ObjectiveTo explore the treatment efficacy and feasibility of large dose of cytidine diphosphate choline (CDPC) in cardiopulmonary cerebral resuscitation.MethodsOne hundred and thirtytwo patients with sudden cardiac arrest successfully treated by the cardiopulmonary cerebral resuscitation were divided into treatment group ( 75 patients) and control group (57 patients) by random number tables.Two groups of patients were given adrenaline resuscitation drugs,reducing the intracranial pressure drugs,hypothermia,hormones and other basic treatment.Control group used CDPC 0.25 g with glucoseinjection 300 ml to do intravenous drip (once a day,21 days as a period of treatment),and treatment group added CDPC to 2.00 g.The patients were treated by basic traditional analeptic.The Glasgow coma scale (GCS) was carried out in two groups in admission to hospital and 3,7,14,21 days after treatment,and the changes of lysophosphatidic acid (LPA) and phosphatidic acid (AP) level were monitored.ResultsThe GCS score was significantly higher in treatment group 7,14,21 days after treatment(P ＜ 0.05 or ＜ 0.01 ),but GCS score had no significant difference before and after treatment in control group(P ＞ 0.05).The level of LPA in treatment group was significantly decreased 14 days after treatment [ (2.98 ± 0.28) μmol/L ] and 21 days after treatment[ (1.85 ± 0.21)μmol/L],and had significant difference compared with that admission to hospital [ (3.75 ± 0.22) μ mol/L ] (P ＜ 0.05 or ＜ 0.01 ).In control group,there was no significant difference before and after treatment (P ＞0.05).The level of AP in treatment group 21 days after treatment was significantly decreased compared with that in control group [ ( 3.45 ± 0.23 ) μ mol/L vs.( 5.20 ± 0.21 ) μ mol/L ](P ＜ 0.01).ConclusionLarge dose of CDPC can improve neurological function of cardiopulmonary cerebral resuscitation,which is a safe,effective and easy way to be popularized.

Objectives To observe the effect of Suanzaoren Decoction on the expression of NMDAR1, NMDAR2A and NMDAR2B RNA in cortex and hippocampus of depression model rats, and explore the mechanism of treating depression. Methods Ninty SD rats were randomly divided into blank group, model group, western medicine group, Suanzaoren Decoction high, medium and low dose group. Except the blank group, the other groups were replicated the rat model of depression in chronic stress. The treatment groups were given corresponding drugs by gavage. The expression of NMDAR1, NMDAR2A and NMDAR2B genes in cortex and hippocampus were detected by RT-PCR. Results Compared with the model group, the positive expression of NMDAR in cortex and hippocampus decreased in Suanzaoren Decoction high and medium dose group (P<0.01). The positive expression of NMDAR2A in cortex and hippocampus of Suanzaoren Decoction high, medium dose group and western medicine group decreased (P<0.05, P<0.01), the expression of NMDAR2A in hippocampus increased in Suanzaoren Decoction low dose group (P<0.05). The positive expression of NMDAR2B in cortex decreased in western medicine group, Suanzaoren Decoction high, medium and low dose group (P<0.01). The expression of NMDAR2B in hippocampus increased in Suanzaoren Decoction medium and low dose group (P<0.01). Conclusion Suanzaoren Decoction can play the role of treating depression by decreasing the expression of NMDAR1, NMDAR2A and NMDAR2B RNA in cortex and hippocampus.

