OBJECTIVETo compare the therapeutic effect of Astragalus and Angelica Mixture (AAM) on treating CKD patients according to different CKD primary diseases, staging and TCM syndromes.

METHODSA multicentre, open-label, and self control clinical design was used, and thirty-two patients in line with inclusive criteria were recruited. Based on maintaining their previous basic CKD treatment, patients additionally took AAM (Astragalus and Angelica each 30 g), once a day, three months consisted of one therapeutic course. Serum creatinine (SCr), estimated glomerular filtration rate (eG- FR), 24 h urinary total protein (UTP), plasma albumin (ALB), hemoglobin (Hb), and changes of TCM syndrome factor integrals were compared before treatment, at the end of month 1, 2, and 3. The differences in the aforesaid indices were compared between CKD patients with different CKD primary diseases (chronic glomerulonephritis, chronic renal tubulointerstitial disease, hypertensive renal damage), different CKD stages (CKD 3 and CKD 4), and patients of qi-blood deficiency syndrome (QBDS) and non-QBDS.

RESULTSAAM could improve 78.12% (25/32) patients' renal function. Compared with before treatment, SCr decreased (12.08% +/- 10.11%), eGFR increased (21.14% +/- 18.55%), and ALB increased (2.76% +/- 1.97%) at the end of 3-month treatment (all P < 0.05). As for TCM syndrome factor integrals, compared with before treatment, the integrals for qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome decreased, while the integrals for dampness heat syndrome and turbid-toxin syndrome increased (all P < 0.05). There was no obvious difference in all indices except the integral for hypertensive renal damage patients of yin deficiency syndrome (P > 0.05). The SCr decreasing percent was 19.82% +/- 8.30% for patients of non-QBDS and 5.24% +/- 10.75% for patients of QBDS. The latter was higher with statistical difference (P < 0.05). As for TCM syndrome factor integrals, the integral differences of qi deficiency and blood deficiency were obviously higher in patients of QBDS, when compared with patients of non-QBDS (P < 0.05).

CONCLUSIONAAM could improve the renal function of CKD patients, elevate their ALB levels, and ameliorate associated qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome, especially for CKD patients of QBDS.

Adolescent ; Adult ; Aged ; Angelica ; Astragalus Plant ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Treatment Outcome ; Yin Deficiency ; drug therapy ; Young Adult

Objective To assess the diagnostic value of CT-gnided pereutaneous fine-needle aspiration biopsy (FANB) for the space-occupying lesions of the pancreas. Methods The authors retrospectively reviewed the medical records of 68 patients with pancreatic lesions who underwent CT-guided percutaneous fine-needle aspiration biopsy. The lesions were located at the pancreatic head (n = 49), body (n = 12) or tail (n = 7). The maximum diameter of the 68 lesions ranged from 2 cm to 7 cm. The lesion's diameter was < 3 cm in 10 cases and was ≥ 3 cm in 58 cases. A 20-gauge fine-needle was used to puncture and to make the aspiration in all patients. Both plain and contrast-enhanced abdominal CT scanning were performed before the biopsy procedure. The technical key points of aspiration biopsy included selection of the appropriate cross-section, the entry of the needle, and multiple insertions in fan-like fashion with fast manipulation of puncture and aspiration. All biopsy specimens were sent for pathologic evaluation. Results All the lesions were safely and successfully punctured through the anterior approach without major complications. The technical success of needle puncturing was 100%. Of 68 patients, the pathological results obtained from the biopsy included malignant tumor in 46, benign lesion in 17 and no abnormal finding in 5, of which follow-up observation found no abnormality in 2 and malignant process was eventually confirmed in remaining three. The overall accuracy, specificity and sensitivity of the biopsy were 96%, 95% and 100%, respectively. The accuracy of CT-guided biopsy for malignant and benign lesions was 94% and 100% respectively (P > 0.05). The diagnostic accuracy for lesions larger than 3.0 cm (97%) or located at the pancreatic tail (100%) was a little higher than that for lesions smaller than 3.0 cm (90%) or located at the pancreatic head (96%) or body (92%), although the difference was not statistically significant (P > 0.05). No serious complications occurred in our series. Conclusion CT-guided percutaneous fine-needle aspiration biopsy is a safe and effective technique for the diagnosis and differentiation of the space-occupying lesions of the pancreas.

