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ObjectiveTo explore the clinical efficacy and safety of the combination of Erchentang and Bixie Fenqingyin in the treatment of patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome to provide a new method and evidence for the treatment of acute cerebral infarction with hyperuricemia. MethodA total of 132 eligible patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome admitted to the Putuo Hospital of Shanghai University of Traditional Chinese Medicine（TCM） from May 2021 to May 2022 were randomly divided into a Chinese medicine group， a western medicine group， and a control group， with 44 cases in each group. All three groups received routine western medical treatment for acute cerebral infarction. Additionally， the Chinese medicine group received Erchentang combined with Bixie Fenqingyin， the western medicine group received Benzbromarone tablets， and the control group did not receive any uric acid-lowering treatment. The treatment duration was four weeks. The modified Rankin Scale （mRS） score after three months of onset， as well as the National Institutes of Health Stroke Scale （NIHSS） scores， TCM syndrome scores， serum uric acid （SUA） levels， serum C-reactive protein （CRP） and interleukin-6 （IL-6） levels， serum superoxide dismutase （SOD） and malondialdehyde （MDA） levels， and other safety indicators were observed before and after treatment. ResultA total of 129 cases completed the trial observation， with 43 cases in the Chinese medicine group， 42 cases in the western medicine group， and 44 cases in the control group. The rate of good prognosis in the Chinese medicine group （83.7%，36/43） was higher than that in the western medicine group （64.3%，27/42） and the control group （40.9%，18/44） （χ2=4.184，16.930，P<0.05）， and the western medicine group was superior to the control group （χ2=4.707，P<0.05）. After treatment， the NIHSS scores， TCM syndrome scores， SUA， CRP， IL-6， and MDA levels of the patients in all three groups decreased， while the SOD levels increased compared with those before treatment （P<0.05）. Among them， the improvement in NIHSS score was better in the Chinese medicine group and the western medicine group than in the control group （P<0.05）. The Chinese medicine group showed the greatest improvement in TCM syndrome （P<0.05）， while the western medicine group showed the greatest reduction in uric acid levels （P<0.05）. No significant abnormalities in safety indicators were observed before and after treatment in the three groups， and no serious adverse reactions were reported. ConclusionThe combination of Erchentang and Bixie Fenqingyin can significantly improve the prognosis， early neurological deficits， and TCM syndromes of patients acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome. It can also lower uric acid levels and inhibit inflammatory and oxidative stress reactions.
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Objective:To investigate the relationship between hyperuricemia and outcome in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke admitted to Department of Neurology, Putuo Hospital, Shanghai University of Tranditional Chinese Medicine between January 2020 and September 2020 were enrolled retrospectively. The modified Rankin Scale (mRS) score was used to evaluate the clinical outcome 3 months after the onset. ≤2 was considered as good outcome, and >2 was considered as poor outcome. The demography and baseline characteristics were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of the outcome. Results:A total of 210 patients were included, their age was 69.87±62.62 years. There were 125 males (59.52%) and 85 females (40.48%). The baseline median National Institutes of Health Stroke Scale (NIHSS) score was 4. The serum uric acid level in 169 patients (80.48%) was normal and 41 (19.52%) had hyperuricemia; 120 patients (57.14%) had a good outcome, and 90 (42.86%) had a poor outcome. Blood glucose level, serum uric acid level, baseline NIHSS score and the proportions of diabetes mellitus, history of stroke or transient ischemic attack, hyperuricemia in the poor outcome group were significantly higher than those in the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [ OR] 2.735, 95% confidence interval [ CI] 1.461-5.121; P=0.002), hyperuricemia ( OR 2.400, 95% CI 1.102-5.228; P=0.027), and higher baseline NIHSS score ( OR 1.233, 95% CI 1.118-1.360; P<0.001) were the independent risk factors for poor outcome in patient with acute ischemic stroke. Conclusion:Hyperuricemia is an independent risk factor for poor outcome in patients with acute ischemic stroke.
