Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well unde...Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.展开更多
OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play...OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.展开更多
AIM: To explore the effect of in vitro porcine esophageal variceal pressure on complete ligation degree for polycyclic ligators. METHODS: An in vitro model of experimental porcine venous vessels was used to test vario...AIM: To explore the effect of in vitro porcine esophageal variceal pressure on complete ligation degree for polycyclic ligators. METHODS: An in vitro model of experimental porcine venous vessels was used to test various venous pressures. Three treatment groups were designated according to the preset pressure range: P1 = 25-30 cm H2O; P2 = 35-40 cm H2O; P3 = 45-50 cm H2 O. The effect of pressure on ligation was assessed and compared among the groups. RESULTS: Complete ligation was achieved at a rate of 56.25%(18/32) in group P1, 37.5%(12/32) in group P2, and 33.33%(11/33) in group P3(χ2 = 3.6126; P = 0.0573). CONCLUSION: Higher variceal pressures impair the ligation completion rate. Therefore, measuring variceal pressure may help predict the effect of endoscopic ligation and guide treatment choice.展开更多
Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively refl...Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively reflects the blood status of patients with acute ischemic stroke(AIS)and is important in the treatment and prognosis of AIS.To identify the relationship between TCM syndrome factors and TEG in AIS patients and standardize TCM syndrome differentiation and treatment objectives,we designed a prospective cohort study of 103 AIS patients.Methods:We used the diagnostic criteria for AIS in the Chinese Guideline for Diagnosis and Management of Acute Ischemic Stroke 2010.Diagnosis of phlegm-heat and fu-organ excess syndrome was based on the TCM Scale for the Syndrome of Phlegm-heat and fu-organ Excess.The ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to identify and diagnose syndrome factors.General information,scores of syndrome factors and values of TEG parameters of all enrolled patients were recorded.Results:There were significant differences in internal fire and phlegm-dampness scores between patients with and without phlegm-heat and fu-organ excess syndrome(P<.05).In patients with phlegm-heat and fu-organ excess syndrome,internal fire was negatively correlated with TEG parameters R and K(P<.05)and positively correlated with alpha Angle and coagulation index(P<.01).There were no significant correlations between the two syndrome factors and MA(P Z.058)and LY30(P>.05)or between both syndrome factors and TEG parameters in patients without phlegm-heat and fu-organ excess syndrome.Conclusion:The syndrome factor internal fire is a potential predictor of increased platelet function and fibrinogen activity in AIS patients with phlegm-heat and fu-organ excess,and a potentially important predictor of blood hypercoagulability in TCM.展开更多
Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group...Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group(n=45)and the control group(n=45)according to the random number table method.The control group received basic Western medicine treatment+rehabilitation treatment of Western medicine,and the treatment group was additively treated with"hand and foot 12 needle acupuncture"on the basis of the control group.NIHSS score,MRS score and Barthel index(BI)before and after treatment were observed in the two groups,and the clinical efficacy of the two groups was compared.Results:The clinical efficacy of stroke patients in the convalescent period of phlegm-dampness constitution after treatment:the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 66.67%.After statistical processing,the clinical efficacy of the treatment group was significantly better than the control group;NIHSS score,MRS score and Barthel index(BI)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:"Hand and foot 12 needle acupuncture"treatment of phlegm-dampness constitution convalescent stroke clinical effect is remarkable.展开更多
As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomech...As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomechanical in vivo studies of the lumbar spine are mainly performed by implants or imaging data to record the real-time changes of form and stress on the intervertebral disc during motion. However, the current developments are slow due to the technological and ethical limitations. In vitro experiments include animal experiments and cadaver experiments, which are difficult to operate or differ greatly from normal human structures, and the results still need to be verified repeatedly to test their accuracy. As for finite element method, it is relatively low cost and can repeat the experimental results. Therefore, we believe that finite element analysis plays an extremely important role in biomechanical research, especially in analyzing the relationship between different surgical models and the degeneration caused by different mechanics.展开更多
