Objective To compare the efficacy of cilostazol and aspirin in the treatment of vascular dementia with white matter lesions.Methods 50 patients with vascular dementia with white matter lesions were randomly divided into control group (aspirin and nimodipine group)and observation group (cilostazol and nimodipine group). The control group was orally given aspirin enteric -coated tablets and nimodipine tablets,the observation group was treated with cilostazol tablets and nimodipine tablets.Then,the patients were followed up,compared the cognitive function and adverse events of the two groups after treatment 6 months and 1 2 months.Results 6 months and 1 2 months after treatment,MMSE score and MoCA score of the control group were significantly improved[the MMSE score and MoCA score before treatment were (20.1 2 ±4.25)points,(1 4.25 ±4.25)points,6 months after treatment were (21 .22 ±4.68)points,(1 6.45 ±3.25)points,1 2 months after treatment were (22.38 ±5.64),(1 6.95 ± 4.68);6 months after treatment,t =0.87,2.06;1 2 months after treatment,t =1 .96,2.1 4,all P <0.05].6 months and 1 2 months after treatment,MMSE score and MoCA score of the observation group were significantly improved than before treatment [before treatment the MMSE score and MoCA score were (1 9.85 ±5.1 4)points,(1 3.98 ± 6.28)points,6 months after treatment were (23.76 ±4.1 5)points,(1 8.75 ±4.28)points,1 2 months after treatment were (25.26 ±3.72)points,(23.95 ±5.43 )points,6 months after treatment t =2.96,3.1 4;1 2 months after treatment,t =4.26,6.00,all P <0.05].6,1 2 months after treatment,the MMSE score between the two groups had significant difference (t =2.03,2.1 3,all P <0.05),MoCA score between two groups had significant difference(t =2.1 4,4.88,all P <0.05).The incidence rates of cerebral hemorrhage in the observation group and control group were 0.00%,1 2.00%,the difference was significant (χ2 =3.1 9,P <0.05).Conclusion Cilostazol and nimodipine in the treatment of vascular dementia with white matter lesions,can significantly improve cognitive function of patients, and has less cerebral hemorrhage,significantly clinical effect,good security.

OBJECTIVE: To investigate the therapeutic effect of treatment based on syndrome differentiation and its influence on the serum levels of testosterone and insulin in women with polycystic ovary syndrome (PCOS). METHODS: Forty-three women, diagnosed with PCOS as well as syndrome of kidney yin deficiency or syndrome of spleen qi deficiency, were enrolled in the study. Twenty-five PCOS women with syndrome of kidney yin deficiency were treated with traditional Chinese herbs for nourishing yin to reduce fire (nourishing yin group), and 18 PCOS women with syndrome of spleen qi deficiency were treated with herbs for invigorating spleen and replenishing qi (replenishing qi group). Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and the serum levels of insulin and testosterone before and after treatment were detected. RESULTS: Among the 43 cases, 20 cases had high serum testosterone level, in which 13 cases with syndrome of kidney yin deficiency, 7 cases with syndrome of spleen qi deficiency, but the difference had no statistic significance; 17 cases had high serum insulin level, in which 11 cases with syndrome of spleen qi deficiency, 6 cases with syndrome of kidney yin deficiency, the difference had statistic significance (P<0.05). In nourishing yin group, the serum levels of insulin and testosterone declined after treatment (P<0.05), and BMI, WHR and WC showed no significant changes. In replenishing qi group, the serum level of insulin declined after treatment (P<0.01), and BMI, WHR, WC and the serum level of testosterone showed no significant changes. CONCLUSION: Traditional Chinese herbs for nourishing yin to reduce fire can significantly reduce the serum levels of testosterone and insulin in PCOS women with syndrome of kidney yin deficiency, and herbs for invigorating spleen and replenishing qi can significantly reduce the serum level of insulin in PCOS women with syndrome of spleen qi deficiency.

