Evaluation of the Effects of Tianma Gouteng Decoction Combined with Magnesium Sulfate and Labetalol on Lowering Blood Pressure and Improving Hemorheology in Patients with Gestational Hypertension / 广州中医药大学学报

Objective To observe the effects of Tianma Gouteng Decoction combined with magnesium sulfate and Labetalol on lowering blood pressure and improving hemorheology in patients with gestational hypertension.Methods Ninety patients with gestational hypertension of liver-yang hyperactivity type were randomly divided into the combination group and the control group,with 45 cases in each group.The control group was treated with magnesium sulfate combined with Labetalol,and the combination group was treated with Tianma Gouteng Decoction on the basis of treatment for the control group.The course of treatment lasted for 5 days.The changes of systolic blood pressure(SBP),diastolic blood pressure(DBP),urinary protein level,and hemorheological indicators of the two groups were observed before and after the treatment.Moreover,the adverse pregnancy outcomes,adverse reactions,and patients'satisfaction of the two groups were compared.Finally,the influencing factors of patients'adverse pregnancy outcomes were investigated by logistic regression analysis.Results(1)After treatment,the SBP,DBP and urinary protein level of patients in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the combination group was significantly superior to that in the control group(P＜0.01).(2)After treatment,the hemorheological indicators of plasma viscosity,whole blood viscosity and hematocrit of patients in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the combination group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(3)The total incidence of adverse pregnancy outcomes in the combination group was 11.11%(5/45),which was significantly lower and that in the control group(33.33%,15/45),the difference being statistically significant(P＜0.05).(4)The patients'satisfaction of the combination group was 97.78%(44/45),which was significantly higher than that of the control group(84.44%,38/45),and the difference was statistically significant(P＜0.05).(5)The total incidence of adverse reactions in the combination group was 13.33%(6/45)and that in the control group was 8.89%(4/45),but the intergroup comparison showed no significant difference between the two groups(P＞0.05).(6)Logistic regression analysis of influencing factors showed that no medication of Tianma Gouteng Decoction combined with Labetalol and magnesium sulfate,and poor antihypertensive effect were the independent risk factors for adverse pregnancy outcomes in patients with gestational hypertension(all OR＞1,P＜0.05).Conclusion Tianma Gouteng Decoction combined with magnesium sulfate and Labetalol in treating gestational hypertension exerts certain antihypertensive effect,and the therapy can effectively improve the hemorheological indicators and the adverse pregnancy outcomes,and enhance the patients'satisfaction.

Advances in diagnosis and treatment of pulmonary embolism / 医疗卫生装备

The clinical manifestations and classification of pulmonary embolism (PE) were described,and the causes and risk factors were analyzed for venous and pulmonary embolism.The significance and methods for early diagnosis of pulmonary embolism were discussed.Some techniques for diagnosing and treating PE were introduced.It's pointed out that PE diagnosis and treatment may be changed greatly with the involvement of multi-slice CT and MRI in elementary hospitals,being standardized imaging examination techniques as well as developing treatment measures.

Advances in diagnosis and treatment of pulmonary embolism / 医疗卫生装备

The clinical manifestations and classification of pulmonary embolism (PE) were described,and the causes and risk factors were analyzed for venous and pulmonary embolism.The significance and methods for early diagnosis of pulmonary embolism were discussed.Some techniques for diagnosing and treating PE were introduced.It's pointed out that PE diagnosis and treatment may be changed greatly with the involvement of multi-slice CT and MRI in elementary hospitals,being standardized imaging examination techniques as well as developing treatment measures.

