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We investigated the effectiveness of hangekobokuto in alleviating dysphagia and aspiration pneumonia attributed to latestage neurosyphilis. Our study subject, a 67-year-old man treated for his leg pain in our department, hoped this treatment would relieve his severe cough and sore throat. According to a neurological investigation and the analysis of blood and cerebrospinal fluid, his symptoms (swallowing disturbance and aspiration pneumonia in the lower lobes of both lungs) led to the diagnosis of cerebral bulbar paralysis caused by latestage neurosyphilis. The patient requested drug therapy ; thus, we prescribed 7.5 g/day of hangekobokuto, to be administered orally, based on his medical findings of qi stagnation and tan yin. Dysphagia was relieved one week after oral administration of hangekobokuto, and after three weeks, the patient's discomfort had almost disappeared. Moreover, aspiration pneumonia was also improved in his chest CT image finding. Late-stage neurosyphilis symptoms usually develop within 20 to 30 years of contracting syphilis, an infection caused by the bacterium Treponema pallidum. Symptoms may include a loss of swallowing reflex and cough reflex due to the paralysis of cerebral basal ganglia. However, hangekobokuto was found to increase the concentration of substance P released in the pharyngeal head and tracheal mucosa, and thus improve swallowing function. We conclude that hangekobokuto is a useful agent for alleviating the swallowing abnormality of late-stage neurosyphilis.
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Objective To investigate the predictive value of extra pulmonary multiple factors including creatine kinase-isoenzyme MB (CK-MB) for the prognosis of patients with acute paraquat poisoning.Methods A retrospectively analysis were conducted on 641 patients who were treated at the First Affiliated Hospital of Zhengzhou University due to oral paraquat poisoning from October 2002 to April 2017.The observation end point was that the patients died from paraquat poisoning within 3 months after admission or were still alive within 3 months after paraquat poisoning.The patients' data were retrieved,including general information,the dose of poison,urinary paraquat concentration,arterial blood gas analysis,alanine transaminase (ALT),total bilirubin (TBIL),uric acid (UA),aspartate transaminase (AST),creatine kinase (CK),CK-MB,B type natriuretic peptide (BNP),lactic dehydrogenase (LDH),high sensitivity troponin T (hsTnT),C-reaction protein (CRP) and procaicitonin (PCT).According to the patient's prognosis within 3 months,the patients were divided into a survival group and a non-survival group.The above indicators were compared between the two groups and the diagnostic value of CK-MB for acute paraquat poisoning was analyzed according to the receiver operating characteristics (ROC) curve.Collect the last arterial blood gas analysis,and laboratory test results were analyzed by binary logistic regression analysis to determine the risk factors for death in patients with acute paraquat poisoning.Results Among the 641 patients with acute paraquat poisoning,315 (49.1％) patients survived and 326 (50.9％) died.Compared with the survival group,patients in the non-survival groupthere were older,had a shorter hospital stay,and had a higher oral paraquat dose and urinary paraquat concentration;Lac,TBIL,UA,AST,CK,CK-MB,BNP,LDH,CRP and PCT were higher,while blood gas analysis index were lower in the non-survival group (P＜0.05).Binary logistic regression analysis showed that the dose of paraquat,CK-MB and AST were closely related to the prognosis of patients with acute paraquat poisoning.The optimal cut-off value of ingestion dose,the first urinary paraquat concentration on admission and CK-MB in predicting the prognosis of patients with acute paraquat poisoning were 7 g (AUC=0.918,sensitivity 80.6％,specificity 87.5％,Yoden index 0.681,P＜0.01),5.16 μg/mL (AUC=0.879,sensitivity 93.8％,specificity 70.1％,Yoden index 0.639,P＜0.01),and 18.2 U/L (AUC=0.846,sensitivity 83.9％,specificity 71.9％,Yoden index 0.558,P＜0.01),respectively.Binary logistic regression analysis of the last biochemical indicators of paraquat poisoning showed that the dose of poison,the last CK-MB,the last SCr,urinary paraquat concentration,and the last blood Na+ were closely related to the prognosis of patients with acute paraquat poisoning.Among them,the last CK-MB＞18.05 U/L often indicated poor prognosis (AUC=0.808,sensitivity 79.7％,specificity 65.8％,Yoden index 0.455,P＜0.01).Conclusions In the treatment of patients with acute paraquat poisoning,there are significant differences in extra pulmonary factors such as heart,liver,kidney,electrolytes and inflammatory markers in patients with different prognosis,so the monitoring and follow-up should be improved,in addition to focusing on the presence and treatment of pulmonary fibrosis.In particular,CK-MB is an independent risk factor for the prognosis of acute paraquat poisoning.In the late stage of poisoning,CK-MB,SCr,and blood Na+ have a strong predictive value for the prognosis of the patients,and we should pay attention to the regular follow-up of the above mentioned laboratory items.