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Objective To systemic evaluate postoperative pulmonary function between segmentectomy and lobectomy in patients with early stage non-small cell lung cancer.Methods Computer searched was performed up to September 2016 at the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and Wanfang database,collected postoperative pulmonary function between segmentectomy and lobectomy in Patients with early stage Non-Small Cell Lung Cancer.Study selection,data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Results Eight studies included 308 segmentectomy and 386 lobectomy were identified for inclusion.FVC％ (MD =9.91,95％ CI:3.53-16.30,P =0.002),postoperation / preoperation FVC％ (MD =6.74,95％ CI:5.52-7.79,P ＜0.05),FEV1％ (MD =13.25,95％ CI:10.25-16.26,P ＜ 0.05),postoperation / preoperation FEV1％ (MD =7.18,95 ％ CI:5.88-8.48,P ＜ 0.05) showed significant difference.Conclusion Pulmonary function index was superior to lobectomy after segmentectomy in patients with early stage lung cancer,and segmentectomy resection was more beneficial to preserve lung function.
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Objecive To design and develop a simulated maritime rescue training platform to emulate different sea conditions and carry out maritime rescue training.Methods Corresponding computer program was used to control a 3 degreeof-freedom electric platform,and the rolling,pitching and heaving of the ambulance boat were simulated by setting vibration frequency and displacement.An operating training room was set up and equipped with necessary emergency devices.Results By changing the frequency and displacement of the training platform,the operating environment in the ambulance boat was simulated under the second to fifth grades of sea conditions to execute the training for antivertigo,fine operation and nursing.Conclusion The platform facilitates the medical staff to be familiar with maritime environment,master treatment techniques at different sea conditions and enhance support efficiency.
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Objective To systemic evaluate postoperative pulmonary function between segmentectomy and lobectomy in patients with early stage non-small cell lung cancer.Methods Computer searched was performed up to September 2016 at the Cochrane Library,PubMed,EMBASE,CBM,CNKI,VIP and Wanfang database,collected postoperative pulmonary function between segmentectomy and lobectomy in Patients with early stage Non-Small Cell Lung Cancer.Study selection,data collection and critical assessment of the included studies were performed according to the recommendations of the Cochrane Collaboration.Results Eight studies included 308 segmentectomy and 386 lobectomy were identified for inclusion.FVC％ (MD =9.91,95％ CI:3.53-16.30,P =0.002),postoperation / preoperation FVC％ (MD =6.74,95％ CI:5.52-7.79,P ＜0.05),FEV1％ (MD =13.25,95％ CI:10.25-16.26,P ＜ 0.05),postoperation / preoperation FEV1％ (MD =7.18,95 ％ CI:5.88-8.48,P ＜ 0.05) showed significant difference.Conclusion Pulmonary function index was superior to lobectomy after segmentectomy in patients with early stage lung cancer,and segmentectomy resection was more beneficial to preserve lung function.
