[The emergent repair of peripheral nerve injury of the wrist].

OBJECTIVE: To investigate the effect of the emergent repair of peripheral nerve injury of the wrist. METHODS: From July 1993 to December 1997, 17 cases were admitted, which 21 injured peripheral nerves were repaired emergently. Among them, there were 11 cases of median nerve injury, 2 cases of ulnar nerve injury and 4 cases of median and ulnar nerve injury. All the nerves were ruptured completely except one which was partially ruptured. The emergent operation was taken and the injured nerves were repaired by microsurgical technique. RESULTS: Followed up 6 to 18 months after operation, 95.25% injured nerves had good outcome. CONCLUSION: Because of the specific structure of the wrist, nerve injury at this part need to be repaired emergently. It can enhance the regeneration of the injured nerve, preserve the function of the intrinsic muscle of hand, and decrease the local adhesion.

Systematic clinical auditing in complementary medicine: rationale, concept, and a pilot study.

A scientific evaluation of complementary medical practices commonly used in healthcare is urgently required. Although randomized clinical trials are the primary tool for such an evaluation, for a number of conceptual and pragmatic reasons, they should not be the only tool. The authors propose systematic clinical auditing as a concept to (1) provide information on the "epidemiology" of complementary medical practices, (2) make the processes used in the daily practice of these complementary methods clearly intelligible, and (3) give a preliminary estimation of outcomes. Systematic clinical auditing uses mainly observational studies of large samples of patients. A pilot study was conducted to investigate the feasibility of using a systematic clinical audit in a hospital for traditional Chinese medicine in Germany. All 1597 patients admitted between February 1, 1992, and August 31, 1993, were included in the study. Patients' characteristics, diagnoses, and preventive and therapeutic interventions were recorded, and patients were asked to rate the intensity of their main complaints (on scale of 1 to 10) at admission; at discharge; and at 2, 6, and 12 months after admission. About two thirds of all patients had chronic pain complaints; the most common diagnosis was migraine (n = 244). Nearly all patients received acupuncture and Chinese herbal therapy; 61% received tuina massages, and 16% received qigong. The mean intensity of main complaints was 7.0 (2.0, SD) at admission, 4.6 (2.4) at discharge, and 5.5 (2.7) 12 months after admission. In the authors' opinion, systematic clinical auditing is a valuable tool for collecting basic information on structural characteristics, processes, and outcomes in complementary medicine and for determining representative and relevant questions for future randomized clinical trials.

[Effects of Astragalus membranaceus on left ventricular function and oxygen free radical in acute myocardial infarction patients and mechanism of its cardiotonic action].

Dynamic observations for 4 weeks were made on left ventricular function and oxygen free radical (OFR) in 43 patients first suffering from acute myocardial infarction and hospitalized in Coronary Care Unit with an attack less than 36 hours. The results showed that the Astragalus membranaceus (AM) could strengthen the left ventricular function and had an effect of anti-OFR. After administration of AM, the ratio of pre-ejection period/left ventricular ejection time (PEP/LVET) was decreased, the superoxide dismutase (SOD) activity of red blood cell was increased, and the lipid peroxidation (LPO) content of plasma was reduced. There was a significant difference between the AM group and the control group in the parameters above-mentioned. The study demonstrated that the PEP/LVET ratio was closely correlated with the SOD and LPO. It suggested that the anti-OFR effect of AM was one of the mechanisms of its cardiotonic action.

[Action of Astragalus membranaceus on left ventricular function of angina pectoris].

The action on left ventricular function of Astragalus Membranaceus (AM), a Qi-tonic, in 20 patients with angina pectoris was studied by means of Doppler Echocardiogram (DEC). It showed that cardiac output increased from 5.09 +/- 0.21 to 5.95 +/- 0.18 L/min 2 weeks after AM was administered (P < 0.01), and no improvement of left ventricular diastolic function appeared. Adenosine triphosphatase activity was not inhibited by using AM, which was different from that of digitalis.

[Relation between traditional Chinese medicinal syndrome differentiation and blood platelet function in 310 cases of blood stasis].

