Network Meta-analysis of Chinese medicine injection combined with conventional western medicine in treatment of stable angina pectoris / 中国中药杂志

This study aimed to systematically evaluate the efficacy and safety of different Chinese medicine injections combined with conventional western medicine for stable angina pectoris. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, and SinoMed were searched to collect randomized controlled trial(RCT) of Chinese medicine injection combined with conventio-nal western medicine in the treatment of stable angina pectoris from the inception of the databases to July 8, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Stata 15.1 was used for network Meta-analysis. A total of 52 RCTs were included, involving 4 828 patients treated by 9 Chinese medicine injections(Danhong Injection, Salvia Miltiorrhiza Polyphenol Hydrochloride Injection, Tanshinone Sodium Ⅱ_A Sulfonate Injection, Salvia Miltiorrhiza Ligustrazine Injection, Dazhu Hongjingtian Injection, Puerarin Injection, Safflower Yellow Pigment Injection, Shenmai Injection and Xuesaitong Injection). The network Meta-analysis showed that:(1)in terms of improving the efficacy of angina pectoris, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Xuesaitong Injection>Shenmai Injection>Puerarin Injection>Safflower Yellow Pigment Injection>Dazhu Hongjingtian Injection;(2)in terms of improving the efficacy of electrocardiogram(ECG), SUCRA followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Puerarin Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Shenmai Injection>Xuesaitong Injection>Safflower Yellow Pigment Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(3)in terms of increasing high-density lipoprotein cholesterol(HDL-C), SUCRA followed the order of conventional western medicine combined with Danhong Injection>Shenmai Injection>Safflower Yellow Pigment Injection>Xuesaitong Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(4)in terms of lowering low-density lipoprotein cholesterol(LDL-C), SUCRA followed the order of conventional western medicine combined with Safflower Yellow Pigment Injection>Danhong Injection>Shenmai Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection>Xuesaitong Injection;(5)in terms of safety, the overall adverse reactions of Chinese medicine injection combined with conventional western medicine were less than those of the control group. Current evidence indicated that Chinese medicine injection combined with conventional western medicine could improve the curative effect of stable angina pectoris with higher safety. Limited by the number and quality of included studies, the above conclusion needed to be verified by more high-quality studies.

Analysis of the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and the factors of postoperative brain dysfunction / 国际外科学杂志

Objective:To observe the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and to explore the factors affecting postoperative brain dysfunction.Methods:A retrospective Case-control study was conducted to select 168 hypertensive intracerebral hemorrhage patients who were treated with 3D printing assisted hematoma puncture and drainage in the People′s Hospital of Yuechi County from January 2020 to September 2022 as the observation group, and 125 hypertensive intracerebral hemorrhage patients who were treated with CT guided hematoma puncture and drainage in the People′s Hospital of Yuechi County at the same time as the control group. The clinical efficacy of the two groups of patients was compared. According to the occurrence of postoperative brain dysfunction, the patients in the observation group were divided into normal brain function group ( n=121) and brain dysfunction group ( n=47). The clinical data of age, preoperative cerebral hernia, blood loss, ventilator-assisted ventilation, postoperative Glasgow coma index score (GCS) and postoperative complications were compared between the two groups. Multivariate Logistic regression was used to analyze the factors affecting postoperative brain dysfunction in the observation group, and a line chart model was constructed and its predictive efficiency was evaluated. The measurement data of normal distribution is expressed as mean ± standard deviation ( ± s), and independent sample t-test is used for inter group comparison. Chi-square test was used for comparison between count data groups. Results:The proportion of the drainage tube in the hematoma, hematoma clearance rate at 3 and 7 days after surgery, total effective rate of treatment, and GCS score at 1 week after surgery in the observation group were 88.69%(149/168), 54.17%(91/168), 96.43%(162/168), 92.86%(156/168), and 10.72±3.45, respectively, the control group was 75.20%(94/125), 36.80%(46/125), 81.60%(102/125), 76.80%(96/125), and 9.08±3.22, respectively, the difference between the two groups was statistically significant ( P<0.05). Advanced age ( OR=1.983, 95% CI: 1.169-2.732, P=0.017), preoperative cerebral hernia ( OR=1.532, 95% CI: 1.113-2.139, P=0.029), bleeding volume ≥ 50 mL ( OR=2.538, 95% CI: 1.802-3.347, P=0.003), postoperative GCS score 3-5 ( OR=2.874, 95% CI: 2.265-3.449, P<0.001), postoperative hypoxemia ( OR=2.251, 95% CI: 1.673-2.842, P=0.010) and postoperative chronic hydrocephalus ( OR=1.642, 95% CI: 1.214-2.021, P=0.022) were risk factors for postoperative brain dysfunction, while ventilator-assisted ventilation ( OR=0.656, 95% CI: 0.132-0.828, P=0.038) was protective factors. The internal verification of the line chart model by Bootstrap resampling method shows that the model has high differentiation, accuracy and validity. Conclusion:The application of 3D printing-assisted localization in hematoma puncture and drainage can improve the puncture condition and the hematoma clearance rate and clinical effect of patients with hypertensive intracerebral hemorrhage. Advanced age, preoperative cerebral hernia and bleeding volume are related to postoperative brain dysfunction. Clinical attention should be paid to patients with risk indicators of postoperative brain dysfunction.