OBJECTIVETo explore the anesthetic effect of preemptive analgesia of frequency acupoint electrical stimulation on painless-induced abortion as well as its effect on anesthetics dosage.

METHODSNinety cases of early pregnancy who selected painless-induced abortion were randomly divided into two groups, 45 cases in each group. Frequency acupoint electrical stimulation at Ciliao (BL 32) and Shenshu (BL 23), disperse-densewave, 2 Hz/100 Hz in frequency for 15 to 20 min, was applied in the group A, which was followed by intravenous anesthesia of propofol. The intravenous anesthesia of propofol was applied in the group B. The blood pressure (BP), heart rate (HR) and SpO2 before, during and after surgery, anesthetic effect and dosage, waking time and adverse events were observed in the two groups.

RESULTSThe BP and HR during and after the surgery in the group A were not statistically different from those before the surgery (all P > 0.05). The BP was reduced and HR was slowed down during the surgery in the group B, which was significantly different from those before the surgery as well as those in the group A (all P < 0.05). The dosage of propofol was (114. 3-+6. 1) mg in the group A. obviously less than (193.2 +/- 8.9) mg in the group B (P < 0.05). The waking time was (5.6 +/- 1.2) min in the group A, obviously less than (10.1 +/- 3.9) min in the group B (P < 0.05). As for anesthetic effect, the incidence of Grade I in the group A was more than the group B (P < 0.05). The adverse events, including nausea, vomiting and contractions pain in the group A were evidently less than those in the group B (all P < 0.05).

CONCLUSIONThe preemptive analgesia of frequency acupoint electrical stimulation could significantly improve anesthetic effect of painless-induced abortion, reduce dosage of anesthetics, shorten waking time of surgery and guarantee the safety of surgery.

Abortion, Induced ; Acupuncture Analgesia ; Acupuncture Points ; Adult ; Electric Stimulation ; Female ; Humans ; Pain Management ; Pregnancy ; Young Adult

OBJECTIVETo explore the effective method of the prevention and treatment of procedural pain in dressing changes of burn wounds.

METHODSNinety patients of burn injury were randomized into 3 groups, 30 cases in each one. In the group A, fentanyl citrate injection was used at corresponding injury area, jiaogan (AH6a, sympathetic nerve), fei (CO14, lung), neifenmi (CO18, endocrine) on ear, 0.25 mL at each point. In the group B, fentanyl citrate injection was applied subcutaneously in the deltoid muscle, 1 mL. In the group C, 0.9% sodium chloride injection was applied subcutaneously in the deltoid muscle, 1 mL. The visual analogue scale (VAS) was used to evaluate the analgesic effect before, during and 10 min after dressing change in the patients of the three groups separately.

RESULTSIt was not different in VAS score before dressing change among the three groups (P> 0.05). Compared with that before dressing change, the pain was not significant and VAS score was not different during and after dressing change in the patients of the group A (both P>0.05), but the score in the patients of the group B and C was different significantly (all P<0.05). The VAS score during and after dressing change in the group A was lower than that in the group B and C (all P<0.05), and the score in the group B was lower than that in the group C (P<0.05).

CONCLUSIONFentanyl injection of small dose at auricular points achieves definite analgesic effect on procedural pain in dressing changes of burn wounds, superior to subcutaneous injection of fentanyl.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Burns ; complications ; therapy ; Female ; Fentanyl ; administration & dosage ; Humans ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Pain Measurement ; Young Adult

Aged ; Diagnosis, Differential ; Fibronectins ; metabolism ; Glomerulonephritis, Membranoproliferative ; pathology ; Humans ; Immunohistochemistry ; Kidney Diseases ; metabolism ; pathology ; Kidney Glomerulus ; metabolism ; pathology ; ultrastructure ; Male ; Microscopy, Electron

