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Objective To investigate the reduce of experimental autoirnmune encephalomyelitis(EAE) susceptivity after lipopolysaccharide (LPS) exposure in neonatal rats and its relation with inhibition of macrophage immune function.Methods Litter male neonatal rats were divided into blank control group (n=1 1),phosphate buffer (PBS) group (n=12) and LPS group (n=12);rats in the LPS group were performed intraperitoneal injection of 50 μL LPS on postpartum day 3 and 5.Rats in the PBS group and LPS group were established EAE models by immune induce of spinal cord homogenate of guinea pig with complete Freund's adjuvant at 12 weeks old,while rats in the blank control group were given immune induce of complete Freund's adjuvant.Since the day of induce,the behavioral scale scores of all the rats were assessed.On the 20th d,all rats were sacrificed and paraffin sections were cut and stained with HE to detect inflammatory cell infiltration.The number of infiltrating macrophages and the expressions of CD86,CD80,MHC-Ⅱ were determined by flow cytometry.The transcriptional levels of C-C chemokine receptor type 2 (CCR2),interleukin (IL)-1β and tumor necrosis factor (TNF)-α in macrophages were determined by real-time fluorogenic quantitative PCR.Results As compared with the PBS group,LPS group had significantly lower EAE incidence (11/12 vs.5/12) and higher EAE latency ([10.50±0.71] d vs.[12.17± 1.17] d),and statistically decreased cumulative clinic scores and peak clinic scores (20.00±9.13 vs.5.58±7.12;2.58±1.08 vs.1.03±0.83,P＜0.05).The inflammation in the spinal cord of the PBS group was severer than that in the LPS group (2.83±0.75 vs.1.17±1.17,P＜0.05).The number of infiltrating macrophages of the PBS group was significantly larger than that in the LPS group ([202.70 ±81.89] × 103 cells vs.[92.58 ±42.65] × 103 cells,P＜0.05).The expressions of CD80 and MHC-Ⅱ,and mRNA levels of CCR2,IL-1β and TNF-α in the PBS group were significantly higher than those in the LPS group (P＜0.05).Conclusion Neonatal LPS exposure reduces the severity of EAE,which may relate to impaired macrophage immune function.
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Objective To investigate the clinical efficacy of liver-soothing and spleen-reinforcing acupuncture in treating functional constipation.Methods Sixty patients with functional constipation were randomly allocated to treatment and control groups, 30 cases each. The treatment group received liver-soothing and spleen-reinforcing acupuncture and the control group, oral administration of prucalopride succinate tablets. The number of complete spontaneous bowel movements (CSBM), the number of spontaneous bowel movements (SBM), constipation symptoms (defecation time, defecatory difficulty and fecal characters) scores and The Patient Assessment of Constipation Quality of Life (PAC-QOL) score were recorded in the two groups before and after two and four weeks of treatment. The clinical therapeutic effects were compared.Results After two weeks of treatment, there were statistically significant pre-/post-treatment differences in CSBM and SBM in the treatment group (P0.05). After two and four weeks of treatment, there were statistically significant pre-/post-treatment differences in constipation symptoms scores in thetwo groups (P0.05). The total efficacy rate was 80.0% in the treatment group and 73.3% in the control group; there was no statistically significant difference between the two groups (P>0.05).Conclusions Liver-soothing and spleen-reinforcing acupuncture has a marked therapeutic effect on functional constipation. It produces a quick effect with high safety.
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Objective To observe the clinical efficacy of Bu Shen Tiao Qi(supplementing the kidney and regulating qi) needling in treating perimenopausal syndrome.Method Fifty patients were randomized into two groups, 25 cases each. The treatment group was intervened by Bu Shen Tiao Qineedling combined with electroacupuncture, while the control group was by shallow needling plus sham electroacupuncture. Kupperman Index (KI) wasobserved respectively before treatment, after 2-week and 4-week treatment, and in the 4-week follow-up study. The differences of scores and improvements of the 13 symptoms listed in KI were calculated.Result The total effective rate was 92.0% in the treatment group versus 44.0% in the control group; in the treatment group, the KI scores after 2-week treatment and in the 4-week follow-up study were significantly different from that before treatment (P<0.05), and a more significant difference was found after 4-week treatment (P<0.01); the between-group differences were statistically significant in comparing KI (P<0.05).Conclusion Bu Shen Tiao Qineedling can produce a satisfactory efficacy in treating perimenopausal syndrome.