[Absract] Objective To investigate the imaging features of CT and MRI of echinococcosis, and improve the imaging knowledge of the disease. Methods Clinical and radiological findings of echinococcosis of ribs were retrospectively analyzed by reviewing the seventeen cases confirmed by clinical and pathological findings. All patients had CT scan, eight had X?ray plain film and five had MR examination, while 4 patients underwent additional contrast?enhanced CT examination. Results All lesions were unilateral. There were 33 ribs involved, and single involved rib was seen in 7 cases. On CT scans, 10 cases showed cystic, swelling and osteolytic bone destruction, and 7 cases showed moth?eaten osteolytic bone destruction. There were 13 cases of hydatid cyst, 3 cases of a single sac watery density shadow and 10 cases of polycystic separating wheels form. There were 4 cases of fractured ribs, 2 cases of the longitudinal fracture and 2 cases of the transverse fracture. On MRI, there was one case of rib medullary cavity expansion destruction. It was a single cyst with hypointensity on T1WI, hyperintensity on T2WI and hyperintensity on short time inversion recovery (STIR) images. There were one case of rib medullary cavity expansion destruction and 3 cases of hydatid erosion ribs cortex among 4 cases of polycystic type. Polycystic type echinococcosis appeared hypointensity on T1WI, hyperintensity on T2WI and hyperintensity on STIR images. Polycystic type had mother sac and ascus structure, and signal intensity of ascus was higher. STIR sequence showed more clearly polycystic structure. Conclusions CT and MRI can clearly show location of echinococcosis of ribs. There are the imaging features of cystic, swelling and osteolytic bone destruction or complicating cyst of polycystic type which can help the qualitative diagnosis of rib echinococcosis.

ObjectiveTo observe the effect of rhubarb as the main composition in the therapy for patients with acute paraquat poisoning (APP).MethodsA prospective randomized controlled trial was conducted. 128 patients with APP admitted to Harrison International Peace Hospital from March 2011 to December 2013 were randomly divided into western medicine control group (n = 64) and western medicine and traditional Chinese medicine (TCM) combination group (n = 64). All the patients were treated with repeated gastric lavage and oral kaolin. The patients in western medicine control group were given 20% mannitol and (or) magnesium sulfate for catharsis, early (within 8 hours of admission) hemoperfusion (HP), and also given the routine combined therapy. In TCM combination group, in addition to the above treatment patients were given oral paraquat poisoning detoxification prescription No.1 every 2 hours for catharsis, which was composed of rhubarb 10 g, glauber salt 12 g, agrimony 12 g, and licorice 6 g. When green stool disappeared, detoxification therapy was changed to No. 2 compound once a day for 14 days, which was consisted of rhubarb 10 g, ginseng 6 g, agrimony 15 g, rhizoma chuanxiong 10 g, licorice 6 g. The poison volume, first dose of oral drug, time for the first HP, time of the first defecation, the time of last green stool, decontamination time, white blood cell count (WBC), C-reactive protein (CRP), arterial blood gas analysis, blood lactic acid (Lac), liver and kidney functions, myocardial enzyme spectrum, chest CT, adverse reaction, days of hospitalization, and mortality rate were observed in both groups. The levels of paraquat in plasma and urine were determined before treatment and 12 hours after poisoning in both groups. Sixty days after discharge, chest CT was taken for observation of pulmonary fibrosis. ResultsThere were no significant differences in the poison volume, ingestion time and the time for the first HP between the two groups. Compared with western medicine control group, the first defecation time (hours: 3.94±1.14 vs. 6.17±1.52), the last time of green stool (hours: 36.90±4.10 vs. 51.63±4.91), and poison clean-up time from plasma (hours: 19.48±3.63 vs. 23.84±3.29) in combination with TCM group were significantly earlier (allP< 0.01). WBC, CRP, alanine aminotransferase (ALT), blood urea nitrogen (BUN), and serum creatinine (SCr) levels were gradually increased after admission in combination with TCM group, and they peaked on 5th day [WBC (×109/L): 15.35±2.17 vs. 17.47±2.09, CRP (mg/L): 32.62±2.76 vs. 39.51±2.45, ALT (U/L): 270.88±11.06 vs. 334.67±7.85, BUN (mmol/L): 13.29±1.90 vs. 17.63±1.42, SCr (μmol/L): 203.54±18.40 vs. 251.53±14.38, allP< 0.05], and then they declined; Lac after admission was gradually increased, and peaked at 7 days (mmol/L: 3.53±0.21 vs. 3.82±0.14, P< 0.05), and then