RESUMO
Objective:To explore the clinical and pathological characteristics of epidermoid cyst in intrapancreatic accessory spleen (ECIPAS).Methods:The clinical and pathological data on 12 cases of confirmed ECIPAS in the First Affiliated Hospital of Naval Medical University and Huashan Hospital Affiliated to Fudan University from January 2011 to December 2020 were retrospectively analyzed. Patients′ sex, age, serum tumor markers, tumor size, tumor location and distant metastasis were recorded. Tissue expression of synaptophysin (Syn), chromogranin A(CgA), cytokeratin (CK) and CK5/6, estrogen receptor (ER), progesterone receptor (PR), proliferation index Ki-67 and tumor suppressor gene p53 were evaluated by immunohistochemistry.Results:All the patients were incidentally diagnosed during routine body examination. Among them, there were 4(33.3%) men and 8(66.7%) women. Patient's average age was 42 years old. All the lesions were located at the tail of the pancreas. 3 patients had elevated carbohydrate antigen 19-9(CA19-9). The ECIPAS were demonstrated as clear-boundary low or no echo on abdominal ultrasound, low-density mass on CT, and cystic and solid lesion on pancreas MRI, respectively. Eleven patients received resection of body and tail of pancreas and spleen, one patient received pancreatectomy with preservation of the spleen. The resected specimens from the 12 patients were showed as cystic and solid mass in the pancreatic tail with a maximal diameter ranging from 1.4 cm to 4.0 cm. Under microscopy, multi-cystic lesions covered with stratified squamous epithelial cells were observed. Immunohistochemistry showed that the squamous cell marker CK was expressed. In a follow-up period of 5 to 119 months, and no recurrence were diagnosed.Conclusions:ECIPAS is a rare lesion often occurring in tails of pancreas and the patients usually have no clinical symptoms. It is challenging to make a correct diagnosis by imaging, but this lesion has unique pathological manifestations and good prognosis.
RESUMO
Objective:To observe the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in frequencies of 5 Hz and 10 Hz for post-herpetic neuralgia (PHN). Methods:From March, 2017 to March, 2018, 60 PHN patients were randomly divided into groups A (n = 20), B (n = 20) and C (n = 20), who accepted sham rTMS, 5 Hz rTMS and 10 Hz rTMS, respectively, ten times for two weeks. They were assessed with Visual Analogue Scale (VAS) of pain, Pittsburgh Sleep Quality Index (PSQI), Patients' Global Impression of Change Scale (PGIC), medication regulation (MR) and incidence of adverse events, before treatment (T0), immediately after stimulation (T1-T10), one month after treatment (T11) and three months after treatment (T12). Results:Compared with group A, VAS scores reduced in groups B and C at T3-T12 (P < 0.05), and reduced more in group C than in group B at T7-T12 (P < 0.05). The average VAS reduction was less in group B than in group C (χ2 = 5.347, P < 0.05). The PSQI and PGIS scores were less in groups B and C than in group A at T12 (P < 0.05), while it was less in group C than in group B (P < 0.05). There was no significant difference among three groups in MR and the incidence of adverse events. Conclusions:rTMS in either frequencies of 5 Hz or 10 Hz may relieve pain, and improve sleep for PHN patients, while 10 Hz rTMS seems more effective in terms of pain and sleep.
RESUMO
Objective:To observe the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in frequencies of 5 Hz and 10 Hz for post-herpetic neuralgia (PHN). Methods:From March, 2017 to March, 2018, 60 PHN patients were randomly divided into groups A (n = 20), B (n = 20) and C (n = 20), who accepted sham rTMS, 5 Hz rTMS and 10 Hz rTMS, respectively, ten times for two weeks. They were assessed with Visual Analogue Scale (VAS) of pain, Pittsburgh Sleep Quality Index (PSQI), Patients' Global Impression of Change Scale (PGIC), medication regulation (MR) and incidence of adverse events, before treatment (T0), immediately after stimulation (T1-T10), one month after treatment (T11) and three months after treatment (T12). Results:Compared with group A, VAS scores reduced in groups B and C at T3-T12 (P < 0.05), and reduced more in group C than in group B at T7-T12 (P < 0.05). The average VAS reduction was less in group B than in group C (χ2 = 5.347, P < 0.05). The PSQI and PGIS scores were less in groups B and C than in group A at T12 (P < 0.05), while it was less in group C than in group B (P < 0.05). There was no significant difference among three groups in MR and the incidence of adverse events. Conclusions:rTMS in either frequencies of 5 Hz or 10 Hz may relieve pain, and improve sleep for PHN patients, while 10 Hz rTMS seems more effective in terms of pain and sleep.
