Objective To observe the effect of monosialoteterahexosyl ganglioside (GM1) combined with Shuxuening injection on nerve function in patients with acute cerebral infarction (ACI) and its mechanism.Methods A total of 94 patients with ACI admitted to the Department of Neurology in Xiangyang First Peoples' Hospital Affiliated to Hubei Medical College from January 2013 to June 2016 were enrolled,and they were divided into two groups by random number table,each group 47 cases.The patients in two groups were all given conventional western medicine treatment;The patients in one group (single group) were treated by intravenous (Ⅳ) drip of GM1,100 mg once a day;and the patients in another group (combined group),by above GM1 Ⅳ drip combined with Shuxuening intramuscular injection,once 2 mL,twice a day;the therapeutic course in two groups was 14 days.Before and after treatment,the changes of China stroke clinical neurological impairment score (CSS score),glasgow coma score (GCS),nerve factor,oxidative stress index and hemodynamics index of two groups were observed.Results Compared with those before treatment,after treatment the CSS score,the levels of neuron specific enolase (NSE),and malondialdehyde (MDA) were significantly lower,while the GCS score,the levels of nerve growth factor (NGF),neurotrophic factor (NTF),maximum blood flow velocity (Vmax),minimum blood flow velocity (Vmin),mean blood flow velocity (Vmean),mean blood flow quantity (Qmean),glutathione peroxidase (GSH-Px),catalase (CAT) and superoxide dismutase (SOD) were all significantly higher in the combined group (all P ＜ 0.05).After treatment,the CSS score,levels of NSE and MDA in the combined group were significantly lower than those of the single group [CSS:11.20 ± 1.78 vs.16.24 ± 1.95,NSE (μg/L):13.17± 1.00 vs.17.68 ± 1.84,MDA (μmol/L):4.14±0.49 vs.5.61 ±0.50,all P ＜ 0.05],GCS score,NGF,NTF,GSH-Px,CAT,SOD,Vmax,Vmin,Vmean and Qmean of the combined group were all significantly higher than those of the single group [GCS:13.68± 1.85 vs.12.01±1.76,NGF (ng/L):88.10±8.83 vs.68.13±7.16,NTF (pg/L):5.13±0.38 vs.3.71±0.30,GSH-Px (U/L):128.13±8.07 vs.103.90±6.58,CAT (U/L):25.74±2.15 vs.19.43± 1.84,SOD (μU/L):94.36±8.00 vs.77.29±7.34,Vmax (cm/min):48.23±3.36 vs.43.17±2.88,Vmin (cm/'min):8.11±0.76 vs.6.85 ± 0.64,Vmean (cm/min):18.69 ± 1.37 vs.15.60 ± 1.24,Qmean (mL/min):9.10 ± 0.74 vs.7.79 ± 0.66,all P ＜ 0.05].Conclusions GM1 combined with Shuxuening injection can improve nerve function in patients with ACI by improving brain blood flow,secreting neurotrophic related factors and inhibiting oxidative stress reaction,thus it has important clinical significance for repairing the damaged nerve function.

Objective To observe the effects of treating acute ischemic stroke in rats with interventional administration of nitric oxide precurcer L-Arginine or nitric oxide donor nitroglycerin.Methods The right middle cerebral arteries of rats were occluded by insertion of a suture to duplicate ischemia-reperfusion models.Forty-two male SD rats were randomly divided into four groups: MCAO group(n=12);sham operation group(n=6);NG group(n=12) and L-ARG group(n=12),intracarotid arteries administrated respectively by NS、NS、NG and ARG.Each of the four groups were subdivided into 2 groups according to the reperfusion time(3 h and 24 h),measurement of Longa scores,NO2-/NO3-in serum,HE staining and immunohistochemical(SABC)method were utilized to assess the changes of ischemic brain tissues in different groups.Results OX-42 positive cells of cortex and CA3 area of hippocampal: OX-42 positive cells were found,their features identified at 3 h after reperfusion.24 h the response of microglias was obvious,the number of the cells increased(P

