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During the carcinoma transformation of colitis， the imbalance of “metabolic-immune interaction” resulted from abnormal energy and metabolic substrates flow and direction was the key process， which caused by intercellular metabolic competition. Based on traditional Chinese medicine （TCM） theory and clinical research， we found that “fire failing to warm earth” is the key pathogenesis of colon-cancer transformation. “Fire” was a synonym for TCM to understand the energy metabolism， combined modern medical research findings， we thought energy metabolism disorders was a microcosmic manifestation of the “fire decline”， while abnormal immune function was the biological basis of “earth deficiency”. The imbalance between “metabolism-immune interaction” and the “fire failing to warm earth” pathogenesis of colitis-cancer transformation demonstrated the different understanding of the same pathological mechanism between western medicine and TCM. For treatment， it could be effectivce to delay the transformation of colitis-cancer by synergistically regulated the energy metabolism - “replenish fire” and enhanced the immune function - “nourish earth”， which was called the methods of replenishing fire to nourish earth.
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Objective: To observe the clinical efficacy of pediatric Tuina (Chinese therapeutic massage) plus oral administration of Chinese medication for pediatric anorexia due to spleen failing in transportation. Methods: A total of 94 children with anorexia due to spleen failing in transportation were randomized into an observation group and a control group by the random number table method at a ratio of 1:1, with 47 cases in each group. The control group was treated with modified Bu Huan Jin Zheng Qi San, and the observation group was treated with additional Tuina manipulation of Yun Shui Ru Tu based on the treatment in the control group. After 4 weeks of treatment, the clinical efficacy of the two groups was observed, and the traditional Chinese medicine (TCM) symptom score, serum leptin, neuropeptide Y, and serum zinc and calcium levels were compared. Results: After 4 weeks of treatment, the total effective rate of the observation group was 87.2％, and that of the control group was 74.5％. The difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups decreased significantly (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). After treatment, the serum leptin level in both groups decreased, and the level in the observation group was lower than that in the control group (P<0.05). The serum neuropeptide Y, zinc, and calcium levels in both groups increased after treatment, and the levels in the observation group were higher than those in the control group (P<0.05). Conclusion: Tuina manipulation of Yun Shui Ru Tu plus oral administration of Chinese medication is significantly effective in treating pediatric anorexia due to spleen failing in transportation, which can improve the appetite of children and improve the symptoms of anorexia, and the curative effect is better than that of oral administration of Chinese medication alone.
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Resumen La reoperación en pacientes con cirugía cardiaca previa en bioprótesis disfuncionantes representa una situación de alto riesgo quirúrgico, con elevada morbi-mortalidad perioperatoria. En la actualidad en casos seleccionados, el tratamiento percutáneo transcateter permite reemplazar la válvula mitral con acceso transapical o transeptal. El reemplazo percutáneo de la válvula mitral, tiene menor morbilidad y mortalidad comparado con la cirugía convencio nal, representando una alternativa terapéutica, la cual representa la única opción en pacientes de alto riesgo quirúrgico. Se presentan dos casos tratados de forma exitosa en nuestro centro con acceso transapical y válvula percutánea balón expandible Sapien XT.
Abstract Transapical mitral Valve in Valve in Hospital México, report of two cases and literatura review Surgical reintervention in patients with previous open heart surgery represents a high risk condition, with high morbidity and mortality in the perioperative period. Nowdays in selected clinical situations of patiens with failing bioprosthesis in mitral position, transcatheter percutaneous treatment allows the replacement of the mitral valve with transapical or transseptal access. The transcatheter percutaneous mitral valve replacement has lower morbidity and mortality in comparison with conventional surgery, representing a therapeutic alternative, wich migth be the only option in high risk patients. We present two cases done at our center with success using apical access and the ballon expandable device Sapien XT.