RESUMO
Papillary adenoma (PA) of kidney is defined as a lesion measuring less than 15 mm and featuring papillary or tubular architecture along with nuclei of low grade.Clear cell renal cell carcinoma (CCRCC) is the most common seen group of malignant neoplasms consists of cells with clear or eosinophilic cytoplasm.The coexistence of these two kinds of tumor is rare and was only reported in one piece of literature to date.We report a thought-provoking case in which CCRCC is coexisting with multiple PAs.The CCRCC shows no difference with other common cases while the PAs share the same clinical and pathological features with other ones and demonstrates no amplifying of 3,7 or 17 chromosome.However,the multiple PAs were neglected by imaging doctors and surgeons,and some tiny lesions were not found until the observation under microscope.This case reminds that patients accepting partial nephrectomy for CCRCC may have PAs,so attention should be paid to the image studies along with routine pathological examination of kidney for that there may exists two or more kinds of lesions.
RESUMO
Objectives:To analyze the statistics of nursing errors of nursing staff in the top three hospital during last year,and the relationship between nursing staff's job satisfaction and job. Methods:From February 2017 to Au-gust 2017,a cluster randomized sampling method was used to select 320 cases of standard nursing staff in the top three hospitals. The questionnaires for general information, questionnaires for nursing job errors, job satisfaction questionnaire,and job burnout survey questionnaire for nursing staff were used to investigate and analyze,and to ex-plore the relevance of nursing work errors, job satisfaction and job burnout. Results:The incidence of nursing error rate was 65.61%. Statistical analysis shows that the occurrence of nursing work errors was related to job satisfaction and job burnout. Among them, nursing staff's personal sense of achievement, personality and overload work, work not recognized, lack of management, unclear responsibility, and low welfare benefits easily led to nursing errors. Conclusions:Based on the impact of job satisfaction and job burnout on the work of nursing staff,improving the nurs-ing staff satisfaction,alleviating the job burnout would reduce the occurrence of nursing errors through the optimiza-tion of scheduling,welfare,management communication and other development opportunities.
RESUMO
Internal carotid arterial system is the main source of blood supply in brain. In forensic identi-fication practice, blunt injures of internal carotid arterial system usually cause complications such as throm-bus, aneurysm and arteriovenous fistula, etc. The deaths following delayed cerebral infarction or intracra-nial haemorrhage are not rare. At present, literature of deaths caused by blunt injuries of internal carotid arterial system mainly consist of case reports in China. This paper reviews related literature and case re-ports at home and abroad, and summarizes forensic medical features and identification method of the deaths caused by such injuries. The results show that blunt injures of internal carotid arterial system are related to the direct or indirect force on head and neck, which can result in exceed physiological range traction of head and neck, incision following basicranial fracture, etc. Such injuries are common in the cases as mechanical asphyxia, cervical manipulation, traffic accident and fall, etc. The artery should be examined carefully, and the relationship among injury, disease and death should be analysed correctly when no cause of infarction and hemorrhage was found in routine examination of such cases in forensic pratice. Because of the difficulty for exposing the artery completely in autopsy, angiography can be used to infer the location when necessary for improving the scientificity and reliability of the appraisal conclusion.
RESUMO
OBJECTIVES@#To explore the species distribution and constituent ratio of diatoms in main sections of urban district rivers where drowning occurs frequently in Chengdu.@*METHODS@#Total 39 water samples from the sampling points of 5 rivers （Jinjiang, Jinniu, Qingyang, Wuhou and Chenghua districts） in October 2014 were collected. The diatoms smear were made and the species distribution and constituent ratio of diatoms from the water samples were analyzed using biological microscope and acquisition system of digital microscope.@*RESULTS@#Total 21 species of diatoms were detected in main sections of urban district rivers in Chengdu. Significant differences in the dominant diatom species and proportions of the different rivers were observed, and there were different species existed in all sampling points of the upstream, midstream and downstream of the rivers.@*CONCLUSIONS@#The database of species map, species distribution and constituent ratio of diatoms in main sections of urban district rivers in Chengdu are preliminarily established, which has special meaning for the analysis and evaluation of falling location inference using diatoms test in case investigation.