BACKGROUND: Studies have shown that Maca can enhance immune cel function, improve mitochondrial respiratory chain enzymes, and play a role in anti-oxidation and anti-aging.
OBJECTIVE: To observe Maca effects on kidney mitochondrial respiratory function and anti-aging capabilities in elderly rats after exhausted exercise.
METHODS: 10-month-old elderly rats were intragastrical y administrated Maca powder 5 g/kg, once a day, and did treadmil exercise, 5 days in a week. Rats were randomly divided into control group, Maca group and training group and Maca+training group. At 6 weeks after training, rats in each group did exhausted exercise (35 m/min), and immediately received intraperitoneal injection of 2% sodium pentobarbital. The kidney was obtained, and mitochondria were extracted by differential centrifugation. A spectrophotometer was used to measure mitochondrial respiratory chain activity.
RESULTS AND CONCLUSION: (1) Mitochondrial respiratory chain enzyme and antioxidant enzyme activity: mitochondrial respiratory chain enzyme I-III, superoxide dismutase and glutathione peroxidase activities were higher in the Maca+training group than in the control group, Maca group and training group (P < 0.05 or P < 0.01), but malondialdehyde content was lower (P < 0.05 or P < 0.01). (2) Results suggested that the combination of supplement Maca and incremental exercise can improve mitochondrial respiratory function and delay aging in the kidney of aged rats after exhausted exercise. Moreover, supplemented Maca and incremental exercise have a synergistic effect.

Objective:To investigate the efficacy of Xiaoer Jinqiao granule combined with interferon α-2b on acute herpangina in children and its effect on immune function and myocardial enzyme. Methods:A total of 102 children with acute herpangina who received treatment in Hangzhou Ninth People's Hospital from January 2019 to January 2020 were randomly assigned to receive treatment with either interferon α-2b (control group, n = 51) or Xiaoer Jinqiao granule combined with interferon α-2b (observation group, n = 51) for 5 d. The time to disappearance of main symptoms, changes in humoral immune function, changes in cellular immune function and myocardial enzyme level after treatment relative to before treatment as well as curative effect were compared between the control and observation groups. Results:The time to disappearance of pharyngeal herpes [(3.05 ± 0.74) d], salivation [(2.31 ± 0.68) d], and fever [(1.36 ± 0.39) d] in the observation group were significantly shorter than those in the control group [(4.38 ± 0.98) d, (3.83 ± 1.07) d, (2.54 ± 0.71) d, t = 7.773, 8.562, 10.403, all P < 0.05]. After treatment, serum IgA [(1.49 ± 0.16) g/L], IgG [(10.29 ± 0.89) g/L] and IgM [(1.26 ± 0.14) g/L] levels in the observation group were significantly higher than those in the control group [(1.13 ± 0.12) g/L, (9.35 ± 0.72) g/L and (0.98 ± 0.13) g/L, t = 12.855, 5.864 and 10.466, all P < 0.05]. After treatment, CD 3+ [(74.29 ± 2.15)%], CD 4+ [(40.85 ± 1.65)%] and CD 4+/CD 8+ expression [(1.87 ± 0.23)] in the observation group were significantly higher than those in the control group [(67.96 ± 2.43)%, (38.02 ± 1.20)% and (1.49 ± 0.14), t = 13.933, 9.906 and 10.079, all P < 0.05]. After treatment, serum creatine kinase [(147.86 ± 15.42) U/L] and lactate dehydrogenase [(128.64 ± 14.25) U/L] in the observation group were significantly lower than those in the control group [(176.95 ± 13.15) U/L and (184.32 ± 18.98) U/L, t = 10.251, 16.754, both P < 0.05]. Total effective rate in the observation group was significantly higher than that in the control group [92.16% (47/51) vs. 74.51% (38/51), χ 2 = 5.718, P < 0.05]. Conclusion:Xiaoer Jinqiao granule combined with interferon α-2b has obvious curative effect on acute herpangina in children because it can improve the humoral and cellular immune function and reduce myocardial damage.

Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.

