Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

For probing into therapeutic effect, action, and proper and effective administration way of Jiang Ni Fu Sheng Liquid for treatment of acute cerebral hemorrhage, 150 cases were assigned at random to two groups to receive different therapies. Integral of hyponeuria, change of disturbance of consciousness, change of blood pressure, CT and clinical therapeutic effect were observed before and after treatment in the two groups. Results showed that the therapeutic effect in the treated group was obviously superior to that in the control group, with a markedly effective rate of 51. 1% and an effective rate of 90. 0%. It is suggested that Jiang Ni Fu Sheng Liquid has the action of relieving disturbance of consciousness, promoting recovery of nervous function, keeping stability of blood pressure, accelerating absorption of cerebral hemorrage, alleviating cerebral edema and hemorrhage of digestive tract, and so on.

Objective To explore the short- term efficacy of argon- helium knife cryotherapy followed by chemotherapy in treating advanced non- small cell lung cancer (NSCLC) and to investigate its effect on the long- term survival. Methods During the period from March 2005 to March 2008, a total of 61 patients withⅢb or Ⅳ stage NSCLC received argon- helium knife cryotherapy followed by chemotherapy (study group), and other 52 patients with Ⅲb or Ⅳ stage NSCLC were treated with chemotherapy only (control group). The clinical data were retrospectively analyzed. The pain was evaluated by numeric rating scale (NRS) and the quality of life (QOL) was assessed by functional assessment of cancer therapy- general (FACT- G) scale. The clinical effect was evaluated according to RECIST criteria for solid tumor, and the patient’s survival time was recorded. Results (1) Twenty- six patients had local pain before the treatment, and the pain was relieved in different degrees after cryotherapy. The QOL, including all respects of FACT - G, was significantly improved after cryotherapy in all 61 patients. (2) The remission rate of the study group and the control group was 34.4% and 15.4% respectively, the difference between the two groups was statistically significant (P <0.05). (3) The median survival time of the study group and the control group was 12.9 months and 9.5 months respectively, and the one- year survival rate of the study group and the control group was 53.6% and 35.4% respectively. The differences between the two groups were statistically significant (P < 0.01). Conclusion Argon- helium knife cryotherapy is a safe and effective local treatment for advanced NSCLC, which can quickly reduce the tumor load, relieve the pain and improve patient’s quality of life. Cryotherapy with subsequent chemotherapy is superior to simple chemotherapy in improving the patient’s survival rate.

To study the effects of Feiyanning Decoction, a compound traditional Chinese herbal medicine, on the ratio of CD4(+)CD25(+) regulatory T cells and expression of transcription factor Foxp3 in mice with Lewis lung cancer.

To study the effect of Feiyanning Decoction (FYN), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) activated by tumor necrosis factor-α (TNF-α) in human lung adenocarcinoma epithelial cell line (A549).

Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.

OBJECTIVE To analyze the prophylactic application of antibiotics during perioperative period in surgical department and provide the scientific basis for management and rational application of antibiotics.METHODS The rational use of antibiotics during perioperative period was evaluated based on antibiotics selection,usage,dosage,the first time of application,treatment course,and the percentage of antibiotic application for cleaning operation.RESULTS All of surgical operations were used antibiotics.As for the first time of application,the use rate of thirty minutes before operation was 4.1%,but nothing used before operation was 73.2%.The treatment period after operation within 3 days was 8.1%.Among all kinds of used antibiotics,the third generation of cephalosporin accounted for 49%,and quinolones for 25%.CONCLUSIONS There are still some problems about prophylactic application of antibiotics during perioperative period in surgical department in our hospital.It is necessary to standardize application of antibiotics during perioperative period.

Objective To evaluate the diagnostic significance of ECG and coronary arteriography (CAG) in coronary heart disease in different age groups. Methods totally 216 cases of suspected or CAG-confirmed coronary heart disease were retrospectively analyzed. The non-elderly group included patients aged 45-59 years, and the elderly one was older than 60. Patients in each group were further divided into subgroup A and B with or without the pain in heart front area, respectively, accompanied by ST-T change in ECG. Comparative analysis of CAG and ECG changes was done between different age groups, and between subgroup A and B. The history of pain in heart front area, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), platelet count (PLT), and fibrinogen (Fg) were also analyzed for clinical diagnosis. Results In the non-elderly, positive CAG was 88.8% in subgroup A while 56.3% in group B ( P0.05). TC, LDL-C, and Fg were significantly higher in subgroup A than in subgroup B for the elderly group. But in non-elderly, TC, TG, LDL-C, and Fg in subgroup A were significantly higher than those in subgroup B(all P0.05). The history of pain in heart front area was longer in the elderly, and also in this age group, more patients showed multivessel involvement. Conclusions ST-T change of ECG accompanied by classical pain in heart front area is more valuable than single ST-T change in the diagnosis of coronary heart disease, especially among non-elderly patients. ST-T change could not be used simply as a tool to diagnose coronary heart disease. The diagnosis should be made generally considering the typical symptom of the pain in heart front area, clinical history, TC, TG, LDL-C, and Fg. CAG could increase the positive diagnostic rate of coronary heart disease and decrease the rate of misdiagnosis as well.