Assuntos
China , Cidades , Diatomáceas/classificação , Afogamento , RiosRESUMO
OBJECTIVE@#To study the effect of sitagliptin on adipocytokines expression in diabetic rats and its molecular mechanism.@*METHODS@#Male SD rats were chosen and randomly divided into NC group, T2DM group, SP group and SP + LY group. NC group received conventional breeding, T2DM group, SP group and SP + LY group received intraperitoneal injection of streptozotocin after 12 weeks of high-fat diet to establish diabetes animal model, SP group received sitagliptin intervention and SP + LY group received sitagliptin combined with PI3K inhibitor LY294002 intervention. Six weeks after the intervention, serum was collected to determine the levels of biochemical indexes and adipocytokines, and visceral adipose tissue was collected to determine expression levels of adipocytokines.@*RESULTS@#Serum TC, TG, LDL-C, FBG, FINS, Leptin and Chemerin levels as well as HOMA-IR of T2DM group were higher than those of NC group, and HDL-C, Adiponectin and Omentin-1 levels were significantly lower than those of NC group; serum TC, TG, LDL-C, FBG, FINS, Leptin and Chemerin levels as well as HOMA-IR of SP group were lower than those of T2DM group, and HDL-C, Adiponectin and Omentin-1 levels were significantly higher than those of T2DM group; Leptin and Chemerin levels in serum and visceral adipose tissue of SP + LY group were higher than those of SP group while Adiponectin and Omentin-1 levels were significantly lower than those of SP group.@*CONCLUSION@#Sitagliptin can regulate the expression of adipocytokines in adipose tissue of diabetic rats through PI3K-AKT pathway.
RESUMO
Objective To study the effect of sitagliptin on adipocytokines expression in diabetic rats and its molecular mechanism. Methods Male SD rats were chosen and randomly divided into NC group, T2DM group, SP group and SP + LY group. NC group received conventional breeding, T2DM group, SP group and SP + LY group received intraperitoneal injection of streptozotocin after 12 weeks of high-fat diet to establish diabetes animal model, SP group received sitagliptin intervention and SP + LY group received sitagliptin combined with PI3K inhibitor LY294002 intervention. Six weeks after the intervention, serum was collected to determine the levels of biochemical indexes and adipocytokines, and visceral adipose tissue was collected to determine expression levels of adipocytokines. Results Serum TC, TG, LDL-C, FBG, FINS, Leptin and Chemerin levels as well as HOMA-IR of T2DM group were higher than those of NC group, and HDL-C, Adiponectin and Omentin-1 levels were significantly lower than those of NC group; serum TC, TG, LDL-C, FBG, FINS, Leptin and Chemerin levels as well as HOMA-IR of SP group were lower than those of T2DM group, and HDL-C, Adiponectin and Omentin-1 levels were significantly higher than those of T2DM group; Leptin and Chemerin levels in serum and visceral adipose tissue of SP + LY group were higher than those of SP group while Adiponectin and Omentin-1 levels were significantly lower than those of SP group. Conclusion Sitagliptin can regulate the expression of adipocytokines in adipose tissue of diabetic rats through PI3K-AKT pathway.