Objective To evaluate the efficacy of integrated traditional Chinese medicine(TCM)and western medicine in treatment of acute exacerbations of chronic obstructive pulmonary disease(AECOPD)combined with respiratory failure,TCM syndromes of spleen-kidney-yang deficiency and phlegm-dampness by comparison between the integrated therapy and simple western therapy in treatment of the disease. Methods 160 patients with AECOPD combined with respiratory failure,spleen-kidney-yang deficiency and phlegm-dampness syndrome in the intensive care units(ICU)of Affiliated Hospital of Chengdu University of TCM and other four hospitals were randomly allocated into two groups in this double-blinded,multicenter,prospective,randomized,controlled trial. In the control group (78 cases),western medicine and placebo were given to the patients,and in the treatment group(82 cases), conventional western medicine plus fei-shuai mistura 25 mL were administered,four times per day,the therapeutic course lasting for 2 weeks in both groups. The all-cause mortality,respiratory failure-cause mortality,improvement of modified Medical Research Council(mMRC)Dyspnea Scale grades,6 minutes walk distance(6MWD),the forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)were observed in the 28 days after the end of treatment. Results In the comparisons between the control and treatment groups,there were no statistical significant differences in the all-cause mortality〔54.87%(45/82)vs. 64.10%(50/78)〕and the cases of FEV1/FVC(both P>0.05)in the 28 days after the end of treatment;the 28 day respiratory failure-cause mortality was significantly decreased〔19.51%(16/82)vs. 33.33%(26/78),P<0.05〕,the number of patients with mMRC Dyspnea Scale grades (1-2)was obviously increased(22 cases vs. 7 cases,P<0.05),and the number of patients with 6 MWD grades (4-6)was markedly enhanced in the treatment group(21 cases vs. 8 cases,P<0.05). Conclusions The integrated TCM and western medicine has better therapeutic results in improvement of the patients' degree of dyspnea, 6 MWD and respiratory failure mortality than simple treatment with western therapy for treatment of patients with AECOPD combined with respiratory failure, spleen-kidney-yang deficiency and phlegm-dampness syndrome. However,in regard to the effect on pulmonary function and all cause mortality,the integrated therapy for treatment of such patients in short term has no significant effect.

Objective To investigate the imaging features of the nigrosomes-1 region in the substantia nigra at 3.0 T with enhanced gradient echo T2 star weighted angiography(ESWAN), and to explore its clinical value in the evaluation of Parkinson disease (PD). Methods Fifty-four patients diagnosed with PD (PD group), and 51 non-PD volunteers (N-PD group) were scanned with 3.0 T ESWAN, who had selected randomly. The widths of the typical high signal correspondence with the nigrosomes-1 region (a), the width at the middle of the substantia nigra (b) and the width of the banded high signal of which the oval structure were not displayed (c) were measured and collected. The result of reclassification performed by 2 physicians were compared with clinical gold standard. Specificity and sensitivity were calculated; Eleven outpatients with clinically suspected PD but undiagnosed (UD group) were continusouly selected. They received the same scanning and were performed with imaging diagnosis according to the conclusions of previous studies, then compared the imaging diagnosis with the final clinical diagnosis. Results In non PD group, hyperintensity of nigrosomes-1 were shown in 49 cases (96.1%) in bilateral or unilateral of the SN, the hyperintensity were shaped as“drop”, wedge or oval and the average size (a/b) was (0.31 ± 0.07)mm approximately; PD group, all 54 cases (100.0%) of the oval rear the“drop”were completely disappeared. The sensitivity of the loss of the hyperintensity of nigrosomes-1 for the diagnosis of PD was about 100.0%(54/54)and the specificity of it was about 96.08%(49/51). In UD group, 7 cases with the“drop”completely missed and 1 case with smaller“c”were clinically proven to PD, 2 cases with the typical hyperintensity and 2 case with larger“c”were proven to Parkinson plus syndrome. Conclusions The nigrosomes-1 typical hyperintensity in PD patients' substantia nigra on the 3.0 T ESWAN are disappeared. There may be an effective method for PD and Parkinson's plus syndrome identification that by analyzing of the presence or absence of the typical hyperintensity and its size in the patients with symptoms of PD.

Objective To explore the relationship between the levels of Cu, Fe, Mn, Zn in serum and Parkinson disease (PD). Methods A total of 40 patients with PD (PD group) and 40 control subjects (control group)were enrolled in this study. Serum levels of Mn were measured by graphite atomic absorption, and Cu ,Fe, Zn were measured by inductively coupled plasma(ICP)mass spectrometry. Resudts There were significantly increase in the levels of Mn and Fe in PD group than those in control group [(0.269±0.326) μ mol/L vs (0.125±0.054) μmol/L, P< 0.05, (1.512±0.949) μmol/L vs (0.676±0.111) μmol/L, P< 0.01)]. There were no significant difference in the levels of Cu and Zn between two groups (P> 0.05). Condusion Micreelements may play important roles in pathogenesis and development of PD, especially Fe and Mn.