310 patients (153 male, 157 female) of Blood Stasis were divided into various groups by Syndrome Differentiation of TCM and 35 healthy subjects were taken as control. The relationship of TCM Syndrome and function of blood platelet were studied with blood platelet counting, its volume, adherence and aggregation, plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha(6k-PGF1 alpha) as indices of observation. The results were: (1) Blood platelet aggregation of Blood Stasis patients was higher than that in control (P > 0.001). (2) There were some differences of platelet aggregation among different TCM Syndromes. Platelet aggregation of Blood Stasis patients with Qi Deficiency was higher than that with other Syndromes significantly, and the aggregating rate in those patients was higher than that in control (P < 0.05). (3) The platelet aggregation and TXB2 of patient with Heart Qi Deficiency were significantly higher than those of the control (P < 0.05, P < 0.001), and they were also higher than of other groups of blood stasis patient with Spleen, Lung or Kidney Qi Deficiency.

[Experimental study on effects of 18 kinds of Chinese herbal medicine for synthesis of thromboxane A2 and PGI2].

The effect of 18 kinds of Chinese herbal medicine for the synthesis of TXA2 and PGI2 was studied. The porcine lung microsoma was used as donor of enzymes such as cyclo-oxygenase, thromboxane A2 synthetase and prostacyclin synthetase, etc. It was found that Glehnia littoralis could inhibit the synthesis of TXA2 and increase the formation of PGI2. Rheum palmatum (300 mg group) and Erigeron breviscapus significantly inhibited the synthesis of TXA2, but no apparent effection on the synthesis of PGI2. When Codonopsis pilosulae, Astragalus membracaceus, Angelica sinensis, Ginsenosides and Baicalin, etc. markedly inhibited the formation of TXA2 and mildly affected the formation of PGI2. Some Chinese herbs for promoting blood circulation play an important role on the inhibition of TXA2 synthesis. Some tonic herbs could either inhibit the synthesis of TXA2 and increase the synthesis of PGI2 or inhibit the formation of PGI2. Therefore these tonic herbs had the characteristics of both strengthening the body resistance and eliminating pathogenic factors. In this aspect they are better than the control drug (Aspirin) and other herbs of promoting blood circulation.

[Effect of yiqi huoxue therapy on blood coagulation process in vivo].

YiQi HuoXue (YQHX) therapy is one of the most widely used treatments to deal with the coronary heart disease (CHD). This paper stressed on study the effects of YQHX therapy on blood coagulation process in vivo. The effects of several TCM preparations on CHD patients were observed by thromboelastography (TEG), prothrombin time, etc. After giving various preparations 20ml intravenously, the results of TEG showed that the values of r, k, c, 1 were decreased and ma increased by QiXue injection, the differences of k and ma were significant; while no significant change by Shen Qi injection and the k value was significantly reduced by DanShen injection. The results of prothrombin time with QiXue injection showed distinct dose-dependent effects, it shortened with 20ml and significantly lengthened with 40ml. This results suggested that there was complicated effects of different YQHX preparations as well as of different dosages.

Clinical and experimental studies of coronary heart disease treated with yi-qi huo-xue injection.

The purpose of the present work was to evaluate the clinical efficacy and the mechanism of Yi-qi Huo-xue Injection (YHI) in treatment of coronary heart disease. YHI consists of Ginseng, Astragalus and Angelicae Sinensis. The 10% dextrose serves as a placebo. The results were as follows: 1. the frequency and severity of angina episodes were reduced by 90.63%; 2. the ischemic ST-T in ECG was improved in 56.25% of cases; 3. the tolerance to treadmill exercise was increased from 348.50 to 503.50 M.; 4. the left ventricular function was strengthened, PEP/LVET ratio reduced from 0.45 to 0.36, the activity of (Na(+)-K+) ATPase in myocardial cell membrane of rats inhibited by 19.2%; 5. the blood viscosity and erythrocyte electrophoretic time lowered; 6. the adhesion and aggregation of platelet in patients with CHD were inhibited by 27% and 59.4% respectively; 7. the plasma TXB2 level in CHD was reduced from 260.28 +/- 164.4 to 139.29 +/- 57.01 pg/ml; 8. the plasma 6-keto-PGF1 alpha level in CHD was increased from 33.45 +/- 22.5 to 57.48 +/- 13.1 pg/ml, and in rats from 185.77 to 366.33 pg/ml. The differences were all statistically significant (P less than 0.05-0.01) in comparison with the placebo group.