RESUMO
<p><b>BACKGROUND</b>The dilemma of pathogens identification in patients with unidentified clinical symptoms such as fever of unknown origin exists, which not only poses a challenge to both the diagnostic and therapeutic process by itself, but also to expert physicians.</p><p><b>METHODS</b>In this report, we have attempted to increase the awareness of unidentified pathogens by developing a method to investigate hitherto unidentified infectious pathogens based on unbiased high-throughput sequencing.</p><p><b>RESULTS</b>Our observations show that this method supplements current diagnostic technology that predominantly relies on information derived five cases from the intensive care unit. This methodological approach detects viruses and corrects the incidence of false positive detection rates of pathogens in a much shorter period. Through our method is followed by polymerase chain reaction validation, we could identify infection with Epstein-Barr virus, and in another case, we could identify infection with Streptococcus viridians based on the culture, which was false positive.</p><p><b>CONCLUSIONS</b>This technology is a promising approach to revolutionize rapid diagnosis of infectious pathogens and to guide therapy that might result in the improvement of personalized medicine.</p>
Assuntos
Feminino , Humanos , Masculino , Herpesvirus Humano 4 , Genética , Sequenciamento de Nucleotídeos em Larga Escala , Métodos , Estreptococos Viridans , GenéticaRESUMO
<p><b>OBJECTIVE</b>To study clinical characteristics and resistance of wound surface infections, so as to guide clinical diagnosis and rational administration.</p><p><b>METHODS</b>The clinical setting and laboratory results were collected by analyzing 20 strains of Bacillus cereus isolated from clinical samples in patients from our hospital from October 2011 to June 2012, including 18 males and 2 females,ranging in age from 22 to 67 years old, averaged (47.30 +/- 11.16) years old. The courses of disease ranged from 5 to 20 days. All the patients were treated with nutrition support therapy, debridement and the corresponding antibiotic therapy. The patients had anemia, low protein hyperlipidemia and wound contamination history while Bacillus cereus infected. Thirty people were selected as normal group, including 23 males and 7 females,with an average age of (45.20 +/- 15.05) years old. Infection control condition was assessed by comparing culture for pathogens and patients wound redness or exudation cases before and after treatment. Antimicrobial susceptibility test was conducted by K-B method.</p><p><b>RESULTS</b>A total of 20 stains of Bacillus cereus were isolated from wound surface infections in department of orthopedics of our hospital. Among them,the infections were correlated with the wound contamination (16/20), malnutrition (20/20), and open-fracture (20/20), operation time (15 cases > 3 h). The laboratory blood test showed that the levels of TP [(49.94 +/- 8.24) g/L], ALB [(29.54 +/- 5.45 ) g/L] and Hb [(103.20 +/- 11.79) g/L] in the infection group was lower than those of control group; in the contrast, the levels of WBC [(8.35 +/- 2.31) x 10(9)/L], NEUT [(6.98 +/- 1.99) x 10(9)/L], hs-CRP [(73.60 +/- 55.14) mg/L] and CK [(900.10 +/- 1 259.12) IU/L] were higher in the infection group than those of control group, and the differences were statistically significant (P < 0.01). The diameter of inhibition zone in penicillin, cefazolin, cefuroxime, ceftazidime, cefepime, cotrimoxazole, erythromycin were less than 15 mm, and suggested that Bacillus cereus resisted to these antibiotics. However, the diameter of inhibition zone in clindamycin, vancomycin, gentamicin, ciprofloxacin, imipenem were larger than 20 mm and this data indicated that the bacteria were highly sensitive to these antibiotics.</p><p><b>CONCLUSION</b>Orthopedic patients who immunocompromised, hypoproteinemia and accompanied by open wounds and contaminated wound susceptible to infect Bacillus cereus; sensitive antimicrobial drugs should be selected on the basis of supplement albumin, symptomatic and supportive treatment.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antibacterianos , Farmacologia , Bacillus cereus , Ortopedia , Infecção dos Ferimentos , MicrobiologiaRESUMO
During the seven-year transitional period of European Union Directive 2004/24/EC, only a few of traditional Chinese medicines had been approved for registration. In other words, the EU directive has become an unavoidable registration barrier to hinder Chinese enterprises from entering EU market. By analyzing difficulties of enterprises in registration in EU and studying the only successful case in China--Di Ao Group, this article proposes countermeasures in the hope of providing effective reference for Chinese enterprises in expanding EU market, and promoting the internationalization progress of traditional Chinese medicine.