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OBJECTIVE:To systematically review the efficacy and safety of pituitrin combined with phentolamine versus pitui-trin alone in the treatment of bronchiectasis hemoptysis(BH),and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CJFD,Wanfang and VIP database,the randomized controlled trails(RCT)about pituitrin combined with phentolamine(test group)versus pituitrin alone(control group)in the treatment of BH were collected,and afterdata extract and quality evaluation ,Meta-analysis was performed by using Rev Man 5.2.3 statistics soft-ware. RESULTS:A total of 43 RCTs were included,involving 3 094 patients. Results of Meta-analysis showed the significant effi-cacy [RR=1.50,95%CI(1.38,1.62),P<0.001] and effective rate [RR=1.25,95%CI(1.20,1.30),P<0.001] in test group were sig-nificantly higher than control group,inefficacy [RR=0.29,95%CI(0.23,0.36),P<0.001], hemoptysis stopped or remission time [MD=-2.00,95%CI(-2.43,-1.57),P<0.001],incidence of headache [RR=0.36,95%CI(0.22,0.59),P<0.001],incidence of chest tightness [RR=0.41,95%CI(0.26,0.63),P<0.001],incidence of abdominal pain [RR=0.26,95%CI(0.16,0.43),P<0.001] and incidence of elevated blood pressure [RR=0.28,95%CI(0.14,0.56),P<0.001] in test group were significantly lower than control group,there were significant differences in 2 groups. CONCLUSIONS:Pituitrin combined with phentolamine has better efficacy and safety than pituitrin alone in the treatment of BH. Due to the limit of methodological quality and sample size,it re-mains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.
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Objective:To share the experience of clinical cooperation of physicians and clinical pharmacists in the treatment of one case of rodenticide poisoning. Methods: One case of rodenticide poisoning was early diagnosed by physicians according to the con-sciousness disorder and coagulation dysfunction. Clinical pharmacists participated in the drug treatment actively through providing vita-min K1 at the dose of 30 mg·d-1 as the treatment dose and monitoring the effectiveness. Toxicology analysis was recommended, and 718 ng·ml-1 bromadiolone was found out in the blood samples. According to the long half-life of bromadiolone, the initial duration of treatment was set at 2-3 months, while follow-up plan and final duration of treatment were defined based on coagulation parameters and poison concentration monitoring results. Results:The patient recovered rapidly after hospitalization due to the cooperation of physicians and clinical pharmacists through quickly correcting diagnosis of physicians and actively participating in medication of clinical pharma-cists. After the 3-month treatment, the coagulation parameters of the patient were normal and the patient was discharged with follow-up. Conclusion:The collaboration of physicians and clinical pharmacists leads to the optimal regimen with early, full dose and long course of vitamin K1 therapy.
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Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P＜0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.
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Objective To investigate the frequency of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in each ear,and to explore the effect of sleep position in lateral-predominance of ear by PC-BPPV during sleep onset in elderly patients. Methods Totally 114 patients aged (67.4±7.5) years with unilateral PC BPPV confirmed by a positive Dix Hallpike test,were retrospectively reviewed.All patients included in the study were able to define a leteral predominant,favorate head-lying side (right,left or supine position) during sleep onset. Results The Dix Hallpike test was found to be positive on the right side in 72 patients and positive on the left side in 42 cases.During sleep onset,61 patients habitually laid their head on the right side,34 laid their head on the left,and the remaining 19 cases on the supine position.Among 114 cases with positive Dix Hallpike test,there were 78 cases with the same side between affected ear and sleep position (52 cases right,26 cases left),36 cases with different side (9 cases with right position and left positive Dix Hallpike test,8 cases left position and right positive Dix Hallpike test,19 cases slept in a supine position including 12 cases with right positive Dix Hallpike test and 7 cases with left positive).The association between affected ear and head-lying side during sleep onset was statistically significant (x2 =35.737,P＜0.01) and Pearson coefficient of continency was 0.4885. Conclusions Among the elderly,right-sided PC-BPPV is popular,and these patients favorite right head-lying position during sleep.There is association between the affected side by PC-BPPV and the head-lying side during sleep.