it was decreased. Myocardial enzyme spectrum was increased after admission, and peaked on 3rd day [creatine kinase (CK, U/L): 192.09±16.26 vs. 216.20±11.96, creatine kinase isoenzyme enzyme (CK-MB, U/L):39.03±3.75 vs. 47.22±5.84, bothP< 0.05), and then they declined gradually. Arterial partial pressure of oxygen (PaO2) and base excess (BE) were gradually decreased after admission, down to trough on the 7th day after admission [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 87.04±2.37 vs. 84.93±2.44, BE (mmol/L): -7.31±2.31 vs. -9.18±2.49, bothP< 0.05], and then they were increased. At 12 hours after poisoning, paraquat contents in plasma and urine in combination with TCM group were significantly lower than those of the western medicine control group [plasma (ng/L):0.83±0.08 vs. 0.96±0.10, urine (ng/L): 0.88±0.09 vs. 0.97±011, bothP< 0.05]. The injury to lung tissue was significantly improved in combination with TCM group compared with that in the western medicine control group, and no serious adverse reactions was found, and the hospital stay time (days: 20.46±6.07 vs. 29.73±9.16) was significantly shortened (P< 0.01), and the mortality rate [35.9% (23/64) vs. 45.3% (29/64)] was significantly lowered compared with western medicine control group (P< 0.05). In the combination with TCM group pulmonary fibrosis was lighter than that in the western medicine control group during the 60-day follow-up. ConclusionThe sequential treatment of No. 1 and No. 2 detoxification of APP, using rhubarb as the main drug, can effectively eliminate paraquat, reduce absorption of the toxin, prevent the development of multiple organ dysfunction syndrome (MODS) induced by the toxin, shorten the hospital stay days, and improve the prognosis of APP.

ObjectiveTo observe the effects of extract of Ginkgo biloba, Ginaton, on cerebral oxygen utilization coefficients (O2UCc) and lactate clearance rate (LCR) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods The 196 patients with DEACMP admitted to Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2011 to March 2016 were enrolled, and they were randomly divided into a control group and an observation group, 98 cases in each groups. The control group received routine treatments such as hyperbaric oxygen, measures to prevent and treat cerebral edema, and promote brain cell metabolism, etc routine therapies: while in the observation group, besides the above routine treatments, additionally intravenous drip of Ginaton 70 mg (with 0.9% sodium chloride injection 250 mL added), once a day, for consecutive 2 weeks to complete one therapeutic course. At ambient air, before treatment and 6, 24 and 72 hours after treatment, the O2UCc and LCR and the changes of mini-mental state examination (MMSE) score, clinical efficacy and hospital mortality were observed and compared between two groups. Pearson correlation test was used to analyze the correlations between O2UCc, LCR and MMSE score.Results On the day of admission before treatment, there were no differences in O2UCc, lactate and MMSE score between the two groups (allP > 0.05). At 6 hours, 24 hours after treatment, the levels of O2UCc in observation group were obviously lower than those in control group [6 hours: (40.64±9.50)% vs. (45.78±7.94)%, P = 0.000; 24 hours: (30.51±6.76)% vs. (33.34±8.19)%,P = 0.009], while the levels of LCR were significantly higher than those in control group [6 hours: (14.93±2.27)% vs. (11.45±1.88)%,P = 0.000; 24 hours: (19.86±3.42)% vs. (13.73±2.35)%,P = 0.009]. There were no statistical significant differences in O2UCc and LCR at 72 hours after treatment between the two groups (P > 0.05). The MMSE scores at 6, 24 and 72 hours after treatment in observation group were higher than those in control group (6 hours: 15.52±3.61 vs. 11.60±2.49, 24 hours: 20.05±5.79 vs. 14.85±5.71,72 hours: 23.87±5.96 vs. 18.07±6.97, allP < 0.05). The total effective rate in observation group was significantly higher [77.55% (76/98) vs. 61.22% (60/98),P < 0.05], and the mortality [3.06% (3/98) vs. 10.20% (10/98),P < 0.05] was obviously lower than their own counterparts in control group. The correlation analysis showed that at different time points, the levels of O2UCc were negatively correlated to the corresponding MMSE scores (r6 h = -0.153,r24 h = -0.158, P6 h = 0.032,P24 h = 0.027), and there were positive correlations between the levels of LCR and MMSE scores (r6 h = 0.473, r24 h = 0.242,P6 h = 0.000,P24 h = 0.001) in patients with DEACMP.Conclusions The treatment of Ginaton in patients with DEACMP can effectively elevate the LCR and MMSE score, reduce O2UCc, decrease mortality and improve the prognosis, thus the clinical curative effect is distinct.