Treatment of Allergic Rhinitis with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

This article reviews the clinical studies about the treatment of allergic rhinitis （AR） with traditional Chinese medicine （TCM） in recent years. AR is a common and frequently occurring disease in the department of otolaryngology. The common manifestations of AR include nasal congestion， sneezing， runny nose， and nasal itching. AR， belonging to the category of rhinitis， is a dominant disease in the TCM treatment of otorhinolaryngologic diseases and head and neck diseases. The ancient literature has laid a solid theoretical basis on the etiology and pathogenesis of AR. According to the ancient literature， the theoretical basis， and their own experience， modern doctors classified the causes of AR into the disorders in Zang-fu organs and six meridians. Most of the explanations focus on the disorders in Zang-fu organs， especially the lung， spleen， and kidney. The clinical studies in this field mainly involve TCM treatment alone， integrated TCM and Western medicine treatment， and TCM external treatment. These therapies have good efficacy in the clinical treatment of AR. Among them， TCM treatment alone has significant advantages in alleviating the symptoms and nasal signs， declining the scores of related scales， and reducing the eosinophil count （EOS） of nasal secretions， with definite long-term efficacy. Integrated TCM and Western medicine treatment can complement with each other. The TCM external treatment methods include acupuncture， moxibustion， acupoint catgut embedding， acupoint application， and nasal irrigation with TCM， which are safe， simple， acceptable by patients and have good therapeutic effect. Finally， the clinical research status of TCM treatment of AR was summarized， and suggestions were put forward from three aspects： standardizing the clinical research protocol of TCM， encouraging pure TCM research， and exploring the mechanism of TCM treatment on the basis of frontier research achievements. This review aims to provide higher-level evidence for subsequent clinical research and promote the research on dominant AR diseases.

Efficacy of S-ketamine mixed with hydromorphone for improving patient-controlled intravenous analgesia after lumbar spinal surgery / 中华麻醉学杂志

Objective:To evaluate the efficacy of S-ketamine mixed with hydromorphone for improving patient-controlled intravenous analgesia (PCIA) after lumbar spinal surgery.Methods:Ninety-six American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-64 yr, with body mass index of 18.5-29.9 kg/m 2, scheduled for elective lumbar fusion surgery under general anesthesia, were divided into 2 groups ( n=48 each) using a random number table method: hydromorphone for PCIA group (group H) and S-ketamine mixed with hydromorphone for PCIA group (group S+ H). PCIA was performed at the end of operation.PCIA solution contained hydromorphone 0.05 mg/ml mixed with S-ketamine 0.25 mg/ml in group S+ H and hydromorphone 0.05 mg/ml in group H. The PCIA pump was set up to deliver a 2 ml bolus dose with a 10-min lockout interval, background infusion at 2 ml/h and total volume of 200 ml.When the numerical rating scale score ≥4 and analgesia was ineffective by pressing the PCA pump for 3 consecutive times, hydromorphone 0.2 mg was intravenously injected as rescue analgesic.The cumulative consumption of hydromorphone (consumption for analgesic pump and consumption for rescue analgesia) and occurrence of adverse reactions such as pruritus, respiratory depression, nausea, vomiting, drowsiness, dizziness, headache, hallucinations and nightmares within 48 h after operation were recorded.The patients′ satisfaction with analgesia was recorded at 48 h after operation.The time to first flatus after operation and quality of recovery (QoR-15 scale) at 24 and 48 h after operation were recorded. Results:Compared with group H, the cumulative consumption of hydromorphone within 48 h after surgery were significantly reduced, the patients′ satisfaction with analgesia was increased, the time to first flatus after operation was shortened, QoR-15 scores were increased at 24 and 48 h after operation ( P<0.05), and no significant change was found in the requirement for rescue analgesia and incidence of adverse reactions within 48 h after surgery in group S+ H ( P>0.05). Conclusions:Compared with PCIA with hydromorphone, S-ketamine mixed with hydromorphone can reduce postoperative consumption of hydromorphone, increase satisfaction with analgesia, and promote early postoperative recovery after lumbar spinal surgery.