OBJECTIVE: To observe the clinical effect of oral traditional Chinese medicine granules combined with health education to regulate phlegm constitution and treat simple obesity. METHODS: According to the method of cons...OBJECTIVE: To observe the clinical effect of oral traditional Chinese medicine granules combined with health education to regulate phlegm constitution and treat simple obesity. METHODS: According to the method of constitution evaluation in TCM Constitution Classification and Evaluation(Chinese Association of Chinese Medicine), the TCM classification of Chinese medicine was performed on patients who came to the outpatient department of the Traditional Chinese Medicine Hospital of Pinggu District of Beijing and met the diagnostic criteria of simple obesity. One hundred patients with phlegm constitution were selected and those in accordance with the standards, were randomly divided into group with oral TCM granules combined with health education(refer to as treatment group) and health education group(refer to as control group) according to 1:1 ratio. The control group was given health education including diet and exercise instruction. Treatment group:(1) Health education includes diet and exercise instruction.(2) Oral Chinese medicine granules: ingredients: atractylodes rhizome 15g, raw barley 30g, Folium Nelumbinis 10g, Chinese hawthorn fruit 10g, Chinese waxgourd peel 15g, milk-vetch root;15g, kudzuvine root 15g, danshen root10g, 2 times/d. The two groups were intervened for 12 weeks each time, and obesity evaluation indicators such as body weight, body fat, waist circumference, hip circumference, weight index, and score table of TCM constitutional were observed before and after the intervention. Statistical software was used for statistical analysis. RESULTS: The total curative effect of the treatment group was better than that of the control group(P<0.001). The weight index, body weight, waist and hip circumference decreased significantly after treatment(P <0.01). Compared with the two groups, the treatment group is better than the control group in terms of dampness constitution improvement, weight and fat losing and waist and hip circumference reducing.(P<0.01). CONCLUSION: Oral Chinese medicine granules Jiangzhuo Fang(combined with health education) and simple health education can improve phlegm constitution, and improve the body weight, body fat percentage and other indicators of the patients, but oral granules combined with health education to improve the physical fitness of phlegm is better than simple health education. The thoughts and methods of Chinese medicine granules combined with health education to regulate phlegm constitution is effective for weight losing and is worthy of further research and promotion.展开更多
Objective: to explore the effect of clinical outpatient mode of prenatal examination on the delivery mode and labor course of puerpera. Methods: retrospective study, 48 cases of pregnant women who received prenatal ex...Objective: to explore the effect of clinical outpatient mode of prenatal examination on the delivery mode and labor course of puerpera. Methods: retrospective study, 48 cases of pregnant women who received prenatal examination in our hospital from 2020.3 to 2021.7 were selected and randomly divided into groups, including control group 25 routine intervention, observation group 23 cases of prenatal examination outpatient mode, observe the two groups of maternal delivery mode and labor process. Results: the rate of maternal natural childbirth in the observation group was as high as 73.91%, significantly higher than that in the control group (40.00%), and the puerpera in the observation group was shorter, the data of the two groups were compared, P < 0.05. Conclusion: the implementation of out-patient prenatal examination can shorten the time of labor and increase the rate of natural childbirth.展开更多
Objective: to analyze the effect of non-invasive positive pressure ventilation in patients with severe pulmonary infection. Methods: 120 patients with severe pulmonary infection admitted from February 2019 to August 2...Objective: to analyze the effect of non-invasive positive pressure ventilation in patients with severe pulmonary infection. Methods: 120 patients with severe pulmonary infection admitted from February 2019 to August 2020 were included. They were equally divided into experimental group (n=60) and reference group (n=60) in the form of random number table. The reference group received routine treatment, while the experimental group received non-invasive positive pressure ventilation on the basis of the reference group. The total effective rate, oxygen partial pressure, CO2 partial pressure, respiratory rate and inflammatory factors of the two groups before and after treatment were recorded. Results: the total clinical effective rate of the experimental group was higher than that of the reference group, and there was a difference between the two groups (P < 0.05). Before treatment, there was no difference in oxygen partial pressure, CO2 partial pressure, respiratory frequency and inflammatory factors between the two groups (P > 0.05). After treatment, the partial pressure of oxygen in the experimental group was higher than that in the reference group, while the partial pressure of CO2, respiratory rate, CRP, IL-6 and TNF-α contents in the experimental group were all lower than those in the reference group, with differences in comparison between the groups (P < 0.05). The total adverse reaction rate of the experimental group was lower than that of the conventional group, and there was a statistical difference between the two groups (P<0.05). Conclusion: non-invasive positive pressure ventilation for patients with severe pulmonary infection is more conducive to the recovery of various indicators and the overall treatment effect is significant.展开更多
