An-Gong Niu-Huang (AGNH) Pill is an emergency medication in traditional Chinese medicine (TCM). It has been widely used in the treatment of cerebrovascular diseases, meningitis, toxic encephalopathy, hematosepsis, and various types of fever and coma. Pharmacological studies on AGNH Pill revealed that it had the effects of anti-inflammation, cerebral circulation improvement, brain cell protection, brain injury-reducing, and post-injury brain edema improvement. All these effects became the research hotspots in its therapeutic mechanism study. This article summarized the Chinese medicine and modern medicine understanding of AGNH Pill, its clinical application and pharmacological mechanism in the treatment of acute cerebrovascular diseases in recent years, in order to provide references for clinical practice as well as new thinking and prospect for further research.

AIM: To study the clinical treatments and prognosis of the severe pneumonia in 12 patients after renal transplantation. METHODS: Twelve patients with severe pneumonia following renal transplantation treated in Guangdong Provincial Hospital of Traditional Chinese Medicine were selected between May 2004 and October 2006. They all agreed to the experiment. Seven patients had pneumonia at 3 months after transplantation, 1 at 3.5 months, 3 at 4 months and 1 at 5 months. The main therapy included immunosuppressive removal at early stage, mask oxygen inhalation, bi-level airway pressure ventilation or tracheal intubation to correct the hypoxemia; the algogen was detected by many approaches, and specific treatment was carried out according to the susceptibility test; gastroenteric nutrition was supplied through nasogastric tube, and part patients were given parenteral nutrition to strengthen nutrition support. Imaging examination of lung and blood gas analysis were performed every two to three days to evaluate the curative effect; transplanted kidney function was detected to determine the acute rejection early. RESULTS: All 12 patients were involved in the result analysis without any lost. Etiological agent detection: There were three cases with fungal pneumonia, 4 with cytomegalovirus pneumonia, 3 with bacterial pneumonia, 1 with mixed infection and 2 with unclear agent. Two cases of cytomegalovirus pneumonia developed rapidly into acute respiratory distress in 1 week after hospitalization and finally died of respiratory failure; the rest 10 patients were rescued successfully, except one with pulmonary interstital fibrosis, which could affect the life quality. CONCLUSION: The key points of successful treatment for severe pneumonia are the combination of early aggressive reduction of the immunosuppressive therapy, early detection of responsible pathogen and effective control of severe hypoxemia.

Objective To analyze the outcome of allograft function of the HBsAg(+) recipients and discuss the suitable time of antiviral therapy. Methods Twenty-one HBsAg(+) recipients were randomly divided two groups: one group (11 cases) taking lamivudine orally after recovery of intestinal function, and another group (10 cases) taking lamivudine orally when liver dysfunction and increased HBV-DNA (HBV-DNA>106 copies/L) occurred during the period of follow-up. Liver function, allograft function, and hepatitis virus reactivation were followed up for 2 years after transplantation. Results Hepatitis recurrence and liver dysfunction after renal transplantation lay in viral replication after immuno-suppression. Lamivudine therapy accomplished the goals of viral suppression, and normalization of alanine aminotransferase (ALT) levels. Preemptive lamivudine therapy for recipients had a better liver and allograft function than oral administration for patients with liver dysfunction and increased HBV-DNA copies during a period of the two-years follow-up. Conclusion HBsAg (+) is not contraindication of renal transplantation. Preemptive lamivudine therapy early after operation could avoid liver dysfunction and improve the renal allograft function during the period of two-years follow-up.

This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.