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Objective The aim of this study was to investigate the association between maternal serum lev-el of neutrophil-lymphocyte ratio(NLR)and preterm labor in late stage of pregnancy. Methods In this retrospec-tive analysis of 200 pregnant women who underwent routine prenatal examination and delivered from January 12016 to December 312016 in the Maternal and Child Health family planning services,Xinhui District,Jiangmen city. The patients were divided into the PIR group(n = 100)and the control group(n = 100). The levels of leuko-cytes,neutrophils,lymphocytes,CRP and NLR of the two groups were compared. Multivariate analysis was per-formed to identify independent risk factor. Logistic regression model was established and the area under the receiver operating characteristic curve(ROC)was recorded for analysis of the prognostic value of different serum inflamma-tory makers in late stage of pregnancy. Results The NLR predict premature occurrence of AUC,the sensitivity and specificity of which were higher than those of peripheral blood leukocyte,neutrophil count,lymphocyte count and CRP. Conclusion Increased NLR in late stage of pregnancy could serve as an effective factor to predict the risk of preterm labor.
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Objective To evaluate the effect of gastric compound on patients with middle-late gastric cancer of spleen deficiency and stasis toxin. Methods Ninety patients with middle-late gastric cancer of spleen deficiency and stasis toxin were randomly divided into combined group, chemotherapy group, and gastric compound group, 30 cases in each group. Patients in the combined group were treated with gastric compound and chemotherapy;patients in the chemotherapy group were treated with placebo;patients in the gastric compound group were treated with gastric compound. The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky integral, and toxic and side effects of digestive tract and myelosuppression were observed to evaluate the effect of gastric compound on quality of life in patients. Results The changes of QLQ-C30 scale integral, fatigue scale intergral, TCM symptom intergral, Karnofsky intergal in combined group were better than those in chemotherapy group and gastric compound group, with statistical significance (P<0.05). The changes of fatigue scale intergral and TCM symptom intergral in gastric compound group were better than those in chemotherapy group, with statistical significance (P<0.05). The myelosuppression and toxic and side effects of digestive tract of combined group was lighter than those of chemotherapy group, with statistical significance (P<0.01). Conclusion Gastric compound combined with chemotherapy can improve quality of life in patients with middle-late gastric cancer of spleen deficiency and stasis toxin, and reduce myelosuppression and toxic and side effects of digestive tract.
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Objective To investigate the effects of Qi-Boosting Toxin-Resolving Formula (QBTRF) on CD4+CD25+ regulatory T cells and Th17 cells of patients with middle to late staged nasopharyngeal carcinoma (NPC). Methods Flow cytometry was performed to detect the ratio of CD4+CD25+ regulatory T cells and Th17 cells in the peripheral blood mononuclear cells (PMBC) among 18 patients with middle to late stage of NPC treated by QBTRF added to conventional therapy (treatment group), Foxp3 mRNA and ROR-γt mRNA in PMBC was determined by RT-PCR technique. Furthermore, serum levels of IL-6 and TGF-β were assayed by ELISA. Meanwhile, 15 patients with NPC treated by conventional therapy were taken as the control group. Results The ratio of CD4+CD25+ regulatory T cells to the total CD4+ T cells and the transcriptional level of Foxp3 mRNA in PMBC were significantly lower in treatment group than that of control group (P<0.05), the ratio of Th17 cells to the total CD4+T cells and the transcriptional level of ROR-γt mRNA in PMBC were significantly higher in treatment group than that of control group (P<0.05). However, the serum level of IL-6 was obviously higher in treatment group than that of control group (P<0.05), and the serum leve of TGF-βwas obviously lower in treatment group than that of control group (P<0.05). Conclusion QBTRF can significantly affect the number ratio and functional activity of CD4+CD25+ regulatory T cells and enforce the differentiation of Th17 cells among patients with middle to late staged NPC, which it may be reversed the immune tolerance of NPC through regulating the level of IL-6 and TGF-β.