Analysis of clinical efficacy and risk factors of relapse in young patients with cervical instability treated by manipulation / 中国骨伤

OBJECTIVE@#To determine the clinical efficacy of different manipulation in the treatment of cervical instability in young people, and to analyze the risk factors of relapse of cervical instability in young people.@*METHODS@#From March 2021 to June 2022, the clinical data of 120 young patients with cervical instability were retrospectively analyzed. According to the different treatment methods, they were divided into rotation group (60 cases, 3 cases of loss) and tendon group (60 cases, 5 cases of loss). There were 25 males and 32 females in rotation-traction manipulation group;age ranged from 22 to 44 years old with a median of 28 years old;course of disease ranged from 0.17 to 120 months with amedian of 22 months. There were 22 males and 33 females in tendon-regulating manipulation group;age ranged from 21 to 42 years old with a median of 27 years old;course of disease ranged from 0.23 to 180 months with a median of 24 months. Both groups were treated for 2 weeks, once every other day for 7 times, and were followed up for 1 year. The clinical efficacy of the two groups was evaluated, and the visual analogue scale (VAS), neck disability index (NDI) were observed before and after treatment. One year after the course of treatment, patients with effective treatment were followed up to make statistics on recurrence. Patients with recurrence were included in the recurrence group, while those without recurrence were included in the non-recurrence group. Factors that may affect symptom recurrence were analyzed, and univariate and multivariate Logistic regression analysis were performed.@*RESULTS@#The 13 patients who failed the treatment (4 cases in the rotation-traction manipulation group and 9 cases in the tendon-regulating manipulation group) were not followed up. All the 99 patients who were effective in treatment were followed up ranged from 303 to 406 days with a median of 359 days. No complications occurred in all patients. There were significant differences in VAS and NDI between the two groups after treatment and before treatment (P<0.05), and there were significant differences in VAS and NDI between the two groups after treatment (P<0.05). Ninety-nine patients achieved follow-up, 56 (56.57%) relapsed and 43 (43.43%) did not. Univariate correlation analysis showed that NDI index, the time spent at the desk every day, the time spent using electronic products every day and angular displacement of anterior flexion before treatment in the relapse group were significantly higher than those in the non-relapse group (P<0.05). Logistic regression analysis showed that the time spent at the desk every day [OR=2.447, 95%CI(1.255, 4.771)], the time spent using electronic products every day [OR=1.892, 95%CI(1.066, 3.358)] and the angular displacement of anterior flexion of the cervical before treatment [OR=1.246, 95%CI(1.045, 1.485) ]were the risk factors for relapse.@*CONCLUSION@#Both rotation-traction manipulation and tendon-regulating manipulation can effectively treat cervical instability in young people, and rotation-traction manipulation has more advantages than tendon-regulating manipulation in improving cervical pain and cervical dysfunction in patients. The time spent at the desk every day, the time spent using electronic products every day, and the increase of cervical flexion angle displacement will increase the risk of relapse in patients.