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Objective To explore the chronergy of fibrinolysin and its influence on fibrinogen ( FIB ) and thrombus precursor protein (TpP) in treatment of acute cerebral infarction (ACI). Methods The clinical trial adopted the randomized single-blind placebo-controlled design.Totally, 150 patients with ACI (onset time≤12 h) were chosen and randomly divided into experimental group A ( group A receiving treatment of fibrinolysin after 12 h onset of ACI ) , experimental group B ( group B receiving treatment of fibrinolysin after 24 h onset of ACI) and control group ( group C without fibrinolysin treatment) , 50 cases in each group.The patients in experimental group A and B received basic treatment for ACI and fibrinolysin treatment.Patients in group C were given the basic treatment for ACI and placebo.The level of FIB and TpP before and after 7 days treatment, NIHSS scores before and after 14 days treatment, BI scores before and after 90 days treatment, incidence rate of progressive cerebral infarction ( PCI ) , stroke recurrence and mortality rate of the three groups were analyzed to evaluate the clinical effect of fibrinolysin.Hepatic and renal function before and after 7 days treatment, incidence rates of haemorrhage and hypersensitiveness were analyzed to evaluate the security of fibrinolysin. Results The NIHSS score of patients in group A, B and C (4.0±1.6, 6.5±2.2 and 8.0±4.7) was declined significantly after treatment (P0.05).The FIB in group A, B and C after treatment was (2.74±0.75) g?L-1,(2.82±0.83) and (3.67±1.35) g?L-1, respectively.The level of FIB in the three groups did not decrease significantly after treatment (P>0.05).However, the level of FIB in group A and B declined significantly as compared with that in group C.The TpP in group A, B and C after treatment was (3.56±1.26) mg?L-1, (3.43±1.22) and (13.21±6.54) mg?L-1, respectively.The level of TpP in group A and group B decreased significantly after treatment (P<0.05). The level of TpP in group A and B declined even more significantly than that in group C.Fibrinolysin did neither obviously injure liver and kidney nor increase the risk of bleeding, and had low hypersensitiveness incidence rate. Conclusion Treatment with fibrinolysin within 24 h after onset of cerebra infarction benefits the patients. However, dosing after 12 h onset of ACI benefits more than dosing after 24 h.Fibrinolysin plays a role of anti-thrombosis primarily by lowering the TpP level, and its influence on fibrinogen is limited.
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BACKGROUND: To establish experimental animal model for rapid evaluation of combined wound with seawater immersion so as to benefit wound healing and recovery.OBJECTIVE: To explore the plan of simple evaluation of combined wound with seawater immersion.DESIGN: Group division and controlled experiment was designed.SETTING: Second Department of Orthopaedics, the 113 Hospital of Chinese PLA; Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA MATERIALS: Totally 32 health hybridized adult dogs were employed,mass weighted varied from 12 to 15 kg, of either sex.METHODS: The experiment was performed partially in the specific sea area of the Fifth and Sixth Room , Research Institute of Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from October 2001 to June 2002. The dogs were randomized into burn-blast combined wound group and projectile-burn combined wound group and each group was subdivided into immersion group (10 dogs) and the control (6 dogs). Burn-blast combined wound group: The model of burn and mild blast injury was prepared. In the control, the dogs were put in a room at 25 ℃ directly after injury; But in immersion group, the dogs were immersed immediately in simulated seawater with holder. Projectile-burn combined wound group: The model of burn and mild projectile injury was prepared. The managements were same as the previous after injury in the control and immersion group. The change of physiologic indexes was observed in 28 hours after injury. The indexes related to death were picked up for correlative analysis and establishing wound scoring scale, inducing body temperature, heart rate, mean arterial pressure (MAP), chloride concentration, PaO2 and causative factor, 0-5 score were designed, the higher the score was, the higher mortality would be.MAIN OUTCOME MEASURES: ① Analysis of dead cases in each group. ② Wound scoring. ③ Verification of wound in scoring scale.RESULTS: 32 dogs all entered result analysis. ① Analysis of dead cases and relationship: Totally, 12 dogs were died. The peak of death was in 10-12hours, no matter the immersion happened or not. 5 indexes were associated significantly with death, named body temperature, heart rate, MAP, PaO2 and chloride concentration (P ＜ 0.05). ② Comparison of wound scoring, predictive mortality and actual mortality in each group: The results in burn-blast control were (5.89±3.25) score, 0 and 17% successively. Those in projectileburn control were (6.78±2.02), 25% and 33% successively. Those in burn blast immersion group were (9.50±4.20) scores, 50% and 30% and those in projectile-burn immersion group were (11.13±3.57) scores, 50% and 60%.CONCLUSION: ① The established scoring scale is apt to obtain common physiological indexes so as to evaluate the wound rapidly, which is applica ble for either seawater immersed cases or non-immersed cases, indicating extensively applications. ② The correction of evaluation is acceptable with verification. ③ The scale is based on animal experimental data, for which,it is still different from the one of real wound evaluation.