Assuntos
Humanos , União Europeia , Medicina Tradicional ChinesaRESUMO
<p><b>BACKGROUND</b>Visceral pain is a common cause for seeking medical attention. Afferent fibers innervating viscera project to the central nervous system via sympathetic nerves. The lumbar sympathetic nerve trunk lies in front of the lumbar spine. Thus, it is possible for patients to suffer visceral pain originating from sympathetic nerve irritation induced by anterior herniation of the lumbar disc. This study aimed to evaluate lumbar discogenic visceral pain and its treatment.</p><p><b>METHODS</b>Twelve consecutive patients with a median age of 56.4 years were enrolled for investigation between June 2012 and December 2012. These patients suffered from long-term abdominal pain unresponsive to current treatment options. Apart from obvious anterior herniation of the lumbar discs and high signal intensity anterior to the herniated disc on magnetic resonance imaging, no significant pathology was noted on gastroscopy, vascular ultrasound, or abdominal computed tomography (CT). To prove that their visceral pain originated from the anteriorly protruding disc, we evaluated whether pain was relieved by sympathetic block at the level of the anteriorly protruding disc. If the block was effective, CT-guided continuous lumbar sympathetic nerve block was finally performed.</p><p><b>RESULTS</b>All patients were positive for pain relief by sympathetic block. Furthermore, the average Visual Analog Scale of visceral pain significantly improved after treatment in all patients (P < 0.05). Up to 11/12 patients had satisfactory pain relief at 1 week after discharge, 8/12 at 4 weeks, 7/12 at 8 weeks, 6/12 at 12 weeks, and 5/12 at 24 weeks.</p><p><b>CONCLUSIONS</b>It is important to consider the possibility of discogenic visceral pain secondary to anterior herniation of the lumbar disc when forming a differential diagnosis for seemingly idiopathic abdominal pain. Continuous lumbar sympathetic nerve block is an effective and safe therapy for patients with discogenic visceral pain.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Disco Intervertebral , Patologia , Deslocamento do Disco Intervertebral , Dor Lombar , Tratamento Farmacológico , Vértebras Lombares , Patologia , Região Lombossacral , Estudos Prospectivos , Dor Visceral , Tratamento FarmacológicoRESUMO
PURPOSE: To investigate the efficacy and the feasibility of application of percutaneous lysis of epidural adhesions in failed back surgery syndrome (FBSS) using a stiff type guide wire and 4F vascular catheter. METHODS: Ninety two patients with FBSS were randomly divided into two groups, the control group (treated by injection dexamethasone only) and percutaneous lysis of epidural adhesions group. Visual analog scale scores (VAS) and therapeutic evaluation were observed in the preoperative, seven days postoperative, one month and six months postoperative. RESULTS: VAS scores for pain were significantly reduced in both groups at seven days. The VAS scores were in controlled group at one month, six months was significantly higher than that in epidural lysis group. However, there was no statistical difference in VAS scores of one month and six months when respectively compared to that of before operation in controlled group. Patients on epidural lysis reported clinical effectiveness rate was 50%. Patients on control was 5.26%, there was a statistical difference between two groups. CONCLUSION: Percutaneous lysis of epidural adhesions by using a stiff type guide wire and 4F vascular catheter is an effective method in the treatment of FBSS and it has a value in clinical application.
OBJETIVO: Investigar a eficácia e a exequibilidade da aplicação da lise percutânea de aderências epidurais na síndrome pós-laminectomia usando um fio-guia tipo Stiff e um cateter vascular 4F. MÉTODOS: Noventa e dois pacientes com síndrome pós-laminectomia foram randomizados em dois grupos: grupo controle (tratado somente com injeção de dexametazona) e grupo lise percutânea de aderências epidurais. Escores de escala visual analógica (VAS) e avaliação terapêutica foram observadas no pré-operatório, no sétimo dia de pós-operatório, um mês e seis meses de pós-operatório. RESULTADOS: Escores VAS para dor foram significantemente reduzidos em ambos os grupos aos sete dias. Os escores VAS foram mais altos no grupo controle comparado ao da lise epidural nos tempos de um mês e seis meses. Entretanto, não há diferença estatística nos escores VAS de um mês e seis meses quando comparados, respectivamente, àqueles de antes da operação do grupo controle. Pacientes com a lise epidural relataram taxa de eficiência de 50%. Nos pacientes do grupo controle foi 5,26%, havendo diferença estatística entre os dois grupos. CONCLUSÃO: A lise percutânea de aderências epidemias usando um fio-guia tipo Stiff e um cateter vascular 4F mostrou-se um método efetivo no tratamento de FBSS e tem valor na aplicação clínica.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espaço Epidural , Síndrome Pós-Laminectomia/terapia , Dispositivos de Acesso Vascular , Resultado do Tratamento , Aderências Teciduais/terapiaRESUMO