Curative effect of modified Parks incision combined with rectus linear tucking on adults with concomitant strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the curative effect of modified Parks incision combined with rectus linear tucking on adults with concomitant strabismus and its influences on postoperative recovery of visual function and ocular aesthetics.METHODS: A total of 160 adults with concomitant strabismus were enrolled as the research subjects between June 2019 and June 2021. They were divided into observation group(modified Parks incision combined with rectus linear tucking, 89 cases)and control group(corneal limbal trapezoid conjunctival flap incision combined with rectus linear tucking, 71 cases)according to different surgical methods. The clinical curative effect and surgical related indexes between the two groups were compared. The changes in scores of corneal fluorescence staining, standard patient of eye dryness(SPEED), visual analogue scale(VAS)and Vancouver scar scale(VSS)before and after surgery in both groups were observed. The occurrence of complications such as poor conjunctival healing and astigmatism was statistically analyzed at 1mo after surgery.RESULTS: The total response rate of surgery in observation group was higher than that in control group, and length of surgical incision was shorter than that in control group(all P&#x003C;0.05). The scores of postoperative corneal fluorescence staining and dry eye in observation group were lower than those in control group, and VAS scores at 1wk after surgery were lower than that in control group(all P&#x003C;0.05). Postoperative divergent fusion range, strabismus angles of short-sighted 33cm and far-sighted 5m in observation group were greater than those in control group. Convergent fusion range was smaller than that in control group, and stereopsis of short-sighted 33cm and far-sighted 5m was lower than that in control group(all P&#x003C;0.05). Postoperative break-up time in observation group was longer than that in control group, lacrimal secretion was more than that in control group, and scores of corneal surface regularity index(SRI)and VSS scores were lower than those in control group(all P&#x003C;0.05). The total incidence of complications in observation group was lower than that in control group(P&#x003C;0.05).CONCLUSION: The modified Parks incision combined with rectus linear tucking can not only improve surgical effect and promote the recovery of visual function and tear film function in adults with concomitant strabismus, but also relieve dry eye and postoperative pain, improve ocular aesthetics and reduce the incidence of postoperative complications.

Effect analysis of the intravitreal Conbercept in the treatment of choroid neovascularization of macular with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of intravitreal conbercept in the treatment of chorionic neovascularization(CNV)of macular macula with high myopia. <p>METHODS: Totally 56 patients with high myopia caused by macular angiogenesis in our hospital were retrospectively selected as the research objects from June 2015 to December 2019. According to the treatment methods, patients were divided into the control group and the observation group. The 28 cases(28 eyes)of patients in the control group were treated with the intravitreous injection of Rayzumab, and 28 cases(28 eyes)of patients in the observation group were treated with intravitreal injection of conbercept. After the last treatment, the patients were followed up for 3mo to record the intraocular pressure, the best corrected visual acuity(BCVA)and the incidence of complications. Optical coherence tomography(OCT)was used to measure the thickness of macular fovea retinal(CMT), and horizontal linear scanning of OCT instrument was used to measure the CNV area.<p>RESULTS:After treatment, the visual acuity of patients in the observation group gradually increased, and the improvement of BCVA was significantly higher than that of the control group at the same time point(<i>P</i><0.05). After 3mo of treatment, it showed that IOP, CNV area and CMT in the observation group were significantly reduced after the combined treatment, and the improvement was better than that in the control group(<i>P</i><0.05). The incidence of complications in the observation group(4%)was significantly lower than that in the control group(18%).<p>CONCLUSION:The treatment of intravitreal conbercept injection for the high myopia CNV was superior to lucentis, which could improve clinical efficacy by increasing BCVA, reducing CMT thickness, improving vision and reducing postoperative complications.

125I implantation under computed tomography guidance to treat patients with recurrent pelvic tumors: Retrospective analysis of clinical results

Objective: The objective of the study was to evaluate computed tomography (CT)-guided 125I implantation for the treatment of recurrent and malignant pelvic tumors. Materials and Methods: Fifteen cases of pelvic malignant tumors were studied. Tumor length/diameter was 4–10 cm (average: 6.8 ± 2.3 cm). In patients with pelvic recurrence or metastasis of malignant tumors, comprehensive treatment, including surgery, chemotherapy, or radiotherapy, was performed alongside CT-guided 125I implantation. The follow-up clinical benefit rate, rate of pain relief, quality of life score, and status of any complications were analyzed. Results: The patients were followed up for 6 months after the operation, and evaluation of lesions revealed complete response (CR) in 3/15 cases, partial response (PR) in 8/15 cases, stable disease in 3/15 cases, and progressive disease in 1/15 cases. The total effective rate (CR + PR) was 73.3% (11/15), and the pain relief rate was 86.6% (13/15). No bleeding, pelvic abscesses, intestinal fistulas, intestinal perforations, or other complications were reported. Conclusions: When using CT-guided 125I implantation, patients with malignant abdominal tumors undergo a convenient operation, sustain little trauma, and have an improved quality of life

A retrospective study of Xiaoyan Decoction combined with symptomatic maintenance in treatment of advanced non-small cell lung cancer / 中草药

