19 (38.8%) full-term babies. Their birth weight ranged between 1 010 and 5 000 g with an average of (2 450±700) g. Low birth weight infants accounted for 59.2% (29/49). There were 11 cases (22.4%) having perinatal adverse events, 17 (34.7%) complicated by septic shock before the operation, and six (12.2%) with digestive tract malformation. Two cases (4.1%) underwent resuscitation due to postnatal asphyxia; two (4.1%) received mechanical ventilation due to respiratory distress syndrome; 12 (24.5%) received indwelling were indwelled gastric tube or gastric lavage. (2) The average onset time of neonatal gastric perforation in the 49 cases was (3.8±2.0) d after birth, and 47(95.9%) of them presented initial symptoms within one week, including 36 within four days. Twenty-five cases (51.0%) were operated within 12 h after the onset. (3) The common first symptoms include abdominal distention [69.4% (34/49)] and abdominal distension complicated with vomiting (24.5%, 12/49). Thirty-nine cases (79.6%) showed a large amount of free gas under the diaphragm, compressed and down-moving liver, and decreased or disappeared stomach bubble in the preoperative abdominal radiograph. (4) All cases received emergency laparotomy and primary gastric wall repair after admission. During the operation, 27 (55.1%) of all the cases had perforation at the greater curvature, five (10.2%) at the lesser curvature, 14 (28.6%) at the anterior wall, and three (6.1%) at the posterior wall. Perforation larger than 3 cm in diameter was found in 33 cases (67.3%). Three cases (6.1%) had postoperative wound infection; two (4.1%) developed anastomotic leakage; one was complicated by pneumohydrothorax 48 h after the operation due to esophageal duplication and perforation, which was confirmed by a second operation. (5) Of the 49 cases, 35 (71.4%) were due to congenital gastric wall muscular defect, four (8.2%) were caused by iatrogenic injury, and 10 (20.4%) were spontaneous perforation. (6) Among all cases, 36 (73.5%) survived, while eight (16.3%) died, and five (10.2%) withdraw treatment after the operation. After excluding the five cases giving up treatment after the operation, the proportion of patients who underwent operation within 12 h after onset or had the perforation <3 cm in diameter was higher in the survival group than in the fatality group [61.1% (22/36) vs. 1/8, χ2=4.404, P<0.05; 41.7% (15/36) vs. 0/8, P<0.05], and the incidence of septic shock before the operation was lower [22.2% (8/36) vs. 6/8, χ2=6.147, P<0.05]. Conclusions:Neonatal gastric perforation shows a high mortality rate, and its underlying pathologic etiology is congenital gastric wall muscle defect. Abrupt abdominal distension is the main clinical manifestation. Early operation is critical to improving neonatal prognosis.

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