Effect of Internet continuity nursing on the psychological status and adverse reactions of the colorectal cancer patients receiving oxaliplatin chemotherapy / 中国实用护理杂志

Objective:To explore whether Internet continuous nursing can reduce anxiety and depression, chemotherapy-induced peripheral neuropathy, improve treatment compliance and reduce adverse reactions in patients with colorectal cancer undergoing oxaliplatin chemotherapy.Methods:A total of 69 patients with colorectal cancer in the Department of oncology, General Hospital of Northern War Zone from July 2019 to June 2020 were selected and divided into the observation group (34 cases) and the control group (35 cases) by random digits table method. The control group was given conventional nursing mode, and the observation group was given Internet continuity nursing mode. All patients were followed up to 3 months after the end of chemotherapy. The basic information, treatment anxiety and depression, chemotherapy-induced peripheral neuropathy, compliance, incidence of adverse reactions and patient satisfaction of the two groups were compared.Results:There was no significant difference in the anxiety and depression before and after chemotherapy, chemotherapy-induced peripheral neuropathy after chemotherapy( P>0.05). After 3 months of chemotherapy, the anxiety and depression and chemotherapy-induced peripheral neuropathy were (20. 97± 3.46),(14.27 ± 1.14) points in the observation group, and (24. 99 ± 1.11),(18.16 ± 2.55) points in the control group, the differences were statistically significant ( t values were 3.80, 5.09, P<0.05). In the control group, there were 19 cases of regular review, 20 cases of persistent chemotherapy, 21 cases of disease awareness, 21 cases of scientific diet, 19 cases of psychological compliance and 19 cases of self-protection. In the observation group, there were 28 cases of regular review, 29 cases of persistent chemotherapy, 30 cases of disease awareness, 28 cases of scientific diet, 30 cases of psychological compliance and 28 cases of self-protection. The treatment compliance in the observation group were significantly higher than those in the control group (χ 2 values were 4.186-9.657, P<0.05). In the control group, there were 7 cases of peripheral neurotoxicity, 2 cases of acute laryngopharyngeal paresthesia, 18 cases of gastrointestinal reaction and 4 cases of hematotoxicity. Fourteen cases of gastrointestinal reaction in the observation group. The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant ( χ2 value was 8.26, P<0.05). In the control group, 6 were very satisfied, 27 were satisfied and 2 were good.The observation group was very satisfied and satisfied with 16 people and 18 people. The satisfaction in the observation group was higher than that in the control group, and the difference was statistically significant ( Z value was 1.853, P<0.05). Conclusions:Internet continuous nursing can effectively reduce the anxiety and depression of patients and chemotherapy-induced peripheral neuropathy, improve the treatment compliance of patients, reduce the adverse reactions after medication, and improve the quality of life of patients, which is worthy of application and promotion.

Improvement of detection method for acetaldehyde, butyraldehyde and isobutyraldehyde in workplace air / 中国职业医学

OBJECTIVE: To improve the standard detection method for acetaldehyde, butyraldehyde and isobutyraldehyde in the air of workplace. METHODS: Acetaldehyde, butyraldehyde and isobutyraldehyde in the air of workplace were collected using silica gel tube, desorbed with 45.0% ethanol, separated by a capillary column and detected by a flame ionization detector. RESULTS: The linear range of this method for detecting acetaldehyde, butyraldehyde and isobutyraldehyde were 1.57-1 568.00, 1.60-1 600.00 and 1.59-1 588.00 mg/L, respectively. All the correlation coefficients were greater than 0.999. The detection limits were 0.52, 0.46 and 0.54 mg/L, respectively. The desorption efficiency was 91.0%-103.0%. The within-run relative standard deviation(RSD) was 0.7%-1.7%.The between-run RSD was 2.0%-3.7%. The samples could be stored for at least 10 days at room temperature. CONCLUSION: This method can be used for simultaneous detection of acetaldehyde, butyraldehyde and isobutyraldehyde in the air of workplace.

Improvement of detection method for acetonitrile in workplace air / 中国职业医学

OBJECTIVE: To improve the standard detection method for acetonitrile in workplace air. METHODS: Acetonitrile in the air of workplace was collected by silica gel, eluted with methanol, separated and determined by gas chromatography with flame ionization detection. RESULTS: After the improvement of the method, the linear range of acetonitrile was 1.57-1 574.00 mg/L, and the correlation coefficient was 0.999 98. The detection limit was 0.29 mg/L and the minimum detection concentration was 0.19 mg/m~(3 )(collected sample volume was 1.5 L). The average desorption efficiency was 93.1%-98.9%. The within-run and between-run precision was 2.6%-3.3% and 1.7%-3.6%, respectively. The samples could be stored at room temperature for at least 10 days. CONCLUSION: The improved method is precisied, accurate and simple to operate, which is suitable for determination of acetonitrile in workplace air.