Objective: To investigate the efficacy of Xiaoyan Decoction in the treatment of non-small cell lung cancer (NSCLC) by retrospective study. Methods: Patients with NSCLC treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 1, 2013 to December 30, 2017 were collected. The patients were divided into two groups: Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group (46) and symptomatic treatment group (50). Analyze the survival of the two groups of patients, compare the Karnofsky scores of the two groups, and analyze the sex, age, smoking history, drinking history, histological grade, chemotherapy regimen, pathological type, TCM syndrome type, vascular invasion, and soft tissue invasion Correlation with patient prognosis. Results: There was a significant difference in median progression-free survival (mPFS) between the two groups (P 0.05).The quality of life of patients in Xiaoyan Decoction plus subtractive prescription combined with symptomatic treatment group was significantly improved (P < 0.05), among which, lung squamous cell carcinoma, no vascular, no soft tissue invasion, and patients with phlegm heat obstruction of lung syndrome had the best efficacy (P < 0.05). Conclusion: Xiaoyan Decoction combined with symptomatic maintenance therapy can prolong median progression-free survival (mPFS) and improve the quality of life of patients with advanced NSCLC. The best beneficiaries are patients with lung squamous cell carcinoma, phlegm-heat obstructive pulmonary syndrome without vascular or soft tissue invasion.

The relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder / 中国神经精神疾病杂志

Objective To investigate the relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder (MDD). Methods The Insomnia Severity Index (ISI) was used to evaluate and group the severity of insomnia in the 57 patients with MDD. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The 24－item Hamilton Depression Scale (HAMD24) was used to evaluate depressive symptoms, and the effect of acute stage (4～6 weeks) was evaluated with its reduction rate. The difference of curative effect was compared among patients with different insomnia levels. Results There was a significantly different recovery rate in acute stage in 3 groups of patients with mild, moderate and severe insomnia ( X2=22.34,P＜0.01). The severity of insomnia in patients with MDD (PSQI) was negatively correlated with the curative effect of acute stage (r=－0.44,P＜0.01). The total score, anxiety/somatization factor score, retardant factor score and despair factor score were significantly higher in severe insomnia group than in the moderate and mild insomnia groups after acute treatment (P＜0.01). Conclusion The severity of insomnia in patients with MDD can predict the curative effect in acute stage. The depressive patients with severe insomnia have residual anxiety/somatization, retardant, feelings of despair and other symptoms more obvious than mild and moderate insomnia patients after acute treatment.

Effect of metoprolol in emergency treatment of chronic congestive heart failure / 中国基层医药

Objective To investigate the efficacy of metoprolol in the emergency treatment of chronic congestive heart failure.Methods From January 2016 to September 2018,300 cases of chronic congestive heart failure with acute attack in Zhoushan Hospital were selected.According to random number table method ,the patients were divided into two groups,with 150 cases in each group.The control group was given conventional heart failure treatment ,the observation group received conventional heart failure therapy combined with metoprolol.The clinical efficacy,heart color ultrasound indicator ,6 minutes walking distance ,NT－proBNP level,life quality score and adverse reactions were compared between the two groups.Results (1) The total effective rate of the observation group was 96.00%(141／150),which was higher than 87.33%(131／150) of the control group ( χ2 ＝7.375,P＜0.05).( 2) After treatment,the LVEDD[(58.12 ±3.89)mm],LVESD[(44.39 ±6.17) mm],NT－proBNP[(378.32 ±27.82)ng／mL] in the observation group were lower than those in the control group (t＝10.646,9.966,9.283,all P＜0.05),the LVEF [(49.36 ±6.25)%],SV[(76.29 ±6.24)mL] in the observation group were higher than those in the control group (t＝9.092,8.739,all P＜0.05).The 6－minute walking distance [(452.37 ±61.75) m] of the observation group was longer than that of the control group (t＝7.717,P＜0.05).The quality of life scores in the emotional field [(6.47 ± 1.29)points],physical field[(10.46 ±1.65)points],other fields[(10.51 ±1.32)points] and comprehensive score [(27.44 ±4.26) points] of the observation group were lower than those of the control group ( t＝9.030,9.024, 9.299,9.114,all P＜0.05).(3) During the treatment,no obvious adverse reactions occurred in the two groups. Conclusion In the emergency treatment of patients with chronic congestive heart failure,the application of conventional anti－heart failure treatment regimen metoprolol can effectively improve the patients＇heart function,and is conductive to improving their clinical efficacy and quality of life,with fewer adverse drug reactions and good safety.