Objective Cryptococcosis is a potential life-threatening systemic mycosis with a heterogeneous susceptible popu-lation which is classified into three groups according to the current guidelines, including AIDS patients, organ transplantation recipients ( OTR) , and non-HIV-infected and non-transplant hosts ( NHNT) .This study aimed to discuss the influence of basic diseases on the clinical features and prognosis of NHNT cryptococcosis patients. Methods Using a retrospective cohort study design, we retrieved the clinical data about 73 NHNT cryptococcosis patients treated in Jinling Hospital.Based on the presence or absence of immunodefi-ciency or infection-increasing complications, we divided the patients into a basic disease group ( n=35) and a non-basic disease group ( n=38) and analyzed their clinical characteristics, chest radiographic features, laboratory results, and clinical outcomes. Results Compared with the non-basic disease group, the basic disease group showed a significantly higher incidence rate of disseminated disea-ses (62.9%vs 21.1%, P<0.01), more cases of patchy consolidation (47.4%vs 16.7%, P<0.05) and mixed lesion (31.6%vs 3.3%, P<0.05) in chest radiography, and a higher mortality (30.0%vs 5.3%, P=0.016). Conclusion Basic diseases have a great impact on the clinical features and prognosis of NHNT cryptococcosis.NHNT patients with basic diseases are susceptible to dis-seminated diseases with severer clinical symptoms and a higher mortality.

Background The surgery for femtosecond laser created laser in situ keratomileusis(LASIK)flaps has made great progression recent year,but the postoperative corneal wound healing and regeneration of nerve fibers after surgery are closely concerned.Objective This study was to compare and analyze the clinical outcomes between FEMTO LDV femtosecond laser flap and mechanical microkeratome Hansatome flap in LASIK.Methods A prospective case-controlled study was designed.The serial 38 myopic eyes of 38 patients were included from March through July,2010 in Henan Armed Police Force General Hospital.The patients were randomized into FEMTO LDV femtosecond laser assisted flap group(20 patients/20 eyes)and mechanical microkeratome Hansatome assisted flap group(18 patients/18 eyes)with the matched age,gender and refraction of spherical equivalent.HRT Ⅲ examinations were performed before surgery,1 week,1 month and 3 months after surgery to compare the morphological changes atthe center and margin of the flaps,and evaluate the similarities and differences of cellular morphology after surgery between the two approaches.Written informed consent was obtained from each patient prior to this medical trial.Results The best corrected visual acuity was ≥ 1.0 and the refract diopter was similar in both groups(+0.21 D±0.48 D and-0.04 D±0.54 D)1 month after LASIK.The corneal thickness was insignificant increased in the first week after LASIK,and the density of shallow stromal cells was decreased in 1 week,1 month and 3 months compared with pre-operation in the femtosecond laser assisted flap group(t =-27.99,-25.49,-28.87,P ＜ 0.01).In the Hansatome assisted flap group,significantly thickened corneal epithelium was seen in the first week after LASIK compared before LASIK(56.73 μm±2.47 μm versus 51.16 μm±1.11 μm)(t=9.29,P＜0.05),and the density of shallow stromal cells was decreased in 1 week,1 month and 3 months compared with pre-operation in the Hansatome assisted flap group(t =-17.57,-14.13,-19.63,P =0.00).The density of high reflective interface particles in cornea was lower in 1 week,1 month and 3 months after LASIK in the femtosecond laser assisted flap group than that in the Hansatome assisted flap group,showing significant differences between them(t =-13.505,-11.900,-14.084,P＜0.01).The active stromal cells were seen beneath the interface in both groups in the first week and gradually decreased after that time.Intact corneal nerve fibers were found in the femtosecond laser assisted flap group,but those in the Hansatome assisted flap group were shorter and smaller 3 months after LASIK.At 3 months after surgery,the flap margin showed stromal higher reflection and irregular secondary fibrosis in the femtosecond laser assisted flap group,and in contrast,the flap margin had the appearance of a unclearly identified fibrotic scar in the Hansatome assisted flap group.Conclusions Compared with the LASIK and Hansatome assisted flap,the LASIK with FEMTO LDV flap shows earlier nerve fiber regeneration and greater fibrotic scarring,which imply a good wound healing process in the LASIK with FEMTO LDV flap.