Correlation analysis of differential gene expression pathways in muscle tissue of Alzheimer's disease mice / 中华老年医学杂志

Objective:To investigate differentially expressed genes in muscular tissue in Alzheimer's disease mice and normal mice, and to elucidate the role of differentially expressed genes in the pathogenesis of Alzheimer's disease.Methods:Muscle tissues of Alzheimer’s disease mice and normal mice were collected and the second-generation high-throughput RNA transcription sequencing(RNA-seq)technique was used to screen differentially expressed genes.Additionally, Gene Ontology(GO)functional annotation and Kyoto encyclopedia of genes and genomes(KEGG)pathway analysis were conducted.Differences in the expression of candidate genes in muscle tissues between Alzheimer’s mice and normal mice were verified by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR).Results:A total of 4 222 genes in muscles had different expression between Alzheimer's disease mice and normal mice, with 2087 genes highly expressed and 2 135 lowly expressed in muscles of Alzheimer's disease mice.GO analysis showed that significantly up-regulated functional genes were mainly enriched in cellular, single biological, metabolic and catalytic processes and activities.KEGG pathway analysis showed that differentially expressed genes were significantly enriched in signal pathways related to metabolism and inflammation.Results from qRT-PCR showed that the mRNA expression of candidate genes was consistent with the trend of transcriptome sequencing results.Conclusions:Differentially expressed genes and related important regulatory signal pathways were screened at the transcriptome level in muscle tissues of Alzheimer's disease mice and normal mice.The differentially expressed genes are enriched in signal pathways related to metabolism and inflammation in muscle tissues of Alzheimer's disease mice and the findings provide an important basis for further exploration of the pathogenesis of Alzheimer's disease.

Efficacy and safety of nalbuphine on analgesia of patients in intensive care unit / 中华危重病急救医学

Objective To analyze the efficacy and safety of nalbuphine in patients with sedative analgesia in intensive care unit (ICU). Methods A prospective observation was conducted. The adult patients with mild and moderate analgesia in general ICU of the First Affiliated Hospital of Zhengzhou University from January to November in 2017 were enrolled, and they were divided into nalbuphine group and sufentanil group in proper order. The nabobrown group was given 40 mg nabobrown, the sufentanil group was given 0.1 mg sufentanil, both of which were injected with 50 mL normal saline for continuous intravenous infusion in micro-pump. Infusion speed was checked according to pain level. The analgesic target was critical-care pain observation tool (CPOT) score < 2. The change in hemodynamics of patients in both groups were observed, and CPOT score and Richmond agitation-sedation scale (RASS) score were recorded before and l, 3, 5, 12, 24 hours after administration. The analgesic and sedative effects of two drugs were evaluated. Results A total of 141 patients were enrolled, including 71 patients in nalbuphine group and 70 in sufentanil group. There was no significant difference in general data including gender, age, body weight, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) or pain source, as well as baseline hemodynamics parameter between the two groups. At 1 hour and 3 hours after administration, nalbuphine had no effect on blood pressure, but the heart rate was decreased slightly, while the heart rate and blood pressure of the sufentanil group were decreased obviously. The two drugs could make the heart rate and blood pressure fluctuate obviously with the time of medication, but there was no statistical difference between the two drugs. The two drugs had no significant effect on pulse oxygen saturation (SpO2) during analgesia. The average dosage of nalbuphine was 0.03 (0.02, 0.05) mg·kg-1·h-1in the nalbuphine group, and the patient was satisfied with the analgesic effect until 3 hours after the use of the drug, and CPOT score was significantly decreased as compared with that before administration [1.0 (1.0, 2.0) vs. 3.0 (2.0, 4.0), P < 0.01], and the sedative effect was increased, RASS score was significantly lower than that before administration [0 (0, 1.0) vs. 1.0 (1.0, 2.0), P < 0.01]. No patients in naporphine group were treated with sufentanil due to unsatisfactory analgesia. The average dosage was 0.11 (0.06, 0.14) μg·kg-1·h-1in the sufentanil group, the patient was satisfied with the analgesic effect until 5 hours after administration, and the CPOT score was significantly lower than that before administration [1.0 (1.0, 2.0) vs. 4.0 (3.0, 6.0), P < 0.01], and the sedative effect was significantly increased, RASS score was significantly lower than that before administration [0 (-1.0, 0) vs. 2.0 (1.0, 2.0), P < 0.01]. The scores of CPOT and RASS in the sufentanil group were significantly higher than those of the naporphine group before use, so the decrease in the CPOT and RASS scores of the two drugs was further analyzed, which indicated the decrease in CPOT score of naporphine group was significantly lower than that in sufentanil group from 3 hours on [1.0 (0, 2.0) vs. 2.0 (1.0, 3.0), P < 0.05], and the decrease in RASS score of naporphine group was significantly lower than that in sufentanil group from 1 hour on [0 (0, 1.0) vs. 1.0 (0, 2.0), P < 0.01]. It suggested that naporphine could achieve sustained and stable analgesic effect and avoid excessive sedation caused by sufentanil. Conclusions Naporphine had a sustained and stable analgesic effect on patients with mild and moderate ICU analgesia. The onset time of naporphine was equivalent to sufentanil, and it had a certain sedative effect and less influence on hemodynamics.