A clinical study on effectiveness of Ningmitai Capsule combined with Dirithromycin Enteric Tablets in treatment of semen nonliquefaction with positive Ureaplasma urealyticum / 中草药

Objective To investigate the clinical effect of Ningmitai Capsule combined with Dirithromycin Enteric Tablets in the treatment of positive semen nonliquefaction in the culture of Ureaplasma urealyticum (Uu). Methods A total of 120 cases of semen liquefaction patients with positive semen Uu culture were randomly divided into treatment group with 80 cases and control group with 40 cases, which were continuous administrated for two weeks for a period of treatment and observated for two courses of treatment. In the treatment group, four Ningmitai Capsules were taken orally per time, three times per day, and 0.5 g Dirithromycin Enteric Tablets were taken orally per time, once per day, after meals, while the control group only took the Dirithromycin Enteric Tablets orally. Uu negative conversion rate and semen liquefaction time (min) were observed, and adverse reactions were also observed. Results The Uu negative conversion rate in the treatment group and control group after 2 weeks, 4 weeks was 72.5%, 95.0% and 55%, 92.5%, respectively, the negative conversion rate of treatment group was obviously higher than that of control group after 2 weeks treatment (P 0.05). The semen liquefaction time before treatment in the treatment group and control group respectively was (76.19 ± 14.13) min and (77.08 ± 13.34) min, which was (58.64 ± 13.15) min and (67.12 ± 12.52) min two weeks after treatment, (48.64 ± 12.38) min and (56.12 ± 12.86) min 4 weeks after treatment were, semen liquefaction time of the two groups before and after treatment was significant different (P < 0.05), and the treatment group was better than control group (P < 0.01). Conclusion Ningmitai Capsule combined with Dirithromycin Enteric Tablets can partly shorten the Uu negative conversion time, obviously shorten the semen liquefaction time, and has obvious clinical efficacy for Uu positive semen nonliquefaction disease.

The Observation of Curative Effect on Leukotriene Receptor Antagonist Combined with Inhaled Hormone in the Treatment of Moderately Severe Asthma / 昆明医科大学学报

Objective To explore the clinical efficacy of Montelukast in the treatment of severe asthma. Methods A retrospective analysis was conducted in the Department of Respiratory Medicine from January 2016 to August 2017.A total of 168 patients with moderately severe asthma were randomly divided into control group and observation group. The control group was treated with leukotriene receptor antagonist Montelukast and the observation group was treated with both Montelukast and budesonide inhalation suspension. Then we compared the clinical effect, lung function and blood gas index before and after treatment between the two groups. Results Significant improvement was observed in the clinical symptoms and lung function in the two groups of patients after the treatment. Compared to the control group, a better improvement was seen in the observation group (P＜0.05) . The results of blood gas analysis were significantly different between the two groups before and after the treatment (P＜0.05) . Conclusion In the treatment of moderately severe asthma, Montelukast combined with budesonide inhalation suspension has good clinical effect and can significantly alleviate symptoms, which can be widely used clinically.

Analysis of curative effects of Pudilan Xiaoyan Koufuye on patients with eOLP and ROU / 中国生化药物杂志

Objective To investigate the clinical effect of the treatment of erosive oral lichen planus and recurrent aphthous ulcer by using Pudilan Xiaoyan Koufuye.Methods The clinical data of 138 cases of oral mucosal diseases were retrospectively analyzed from September 2015 to June 2016 in our hospital, eOLP patients 50 cases, 11 cases in the control group one and the control group two, 28 cases in the observation group; ROU patients 88 cases, 21 cases in the control group one and the control group two, 46 cases in the observation group.The control group one was treated with topical western medicine, while the control group two was treated with Pudilan Xiaoyan Koufuye,and the observation group was treated with local topical spray and Pudilan Xiaoyan Koufuye, compared the total effective rate, VAS score and mucosal congestion in different groups of patients with oral diseases, and to observe the adverse reactions of the patients during the treatment.Results After one week of treatment, the total effective rate of treatment was significantly different between eOLP patients and ROU patients (P<0.05),the total effective rate of the observation group was higher than that of the control group one and the control group two ( P <0.05 ) .After two weeks of treatment, the total effective rate of eOLP patients was significantly different, and the total effective rate of observation group was higher than that of control group one (P<0.05),there was no significant difference among the ROU patients.The degree of mucosal hyperemia and the VAS score in the observation group were significantly different from those in the control group one and control group two in the patients with eOLP and ROU ( P <0.05 ) .No significant adverse mucosal staining occurred in all groups of patients, and there was no discontinuation due to obvious adverse reactions.Conclusion Pudilan Xiaoyan Koufuye adjuvant treatment of eOLP and ROU patients with short-term effect is significant, can improve the total effective rate of treatment, and no serious adverse reactions, high safety.