Objective To study the clinical efficacy and the difference of intervention in appendix inflammatory mass by heavenly cool-inducing technique adopted distant and neighboring point selection. Methods Eighty patients of the appendix inflammatory mass with toxic heat syndrome were randomly divided into control group, distant point selection group, neighboring point selection group, and combined group, 20 cases in each group. The control group adopted the conventional western medicine treatment. On the basis of control group, the rest 3 acupuncture groups adopted the heavenly cool-inducing technique for 14 d. The distant point selection group chose Hegu point and Lanwei point;the neighboring point selection group chose Ashi point and Tianshu point (right);the combined group put them together. The longest diameter and three-dimensional volume of inflammatory mass were determined before and after treatment. The serum levels of white blood cells, C-reactive protein were determined at the same time, and then the clinical effective was estimated. Results The longest diameter, three-dimensional volume of inflammatory mass, the serum levels of white blood cells, and C-reactive protein of patients in 4 groups were reduced after treatment. The above indicators in patients of 3 acupuncture groups were lower than the ones in control group, the indicators in combined group were the lowest (P<0.05, P<0.01), and there was no difference between distant and neighboring point selection groups (P>0.05). The invalid number of cases in 3 acupuncture groups were fewer than the one in control group, and the indicators in combined group were fewest (P<0.05, P<0.01), with no difference between distant and neighboring point selection groups (P>0.05). Conclusion There is obvious therapeutic efficacy of heavenly cool-inducing technique to appendix inflammatory mass, while the combination of distant and neighboring point selection is better than the single methods.

Objective To observe the intervention effect of different compatibility of aconite and peony in Zhenwu Decoction on experimental nephritis in rats, and explore the connotation of suitable fire and evil fire. Methods Sixty experimental rats were randomly divided into blank group, model group, valsartan group, high aconite and low peony group, aconite and peony equivalent group, low aconite and high peony group. All rats except the blank group were made glomerulonephritis model by tail vein injection of monoclonal antibody 1-22-3. Rats were gived continuous gavage administration (blank group and model group were lavaged with NS) after modeling, and killed 2 weeks later. The morphological change of kidney tissues and serum hs-CRP, TNF-α, IL-6 levels were observed. Results The valsartan group, aconite and peony equivalent group, low aconite and high peony group inhibited the rats mesangial cell proliferation and extracellular matrix expansion significantly, so as the level of hs-CRP, TNF-αand IL-6. The effect of aconite and peony equivalent group was better than low aconite and high peony group, but inferior to valsartan group, while high aconite and low peony group accelerated the progress of the disease. Conclusion The different compatibility of aconite and peony in Zhenwu Decoction has resistance and proinflammatory effect on renal inflammation.

This study was aimed to observe the effect of Pediatric Long-term Cough Decoction in the treatment of long-term cough among children. A total of 96 cases were diagnosed in traditional Chinese medicine (TCM) as qi-yin deficiency, and lung-heat accumulation with constipation. The western medicine diagnosis was mycoplasma pneumoniae pneumonia (MPP) infection in the recovery period after chronic cough. All cases were randomly divided into the TCM group and control group, with 48 cases in each group. In TCM group, the Pediatric Long-term Cough Decoction was used to supplement qi and nourish yin, clear away the lung-heat and excrete feces. In the control group, montelukast was used. For both groups, clinical effect of score and CD4+ T lymphocytes, CD8+ T lymphocytes and CD4+/CD8+ ratio were observed one day before treatment and thirty days after treatment. The results showed that after thirty-day treatment, the clinical effect of score in both groups was obviously improved (P < 0.01). The TCM group was better than the control group (P< 0.01). Compared with pretreatment, the posttreatment CD4+ T lympho-cytes, CD8+ T lymphocytes and CD4+/CD8+ ratio in TCM group were obviously improved (P < 0.05). The CD4+ T lymphocytes and CD4+/CD8+ ratio in the control group were obviously improved (P < 0.05). However, there was no change on the CD8+ T lymphocytes. The regulation effect on CD4+ T lymphocytes and CD8+ T lymphocytes of TCM group was better than the control group (P< 0.01). It was concluded that the Pediatric Long-term Cough Decoction can effectively improve clinical symptoms of chronic cough in children and regulate immune function.