Effects of neonatal MK-801 exposure on recognition memory and excitatory-inhibitory balance of hippocampus in adult female rats / 中华行为医学与脑科学杂志

Objective To investigate the long-term effects of repeated neonatal administration of dizocipline maleate (MK-801),the glutamate N-methyl-D-aspartate (NMDA) receptor antagonist,on recognition memory and hippocampal excitatory-inhibitory balance at the synaptic level in adult female rats.Methods Neonatal female Sprague-Dawley (SD) rats were randomly divided into model group and control group.Rats were administrated subcutaneously with MK-801 or normal saline from postnatal day (PND) 5 to PND14 (0.25 mg/kg,twice daily).(1) Object-in-context recognition test was performed on PND73-75.(2)The expression levels of vesicular glutamate transporter 1 (VGLUT1) and vesicular GABA transporter (VGAT) in hippocampus were detected by immunohistochemical staining.Results (1) The preference index of model group for new objects was significantly lower than that of the control group (t =-2.762,P=0.012).(2) There was no significant difference in the expression of VGLUT1 in hippocampus of MK-801 mode group(P＞0.05).Compared with control group(48.19±2.10),the VGAT level of model group in CA1 (39.60±2.19) was lower.Compared with control group (CA1:(0.99±0.05),CA3:(1.28±0.02),the ratio of VGLUT1/VGAT was significantly upregulated in CA1(1.16±0.05) and CA3(1.44±0.03) (P＜0.05).Conclusion Early NMDA receptor inhibition produces long-term deleterious effects on associative recognition memory and excitatory-inhibitory balance of hippocampus in female rats.These biochemical abnormalities may contribute to cognitive impairments observed in this study.

Advances in the diagnosis and treatment of spastic pelvic floor syndrome / 中国综合临床

Objective Spastic pelvic floor syndrome (SPFS) is a common chronic functional constipation characterized by irregular defecation,low defecation frequency,difficult defecation,and discomfort and pain in the anus and perineum.The pathophysiologic mechanism of the disease has not yet been clearly understood,so there is no targeted treatment.At present,biofeedback therapy is an effective,safe and non-invasive method for the treatment of spastic pelvic floor syndrome,which is often combined with Chinese medicine and psychological intervention in clinical treatment.

The therapeutic effect of percutaneous microwave ablation in treatment of focal uterine adenomyosis / 中华医学超声杂志（电子版）

Objective To observe and analyze the therapeutic effect of focal uterine adenomyosis treated with percutaneous microwave ablation by contrast-enhanced ultrasound and dynamic contrast enhanced MRI (DCE-MRI).Methods From January 2013 to July 2016,42 patients with focal uterine adenomyosis voluntarily underwent percutaneous microwave ablation in the tumor hospital of Liaocheng.Contrast-enhanced ultrasound and DCE-MRI were performed before and after percutaneous microwave ablation.The therapeutic effects of percutaneous microwave ablation in treatment of uterine adenomyosis lesions were observed.Results After percutaneous microwave ablation of the 42 cases,the ablated zone showed no enhancement with contrast-enhanced ultrasound and DCE-MRI.Contrast-enhanced ultrasound showed that the volume and ablation rate of ablated zone were (49.0±29.5) cm3 and (91.6± 7.1)％,and that of DCE-MRI were (49.4 ± 29.9)cm3 and (91.9 ± 6.7)％,respectively.The results showed that percutaneous microwave ablation could cure focal uterine adenomyosis at the rate over 90％.Contrast-enhanced ultrasoundand DCE-MRI are in accordance in observing the ablation rate.Conclusions Contrast-enhanced ultrasound can accurately show the ablation rate of focal uterine adenomyosis treated with percutaneous microwave ablation,which is quite consistent with DCE-MRI.Contrast-enhanced ultrasound has its advantages such as identifying the lesions which need immiedately supplemental ablation.