Objective To introduce and evaluate a new surgical technique about concealed penis.Methods The incision was chosen on the outer lamina of the bilateral sides of penis.The excision of fibrous cord of penis dartos and suprapubic fat pad and skin fixation on the penis root were done to the patients.For the severe patients,the superficial layer of the suspensory ligament of penis must be excised.Thirty-nine cases were treated with this new technique,22 cases with Devine technique,and 23 cases with modified Shiraki technique and clinical comparative research was carried out.Results Penis of 39 cases were found 2 to 3 centimeters pro-pubic projection.Within 3 to 36 months of follow-up,no obvious reduction of penis was found and the erection function was normal.By new evaluat standard of surgical efficacy,the clinical efficacy of new technique,Devine′s and modified Shiraki′s technique were 92.31%(36/39 cases),77.27%(17/22 cases) and 78.26%(18/23 cases),respectively and the efficacy rate in new technigue was significcmthy higher than that of Devines and modified Shirak′s groups(Pa

Objective To investigate the influences of psychological rehabilitation nursing on immune function in post stroke depression patients.Methods A total of 80 elderly patients with post stroke depression were recruited from the inpatients in geriatric neurology department at Tianjin Medical University General Hospital.All patients were divided into two groups:the control group received only conventional and auxiliary exercise therapy for 3 months; rehabilitation group received psychological rehabilitation nursing added to the above therapy for 3 months.Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function were detected at recruit and three months after treatment.Results There were no statistically significant differences in clinical data between the rehabilitation group and control group (all P＞0.05).There were no statistically significant differences in Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function between rehabilitation group and control group before treatment (all P＞ 0.05).Compared with control group,the rehabilitation group showed that the Barthel Indexes were increased (P=0.000),Hamilton Depression Sale (HAMD) scores were decreased (P=0.000),the levels of T lymphocyte subpopulation (P＜ 0.05) and immunoglobulin (P＜ 0.01) were increased after three months treatment.Conclusions The combination treatment of psychological rehabilitation nursing,auxiliary exercise and drug are helpful to recover immune function and improve the quality of life in patients with post stroke depression.

Objective To determine the relationship between the serum level of β2-microglobin (β2-MG)and international prognostic index (IPI) and investigate the role of IPI in predicting the prognosis and making individualized therapy for peripheral T-cell lymphoma (PTCL).Methods Eighty-one patients with PTCL were treated by standard CHOP regimen.The clinical characteristics,response,long-term surival rates and the relationship between serum level of β2-MG and IPI scores were analyzed retrospectively.Results Eighty-one patients were eligible.All of them were treated by CHOP regimen.The overall response rate (RR) was 82.7 ％ with 53.1％ complete remission (CR) rate.The RR of IPI low risk,low-intermediate risk,high-intermediate risk,and high risk were 95.7 ％,87.5 ％,53.8 ％ and 20.0 ％,with CR rate 74.5 ％,37.5 ％,15.4 ％ and 0,respectively (P ＜0.05).The median survival times (MST) were 31.2 months at a median follow-up of 30 months (2-98 months).The acturial 1-,3-,and 5-year overall survival (OS) rates were 83.5 ％,41.8 ％ and 34.7 ％,respectively.The 5-year OS rates of low risk,low-intermediate risk,high-intermediate risk,high risk were 57.3 ％,55.9 ％,0 and 0,respectively (P ＜0.05).The OS rates of low risk group (IPI 0-2 scores) and high risk group (IPI 3-5 scores) were 54.8 ％ and 0,respectively (P ＜0.05).Serum levels of β2-MG were significantly elevated in the high risk group than those in the low risk group.The proportion of abnormal serum level of [β2-MG were also significantly elevated in the high risk group than those in the low risk group.The results of multivariante analysis showed that serum level of β2-MG and IPI scores were independent prognostic factors for PTCL (P＜0.05).Conclusion The serum level of β2-MG with IPI scores system can be uscd for evaluating the prognosis of PTCL patients.