Objective To investigate infection rate of human papillomavirus as well as the correlation between cervical precancerous lesions and co-infection of human HPV,herpes simple virus-2 (HSV-2) and cytomegalovirus (CMV) in Chinese women of childbearing age in Kunming,Yunnan province.Methods A total of 2128 women (18-24,25-34,35-49 years of age),who had healthy care examination in our institute from January 2010 to March 2011,were selected prospectively in this study.The infection of HPV,HSV-2 and CMV were detected by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) and cervical precancerous lesions were determined by the ThinPrep liquid-based cytology test (TCT).Results The overall infection rates of high risk HPV (HR-HPV),HSV-2,CMV were 11.04％(235/2128),3.52％ (75/2128) and 5.26％ (112/2128),respectively.The HR-HPV infection rates in groups of Negative for Intraepithelial Lesion or Malignancy (NILM),Atypical Squamous Cells of Undetermined Significance (ASCUS),Low grade Squamous Intraepithelial Lesion (LSIL),High grade Squamous Intraepithelial Lesion(HSIL),and Squamous Cell Carcinoma (SCC) were 4.29％ (82/1912),55.93％ (66/118),84.62％ (44/52),93.19％ (41/44) and 2/2,respectively.HR-HPV infection rates was increased with the development of cervical lesion (r =0.644,P =0.000).No significant difference on the infection rates of HR-HPV and HSV-2 was identified between different age groups (x2 =2.979,P =0.226; x2 =0.798,P =0.671).The peak age groups for CMV infection (7.62％) were 18 to 24 years old and the infection rates of CMV decrease with age.No significant difference of HSV-2 and HR-HPV coinfection was found between the TCT-abnormal (3.24％,7/216) and control groups (2.41％,46/1912,x2 =0.557,P=0.455),and no relationship was found between HSV-2 and HR-HPV infection groups (OR =0.56,95％ CI:0.17-1.82).The infection of HR-HPV were related significantly with CMV infection (OR =3.14,95％ CI:1.25-7.86).Conclusion HR-HPV infection appears to be the key risk factor for cervical cancer and synergistic interaction may occur between CMV and HPV infections in the development of cervical lesion.

Objective To observe and investigate the influence degree of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation.Methods 76 patients with gastric and duodenal ulcer perforation were selected as study subjects,and they were divided into control group(conventional open operation group)and observation group(laparoscopic operation group)according to the random number table,38 cases in each group.The serum body stress hormones and antiinflammatory,proinflammatory related indexes of the two groups at first day before operation and at first,third,seventh day after operation were respectively detected and compared.Results The serum IL -2 levels of the observation group at first,third and seventh day after operation were (3.53 ±0.24)μg/mL,(3.25 ±0.22)μg/mL and (4.37 ±0.33)μg/mL,which were higher than those of the control group(F =5.876,P <0.05),while other serum body stress hormones and antiin-flammatory,proinflammatory related indexes were all obviously lower than those of the control group (all P <0.05), there were significant differences between those postoperative evaluation results of the two groups.Conclusion The influence of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation is relatively small,and it shows that the bad body stress degree caused by the operation is relatively smaller.

Objective To explore the effects of interstitial brachytherapy with permanent seed implants on peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of natural killer cells (NK). Methods Ultrsound-guided or intraoperative implants of radioactive seed 125I were used in 25 patients with pathologically diagnosed and ineradicable malignant tumors. Clinical data of peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of NK cells prior and after the treatment were compared. Results The white blood cells, hemoglobin and platelet prior the treatment were (6 3?2 2)?10 9/L, (122 7?17 3) g/L and (219 9?117 5)?10 9/L, respectively, while at the 1st and 3rd months after the treatment, these were (6 4?1 8)?10 9/L, (114 5?30 9)g/L, (191 5?59 6)?10 9/L, respectively and (6 1?1 2)?10 9/L, (116 3?16 0) g/L, (191 7?108 2)?10 9/L, respectively, without statistically significant differences ( F =1 893, 0 616, 0 596; P =0 072, 0 779, 0 762). In addition, no significant differences were found in values of ALT, AST, BUN, Cr, CK and CK-MB at different times ( F =1 861, 0 551, 1 740, 1 934, 0 412, 0 052; P =0 118, 0 737, 0 142, 0 105, 0 837, 0 998). The values of TB and DB in patients with pancreatic carcinoma obviously decreased within 1 month after the treatment. Interstitial brachytherapy had little effects on T-cell immunity (CD3, CD4 and CD8) and the activity of NK cells ( F =0 287, 0 520, 0 497, 1 101; P =0 752, 0 598, 0 612, 0 342). Conclusions Interstitial brachytherapy with permanent seed implants has no effects on vital organs and immunologic functions, being a safe and minimally invasive technique for cancer.