Tracheal intubation through a supraglottic airway device(SAD)is recommended for difficult airway management.However,specific tracheal tubes for SAD-guided intubation are not always available in emergencies,necessitati...Tracheal intubation through a supraglottic airway device(SAD)is recommended for difficult airway management.However,specific tracheal tubes for SAD-guided intubation are not always available in emergencies,necessitating the use of non-specific tubes such as polyvinyl chloride(PVC)and reinforced tracheal tubes.Although successful intubation with these tubes has been reported,clinicians often face difficulties passing them through the SAD,increasing the risk of airway injury even with correct SAD placement.展开更多
Objective：To observe the clinical efficacy of acupoint massage plus moxibustion in treating refractory insomnia. 〈br〉 Methods：Sixty patients with refractory insomnia were randomized into two groups, 30 in each gro...Objective：To observe the clinical efficacy of acupoint massage plus moxibustion in treating refractory insomnia. 〈br〉 Methods：Sixty patients with refractory insomnia were randomized into two groups, 30 in each group. The treatment group was intervened by acupoint massage on the face and head plus moxibustion at Yongquan （KI 1）;the control group was intervened only by the same acupoint massage. For both groups, the treatment was given once a day, and the therapeutic efficacy was evaluated after 4-week treatment. 〈br〉 Results：The total effective rate was 93.3%in the treatment group versus 80.0%in the control group, and the difference was statistically significant （P〈0.05）. 〈br〉 Conclusion：Acupoint massage plus moxibustion can produce a better efficacy than acupoint massage alone in treating refractory insomnia.展开更多
Objective:To evaluate the efficacy and safety of Jianpi Jieyu Decoction(JJD)for treating patients with mild-to-moderate depression of Xin(Heart)-Pi(Spleen)deficiency(XPD)syndrome.Methods:In this multi-center,randomize...Objective:To evaluate the efficacy and safety of Jianpi Jieyu Decoction(JJD)for treating patients with mild-to-moderate depression of Xin(Heart)-Pi(Spleen)deficiency(XPD)syndrome.Methods:In this multi-center,randomized,controlled study,140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019.They were randomly divided into JJD group and paroxetine group by using a random number table,with 70 cases in each group.The patients in the JJD group were given JJD one dose per day(twice daily at morning and evening,100 m L each time),and the patients in the paroxetine group were given paroxetine(10 mg/d in week 1;20 mg/d in weeks 2-6),both orally administration for a total of 6 weeks.The primary outcome was the change of 17-item Hamilton Depression Rating Scale(HAMD-17)score at week 6 from baseline.The secondary outcomes included the Hamilton Anxiety Scale(HAMA)score,Traditional Chinese Medicine Symptom Scale(TCMSS),and Clinlcal Global Impression(CGI)scores at the 2nd,4th,and 6th weekends of treatment,HAMD-17 response(defined as a reduction in score of>50%)and HAMD-17 remission(defined as a score of 7)at the end of the 6th week of treatment.Adverse events(AEs)were also recorded.Results:From baseline to week 6,the HAMD-17 scores decreased 10.2±4.0 and 9.1±4.9 points in the JJD and paroxetine groups,respectively(P=0.689).The HAMD-17 response occurred in 60%of patients in the JJD group and in 50%of those in the paroxetine group(P=0.292);HAMD-17 remission occurred in 45.7%and 30%of patients,respectively(P=0.128).The differences of CGI scores at the 6th week were not statistically significant(P>0.05).There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week(P=0.001 and P=0.014).The HAMA scores declined 8.1±3.0 and 6.9±4.3 points from baseline to week 6 in the JJD and paroxetine groups,respectively(P=0.905 between groups).At 4th week of treatment,there was a significant difference in HAMA between the two groups(P=0.037).TCMSS decreased 11.4±5.1,and 10.1±6.8 points in the JJD and paroxetine groups,respectively(P=0.080 between groups).At the 6th week,the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group(7.14%vs.22.86%,P<0.05).Conclusion:Compared with paroxetine,JJD was associated with a significantly lower incidence of AEs in patients with mild-tomoderate depression of XPD syndrome,with no difference in efficacy at 6 weeks.(Trial registration No.Chi CTR2000040922).展开更多