<p><b>BACKGROUND</b>With economic growth and urbanization there have been significant changes in the life style and diet of urban residents in large cities of China, which is experiencing a rapid increase in the prevalence of diabetes. While high prevalence of diabetes has been reported, little is known of the long-term effects of diabetes in such a large population. The aim of this study was to estimate the morbidity rate of diabetic peripheral neuropathy (DPN) in a Chinese urban diabetic population with more than 10 years' disease duration, and evaluate the relevant risk factors. The clinical manifestation of DPN and pain status was also assessed.</p><p><b>METHODS</b>Five hundred and sixty-five diabetes patients were recruited into the study. Symptoms and examination helped diagnose neuropathy. The clinical manifestation of DPN was assessed with a visual analog pain score (VAS). Diabetic complication status was determined from medical records. Serum lipids and lipoproteins, glycosylated hemoglobin (HbA1c), and the urinary albumin excretion rate were measured.</p><p><b>RESULTS</b>The morbidity rate of DPN was 46.6%. HbA1c, hyperlipidemia, and retinopathy were significantly associated with neuropathy, and these risk factors were correlated with other diabetic micro and/or macrovascular complications. The average VAS pain score of the DPN patients was 4.12 ± 2.07. Severe and moderate pain was experienced by 11.4% and 40.5% respectively of DPN patients. About 3.7% of diabetic subjects had lower limb ulcer or amputation.</p><p><b>CONCLUSIONS</b>The morbidity rate of DPN for diabetic patients with > 10 years duration is very high compared to the range reported for other populations in the world. The risk factors for DPN include HbA1c, hyperlipidemia, and retinopathy. In long-standing diabetic patients, DPN was not associated with diabetic duration, and half of the DPN patients experienced considerable daily suffering.</p>
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Neuropatias Diabéticas , Epidemiologia , Metabolismo , Hemoglobinas Glicadas , Metabolismo , Hiperlipidemias , Epidemiologia , Metabolismo , Dor , Fatores de Risco , População UrbanaRESUMO
<p><b>BACKGROUND</b>Cervicogenic headache (CEH) is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra.</p><p><b>METHODS</b>Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline (5 ml/min) for 3 - 4 weeks and triamcinolone acetonide 5 mg once weekly for 3 - 4 weeks. Pain was measured via the visual analogue scale (VAS) in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use (NSAID).</p><p><b>RESULTS</b>In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0 +/- 4.3. The mean occurrence of severe pain was (3.20 +/- 0.75) times and the mean oral dosage of NSAID was (1267 +/- 325) mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment (P < 0.01). By 12 months post-treatment, no significant difference in these three outcome measures was noted.</p><p><b>CONCLUSIONS</b>Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anestesia Epidural , Métodos , Vértebras Cervicais , Dexametasona , Usos Terapêuticos , Lidocaína , Usos Terapêuticos , Dor , Tratamento Farmacológico , Patologia , Cefaleia Pós-Traumática , Tratamento Farmacológico , Patologia , Estudos Retrospectivos , Resultado do Tratamento , Triancinolona Acetonida , Usos TerapêuticosRESUMO
<p><b>OBJECTIVE</b>To explore the expression of polymorphonuclear leucocyte adhesive molecules CD11b/CD18 and to study the possible mechanism of Chinese herbal medicine (TCM) for activating blood circulation to remove stasis in preventing vascular diseases.</p><p><b>METHODS</b>Forty-nine patients with diabetes mellitus (DM) but with no complications of hypertension and nephropathy were randomly divided into the treated group (26 patients treated by TCM) and the control group (23 patients treated by conventional treatment). They were treated for 3 months. The changes of urinary albumin excretion rate (UAER), CD11b/CD18 expression and tumor necrosis factor-alpha (TNF-alpha) concentration before and after treatment were observed.</p><p><b>RESULTS</b>The CD11b/CD18 expression and TNF-alpha concentration in DM patients were higher than those of normal range (P < 0.01). After treatment, the UAER, CD11b/CD18 expression and TNF-alpha concentration lowered significantly in the treated group (P < 0.01), but unchanged in the control group. Correlation analysis showed that the lowering of UAER was positively correlated with decreasing of CD11b/CD18 (r = 0.64, P < 0.01) and TNF-alpha (r = 0.56, P < 0.01).</p><p><b>CONCLUSION</b>Expression of CD11b/CD18 increases in patients with DM type 2. The mechanism of Chinese herbal medicine for activating blood circulation to remove stasis in preventing vascular disease in possibly related with its effect in inhibiting CD11b/CD18 expression.</p>