Fever and neck pain after pacemaker lead extraction: A case report.

BACKGROUND: Venous thrombosis (VT) is one of the minor complications of pacemaker lead extraction. It is often found due to the swelling of the limbs after the extraction. It is easy to be neglected or even misdiagnosed in the absence of typical clinical symptoms. The incidence, risk factors, and long-term impact of this complication are still unclear. Herein, we report a case of deep VT caused by transvenous lead extraction, which is easily misdiagnosed. CASE SUMMARY: A 66-year-old woman underwent a pacemaker lead extraction at our hospital because of a pacemaker pocket infection. After the extraction, she began to experience intermittent fever accompanied by sweating. The highest body temperature recorded was 37.9 °C. Additionally, she reported migratory pain that made her uncomfortable. The pain was mistakenly thought to be caused by operation trauma. At first, the pain radiated from the left chest to the mandible. Then, the pain in the left chest was alleviated, but pain in the left neck and throat appeared. Finally, the pain was confined to the mandible and a submandibular mass was palpated with no other abnormalities upon physical examination. Computed tomography venography and angiography finally indicated that the fever and pain were the symptoms of thrombophlebitis caused by lead extraction. The patient was then treated with rivaroxaban for more than three months and has shown no symptoms since she left the hospital. CONCLUSION: The possibility of thrombosis should be considered when pain and recurrent fever occur after pacemaker lead extraction.

Apelin-13 as a novel target for intervention in secondary injury after traumatic brain injury.

The adipocytokine, apelin-13, is an abundantly expressed peptide in the nervous system. Apelin-13 protects the brain against ischemia/reperfusion injury and attenuates traumatic brain injury by suppressing autophagy. However, secondary apelin-13 effects on traumatic brain injury-induced neural cell death and blood-brain barrier integrity are still not clear. Here, we found that apelin-13 significantly decreases cerebral water content, mitigates blood-brain barrier destruction, reduces aquaporin-4 expression, diminishes caspase-3 and Bax expression in the cerebral cortex and hippocampus, and reduces apoptosis. These results show that apelin-13 attenuates secondary injury after traumatic brain injury and exerts a neuroprotective effect.

Efficacy of crest herbal toothpaste in "clearing internal heat": a randomized, double-blind clinical study.

Objective. Evaluation of the efficacy of Crest Herbal Crystal Toothpaste in "clearing internal heat." Methods. This was a randomized, double-blind, controlled parallel design clinical test of a product that was already on the market. 72 subjects were randomly assigned to control group (group A with Colgate Herbal Salty Toothpaste) or treatment group (group B with Crest Herbal Crystal Toothpaste) with ratio of 1 : 2. Subjects were instructed to brush with 1g toothpaste for 2 minutes each time, 2 times per day in a 4-aweek test period; measurement with the rating scale on the efficacy of "clearing internal heat" for the herbal toothpaste was done at baseline, 2 weeks, and 4 weeks of toothpaste usage. Results. The rating scale on efficacy of "clearing internal heat" for the herbal toothpaste reveals that the primitive points of 72-case intention-to-treat (ITT) analysis and 67-case per-protocol (PP) analysis for subjects in group A and subjects in group B were found to be reduced progressively with statistical significance (P < 0.05). The overall effective rates for group A and group B were, respectively, 62.50%, 56.25% (ITT) and 62.50%, 60.64% (PP). The statistical results indicated that the symptoms of fire-heat for both groups of subjects have been improved after application of toothpaste. Conclusion. The efficacy of Crest Herbal Crystal Toothpaste in "clearing internal heat" was confirmed by the trial as compared to Colgate Herbal Salty Toothpaste. And its efficacy was objectively evaluated by the rating scale on efficacy of "clearing internal heat."

Metabonomics-based study of clinical urine samples in suboptimal health with different syndromes.

Objective. To explore the urinary biochemistry features of syndromes of traditional Chinese medicine (TCM) such as syndrome of stagnation of liver Qi, spleen deficiency, liver Qi stagnation, and spleen deficiency (LSSDS) in sub-optimal health status (SHS). Methods. 12 cases for each syndrome group in SHS were selected, 12 subjects were used as a normal control group, and (1)H NMR detection was, respectively, carried out, and the data was corrected by the orthogonal signal correction (OSC) and then adopted a partial least squares (PLS) method for discriminate analysis. Results. The OSC-PLS (ctr) analysis results of the nuclear overhauser enhancement spectroscopy (NOESY) detection indicated that the syndromes in SHS could be differentiated, and there were significant differences in the levels of metabolites of the urine samples of the four groups; the biomarkers of LSSDS in SHS were found out. The contents of citric acid (2.54 and 2.66), trimethylamineoxide (3.26), and hippuric acid (3.98, 7.54, 7.58, 7.62, 7.66, 7.82, and 7.86) in the urine samples of LSSDS group were lower than that of the normal control group. Conclusion. There are differences in the (1)H-NMR metabolic spectrum of the urine samples of the four groups, and the specific metabolic products of the LSSDS in SHS can be identified from metabonomics analysis.