Analysis of clinical effect of operative treatment for grade Ⅳ pronation-external rotation ankle injury / 中国基层医药

Objective To explore the clinical effect of operative treatment for grade Ⅳ pronation-external rotation ankle injury.Methods 60 patients with pronation extorsion type Ⅳ degree of ankle injury were selected as the research subjects.According to the digital table,they were divided into two groups,30 cases in each group.The group A adopted ordinary steel plate,the group B adopted locking plate fixation.The clinical curative effect,postoperative recovery index,AOFAS score and complications were observed.Results The total effective rate of group A was 93.3％,which of group B was 90.0％,the difference was not statistically significant (x2 =0.218,P ＞ 0.05).The swelling subsided time [(24.2 ± 5.0) d vs.(22.9 ± 4.1) d],fracture healing time [(42.4 ± 9.5) d vs.(41.3 ± 9.4) d],postoperative recovery time of walking [(46.6 ± 9.2) d vs.(45.7 ± 9.0) d],AOFAS score [(87.3 ± 2.6) vs.(88.4 ±2.2)] between the two groups had no statistically significant differences(t =1.101,0.451,0.383,1.769,all P ＞0.05).The group A had 1 case in infection,the incidence rate of complications was 3.3％.The group B had no complication.The difference was not statistically significant in the incidence of complications between the two groups (x2 =1.017,P ＞ 0.05).Conclusion In the operative treatment for patients with grade Ⅳ pronation-external rotation ankle injury,whether choose ordinary steel plate fixation,or choose the locking plate fixation,the clinical effects of the two methods are both good,and the postoperative healing is fast.

Analysis of clinical effects of intratympanic injection of dexamethasone in treatment of sudden deafness in different time windows / 中国基层医药

Objective To investigate the clinical effect of intratympanic injection of dexamethasone in treatment of sudden deafness in different time windows.Methods 60 patients (60 ears) with sudden deafness were selected.Sixty patients were divided into control group and observation group according to the random number table method,30 cases (30 ears) in the control group and 30 cases (30 ears) in the observation group.The two groups were given systemic basic therapy, intravenous vinpocetine, alprostadil improve microcirculation, while hyperbaric oxygen therapy,12 days for a course of treatment, treatment for 2 courses.In the control group, dexamethasone was intravenously administered for 12 days.From the 7th day, dexamethasone was injected into the tympanic cavity and injected once every other day.The observation group was treated with dexamethasone at the same time.Injection of dexamethasone, treatment method and time were the same as the control group.At the end of the treatment, the clinical curative effect of the two groups was compared.The average hearing thresholds of the two groups were observed before and after treatment.The dizziness, tinnitus and hearing recovery time of the two groups were observed.Results The total effective rate was 96.67% in the observation group and 93.33% in the control group, the difference was not statistically significant (x2 =0.97,P> 0.05).After treatment, the average hearing threshold of the two groups was significantly improved (t=7.69,8.23,all P<0.05),the average hearing threshold of the observation group was higher than that of the control group, the average hearing threshold before and after treatment had statistically significant differences (t=2.34,2.67,all P<0.05).In the observation group, dizziness, tinnitus and hearing recovery time were shorter than those in the control group (t=3.32,3.14,3.67,all P<0.05).Conclusion The effect of dexamethasone combined with systemic treatment of sudden deafness in patients compared with intratympanic injection of dexamethasone after intravenous administration of dexamethasone is not significantly different, but the improvement of hearing threshold after treatment compared with the latter is obvious, and the average time to disappear symptoms is shorter than the latter, and therefore worthy of clinical promotion.

Phentolamine combined with furosemide on pneumonia complicated with heart failure in children with EDV, ESV levels and ECG effects / 中国生化药物杂志

Objective To study the clinical effect of phentolamine combined with furosemide therapy in children with pneumonia complicated with heart failure.Methods The subjects were 92 cases of children with pneumonia complicated with heart failure in our hospital from October 2015 to December 2016,randomly divided into control group and observation group,46 cases in each group.The control group was treated with on the basis of routine treatment,the observation group,patients received phentolamine combined with furosemide treatment.Compared two groups of the total efficiency and the symptoms disappear time,and compare the cardiac function and electrocardiogram improvement effect.Results The total efficiency of observation group(93.48％)was significantly higher than the control group(71.74％)(χ2=7.57,P<0.05); observation group of the pulmonary rales disappeared time,breath,heart failure control time and hospitalization time were significantly lower than the control group(P<0.05); after treatment,the observation group of the ESV was significantly lower than the control group(P<0.05),EDV was significantly higher than that of control group(P<0.05),electrocardiogram indicators improved significantly better than the control group(P<0.01).Conclusion The clinical curative effect of phentolamine combined with furosemide in treatment of children with pneumonia complicated with heart failure significantly,can effectively improve the cardiac structureAnd function,reduce the occurrence of abnormal ECG,high safety,worthy of clinical promotion