Background Studies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial haemorrhage.We aimed to assess whether tranexamic acid reduces haematoma expansion and impro...Background Studies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial haemorrhage.We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in intracerebral haemorrhage patients susceptible to haemorrhage expansion.Methods We did a prospective,double-blind,randomised,placebo-controlled trial at 10 stroke centres in China.Acute supratentorial intracerebral haemorrhage patients were eligible if they had indication of haemorrhage expansion on admission imaging(eg,spot sign,black hole sign or blend sign),and were treatable within 8 hours of symptom onset.Patients were randomly assigned(1:1)to receive either tranexamic acid or a matching placebo.The primary outcome was intracerebral haematoma growth(>33% relative or>6 mL absolute)at 24 hours.Clinical outcomes were assessed at 90 days.Results Of the 171 included patients,124(72.5%)were male,and the mean age was 55.9±11.6 years.89 patients received tranexamic acid and 82 received placebo.The primary outcome did not differ significantly between the groups:36(40.4%)patients in the tranexamic acid group and 34(41.5%)patients in the placebo group had intracranial haemorrhage growth(OR 0.96,95% CI 0.52 to 1.77,p=0.89).The proportion of death was lower in the tranexamic acid treatment group than placebo group(8.1%vs 10.0%),but there were no significant differences in secondary outcomes including absolute intracranial haemorrhage growth,death and dependency.Conclusions Among patients susceptible to haemorrhage expansion treated within 8 hours of stroke onset,tranexamic acid did not significantly prevent intracerebral haemorrhage growth.Larger studies are needed to assess safety and efficacy of tranexamic acid in intracerebral haemorrhage patients.展开更多
Background:Rosai-Dorfman disease(RDD)is an idiopathic histiocytic proliferative disorder characterized by sinus histiocytosis and massive lymphadenopathy.Extranodal and central nervous system(CNS)involvement is unusua...Background:Rosai-Dorfman disease(RDD)is an idiopathic histiocytic proliferative disorder characterized by sinus histiocytosis and massive lymphadenopathy.Extranodal and central nervous system(CNS)involvement is unusual.We describe two distinctly rare cases of isolated intradural RDD of the spine without cervical lymphadenopathy.Case presentation:We report our experience in the management of two patients with RDD.The first patient had two ventral intradural lesions,radiologically in favour of multiple spinal meningiomas,and the second patient presented an intradural extramedually lesion,extending into the right foramina,suggestive of a sacral perineural cyst.Treatments consisted of total excision and subtotal excision without steroids and radiotherapy,respectively.The definitive diagnosis was confirmed by histopathology and immunochemistry.Conclusions:RDD should be considered in the rare differential diagnosis of a spinal disease.Resection of the lesions is an effective treatment choice to relieve spinal compression symptoms.The efficacy of the adjuvant therapy to control the disease is unknown.展开更多
Background： Over the years, the mechanical ventilation （MV） strategy has changed worldwide. The aim of the present study was to describe the ventilation practices, particularly lung-protective ventilation （LPV）, ...Background： Over the years, the mechanical ventilation （MV） strategy has changed worldwide. The aim of the present study was to describe the ventilation practices, particularly lung-protective ventilation （LPV）, among brain-injured patients in China. Methods： This study was a multicenter, 1-day, cross-sectional study in 47 Intensive Care Units （ICUs） across China. Mechanically ventilated patients （18 years and older） with brain injury in a participating ICU during the time of the study, including traumatic brain injury, stroke, postoperation with intracranial tumor, hypoxic-ischemic encephalopathy, intracranial infection, and idiopathic epilepsy, were enrolled. Demographic data, primary diagnoses, indications for MV, MV modes and settings, and prognoses on the 60th day were collected. Multivariable logistic analysis was used to assess factors that might affect the use of LPV. Results： A total of 104 patients were enrolled in the present study, 87 （83.7%） of whom were identified with severe brain injury based on a Glasgow Coma Scale 〈8 points. Synchronized intermittent mandatory ventilation （SIMV） was the most frequent ventilator mode, accounting for 46.2% of the entire cohort. The median tidal volume was set to 8.0 ml/kg （interquartile range [IQR], 7.0-8.9 ml/kg） of the predicted body weight; 50 （48.1%） patients received LPV. The median positive end-expiratory pressure （PEEP） was set to 5 cmH20 （IQR, 5-5 cmH20）. No PEEP values were higher than 10 cmH20. Compared with partially mandatory ventilation, supportive and spontaneous ventilation practices were associated with LPV. There were no significant differences in mortality and MV duration between patients subjected to LPV and those were not. Conclusions： Among brain-injured patients in China, SIMV was the most frequent ventilation mode. Nearly one-half of the brain-injured patients received LPV. Patients under supportive and spontaneous ventilation were more likely to receive LPV.展开更多
基金supported by Beijing Science and Technology Special Fund[grants number 2161100000116067]。
文摘Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.
基金Supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People’s Republic of China(No.2013BAI13B02).