Development and evaluation of Chinese medicine fire-heat syndrome scale in oral cavity for measuring Chinese herb toothpaste.

OBJECTIVE: To formulate the standard measuring tool for the evaluations on fire-heat syndrome in oral cavity by means of Chinese medicine (CM). METHODS: The measuring scale for fire-heat syndrome in the oral cavity by means of CM was investigated by symptom collection, item pool formulation, item selection, pre-investigation, evaluations on the reliability, validity and reactivity of the measuring scale, according to the principles for measuring scale design and under the guidance of CM theories. RESULTS: The measuring scale was composed of two integrative parts: the self-filling section and the interview section. As far as the reliability was concerned, the total Cronbach α coefficient of the measuring scale was 0.866, the total test-retest reliability coefficient was 0.726 and the split-half reliability coefficient was 0.851. As far as the validity was concerned, the scores for the subjects of fire-heat syndrome in oral cavity and healthy people in their oral cavity in the items of symptoms were statistically different (P<0.01); three common divisors were extracted according to the theoretical dimensions, the accumulated contribution rate was 63.468%. As far as the reactivity was concerned, the difference between the symptom scores before and after the test in which 31 subjects used the Chinese herb toothpaste was statistically significant (P<0.01). CONCLUSIONS: This measuring scale has relatively good reliability, validity and reactivity, and it can be used in an objective quantitative evaluation on patients suffering from fire-heat syndrome in oral cavity, and thus lay the foundations for the evaluations on the therapeutic effects of Chinese herb toothpaste on fire-heat syndrome in oral cavity.

Xiaoyaosan decoction regulates changes in neuropeptide y and leptin receptor in the rat arcuate nucleus after chronic immobilization stress.

The arcuate nucleus (ARC) in the basal of hypothalamus plays an important role in appetite regulation and energy balance. We sought to investigate the central neuroendocrine mechanism of appetite decrease and weight loss under chronic stress by observing the regulatory effects of Xiaoyaosan decoction in the expression of leptin receptor (ob-R) and neuropeptide Y (NPY) in the ARC. Our results showed that bodyweight and food intake of rats in the 21-day stress group increased slower than those of the normal group. Higher contents of Leptin and ob-R were noted in the 21-day stress group compared with control rats, while NPY expression was not statistically different. Xiaoyaosan powder can significantly downregulate the contents of leptin and ob-R in the hypothalamus of stressed rats. These findings suggest that increase of ob-R expression in the ARC is possibly one key central neuroendocrine change for the somatic discomfort. Weight loss and decreased food intake in rats caused by the binding of leptin to ob-R in hypothalamus do not appear to utilize the NPY pathway. This study also suggests that ob-R in the ARC may act as the target of Xiaoyaosan in regulating the symptoms such as appetite decrease and bodyweight loss under chronic stress.

Fertilization increases paddy soil organic carbon density.

Field experiments provide an opportunity to study the effects of fertilization on soil organic carbon (SOC) sequestration. We sampled soils from a long-term (25 years) paddy experiment in subtropical China. The experiment included eight treatments: (1) check, (2) PK, (3) NP, (4) NK, (5) NPK, (6) 7F:3M (N, P, K inorganic fertilizers+30% organic N), (7) 5F:5M (N, P, K inorganic fertilizers+50% organic N), (8) 3F:7M (N, P, K inorganic fertilizers+70% organic N). Fertilization increased SOC content in the plow layers compared to the non-fertilized check treatment. The SOC density in the top 100 cm of soil ranged from 73.12 to 91.36 Mg/ha. The SOC densities of all fertilizer treatments were greater than that of the check. Those treatments that combined inorganic fertilizers and organic amendments had greater SOC densities than those receiving only inorganic fertilizers. The SOC density was closely correlated to the sum of the soil carbon converted from organic amendments and rice residues. Carbon sequestration in paddy soils could be achieved by balanced and combined fertilization. Fertilization combining both inorganic fertilizers and organic amendments is an effective sustainable practice to sequestrate SOC.