Clinical effect of ropivacaine intrathecal injection on carpal tunnel syndrome with nervi medianus entrapment syndrome / 中国生化药物杂志

Objective To investigate the effect of intrathecal injection of ropivacaine in the treatment of carpal tunnel syndrome with nervi medianus entrapment syndrome. Methods 164 patients with carpal tunnel syndrome were selected and divided into two groups, 82 cases in the control group were given intrathecal injection of lidocaine + methylprednisolone + vitamin B1, 82 cases in the experimental group received injection of ropivacaine + methylprednisolone + vitamin B1, the symptom score, nerve electrophysiological examination index, high frequency ultrasound quantitative parameters, the clinical effect and total recurrence rate were compared after treatment. Results The effective rate in the control group(74.39%)was lower than the experimental group(87.81%)(P<0.05); compared with the control group, the visual analogue scale (VAS), global symptom score (GSS), fatigue severity scale (FSS) and Levine carpal tunnel syndrome questionnaire score were lower in the experimental group after treatment, the nervi medianus distal motor latency (DML) level was lower, sensory nerve action potential (SNAP) and sensory conduction velocity (SCV) levels were higher after treatment, the diameter of the nervi medianus, the transverse diameter (a), anteroposterior diameter (b) of nervi medianus and cross sectional area (CSA) were lower after treatment, with significant difference (P<0.05); the total recurrence rate in the control group(53.66%)was higher than the experimental group(37.80%), with significant difference (P<0.05). Conclusion The clinical effect of intrathecal injection of ropivacaine in the treatment of carpal tunnel syndrome with nervi medianus entrapment syndrome was obvious, can effectively alleviate pain, improve the symptoms of nervi medianus entrapment, restore the nervi medianus conduction velocity and function, and reduce the recurrence rate.

Comparison of effect of different dose of dexmedetomidine on postoperative analgesia and sedation / 中国基层医药

Objective To compare the effects of different doses of dexmedetomidine on postoperative analgesia and sedation.Methods From January 2014 to November 2015,60 cases who needed postoperative analgesia and sedation in our hospital were selected.According to the dosage of dexmedetomidine,they were divided into control group and observation group,30 cases in each group.Two groups of patients were given analgesia pump for analgesia, with 0.5μg·kg-1·h-1,1.0μg·kg-1·h-1 two doses of dexmedetomidine,and analgesia 48 h.At different time points,the VAS pain score,Ramsay sedation score of the two groups were compared,the calm satisfaction in both two groups was recorded,the average incidence of delirium and delirium score in the process of the treatment and the occurrence of adverse reactions were observed.Results With the extension of time of postoperative analgesia,VAS scores in each group decreased,VAS scores in the observation group after 4h,8h,12h were (3.01 ±0.53)points, (1.95 ±0.58)points,(1.52 ±0.35)points,which were lower than those of the control group[(3.92 ±0.32)points, (2.86 ±0.67)points,(2.25 ±0.78)points],the differences were statistically significant (t=3.42,4.11,2.43,all P0.05).Postoperative 4h Ramsay score between the two groups had no significant difference (P >0.05 ).With increased postoperative analgesia time,Ramsay scores in two groups decreased,postoperative 8h,12h,Ramsay scores in the observation group [(2.95 ±0.83)points,(2.22 ±0.55)points]were lower than the control group[(3.76 ±0.78)points,(2.98 ± 0.89)points,t=3.45,2.38,all P0.05).The sedation satisfaction of the observation group (96.67%)was higher than the control group (86.67%),the incidence rate of delirium and delirium average score [3.33%,(15.11 ± 2.03)points]were lower than the control group[13.33%,(19.23 ±2.21 )points],the differences were significant between the two groups (t =4.32,4.32,3.27,all P0.05 ).Conclusion The effect of 1 .0μg·kg-1 · h-1 concentration dexmedetomidine within 24h of postoperative analgesia sedative is best,it can reduce the incidence of postoperative delirium,and without obvious drug side effects.