文摘OBJECTIVE:To evaluate the effectiveness of traditional Chinese herbal Xinglouchengqi(XLCQ)decoction for the treatment of constipation in acute ischemic stroke patients,and figure out the role that bowel movements play in the treatment of acute ischemic stroke.METHODS:A total of 317 eligible patients were recruited and randomized to the XLCQ group(211 patients)or the control group(106 patients).In addition to conventional standard medical care and rehabilitation,participants in the XLCQ group received XLCQ decoction,while the control group received clysis therapy using glycerin enemas or lactulose oral solution.Both groups were given treatment for 3 to 6 d,during which they received daily visits to record defecation features and accompanying symptoms.Neurological assessments using the National Institutes of Health Stroke Scale(NIHSS)were conducted before and 1 month after treatment.RESULTS:Patients in the XLCQ group had lower aggregate constipation scores compared with the control group on days 3 and 5(P<0.05).Spontaneous bowel movements tended to reappear more rapidly after taking the XLCQ decoction than after conventional laxative treatment.Both the average aggregate constipation score and the time taken to achieve spontaneous bowel movements showed positive correlations with NIHSS scores before and1 month after treatment(P<0.01).CONCLUSION:Treatment with XLCQ decoction effectively alleviated the overall symptoms of constipation in acute ischemic stroke patients.The status of bowel movements in acute ischemic stroke can reflect the severity of neurological impairment and predict neurological outcomes at 1 month.
基金Special Financial Grant from the China Postdoctoral Science Foundation,No.2012T50868Beijing Municipal Committee and Municipal Government Priority Access to the District Project of Emergency Startup Funds,No.Z111107056811048
文摘AIM: To explore the effect of in vitro porcine esophageal variceal pressure on complete ligation degree for polycyclic ligators. METHODS: An in vitro model of experimental porcine venous vessels was used to test various venous pressures. Three treatment groups were designated according to the preset pressure range: P1 = 25-30 cm H2O; P2 = 35-40 cm H2O; P3 = 45-50 cm H2 O. The effect of pressure on ligation was assessed and compared among the groups. RESULTS: Complete ligation was achieved at a rate of 56.25%(18/32) in group P1, 37.5%(12/32) in group P2, and 33.33%(11/33) in group P3(χ2 = 3.6126; P = 0.0573). CONCLUSION: Higher variceal pressures impair the ligation completion rate. Therefore, measuring variceal pressure may help predict the effect of endoscopic ligation and guide treatment choice.
基金This work was supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People’s Republic of China:Heritage Study on the Special Therapeutic Principles and Methods of Famous Experts in Traditional Chinese Medicine(No.2013BAI13B02).
文摘Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively reflects the blood status of patients with acute ischemic stroke(AIS)and is important in the treatment and prognosis of AIS.To identify the relationship between TCM syndrome factors and TEG in AIS patients and standardize TCM syndrome differentiation and treatment objectives,we designed a prospective cohort study of 103 AIS patients.Methods:We used the diagnostic criteria for AIS in the Chinese Guideline for Diagnosis and Management of Acute Ischemic Stroke 2010.Diagnosis of phlegm-heat and fu-organ excess syndrome was based on the TCM Scale for the Syndrome of Phlegm-heat and fu-organ Excess.The ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to identify and diagnose syndrome factors.General information,scores of syndrome factors and values of TEG parameters of all enrolled patients were recorded.Results:There were significant differences in internal fire and phlegm-dampness scores between patients with and without phlegm-heat and fu-organ excess syndrome(P<.05).In patients with phlegm-heat and fu-organ excess syndrome,internal fire was negatively correlated with TEG parameters R and K(P<.05)and positively correlated with alpha Angle and coagulation index(P<.01).There were no significant correlations between the two syndrome factors and MA(P Z.058)and LY30(P>.05)or between both syndrome factors and TEG parameters in patients without phlegm-heat and fu-organ excess syndrome.Conclusion:The syndrome factor internal fire is a potential predictor of increased platelet function and fibrinogen activity in AIS patients with phlegm-heat and fu-organ excess,and a potentially important predictor of blood hypercoagulability in TCM.
基金Research and Cultivation Program of Beijing Municipal Hospital(Project No.:PZ2018007)。
文摘Objective:To observe the clinical effects of"hand and foot 12 needle acupuncture"on stroke in convalescent period of phlegm-dampness constitution.Methods:The 90 patients were divided into the treatment group(n=45)and the control group(n=45)according to the random number table method.The control group received basic Western medicine treatment+rehabilitation treatment of Western medicine,and the treatment group was additively treated with"hand and foot 12 needle acupuncture"on the basis of the control group.NIHSS score,MRS score and Barthel index(BI)before and after treatment were observed in the two groups,and the clinical efficacy of the two groups was compared.Results:The clinical efficacy of stroke patients in the convalescent period of phlegm-dampness constitution after treatment:the total effective rate of the treatment group was 93.33%,and the total effective rate of the control group was 66.67%.After statistical processing,the clinical efficacy of the treatment group was significantly better than the control group;NIHSS score,MRS score and Barthel index(BI)were better than the control group,and the differences were statistically significant(P<0.05).Conclusion:"Hand and foot 12 needle acupuncture"treatment of phlegm-dampness constitution convalescent stroke clinical effect is remarkable.