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Humanos , Feminino , Idoso , Bioprótese , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca , Costa Rica , Valva MitralRESUMO
[Objective]To discuss the clinical experience of treating primary insomnia with Professor GU Xizhen, the famous Chinese doctor in Jiangsu Province. [Methods]To study the understanding of the etiology and pathogenesis of primary insomnia by Professor GU Xizhen, summarize the experience of treating primary insomnia based on the use of the key suppressing Yang and basing on the syndrome differentiation.[Results]Professor GU Xizhen thinks that the movement of the Ying and Wei is the most important physiological mechanism for the formation of sleep, and that Yang does not enter the Yin is the basis of the pathologic theory, the deficiency of Qi and blood and the dysfunction of the viscera are the pathogenic factors. Based on the urgent cure of the symptoms, delayed treatment of the fundamental principles, put forward the treatment when suppressing Yang into Yin first, on the basis of the emphasis on tonifying Qi and blood, Yin and Yang, clearing heat, removing the wet, regulating Qi activity etc, matching specific time of the drug. It can relieve both primary and secondary symptoms and get good results.[Conclusion]The treatment of primary insomnia by the Professor GU Xizhen is very effective. It deserves further study and promotion in clinical practice. One medical case is attached to prove the above conclusion.
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In dentistry, it is empirically known that the acute exacerbation of periodontal disease often occurs at the time of fatigue, but scientific verification has never been made about the relationship of fatigue and bleeding. In Kampo medicine, there is the concept of spleen failing to control the blood as bleeding at the time of fatigue. Kihito and kamikihito are often used for this condition. Spleen failing to control the blood means that lack of vital energy causes the bleeding. Kamikihito is most often used in the treatment of idiopathic thrombocytopenic purpura. Moreover, there have been some reports on the use of kamikihito in the treatment of gynecological fraud bleeding and aplastic anemia. However, there has been no report on the use of it in the treatment of gingival bleeding. In this case, neither cytopenia nor obvious coagulopathy was recognized. In Kampo medicine, not only spleen failing to control the blood but also blood stasis or blood heat is considered to be the cause of bleeding, but the effectiveness of kamikihito for this case suggested pathophysiology of spleen failing to control the blood. Kamikihito could be a choice to treat gingival bleeding at the time of fatigue.
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La trabeculectomía es generalmente un procedimiento exitoso para reducir la presión intraocular en pacientes con glaucoma. Sin embargo, el fallo de la ampolla de filtración puede ocurrir y provocar un incremento de la presión intraocular. Esto conllevaría a una intervención médica o quirúrgica adicional. Se realiza una revisión bibliográfica sobre la cistitomía transconjuntival, asociada al uso de antimetabolitos (mitomicina C o 5-fluorouracilo) o no. Se demuestra que es mínimamente invasiva, con escasas complicaciones y que constituye un método eficaz, fácil y barato para restablecer el drenaje acuoso y disminuir la presión intraocular
Trabeculectomy is usually a successful procedure to reduce intraocular pressure in glaucoma patients. However, the failure of the filtering bleb can occur, leading to increased intraocular pressure and to a further medical or surgical intervention. A literature review on transconjunctival cystotomy, with or without the use of mitomycin C or 5-fluorouracil, was made. It was demonstrated that this method is minimally invasive with few complications, effective, easy-to-apply and inexpensive to restore aqueous drainage and lowering intraocular pressure
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PURPOSE: We attempted to determine risk factors for the development of failing vein graft and optimal treatment in patients with infrainguinal vein grafts. METHODS: We retrospectively reviewed a database of patients who underwent infrainguinal bypass using autogenous vein grafts due to chronic atherosclerotic arterial occlusive disease of lower extremity (LE) at a single institute between September 2003 and December 2011. After reviewing demographic, clinical, and angiographic features of the patients with failing grafts, we analyzed those variables to determine risk factors for the development of failing grafts. To determine an optimal treatment for the failing vein grafts, we compared results of open surgical repair (OSR), endovascular treatment (EVT) and conservative treatment. RESULTS: Two hundred and fifty-eight LE arterial bypasses using autogenous vein grafts in 242 patients were included in this study. During the follow-up period of 39 +/- 25 months (range, 1 to 89 months), we found 166 (64%) patent grafts with no restenosis, 41 (15.9%) failing grafts, 39 (15.1%) graft occlusions, and 12 (4.7%) grafts lost in follow-up. In risk factor analysis for the development of a failing graft, no independent risk factors were identified. After 50 treatments of the 41 failing grafts (24 OSR, 18 EVT, 8 conservative management), graft occlusion was significantly more common in conservative treatment group and severe (>75%) restenosis was significantly more common following EVT than OSR (P = 0.001). Reintervention-free graft patency was also superior in the OSR group to that of the EVT group (87% vs. 42%, P = 0.015). CONCLUSION: OSR of failing grafts has better outcomes than EVT or conservative management in treating failing grafts.