Objective To investigate the 3D reconstruction of multislice spiral CT technology applications in the diag-nosis and postoperative ankle fracture assessment. Methods DR using X-ray and 3D reconstruction of multislice spiral CT technique in patients with ankle fractures preoperative examination and classification, for review after observing the quality of reduction and fixation into quality. Results Preoperative DR typing results compare with intraoperative find-ings, PAB, PER, SAB SER type Kappa values were 0.76, 0.80, 0.77, 0.75, had a good consistency . Preoperative CT reconstruction with intraoperative findings result of the comparison , PAB, PER, SAB SER type Kappa values were 1, 0.92, 0.90, 0.90, excellent consistency, CT reconstruction typing and intraoperative findings consistent results. The sensitivity and specificity were far superior to DR. DR and CT reconstruction after treatment in PAB, PER, SER type reset mass were significantly different (P<0.05), CT three reconstruction PER, fixed into the SER type mass was signif-icantly different (P<0.05). Conclusion Spiral CT reconstruction of ankle fracture before surgery and postoperative re-duction treatment, quality assessment and internal fixation into a higher accuracy than the X-ray examination, and more reliable.

Objective To describe the evolution of oculomotor nerve paresis (ONP) after endovascular packing of posterior communicating artery aneurysms (PcomA) to prospectively evaluate the effect of mecobalamine treatment on ONP prospective recovery.Methods A total of 56 patients with ONP attributable to PcomA,treated with coils in our hospital from July 2007 to January 2013,were enrolled in a randomized,controlled open study,and 55 of them got follow up;embolization+mecobalamine treatment was performed in 28 and embolization treatment was in 27.The degrees of ONP were recorded one year after treatment.Results All patients succeeded in one year follow-up; 31 patients (56.4％) achieved complete resolution of ONP,19 (34.5％) partial improvement and 5 (9.1％) no changes.The complete recovery rate in the embolization+mecobalamine treatment group was 71.4％ (20/28) and that in the embolization treatment group was 40.7％ (11/27),with statistically significant differences (P＜0.05).Conclusion Endovascular treatment is highly efficacious in treating ONP-inducing PcomA and mecobalamine treatment can promote the recovery of oculomotor nerve palsy after embolism.

Objective To investigate the clinical characteristics of posterior communicating artery (PcomA) aneurysm-induced oculomotor nerve paresis (ONP) before and after endovascular coiling,and provide a reference for diagnosis,treatment and prognosis of PcomA aneurysm-induced ONP.Methods A total of 55 patients with ONP attributable to PcomA,admitted to our hospital from July 2007 to January 2013,were chosen in our study;their clinical data and postoperative recovery were retrospectively analyzed to investigate clinical characteristics of ONP attributable to PcomA.Results The average preoperative paralysis time was 12.24±5.33 days in patients with complete preoperative paralysis and 8.90±3.51 days in patients with incomplete preoperative paralysis with significant difference (P=0.014).Of the 55 patients,31 (56.36％) had complete recovery ofoculomotor nerve function,19 incomplete recovery (34.55％),and 5 (9.09％) remained unchanged after endovascular treatment.Most patients (41/50) began to improve in 3 months after endovascular treatment.The complete recovery ratio between patients encountered improvement of ONP within 30 days and over 30 days had statistical differences (P=0.032).Of 31 patients received complete resolution of ONP at the end of the follow-up,25 (80.65％) fully recovered 6 months after endovascular treatment.Thirty patients (96.77％) fully recovered within one year of endovascular treatment.One (3.23％) received complete resolution of ONP over one year of operation.Within 31 patients encountered complete resolution of ONP,there were 24 patients (77.42％) whose duration of recovery was less than 3 months and 7 patients (22.58％) more than 3 months.Functional recovery was noted firstly in the levator palpebrae muscle,followed by the medial rectus muscle,superior rectus muscle,constrictor muscles of the iris,and ciliary muscle.Patients with incomplete recovery often had residual diplopia in upward gaze and pupillary dysfunction.Conclusions The degrees of oculomotor nerve palsy before endovascular coiling are significantly associated with the paralysis time.Endovascular treatment can promote the recovery of PcomA-induced ONP.The earlier the ONP starting improvement,the better the ONP recoverary after endovascular treatment.The muscles which functional damage occurs early will encounter improvement lately.