Efficacy of automated medication management system in increasing clinical anesthesia management specification / 中华麻醉学杂志

Objective To evaluate the efficacy of automated medication management system in increasing clinical anesthesia management specification.Methods Sixty registered anesthesiologists of both sexes in our hospital,residents or attending physicians,with 1-10 yr of work experience,were divided into 2 groups (n =30 each) using a random number table:traditional medication management mode group (group T) and automated medication management system group (group A).In the clinical anesthesia work,traditional artificial management mode was used in group T,the mode of automated medication management system was used in group A,and 2 licensed pharmacists worked in the center pharmacy of our hospital were introduced for each group.Time of taking medicine was recorded by licensed pharmacists,and the error rates of taking medicine and recording were determined by licensed pharmacists.Results Compared with group T,the error rates of taking medicine and recording were significantly decreased (P＜0.01),and no significant change was found in the time of taking medicine in group A (P＞0.05).Medication errors including taking wrong anesthesia drug,wrong prescription recording,wrong names of the common drugs and drug omission were not detected in group A.Conclusion Application of automated medication management system can reduce the occurrence of errors made in taking medicine and recording,specify medication management and increase the quality of clinical anesthesia management.

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.

Relationship between Platelet-specific Alloantibody and Gravidity or Recurrent Spontaneous Abortion / 沈阳医学院学报

Objective:To investigate the expression of platelet-specific alloantibody in the sera of primipara,pluripara,and recurrent spontaneous abortion (RSA) patients,and analyze the relationship between platelet-specific alloantibody and gravidity or RSA. Methods:A total of 100 primipara, 100 pluripara (gravidity≥2) and 100 RSA patients who received prenatal examination in department of aristogenesis, No. 202 Hospital of PLA from Apr 2015 to Dec 2015 were recruited. The blood samples were collected during 16-28 weeks of pregnancy, and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay. Results:There were 5 positive platelet-specific alloantibody in primipara group, 14 in red all pluripara group,and 26 in RSA group. Platelet-specific alloantibody was significantly associated with gravidity and the incidence of RSA (P<0.05) by chi-square analysis. Conclusion:Screening the expression of platelet-specific alloantibody during pregnancy can provide evidence for the diagnosis and treatment of RSA.

Effects of Supplementation of Calcium and Sunshine During Pregnancy on Serum Level of Total 25-OH-D / 沈阳医学院学报

Objective:To study the effect of supplementation of calcium and sunshine during pregnancy on serum level of total 25-hydroxyvitamin vitamin D (25-OH-D) . Methods: A total of 151 cases of normal pregnant women were divided into four groups:without calcium and sunshine, without calcium and with sunshine, with calcium and without sunshine, with calcium and sunshine. LIAISON XL chemiluminescence analyzer was used to detect the serum level of 25-OH-D. Results:Compared with the group of without calcium and sunshine, the serum level of 25-OH-D in other groups increased significantly.The calcium deficiency rate of puerpera and neonatal decreased significantly.The reference range was 13.96 ng/ml (2.5%percentile), 39.54 ng/ml (50%percentile) and 73.90 ng/ml (92.5%percentile) .The mean value of 25-OH-D was (41.67 ± 14.72) ng/ml.Conclusion:Proper supplementation of calcium and adequate sunshine during pregnancy can prevent calcium deficiency of puerpera and neonate.The reference range of serum 25-OH-D is slightly lower than that in general population.

Information needs of users in biomedical industry clusters / 中华医学图书情报杂志

A large number of starring biomedical industry clusters are emerged in recent years with the develop-ment of biomedical industry. The information access approaches of users in biomedical industry clusters consisting of higher education institutions, scientific research institutions and enterprises, the types of biomedical information they need, the transformation ways of their achievements, and the major barriers of information access were thus in-vestigated in this paper with questionnaires. The different information behaviors were compared between the users of scientific research group and enterprise group. The characteristics of information need of users in biomedical indus-try clusters were summarized, and following suggestions were put forward, namely establishing information service platform, perfecting institution-oriented information service model, and improving information service system for bi-omedical industry clusters.