Objective To evaluate MR diffusion-weighted imaging (DWI)and MR perfusion-weighted imaging(PWI) in differentiating benign from malignant soft tissue tumors by comparing the related parameters. Methods Fifty patients with soft tissue tumors verified by pathology( benign 24, malignant 26) underwent DWI and dynamic contrast-enhanced T2 * -weighted PWI. DWI and PWI data of benign and malignant soft tissue tumors were acquired at the workstation and their difference was analyzed with t-test. The diagnostic accordance rate was verified with x2-test. Subjective overall performance of two techniques were evaluated with receiver operating characteristic (ROC) analysis. Results ADC values of benign and malignant tumors were (2. 03±0. 36) × 10-3 mm2/s, ( 1.52±0. 39) × 10-3 mm2/s,respectively. The signal intensity decrease of them during the first-pass perfusion (SIdecrease ) were ( 13.54 ± 3.37 )%, (47. 57 ± 5. 21 ) % ,respectively. The maximum linearity slope rate of TIC ( SSmax ) of them were ( 5.51 ± 2. 54 ) %, (7.94 ± 3. 33) %, respectively. There were significant differences between benign and malignant tumors of ADC value and SIdecrease ( t = 2. 515,2. 938 ;P < 0. 05 ), while there was no significant difference in SSmax (t = 1. 272,P >0. 05). When the threshold of ADC value was 1. 866 × mm2/s, sensitivity and specificity for determining malignant tumors were 84. 6% (22/26)and 83.3% (20/24). When the threshold of SIdecrease was 40. 33% ,sensitivity and specificity for determining malignant tumors were 88. 5% (23/26)and 75.0% (18/24). In type Ⅰa of TIC,the proportion of benign soft tissue tumor was 3/24 and malignant tumor was 20/26. In type Ⅰb , benign tumor was 14/24 and malignant tumor was 3/26. In type Ⅰc, malignant tumor was 3/26. In type Ⅱ ,benign tumor was 7/24. The diagnostic accordance rate of DWI and PWI were 84. 0% (42/50) and 82. 0% (41/50), respectively. There was no significant difference between them ( x2 = 0. 8, P >0. 05). The accuracies of them were 81.7% , 83. 6% respectively by the area under the ROC curve (AUC). The sensitivity of PWI in diagnosing malignant soft tissue tumors was higher. Conclusions ADC value and SIdecrease are Valllable diagnostic parameters in differentiating benign and malignant soft tissue tumors. The threshold of these parameters for diagnosing malignant soft tissue tumors are 1. 866 × 10-3 mm2/s and 40. 33%, respectively. The type of TIC can help to distinguish malignant tumors from benign tumors, while the SSmax can not. The accuracies of DWI and PWI in the diagnosis of malignant soft tissue tumors are moderate. Compared with DWI, PWI should be selected firstly because of its higher sensitivity in diagnosing malignant tumors.

It is very necessary to apply case-teaching method to Emergency Medicine in Universities of TCM. To establish the case-teaching system,we ourselves have written teaching materials,trained teachers, and designed all sorts of the medical records. Moreover, we have deployed other methods and principles to put this teaching into practice, used clinical skill practising as a essential supplement of teaching effect. Comparing with the traditional teaching method, it is clear that case-teaching method could make students' learning initiative and positivity improved significantly, their test scores promoted obviously. Thus, carrying out case-teaching method in Emergency Medicine could advance students capability of acquisition of knowledge and their clinical thinking .

Objective:To investigate the correlation between cognitive impairment and blood glucose, serum neuron specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) levels after ischemic small-artery stroke.Methods:A total of 160 patients with ischemic small-artery stroke who received treatment in Jincheng People's Hospital from January 2018 to December 2019 were included in this study. They were divided into an observation group (with cognitive impairment, n = 68) and a control group (without cognitive impairment, n = 92) according to whether they had cognitive impairment. General data, blood glucose, NSE and BDNF levels were compared between the two groups. Multivariate logistic regression analysis was used to analyze the correlation between cognitive impairment and each factor after ischemic small-artery stroke. Results:There were no significant differences in gender, age, course of disease, body mass index, history of hypertension, hyperlipidemia, history of type 2 diabetes mellitus, history of smoking, and history of drinking between the two groups (all P > 0.05). The National Institute Health of Stroke Scale (NIHSS) score in the observation group was significantly higher than that in the control group [(18.86 ± 4.08) points vs. (14.27 ± 2.66) points, t = 6.664, P < 0.05], and the Mini-Mental State Examination (MMSE) score in the observation group was significantly lower than that in the control group [(21.45 ± 3.03) points vs. (24.28 ± 3.32) points, t = 4.452, P < 0.05]. There were no significant differences in glycosylated hemoglobin, fasting blood glucose, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol levels between the two groups (all P > 0.05). There were significant differences in oxidized low-density lipoprotein (ox-LDL), NSE and BDNF levels between the two groups. The ox-LDL [(44.8 ± 7.6) mmol/L] and NSE [(26.5 ± 9.5) ng/mL] levels in the observation group were significantly higher than those in the control group [(35.9 ± 4.7) mmol/L, (11.6 ± 6.9) ng/mL, t = 7.04, 8.973, both P < 0.05]. BDNF level in the observation group was significantly lower than that in the control group [(5.1 ± 1.8) ng/mL vs. (6.3 ± 2.4) ng/mL, t = 2.828, P < 0.05]. Multivariate logistic regression analysis showed that ox-LDL and NSE levels and NIHSS score were independent risk factors of cognitive impairment after ischemic small-artery stroke (all P < 0.05), and BDNF level and MMSE score were independent protective factors (all P < 0.05). Conclusion:Cognitive impairment was correlated with NIHSS score, MMSE score, ox-LDL, NSE and BDNF levels in patients with ischemic small-artery stroke. ox-LDL and NSE levels as well as NIHSS score were independent risk factors and BDNF level and MMSE score were independent protective factors of ischemic small-artery stroke.