Four new triterpenoid saponins from Polygala crotalarioides / 中草药

Objective: To study the chemical constituents of Polygala crotalarioides. Methods: The compounds were isolated by silica gel, RP-18, Sephadex LH-20 column chromatography, and semi-pre HPLC. Their structures were elucidated on the basis of spectral analysis and chemical evidence. Results: Four oleanane-type saponins were isolated from the roots of P. crotalarioides. Their structures were elucidated as 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[β-D-glucopyranosyl-(1→3)]-β-D-fucopyranoside (1), 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-4″-mehoxycinnamoyl]-β-D-fucopyranoside (2), 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-3″, 4″-dimethoxycinnamoyl]-β-D-fucopyranoside (3), and 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-3″, 4″, 5″-trimethoxy-cinnamoyl]-β-D-fucopyranoside (4), respectively. Conclusion: Compounds 1-4 are new compounds named crotalarioside C, (E/Z)-crotalariosides D, E, and F, respectively. Among them, compounds 2-4 are cis-trans-isomers, which can not be separated by the experimental technique because of the configuration.

Spectrum-effect relationship of different parts from Ershen Pill on warming spleen to relieve diarrhea / 中草药

Objective: To clarify the contribution of the fingerprint peaks from different parts of prepared Ershen Pill to the effect of warming spleen to relieve diarrhea, and to reflect the material basis. Methods: The HPLC fingerprints of different parts of Ershen Pill (composed of Psoraleae Fructus stir-baked with saltwater and Myristica Fragrans simmered with bran) were established. The diarrhea index of acute diarrhea in mice caused by senna leaf was researched to compare the effect of warming spleen to relieve diarrhea. Results: The fingerprints of different parts of Ershen Pill were established, and all of the similarity degrees were over 0.90. The effect of warming spleen to relieve diarrhea of Ershen Pill was obtained from many constituents collaboratively. The contribution of different peaks to relieve diarrhea with astringents was ranked as 6 > 18 > 7 > 20 > 14 > 21 > 1 > 25 > 24 > 23 > 4 > 3 > 8 > 11. Conclusion: The method for establishing HPLC fingerprints of different parts of Ershen Pill is simple and repeatable. The relationship between the fingerprints and the effect of warming spleen to relieve diarrhea is paralleled to some extent. And this will lay a foundation for the research of processing mechanism of Ershen Pill.

Research on building method of spleen kidney Yang deficiency diarrhea rats model / 中国中药杂志

Spleen kidney Yang deficiency (SKYD) diarrhea is a common syndrome in tranditional Chinese medicine (TCM). Until now, there is not an ideal SKYD diarrhea rat model for the research. In this study, we compared single factor way (method I, injecting hydrocortisone and gavaging Sennae Folium) with compound factors way(method II, gavaging adenine, improper diet, exhaustion, and gavaging Sennae Folium) on establishing SKYD diarrhea rat model. After modelling, diarrhea index, D-xylose excretory rate, NOS/cGMP signal transduction system, organ index and histopathology examination were used to evaluate the two ways. The results showed that, compared with health group, all the assessment criterias of method I and method II had significant differences (P < 0.01, 0.05). In addition, the index such as diarrhea index, NOS/cGMP signal transduction system, organ index (kidney, testis and thymus) and histopathology examination had significant differences (P < 0.01, 0.05) between method I and method II. In conclusion, the compound factors modelling method better conforms to the symptom of diarrhoea model caused by SKYD. This new modelling method provides a basis for studying on TCM astringents warming and tonifying the spleen and kidney, relieving diarrhea.

Detecting underlying malignancy with 18F-FDG PET/CT in patients with suspected paraneoplastic neurological syndrome / 中华核医学杂志

Objective To evaluate 18F-fluorodeoxyglucose (FDG) PET/CT in detecting occult malignancy in patients with suspected paraneoplastic neurological syndrome (PNS).Methods Twenty consecutive patients who underwent PET/CT scanning with the indication of suspected PNS were retrospectively reviewed.The gold standard of PNS was either cytology or clinical follow-up, and the final diagnosis was compared with PET/CT findings.Results Of the 20 patients, six were PNS.PET/CT detected nine cases.Six were true positive and three were false positive.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 100% (6/6), 78.57% (11/14), 85.00% (17/20),66.7% (6/9) and 100.00% ( 11/11 ) respectively.The treatment plan was modified based on the PET/CT results in 4 patients.Conclusions 18F-FDG PET/CT may play a role in detecting the underlying malignancy of PNS.It is also valuable in staging of the malignancy thus providing information for therapy decision making.