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Objective To study the clinical significance of dexamethasone (DT) in the combined spinal and epidural anesthesia for delivery of elderly parturient women. Methods 134 elderly parturient women were selected as the research object, and randomly divided into two groups. 69 cases in DT group received intramuscular injection of dexamethasone and combined anesthesia, while 65 cases in INN group received intramuscular injection of tramadol (INN) and combined spinal and epidural anesthesia. The anesthetic effect of the two groups were observed. Results After treatment, the interleukin (IL-6), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α) and methane dicarboxylic aldehyde (MDA) in DT group were significantly higher than INN group (P<0.05). The five kinds of immunoglobulins levels (IgA, IgD, IgE, IgG and IgM) in DT group were higher than those in INN group (P<0.05). The heart rate (HR) in DT group was lower and mean arterial pressure (MAP) was higher than that in INN group(P<0.05). There was 1 cases of macrosomia, 2 cases of premature delivery in DT group, the adverse pregnancy outcomes was 4.35%(3/69). there was 1 cases of macrosomia, 1 cases of congenital deformity, 1 cases of premature delivery and 1 case of postterm delivery in DT group, the adverse pregnancy outcomes was 5.80%(4/69), with no significant difference between two groups. Conclusion Dexamethasone combined with anesthesia is very effective for delivery of elderly parturient women which shows very good anti-inflammatory and immunoregulation.
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This study was aimed to analyze the "disease-syndrome-treatment-medicine" experiences of professor Ding for diabetes combined with hypertension by using "traditional Chinese medicine (TCM) inheritance support system (V2.5)".By analyzing the data,we summarized Professor Ding's academic experiences.Through collecting the standard clinical cases,combined with the software analysis system,the composing principles were analyzed by using data mining methods such as frequency statistics,revised mutual information,association rules analysis,cluster analysis,improvement of mutual information,complex system entropy clustering,unsupervised hierarchical clustering entropy and so on.The analysis results showed that 28 patients with diabetes combined with hypertension of yin-deficiency and yang-hyperactivity syndrome,the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis,concha margaritifera,rhizoma gastrodiae;the highest-frequency used drug combinations were "radices rehmanniae,rhizoma dioscoreae","folium mori,cortex mori","semen cuscutae,rhizoma dioscoreae,radices rehmanniae" and so on.Analyzing the 27 patients with diabetes combined with hypertension "wind and fire evils stir up syndrome,the characteristics were discovered that the highest-frequency used drugs of Ping Gan Xi Feng were concha haliotidis,concha margaritifera.In addition to the most common combinations used in diabetes,there were "rhizoma coptidis,spica prunellae","spica prunellae,folium mori","rhizoma coptidis,radices rehmanniae,cortex lycii","spica prunellae,folium mori,rhizoma coptidis" and so on.It was concluded that the syndrome differentiation and treatment of diabetes combined with hypertension was focused on the etiology and pathogenesis of wind and fire.The main treatment principle was to calm the liver to stop the wind,nourish yin and suppress hyperactive yang.
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Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .
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To explain the relation between diabetic vasculopathy and'Blood blocking collaterals and phlegm turbidness not being removed'proposed by Mr.ZHU Kan-yu.It is believed that the turbidness is the basic pathological product during the development of diabetes.Blood glucose remains high,which reflects the disorders of transportation and distribution of turbid yin and qi in the body.That is to say that the thick coreal nutrients in the vessels are unable to be distributed and absorbed but stay in the vessels as turbid pathologic factors.Blood stasis and phlegm is the further result of turbid pathologic factors.The TCM explanation of diabetic vasculopathy is that phlegm,turbidness,blood stasis block the meridians and collaterals.Those visible pathological factors deposit in vessels and cause narrow vessels and thick walls.Meanwhile the deposit stimulates,spreads,erodes and burns the walls and finally ruins the walls.