文摘As the elderly population continues to grow, the number of patients with low back pain is gradually increasing. Among them, Lumbar Degenerative Diseases (LDD) is one of the major contributors to low back pain. Biomechanical in vivo studies of the lumbar spine are mainly performed by implants or imaging data to record the real-time changes of form and stress on the intervertebral disc during motion. However, the current developments are slow due to the technological and ethical limitations. In vitro experiments include animal experiments and cadaver experiments, which are difficult to operate or differ greatly from normal human structures, and the results still need to be verified repeatedly to test their accuracy. As for finite element method, it is relatively low cost and can repeat the experimental results. Therefore, we believe that finite element analysis plays an extremely important role in biomechanical research, especially in analyzing the relationship between different surgical models and the degeneration caused by different mechanics.
基金Intervention Study on Traditional Chinese Medicine Granules and Jiangzhuo Formula,Combined with Life Style Guidance on Phlegm Constitution of Simple ObesityBeijing TCM Science and Technology Development Fund Project
文摘OBJECTIVE: To observe the clinical effect of oral traditional Chinese medicine granules combined with health education to regulate phlegm constitution and treat simple obesity. METHODS: According to the method of constitution evaluation in TCM Constitution Classification and Evaluation(Chinese Association of Chinese Medicine), the TCM classification of Chinese medicine was performed on patients who came to the outpatient department of the Traditional Chinese Medicine Hospital of Pinggu District of Beijing and met the diagnostic criteria of simple obesity. One hundred patients with phlegm constitution were selected and those in accordance with the standards, were randomly divided into group with oral TCM granules combined with health education(refer to as treatment group) and health education group(refer to as control group) according to 1:1 ratio. The control group was given health education including diet and exercise instruction. Treatment group:(1) Health education includes diet and exercise instruction.(2) Oral Chinese medicine granules: ingredients: atractylodes rhizome 15g, raw barley 30g, Folium Nelumbinis 10g, Chinese hawthorn fruit 10g, Chinese waxgourd peel 15g, milk-vetch root;15g, kudzuvine root 15g, danshen root10g, 2 times/d. The two groups were intervened for 12 weeks each time, and obesity evaluation indicators such as body weight, body fat, waist circumference, hip circumference, weight index, and score table of TCM constitutional were observed before and after the intervention. Statistical software was used for statistical analysis. RESULTS: The total curative effect of the treatment group was better than that of the control group(P<0.001). The weight index, body weight, waist and hip circumference decreased significantly after treatment(P <0.01). Compared with the two groups, the treatment group is better than the control group in terms of dampness constitution improvement, weight and fat losing and waist and hip circumference reducing.(P<0.01). CONCLUSION: Oral Chinese medicine granules Jiangzhuo Fang(combined with health education) and simple health education can improve phlegm constitution, and improve the body weight, body fat percentage and other indicators of the patients, but oral granules combined with health education to improve the physical fitness of phlegm is better than simple health education. The thoughts and methods of Chinese medicine granules combined with health education to regulate phlegm constitution is effective for weight losing and is worthy of further research and promotion.
文摘Objective: to explore the effect of clinical outpatient mode of prenatal examination on the delivery mode and labor course of puerpera. Methods: retrospective study, 48 cases of pregnant women who received prenatal examination in our hospital from 2020.3 to 2021.7 were selected and randomly divided into groups, including control group 25 routine intervention, observation group 23 cases of prenatal examination outpatient mode, observe the two groups of maternal delivery mode and labor process. Results: the rate of maternal natural childbirth in the observation group was as high as 73.91%, significantly higher than that in the control group (40.00%), and the puerpera in the observation group was shorter, the data of the two groups were compared, P < 0.05. Conclusion: the implementation of out-patient prenatal examination can shorten the time of labor and increase the rate of natural childbirth.
文摘Objective: to analyze the effect of non-invasive positive pressure ventilation in patients with severe pulmonary infection. Methods: 120 patients with severe pulmonary infection admitted from February 2019 to August 2020 were included. They were equally divided into experimental group (n=60) and reference group (n=60) in the form of random number table. The reference group received routine treatment, while the experimental group received non-invasive positive pressure ventilation on the basis of the reference group. The total effective rate, oxygen partial pressure, CO2 partial pressure, respiratory rate and inflammatory factors of the two groups before and after treatment were recorded. Results: the total clinical effective rate of the experimental group was higher than that of the reference group, and there was a difference between the two groups (P < 0.05). Before treatment, there was no difference in oxygen partial pressure, CO2 partial pressure, respiratory frequency and inflammatory factors between the two groups (P > 0.05). After treatment, the partial pressure of oxygen in the experimental group was higher than that in the reference group, while the partial pressure of CO2, respiratory rate, CRP, IL-6 and TNF-α contents in the experimental group were all lower than those in the reference group, with differences in comparison between the groups (P < 0.05). The total adverse reaction rate of the experimental group was lower than that of the conventional group, and there was a statistical difference between the two groups (P<0.05). Conclusion: non-invasive positive pressure ventilation for patients with severe pulmonary infection is more conducive to the recovery of various indicators and the overall treatment effect is significant.