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Objective To evaluating the effectiveness of comprehensive measures to control the plague in epidemic areas in Longlin county Guangxi from 2001 to 2010.Methods Original epidemic places was deratised,indicative animals were investigated,and epidemic clues were searched.Cage trapping method was used to capture rat and rat body fleas were collected in the plague epidemic areas.The flea-carrying rates and flea index of rodents were calculated based on the number of fleas collected from caged rodents.The animals were then subjected to etiological and serological tests to determine the plague infection rate.Results A total of 1008 rats were captured and 571 fleas were collected from 2001 to 2010,of which Rattus Flavipestus accounted tor 81.65％(823/1008) and Xenopsylla Cheopis for 64.10％(366/571).The annual average rodents infected with flea and the index of flea were 23.02％ (177/769) and 0.74,respectively.The annual average density of rodents decreased from 3.99％ (859/21 508,before deratised) to 0.96％ (149/15 600,after deratised).The deratization rate was 75.94％.Conclusion The risk of a plague epidemic in Longlin county is reduced after continued comprehensive measures be taken to deal with the disease.
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Objective To explore the impact of comprehensive musing intervention on the accuracy of non-stress test (NST). Methods With sealed envelope method, 400 cases of primiparous pregnant women without high risk factors were randomly divided into the research group and the control group with 200 cases in each group. The research group was given comprehensive care intervention, the control group received routine nursing. The incidence of non reaction of non-stress test, Apgar score no higher than 7 points, amniotic fluid pollution and cesarean section rate were compared between the two groups. Results The incidence of non reaction of NST was 15.08% in the research group, which was lower than 29.40% of the control group. The incidence of Apgar score no higher than 7 points and amniotic fluid pollution were 8.5% and 19.0% respectively in the research group, which showed no significant difference compared with those of the control group. The cesarean section rate in pregnant was 38.5% in the research group, which was significantly lower than 65.5% of the control group. Conclusions Comprehensive care intervention is effectively to improve the accuracy of NST , so that it can reduce cesarean section rate.
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Objective To observe effect of Sanshen granule preparation combined with MVP regimen in treating middle-late stage non-small cell lung cancer patients. Methods 152 middle-late stage non-small cell lung cancer patients were randomly assigned to treatment group (79 patients) and control group (73 patients). Results Clinical beneficial rate (CR+PR+SD≥6 Months) were 82.3% and 64.4% respectively (P
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Objective To discuss the feasibility of the lung transplantation as an effective treatment for end-stage pulmonary diseases domestically and to compare the major issues involving the practice of lung transplantation domestically and overseas.Methods After the foundation of group of lung transplantation in May 2002, lung transplantation models of porcine were set up. From September 2002 to April 2005, in the 18 cases undergoing lung transplantation, there were subjected to single-lung transplantion (SLT, 83.3%) and 3 bilateral sequential single lung transplants without CPB (DSSLT, 16.7%). Indications for SLT (n=15) included emphysema (n=9), pulmonary fibrosis (n=3), pneumosilicosis (n=1), lymphangioleiomyomatosis (n=1) and ventricular septal defect (VSD) induced Eisenmenger's syndrome (n=1); for DSSLT (n=3) bronchiectasis (n=1) and pulmonary emphysema (n=2). Among the 15 SLTs, there were 9 cases of left SLT and 6 right SLT. Among them, 2 cases shared one same donor's lung block, one case received contralateral lung transplantation―a left donor lung implanted in the recipient’s right thorax, and one case simultaneous right SLT and VSD repair. Results In hospital mortality (HM) was 3/18 ( 16.7%). Among SLTs, early death was due to severe rejection on the 30th postoperative day in one patient and acute rejection on the 15th postoperative day in other patients, and another patient died due to pulmonary vein embolism on the 36th day. There were 3 and 2 patients with the survival time longer than 1 and 2 years respectively. The median overall survival was 10 (2 to 32) months. Conclusions Our LT program shows similar results to those reported by the International Society for Heart and Lung Transplantation for developed countries. The key of successful operation depends on the establishment of group of lung transplantation and cooperation of multi-department. Ischemic-reperfusion injury, acute-rejection and infection are the major reasons of deaths shortly after the operations.