The clinical curative effect of Tianshu capsule in the treatment of migraine and its influence on vascular ;endothelial function and hemodynamics / 中国基层医药

Objective To investigate the clinical efficacy of Tianshu capsule in the treatment of migraine and its influence on vascular endothelial function,hemodynamics.Methods 80 patients with migraine from October 2014 to October 2015 in our hospital were selected as the research subjects,and according to the different treatment methods, they were divided into control group and observation group.The control group was treated with oral flunarizine hydrochloride capsules,the observation group was given Tianshu capsule on the basis of the treatment of the control group.The blood dynamics of the two groups before and after treatment and the clinical curative effect of the patients [the middle cerebral artery (MCA),anterior cerebral artery (ACA),Fu (PCA)after artery peak systolic velocity (Vs)and diastolic peak flow velocity (Vd)index,endothelin (ET)index]were observed.Results The curative effect of two groups was significantly improved compared with before treatment,the total effective rate of observation group (97.50%)was significantly higher than the control group (75.00%)(χ2 =8.54,P<0.05).The related indices of hemodynamics and endothelium were lower than before treatment,and after treatment,Vs of MCA,ACA,PCA in the observation group were (105.02 ±1.12)cm/s,(80.22 ±1.10)cm/s,(60.34 ±1.20)cm/s,Vd of MCA,ACA,PCA in the observation group were (35.22 ±1.13)cm/s,(40.33 ±1.21)cm/s,(21.23 ±1.12)cm/s,which were signifi-cantly lower than those in the control group[Vs of MCA,ACA,PCA:(120.10 ±1.13)cm/s,(95.33 ±1.12)cm/s, (80.21 ±1.13)cm/s;Vd of MCA,ACA,PCA:(42.33 ±1.10)cm/s,(50.23 ±1.10)cm/s,(30.21 ±1.10)cm/s] (t=25.46,25.76,33.38,12.30,17.04,15.55,all P<0.05).Conclusion The curative effect of Tianshu capsule in the treatment of migraine was improved in patients with cerebral blood flow velocity and vascular diastolic function, and is worthy of promotion.

The clinical effect of butylphthalide in the treatment of acute cerebral infarction / 中国基层医药

Objective To investigate the clinical value of butylphthalide in patients with acute cerebral infarction.Methods 120 patients with acute cerebral infarction were randomly divided into study group and control group according to the method of random number table,60 cases in each group.The study group used butylphthalide on the basis of routine treatment,while the control group only received routine treatment.Main outcome measures included the National Institutes of Health Stroke Scale (NIHSS)table,activities of daily living Barthel index,blood viscosity,clinical curative effect and health related quality of life (HRQL)score.Results There was no significant difference in NIHSS score,Barthel score,blood viscosity and HRQL between the two groups on admission (P >0.05 ).When compared with the control group after 3 months,NIHSS score of the study group decreased significantly [(948 ±3.84)points vs.(14.38 ±3.29)points,t=5.395,P=0.000],Barthel score increased significantly[(84.44 ± 10.59)points vs.(75.89 ±8.39)points,t=3.854,P=0.015];blood viscosity decreased significantly[(5.09 ± 0.64)mPa.s vs.(648 ±0.71 )mPa.s,t =7.493,P=0.000];HRQL scores increased significantly [(80.47 ± 1 5.39)pointsvs.(69.58 ±14.39)points,t=4.395,P=0.002];clinical curative effect in the study group was significantly higher than control group (χ2 =6.122,P=0.013).Conclusion Butylphthalide is helpful to improve the prognosis and quality of life in patients with acute cerebral infarction.

Comparison of clinical efficacy after endoscopic submucosal dissection of gastric cancer recurrence with laparoscopic and open radical resection / 中国现代普通外科进展

Objective:To compare clinical efficacy after endoscopic submucosal dissection(ESD)of gastric cancer recurrence with laparoscopic and open radical resection.Methods:ESD postoperative recurrence of 98 cases of gastric cancer were studied.According to different surgical methods were divided into observation group (49 cases of laparoscopic radical resection) and control group (49 cases of radical open surgery),3 years of follow-up,compared two groups of the curative effect,intraoperative and postoperative related indicators,postoperative,and the postoperative complications.Results:The two groups after 1～3 year survival rate and recurrence rate compared with no significant difference (P＞0.05).The operation time of the observation group was longer than the control group,but the total length and amount of bleeding were less than the control group,the differences were statistically significant (P＜0.05).The observation group of exhaust time,gastrointestinal decompression extubation time,extubation time of abdominal drainage,eating for the first time,hospitalization time and hospitalization expenses were less than the control group,the differences were statistically significant (P＜0.05).The patients in the observation group of the overall complication rate was 12.24％,and the control group (8.16％) there was no statistically significant difference (P＞0.05).The observation group patients with laparoscopic radical surgery and recurrence of gender,age,tumor staging,there were no obvious relationship (P＞0.05).The observation group of laparoscopic radical recurrence in patients with lymph node metastasis was 15 cases after surgery,but with gender,age,tumor staging,there were no obvious relationship (P＞0.05).Conclusions:The curative effect of ESD postoperative recurrence in patients with gastric cancer underwent laparoscopic surgery,less damage to patients,is conducive to the recovery,and high safety,worthy of promotion.