Dual roles of Nrf2 in tumorigenesis / 中华地方病学杂志

Activation of the transcription factor NF-E2-related factor 2 (Nrf2)-signaling pathway is an adaptive response to environmental and endogenous stresses and serves to render animals resistant to chemical carcinogenesis and other forms of toxicity. However, overexpression of Nrf2 has been recognized to promote oncogenesis and resistance to chemotherapy. The application of Nrf2 in tumor chemoprevention and treatment has also become a hot topic. This review focuses on the dual roles of Nrf2 in tumorigenesis and the application of Nrf2 in tumor chemoprevention and treatment.

Construction of information service platform for biomedical industry groups / 中华医学图书情报杂志

The construction plan of information service platform for biomedical industry groups was proposed, including expert intelligence database, special database, advanced information service platform and biomedical achievements transformation platform.The information ( including names, subject fields and research interests of experts) in expert intelligence database can be searched according to the subject fields and research interests of experts.The special database is consisted of database of special literature, genes, proteins, special drugs, achievements, patents and demands.The information service platform can provide literature retrieval service, literature novelty assessment service, data-mining service, information analysis service, decision-making support service, and competitive informa-tion service.The biomedical achievements transformation platform can provide service for transforming achievements and for solving difficulty demand problems.

Hepatopulmonary syndrome-related changes in D-dimer, prothrombin time, fibrinogen, CD4 and CD8 in a rat model system / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the changes in levels of D-dimer, prothrombin time (PT), fibrinogen (Fib), CD4 and CD8 in relation to hepatopulmonary syndrome (HPS) by using a rat model system and to assess the association with pathologic changes in lung.</p><p><b>METHODS</b>Forty male Sprague-Dawley rats were divided into equal groups for modeling of cirrhosis and HPS. The two groups were assessed by blood gas analysis, standard biochemical tests to measure D-dimer, PT, Fib, CD4 and CD8, and pathological examination of lung tissues.</p><p><b>RESULTS</b>The HPS rats showed significantly lower PaO2 than the cirrhosis rats (58.20+/-3.19 mmHg vs. 85.00+/-2.53 mmHg, P = 0.000). The HPS rats showed significantly higher levels of D-dimer, Fib and CD8 than the cirrhosis rats (0.39+/-0.09 mg/ml vs. 0.25+/-0.05 mg/ml, P = 0.000; 1.77+/-0.10 g/L vs. and 1.49+/-0.09 g/L, P = 0.010; 32.32+/-4.45/mm3 vs. 20.13+/-6.09/mm3, P = 0.014). The HPS rats showed significantly lower levels of PT, CD4 and CD4/CD8 than the cirrhosis rats (14.86+/-1.04 s vs. 16.23+/-0.75 s, P = 0.036; 20.45+/-3.86/mm3 vs. 26.75+/-5.32/mm3, P = 0.000; 0.64+/-0.09 vs. 1.32+/-0.13, P = 0.000). The lung tissues of the HPS rats showed microthrombosis in pulmonary vessels, which were not observed in lung tissues of the cirrhosis rats.</p><p><b>CONCLUSION</b>HPS-related differential levels of D-dimer, PT, Fib, CD4, CD8 and CD4/CD8 may represent a biomarker profile suggestive of incidence of thromboembolism in lung.</p>

Clinical study onMaxing-Shigan decoction for severe pneumonia of phlegm-heat obstructing lung type / 国际中医中药杂志