Objective To analyze the distribution characteristics and influencing factors of brachial-ankle pulse wave velocity (baPWV) in elderly population in order to direct the early diagnosis and prevention of arteriosclerosis in the elderly.Methods A total of 927 cases of elderly residents were randomly selected from 19 villages in Shengze area,Jiangsu Province.The indexes such as age,gender,height,weight,waist circumference,hip circumference and blood pressure were collected through standardized questionnaire and physical examination.The biochemical indicators including serum bilirubin,creatinine,uric acid,fasting blood glucose and blood lipids were measured,and baPWV was tested by automatic arteriosclerosis measurement system.Results The differences in age,systolic blood pressure,heart rate,serum bilirubin,creatinine,uric acid,triglycerides levels and baPWV were statistically significant between the male and female (all P＜0.05).BaPWV rised with the increase of age.Overall,baPWV was faster in the female than in male (P＜0.01).Blood pressure (r=0.36,0.59,P＜0.001),age (r=0.26,0.30,P＜0.001) and heart rate (r=0.30,0.33,P＜ 0.001) were correlated with baPWV,while uric acid had a correlation with baPWV (r=0.12,0.21,P＜0.01).A correlation was found between total cholesterol and baPWV (r=0.09,0.11,P＜0.05) Multi-variable linear stepwise regression analysis showed that systolic blood pressure,heart rate and age were the influencing factors for baPWV,of which systolic blood pressure had the greatest influence on baPWV (β＞0.5,P＜0.001).Conclusions With the increase of age,the baPWV shows rising trend.The monitor of baPWV may be useful in the elderly,especially in females.Blood pressure control,especially the control of systolic blood pressure can slow the progression of atherosclerosis.

Objective To observe the effects of dexmedetomidine hydrochloride on the cisatracurium-induced neuromuscular blockade in geriatric, young and middle-aged patients. Methods Forty elderly patients and forty young and middle-aged patients undergoing elective abdominal surgery under general anesthesia were randomly divided into 4 groups ( n=20 each):elderly dexmedetomidine hydrochloride group (group DE),elderly control group (group CE),young and middle-aged dexmedetomidine group (group DY) and young and middle-aged control group (group CY).In groups DE and DY,a loading dose of 0.5 μg?kg-1 dexmedetomidine was intravenously infused over 10 min before induction of anesthesia,respectively,followed by infusion at a rate of 0.4μg?kg-1?h-1 until the end of surgery.Equal volume of 0.9% sodium chloride was given in groups CE and CY.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium 0.15 mg?kg-1.Four groups were maintained with infusion of propofol and remifentanil. Neuromuscular blockade was maintained with continuous cisatracurium infusion in the four groups and was monitored with TOF-Watch SX acceleromyography at the adductor pollicis.The onset time,TOF no reaction period,duration of action,the amount of cisatracurium consumption,and the spontaneous recovery index ( T1 25% to 75%) were recorded. Results The four groups were comparable in the demographic data.Intubation conditions,the onset time and recovery index were not significantly different among the four groups. The duration of blockade action in groups DE and DY was ( 61. 1 ± 8.9) min and (53.6±9.3) min,which was significantly longer than that in group CE [(49.9±5.8) min] and group CY [(44.8± 6.4) min] (P<0.01).The duration of blockade action was significantly longer in groups DE and CE than in groups DY and CY (P<0.05).The amount of cisatracurium consumption in groups CE and CY was significantly higher than that in groups DE and DY (P<0.05). Conclusion The neuromuscular blockade is longer and the requirement of cisatracurium is less in elderly patients than in young and middle-aged patients.Continuous infusion of dexmedetomidine hydrochloride can't accelerate the onset time of cisatracurium.But duration of action is prolonged and the amount of cisatracurium consumption is lower in patients with infusion of dexmedetomidine hydrochloride.