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Humanos , Arteriopatias Oclusivas , Constrição Patológica , Seguimentos , Extremidade Inferior , Estudos Retrospectivos , Fatores de Risco , Transplantes , VeiasRESUMO
Background: Noise pollution has seriously negative effects on worker\u2019s health, especially their hearing ability. Occupational hearing loss is one of 21 insured occupational diseases. Occupational hearing loss is common in workers in transpostation, construction, energy heavy and light industry areas. Objectives: 1. To determine the degree of noise pollution in Thua Thien Hue Unity Auto Mechanical Joint Stock Company. 2. To evaluate occupational failing hearing and occupational hearing loss among workers in the company. 3. To promote preventive measures which imnimize occupational failing hearing and occupational hearing loss. Subjects and method:A cross-sectional, descriptive study was carried out in 254 employees in Thua Thien Hue Unity Auto Mechanical \r\n', u'Joint Stock Company. Results and Conclusion: 72.7% the employees of Thua Thien Hue Unity Auto Mechanical \r\n', u'Joint Stock Company have exposed to environmental noise at the level higher than the permitted one. The rate of occupational failing hearing among these people is rather high (33.1%), and occupational hearing loss rate is 11.8%. There is a increased rate of occupational hearing loss according to the employee\u2019s age and seniority. Proposed preventive measures should be immediately conducted (P < 0.05).\r\n', u'
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Perda Auditiva , PatologiaRESUMO
PURPOSE: We wanted to determine the incidence and characteristics of failing graft after implantation of autologous reversed vein grafts. METHOD: From Sep. 2003 to Dec. 2005, 84 leg bypasses using autologous reversed vein grafts were performed for chronic leg ischemia in 75 patients. After the operations, duplex ultrasonography (DUS) and measurement of the ankle brachial index (ABI) were performed every 3 months for the purpose of examining the graft patency. The criteria for a failing graft was a peak systolic velocity (PSV) of the stenotic lesion >300 cm/s, or a PSV distal to the occlusive lesion <40 cm/s, but with sustained patency of the vein graft. We investigated the timing of detection, the site of the causative lesion, and the clinical symptoms of the failing grafts. For the treatment of failing grafts, surgeries (vein patch, graft extension, or inflow artery reconstruction) were performed in 4 legs. The Kaplan Meier method was used for calculating the rate of graft patency. RESULT: Nine failing grafts were detected by DUS in 8 patients. The sites of causative lesions were the inflow artery (2), the proximal anastomosis (6), and the distal anastomosis (1). Seven of the 9 patients with failing grafts were asymptomatic, 1 patient had claudication and another patient suffered from resting pain of the involved leg. The assisted graft primary patency rates at 1 and 2 years after operations were 86% and 53%, respectively. CONCLUSION: Nine cases of failing grafts were detected during surveillance with duplex ultrasonography after implantation of autologous reversed vein grafts.