Objective To assess the clinical efficacy ofMaxing-Shigan decoction in patients with severe pneumonia due to phlegm-heat obstructing the lung.Methods Sixty patients with severe pneumonia in the TCM Department of Dalian Municipal Central Hospital from January to December 2013 were randomly divided into a control group and a treatment group by random number table method, 30 in each group. The control group was treated with anti-infection, fluid infusion and mechanical ventilation. On the basis of treatment in the control group, the treatment group was also givenMaxing-Shigan decoction through nasogastric gavage. The mean arterial pressure (MAP), lactic acid (Lac) and PaO2/FiO2 were compared before and after the treatment in both groups. The scores of the Clinical Pulmonary Infection Score (CPIS) and the Acute Physiology and Chronic Health Evaluation II (APACHEⅡ) were compared between the two groups.Results The total effective rate in the treatment group was significantly higher than that in the control group (80.0%vs.73.3%;χ2=4.800,P=0.029). In both groups, MAP (treatment group: 102.4 ± 11.9 mmHgvs. 70.4 ± 6.4 mmHg, t=12.972,P=0.000; control group: 101.2 ± 12.5 mmHgvs. 69.8 ± 6.6 mmHg,t=12.1672,P=0.000), PaO2/FiO2 (treatment group: 265.4 ± 19.7 mmHgvs. 78.6 ± 10.5 mmHg,t=45.833,P=0.000; control group: 124.8 ± 13.4 mmHg vs. 79.1 ± 11.1 mmHg;t=14.385,P=0.000) after the treatment were significantly higher than before the treatment, and the Lac level were significantly lower (treatment group: 1.04 ± 0.42 mmol/Lvs. 6.37 ± 2.27 mmol/L,t=12.65, P=0.000; control group: 3.88 ± 1.45 mmol/Lvs. 6.39 ± 2.32 mmol/L,t=5.025,P=0.000). The improvements in Lac (t=10.304,P=0.000) and PaO2/FiO2 (t=32.323,P=0.000) in the treatment group were superior to the control group. The scores of the CPIS (treatment group: 2.2 ± 1.5vs. 6.7 ± 1.7,t=10.872,P=0.000; control group: 4.5 ± 2.7 vs. 6.8 ± 1.8,t=3.882,P=0.000) and APACHEⅡ(treatment group: 5.3 ± 2.1vs. 13.8 ± 3.8,t=10.723,P=0.000; control group: 9.3±3.5vs. 13.7 ± 3.5,t=4.869,P=0.000) after the treatment were significantly lower than before the treatment in both groups, and the changes of CPIS (t=4.079,P=0.000) and APACHEⅡ(t=5.368,P=0.000) in the treatment group were greater than those in the control group.ConclusionsMaxing-Shigan decoction has definite therapeutic effects for severe pneumonia due to phlegm-heat obstructing the lung..

Comparison of two and three dimensional quantitative coronary angiography to intravascular ultrasound in the assessment of left main coronary artery bifurcation lesions / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiographic evaluation of left main coronary artery (LMCA) bifurcation lesions is often limited. two dimensional (2D) quantitative coronary angiography (QCA) with segmental analysis provides accuracy for quantification of the degree of stenosis in the main vessel and side branch ostium but can be affected by foreshortening and variable magnification. The accuracy of three dimensional (3D) QCA has recently developed to overcome 2D QCA limitations, however, accuracy and precision of 3D bifurcation QCA measurements in LMCA bifurcation lesions has not been established.</p><p><b>METHODS</b>We investigated whether such 3D and 2D bifurcation QCA measurements differ in their accuracy in assessing significant LMCA bifurcation lesions defined by intravascular ultrasound (IVUS) as a minimum luminal area (MLA) <6 mm(2) of LMCA and MLA <4 mm(2) of proximal left anterior descending (LAD) and/or proximal left circumflex (LCX) RESULTS: LMCA bifurcation lesions were assessed in 44 patients undergoing elective percutaneous coronary intervention. From 2D QCA measurements, MLA correlated moderately with threshold intravascular ultrasound MLA for LMCA (r = 0.81, P < 0.000 1), LAD (r = 0.54, P = 0.000 1) and LCX (r = 0.58, P < 0.000 1). Severity of lesion as MLA by derived 3D QCA, correlated moderately with threshold intravascular ultrasound MLA for LMCA (r = 0.84, P < 0.000 1), LAD (r = 0.53, P = 0.000 2); LCX (r = 0.66, P < 0.000 1). Overall, the C statistics tended to be slightly higher for 3D QCA and 2D QCA measurements in LMCA segment compared with proximal LAD and LCX segments, and there were no significant predictive power of percent diameter stenosis and percent area stenosis on 3D QCA for LCX IVUS MLA <4 mm(2) (percent diameter stenosis: area under curve 0.55, cutoff 23%, sensitivity 88%, specificity 37%, P = 0.618 6; percent arer stenosis: area under curve 0.56, cutoff 41%, sensitivity 83%, specificity 38%, P = 0.518 4, respectively).</p><p><b>CONCLUSIONS</b>The accuracy of 3D bifurcation QCA in detecting significant LMCA bifurcation lesions is limited, especially the proximal LCX ostium. When IVUS is not available or contraindicated, 3D QCA may assist in the evaluation of intermediate LMCA lesions with MLA.</p>