基金Capital Health Improvement and Research(No.2018-4-1116)Beijing Municipal Natural Science Foundation(No.7214221)
文摘Tracheal intubation through a supraglottic airway device(SAD)is recommended for difficult airway management.However,specific tracheal tubes for SAD-guided intubation are not always available in emergencies,necessitating the use of non-specific tubes such as polyvinyl chloride(PVC)and reinforced tracheal tubes.Although successful intubation with these tubes has been reported,clinicians often face difficulties passing them through the SAD,increasing the risk of airway injury even with correct SAD placement.
基金supported by Specific Fund of for Young Teachers by Beijing University of Chinese Medicine(No.2012-QNJSZX018)
文摘Objective：To observe the clinical efficacy of acupoint massage plus moxibustion in treating refractory insomnia. 〈br〉 Methods：Sixty patients with refractory insomnia were randomized into two groups, 30 in each group. The treatment group was intervened by acupoint massage on the face and head plus moxibustion at Yongquan （KI 1）;the control group was intervened only by the same acupoint massage. For both groups, the treatment was given once a day, and the therapeutic efficacy was evaluated after 4-week treatment. 〈br〉 Results：The total effective rate was 93.3%in the treatment group versus 80.0%in the control group, and the difference was statistically significant （P〈0.05）. 〈br〉 Conclusion：Acupoint massage plus moxibustion can produce a better efficacy than acupoint massage alone in treating refractory insomnia.
基金Supported by Special Funds for Fundamental Research Funds of Central-Level Public Welfare Research Institutes(No.ZZ0908001)Science and Technology Innovation Project(Major Research Project,No.CI2021A01312)Traditional Chinese Medicine Prevention and Treatment of Encephalopathy Inheritance and Innovation Team(No.CI2021B006)of China Academy of Chinese Medical Sciences。
文摘Objective:To evaluate the efficacy and safety of Jianpi Jieyu Decoction(JJD)for treating patients with mild-to-moderate depression of Xin(Heart)-Pi(Spleen)deficiency(XPD)syndrome.Methods:In this multi-center,randomized,controlled study,140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019.They were randomly divided into JJD group and paroxetine group by using a random number table,with 70 cases in each group.The patients in the JJD group were given JJD one dose per day(twice daily at morning and evening,100 m L each time),and the patients in the paroxetine group were given paroxetine(10 mg/d in week 1;20 mg/d in weeks 2-6),both orally administration for a total of 6 weeks.The primary outcome was the change of 17-item Hamilton Depression Rating Scale(HAMD-17)score at week 6 from baseline.The secondary outcomes included the Hamilton Anxiety Scale(HAMA)score,Traditional Chinese Medicine Symptom Scale(TCMSS),and Clinlcal Global Impression(CGI)scores at the 2nd,4th,and 6th weekends of treatment,HAMD-17 response(defined as a reduction in score of>50%)and HAMD-17 remission(defined as a score of 7)at the end of the 6th week of treatment.Adverse events(AEs)were also recorded.Results:From baseline to week 6,the HAMD-17 scores decreased 10.2±4.0 and 9.1±4.9 points in the JJD and paroxetine groups,respectively(P=0.689).The HAMD-17 response occurred in 60%of patients in the JJD group and in 50%of those in the paroxetine group(P=0.292);HAMD-17 remission occurred in 45.7%and 30%of patients,respectively(P=0.128).The differences of CGI scores at the 6th week were not statistically significant(P>0.05).There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week(P=0.001 and P=0.014).The HAMA scores declined 8.1±3.0 and 6.9±4.3 points from baseline to week 6 in the JJD and paroxetine groups,respectively(P=0.905 between groups).At 4th week of treatment,there was a significant difference in HAMA between the two groups(P=0.037).TCMSS decreased 11.4±5.1,and 10.1±6.8 points in the JJD and paroxetine groups,respectively(P=0.080 between groups).At the 6th week,the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group(7.14%vs.22.86%,P<0.05).Conclusion:Compared with paroxetine,JJD was associated with a significantly lower incidence of AEs in patients with mild-tomoderate depression of XPD syndrome,with no difference in efficacy at 6 weeks.(Trial registration No.Chi CTR2000040922).