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Objective To explore the effect of atorvastatin combined with aspirin on therapeutic efficacy of acute cerebral infarction, and on the changes in neurologic impairment, blood lipids and carotid plaque, et al. Methods The 80 patients with acute cerebral infarction were randomly divided into the treatment group (n=40) and the control group (n = 40)who took atorvastatin combined with aspirin and aspirin alone respectively. The defect degree of nerve function, curative effect, changes of blood lipids and cervical vascular ultrasound parameters were compared between the two groups, and they were followed up for 6 months to observe the recurrence of cerebral infarction.Results Compared with the control group, the levels of TG, TC, HDL-C and LDL-C, internal diameter of common carotid artery, size of plaque, drag index, pulsatility index and neurological function deficit scale (NFDS) were significantly lower in treatment group [(1.36 ± 0.33) mmol/L vs.(1.77±0.80) mmol/L, (5.21±0.32) mmol/L vs. (5.80±0.37) mmol/L, (1.20±0.10) mmol/L vs. (1.43±0.16) mmol/L, (1.31±0.37) mmol/L vs. (1.57±0.39) mmol/L, (6.43±0.71) mm vs. (6.67±0.47) mm, (40.39±8.94) mm3 vs. (54.26±8.25) mm3, (0.70±0.06) vs. (0.82±0.08), (2.12±0.37) vs. (2.18±0.54), (10.24±3.31) scores vs. (14.69±3.23) scores, all P＜0.05 or ＜0.01]. The intima-media thickness and peak systolic velocity of carotid artery were higher in treatment group than in control group [(1.66±0.50) mm vs. (1.50±0.68) mm, (71.34±15.01)an/s vs. (68.97 ± 18.21 ) an/s, both P＜ 0.01]. The total effective rate was higher in treatment group than in control group (92.5% vs. 75.0%, P＜0.05), and there were no recurrence of cerebral infarction within 6 months. Conclusions Atorvastatin combined with aspirin in treatment of acute cerebral infarction is beneficial to resume neurological function, improve prognosis, decrease the volume of carotid atherosclerotic plaque, stabilize plaque and reduce blood lipids, and it play an positive action in the intervention of cerebral infarction recurrence, and it can be used to treatment acute cerebral infarction as combination therapy.
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Objective To explore the effects of lamotrigine (LTG) on cognitive function and the quality of life (QOL) in patients with partial epilepsy. Methods Twenty six patients with newly diagnosed partial epilepsy were randomly divided into 2 different groups using oral administration of LTG and carbamazepine (CBZ) respectively. By neuropsychological test scores and the Quality of Life in Epilepsy Inventory (QOLIE-31) The cognitive function and QOL were assessed before and 16 weeks after the treatment. A battery of neuropsychological tests comprised WAIS digital span test (WDST), verbal fluency test (VFT), trail making test (TMT, parts A and B), stroop color word test (SCWT), Wisconsin card sorting test (WCST), delayed logical memory test, delayed optical memory test, arithmetic ability and digital symbol conversion test. Results The repeated assessments for the patients taking LTG were associated with significant improvements in many domains. When comparing the results at the end of 16 weeks with the baseline results, the verbal fluency were improved, the time of trail making test parts A and B were shortened, the WCST correct number and classification were improved, and the persistent error number and operation time of WCST were declined as well, digital symbol conversion was increased, delayed logic memory and optical memory were improved (t=3. 043, -3. 287,-2. 543,3. 167,3. 028,-2. 191, -3. 216,3. 061,3. 036, 3. 021 ,all P<0. 01 or P<0. 05). When comparing the efficacy of LTG with the CBZ group, the time of stroop color word test was shortened, digital symbol conversion was increased and arithmetic ability was improved (t= 3. 167,2. 142,2. 101, P<0.01 or P<0. 05). Compared with the baseline, both LTG group and CBZ group showed that the overall QOL, overall health, cognitive function and social function scores were improved (LTG group: t= 3. 321,2. 462,3. 294,3. 512;CBZ group: t=3. 314, 3. 149,3. 294,3. 202,all P<0.05). When comparing LTG group with CBZ group after therapy, cognitive function and social function scores were obviously improved (t = 2. 257,2. 140, both P< 0. 05), and the worry about seizure declined (t=2. 147,P<0. 05). Conclusions LTG may improve the cognitive function and QOL in patients with newly diagnosed partial epilepsy.