Objective To analyze the causes of acute intestinal obstruction after intracerebral hemorrhage,and the therapeutic effect of rectal dripping with Dachengqi decoction and Fusu agent on acute intestinal obstruction complicated with septic shock.Methods The clinical data of a patient with acute intestinal obstruction complicated with septic shock after intracerebral hemorrhage,who was admitted to the Hospital of Chengdu University of Traditional Chinese Medicine(TCM)on March 5,2022,were retrospectively analyzed.The study aimed to observe the effects of rectal dripping with TCM on the recovery of intestinal function and improvement of shock.Results The patient was a 52-year-old male who underwent"left temporal craniotomy intracranial decompression,craniocerebral hematoma removal,cerebrospinal fluid leak repair"on February 19,2022 due to cerebral hemorrhage.On the 7th day after operation,the patient had hiccups and abdominal distension,and after treatment,the patient developed fever,consciousness disorders,hypotension and other symptoms.Abdominal CT showed extensive intestinal fluid,gas and expansion.Hemodynamic monitoring indicated high discharge and low resistance,intra-abdominal pressure was 21 cmH2O(1 cmH2O≈0.098 kPa),and laboratory examination showed increased inflammatory indexes and abnormal biochemical indexes.The western medicine diagnosis was acute intestinal obstruction complicated with septic shock,and the symptomatic treatments such as organ support(lung,circulation,kidney),anti-infection,fluid resuscitation,analgesia and sedation were given.The TCM diagnosis was intestinal knot(yangming visceral substantive,sudden collapse of yang-qi),with treatment principles focusing on tongfu heat relief,wenshen qianyang,Dachengqi decoction and Fusu agent was added and reduced according to the syndrome differentiation,with medications administered rectally.After the use of TCM decoction,the patient's defecation volume increased significantly,the intra-abdominal pressure decreased to the normal range,abdominal distension was significantly reduced,and the shock was relieved.On the 17th day after the operation,the patient's symptoms improved,the respiratory cycle was stable,and the patient was successfully transferred out of intensive care unit(ICU).Conclusion The treatment of acute intestinal obstruction complicated with septic shock by rectal dripping with Dachengqi decoction and Fusu agent can quickly relieve the condition and promote the recovery of intestinal function.

Objective To analyze the distribution of traditional Chinese medicine (TCM) syndromes and characteristics of patients with acute respiratory distress syndrome (ARDS), and to provide reference for further clinical study of ARDS. Methods The clinical data of ARDS patients admitted to the Department of Critical Care Medicine of Affiliated Hospital of Chengdu University of TCM from November 2017 to February 2019 were retrospectively analyzed. The general data (gender and age) and inducing cause of disease, clinical manifestations, intensive care unit (ICU) stay time, total hospitalization time, outcome in ICU, outcome in 28-day follow-up and TCM syndromes were recorded. The different degrees of disease severity, the clinical manifestations and distribution characteristics of TCM syndromes were analyzed. Results A total of 110 patients with ARDS were enrolled, including 2 patients in mild ARDS group, 33 patients in moderate ARDS group and 75 patients in severe ARDS group. In the etiology analysis of ARDS, infection was the commonest cause, including 46 cases of pulmonary infection (41.8%), 27 cases of sepsis (24.5%), 4 cases of abdominal cavity infection (3.6%), 2 case of urinary tract infection (1.9%), and 13 cases had surgical histories (11.8%). The stay in ICU was 9.00 (3.00, 18.00) days and the total hospital stay was 18.00 (10.00, 30.00) days. The mortality in ICU was 32.7% (36/110), and that in 28-day follow-up was 60.0% (66/110). The clinical symptoms of the patients in moderate and severe groups ARDS were mainly dyspnea, cough, fever, sputum, chest tightness, and palpitations, accounting for 75.0% (81/108), 43.5% (47/108), 28.1% (31/108), 26.9% (29/108), 22.2% (24/108) and 25.9% (28/108), respectively. Compared with the ARDS moderate group, the proportions of patients with dyspnea, cough and palpitation in severe ARDS group were significantly higher [80.0% (60/75) vs. 63.6% (21/33), 50.7% (38/75) vs. 27.3% (9/33), 33.3% (25/75) vs. 9.1% (3/33), respectively, all P < 0.05]. The main TCM syndromes were yang deficiency, exuberant heat-toxin, and wind-heat invading lung, accounting for 53.7% (58/108), 28.7% (31/108), and 25.0% (27/108) respectively. The proportion of patients with exuberant heat-toxin syndrome in severe ARDS group was obviously higher than that in the moderate ARDS group [34.7% (26/75) vs. 15.2% (5/33), P < 0.05], while the proportion of patients with wind-heat invading lung syndrome in moderate ARDS group was more than that in the severe ARDS group [42.4% (14/33) vs. 17.3% (13/75), P < 0.05]. Conclusion ARDS is a critical illness with high mortality and various complicated clinical symptoms, the TCM syndromes of ARDS are mainly yang deficiency, exuberant heat-toxin, wind-heat invading lung, and intermingling of deficiency and excess easily leading to collapse syndrome.