基金supported by the National Key R&D program of China(2016YFC1307301)National Natural Science Foundation of China(81820108012)+2 种基金National Natural Science Foundation of China(81870913)National Natural Science Foundation of China(81971614)Beijing Science and Technology Commission(D141100000114002).
文摘Background Studies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial haemorrhage.We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in intracerebral haemorrhage patients susceptible to haemorrhage expansion.Methods We did a prospective,double-blind,randomised,placebo-controlled trial at 10 stroke centres in China.Acute supratentorial intracerebral haemorrhage patients were eligible if they had indication of haemorrhage expansion on admission imaging(eg,spot sign,black hole sign or blend sign),and were treatable within 8 hours of symptom onset.Patients were randomly assigned(1:1)to receive either tranexamic acid or a matching placebo.The primary outcome was intracerebral haematoma growth(>33% relative or>6 mL absolute)at 24 hours.Clinical outcomes were assessed at 90 days.Results Of the 171 included patients,124(72.5%)were male,and the mean age was 55.9±11.6 years.89 patients received tranexamic acid and 82 received placebo.The primary outcome did not differ significantly between the groups:36(40.4%)patients in the tranexamic acid group and 34(41.5%)patients in the placebo group had intracranial haemorrhage growth(OR 0.96,95% CI 0.52 to 1.77,p=0.89).The proportion of death was lower in the tranexamic acid treatment group than placebo group(8.1%vs 10.0%),but there were no significant differences in secondary outcomes including absolute intracranial haemorrhage growth,death and dependency.Conclusions Among patients susceptible to haemorrhage expansion treated within 8 hours of stroke onset,tranexamic acid did not significantly prevent intracerebral haemorrhage growth.Larger studies are needed to assess safety and efficacy of tranexamic acid in intracerebral haemorrhage patients.
文摘Background:Rosai-Dorfman disease(RDD)is an idiopathic histiocytic proliferative disorder characterized by sinus histiocytosis and massive lymphadenopathy.Extranodal and central nervous system(CNS)involvement is unusual.We describe two distinctly rare cases of isolated intradural RDD of the spine without cervical lymphadenopathy.Case presentation:We report our experience in the management of two patients with RDD.The first patient had two ventral intradural lesions,radiologically in favour of multiple spinal meningiomas,and the second patient presented an intradural extramedually lesion,extending into the right foramina,suggestive of a sacral perineural cyst.Treatments consisted of total excision and subtotal excision without steroids and radiotherapy,respectively.The definitive diagnosis was confirmed by histopathology and immunochemistry.Conclusions:RDD should be considered in the rare differential diagnosis of a spinal disease.Resection of the lesions is an effective treatment choice to relieve spinal compression symptoms.The efficacy of the adjuvant therapy to control the disease is unknown.
文摘Background： Over the years, the mechanical ventilation （MV） strategy has changed worldwide. The aim of the present study was to describe the ventilation practices, particularly lung-protective ventilation （LPV）, among brain-injured patients in China. Methods： This study was a multicenter, 1-day, cross-sectional study in 47 Intensive Care Units （ICUs） across China. Mechanically ventilated patients （18 years and older） with brain injury in a participating ICU during the time of the study, including traumatic brain injury, stroke, postoperation with intracranial tumor, hypoxic-ischemic encephalopathy, intracranial infection, and idiopathic epilepsy, were enrolled. Demographic data, primary diagnoses, indications for MV, MV modes and settings, and prognoses on the 60th day were collected. Multivariable logistic analysis was used to assess factors that might affect the use of LPV. Results： A total of 104 patients were enrolled in the present study, 87 （83.7%） of whom were identified with severe brain injury based on a Glasgow Coma Scale 〈8 points. Synchronized intermittent mandatory ventilation （SIMV） was the most frequent ventilator mode, accounting for 46.2% of the entire cohort. The median tidal volume was set to 8.0 ml/kg （interquartile range [IQR], 7.0-8.9 ml/kg） of the predicted body weight; 50 （48.1%） patients received LPV. The median positive end-expiratory pressure （PEEP） was set to 5 cmH20 （IQR, 5-5 cmH20）. No PEEP values were higher than 10 cmH20. Compared with partially mandatory ventilation, supportive and spontaneous ventilation practices were associated with LPV. There were no significant differences in mortality and MV duration between patients subjected to LPV and those were not. Conclusions： Among brain-injured patients in China, SIMV was the most frequent ventilation mode. Nearly one-half of the brain-injured patients received LPV. Patients under supportive and spontaneous ventilation were more likely to receive LPV.