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Humanos , Índice Tornozelo-Braço , Artérias , Diagnóstico , Incidência , Isquemia , Perna (Membro) , Extremidade Inferior , Transplantes , Ultrassonografia , VeiasRESUMO
This article explored the pathology characteristic of the liver failing to maintain the normal flow of qi.It was considered that syndrome of depression of hepatic qi and reversed syndrome of hepatic qi were the main pathology characteristics of the liver failing to maintain the normal flow of qi,and its origin,development and present situation,as well as its diagnosis evidences and treatment methods and medicine were discussed.It also identified the significance of further standardizing the two syndromes of depression of hepatic qi and reversed of hepatic qi.
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BACKGROUND AND OBJECTIVES: Human Troponin T & I (TnT, TnI) has several isoforms which have different functional property. This study was designed to describe the isoform expression of TnT & TnI in failing and hypertrophic human heart and during normal development. MATERIALS AND METHOD: Myocardium was attained from hypertrophic hearts (n=10) of TOF patients who underwent myomectomy, from failing hearts (n=10) of transplant recipients, from normal hearts (n=5) of patients in brain death and from aborted fetal hearts (n=5). After the extraction of RNA, RT-PCR was performed for TnT & TnI isoforms and GAPDH to evaluate the isoform expression qualitatively and quantitatively. RESULTS: In terms of TnI, slow skeletal TnI was expressed more than cardiac TnI in fetal hearts[ratio of Troponin over GAPDH (R)=1.3:0.5] but cardiac TnI was dominant in adult hearts (r=0.3:1.1) (p 0.05). Failing hearts showed similar pattern with adult hearts (r=0.3:1.2) and hypertrophic hearts showed the intermediate pattern (r=0.9:1.3). In terms of TnT, T1 and T3 were expressed in fetal hearts (r=0.04, 0.8) but only T3 was expressed in adult hearts (r=1.1). Failing hearts and hypertrophic hearts showed similar pattern with adult hearts and no differences in the amount of expression (r=1.4, 1.3). CONCLUSION: There is isoform switch from fetal to adult form during development and it might be responsible for the differences of myocardial functional property between fetal and adult heart. Failing and hypertrophic hearts showed no differences with normal hearts, which means the isoform switch of TnT & I might have no significant role in functional disturbances in these conditions.
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Adulto , Humanos , Morte Encefálica , Coração Fetal , Coração , Miocárdio , Isoformas de Proteínas , RNA , Transplante , Trinitrotolueno , Troponina T , TroponinaRESUMO
OBJECTIVE: In order to evaluate the prevalence of cytomegalovirus infection to terminally failing heart, cytomegaloviral DNA was detected in the explanted hearts of transplantation recipients. METHODS: DNA extractions were performed from explanted failing hearts(N=22) and normal hearts (N=5) and polymerase chain reactions(PCRs) were done for detection of late gene sequence coded pp150 phosphoprotein. The products were confirmed with electrophoresis on 1% agarose gel. In order to improve the sensitivity of detection in cytomegaloviral genome, nested PCRs were executed with the primers designed for the original 607 bp products. RESULTS: All patients had IgG anti-cytomegalovirus antibody and did not have IgM anti-cytomegalovirus antibody. Cytomegaloviral genomes in myocardium were detected by polymerase chain reaction. The 607bp products by PCRs were found in both explanted failing hearts(3 cases/22, 13.5%) and normal hearts(1 case/5, 20.0%). In nested PCRs, 186bp products were found in both failing hearts(LV 4/22, LA 3/20, RV 5/22, HA 0/17) and normal hearts(LV 2/5, LA 1/4, RV 1/5, RA 2/5). There was no significant change in the presence of cytomegaloviral DNA between failing and normal hearts. Total positivity of cytomegaloviral genome in explanted hearts was 44.4% according to nested PCR results. CONCLUSION: Cytomegalovirus was rarely observed in explanted hearts of terminal heart failure and nested PCR could enhance the sensitivity of cytomegaloviral genome detection. But cytomegalovirus might have no direct causal relationship in the development of terminal heart failure.