Objective To observe the clinical effect of compound danshen dropping pills on the early diabetic kidney disease.Methods A total of 850 type 2 diabetes mellitus (T2DM) patients with diabetic nephropathy (DN) at stage Ⅲ who met the criteria for DN from January 2012 to July 2012,aged 60 to 75 years [mean age (66.6±4.8) years],were retrospectively analyzed and randomized into the treatment group (n=601) and the control group (n=249).All patients received rational hypoglycemic,antihypertensive,lipids-adjusting treatment and the treatment group received compound danshen drop pill (15 pills,tid),additionally.Laboratory indexes such as urine albumin (UA) and urine creatinine (UCR) were examined 24 weeks after treatment.Results The levels of UA and UCR,and the UA/UCR ratio (ACR) in the treatment group were decreased after versus before treatment.The decreases of UA and UCR had significant differences between the treatment and control group [(39.1±78.7) mg/L vs.(14.7±77.1) mg/L,(1.1±4.5) mmol/L vs.(-0.3± 3.6) mmol/L,t=4.15 and 4.86,both P＜0.01].Conclusions The comprehensive treatment combined with compound danshen dropping pills for 24 weeks can more effectively reduce UA and ACR,thereby it has effects in treating DN and delaying the progression of DN.

To research the action mechanism of Yiqi Huayu Bushen Recipe (YHBR), a compound of traditional Chinese herbal medicine, in treating cervical syndrome (CS) with kidney deficiency in rats.

To explore the mechanism of Yiqi Huayu Bushen Recipe (YHBR), a compound traditional Chinese herbal medicine, in treating cervical syndrome (CS) with qi deficiency, blood stasis and kidney deficiency in rats.

OBJECTIVE: To establish a rat model of cervical syndrome (CS) with kidney deficiency. METHODS: A group of 30 three-month-old female Sprague-Dawley rats were randomly divided into normal control group, CS group and CS with kidney deficiency group (combined group), with 10 rats in each group. Rats in the normal control group received no treatment, rats in the CS group underwent only resection of cervical muscles and ligaments as unbalanced dynamic and static animal model, and rats in combined group underwent resection of both cervical muscles and ovaries as kidney deficiency model. Serum and cervical intervertebral discs were collected. Kidney deficiency was determined by observing the morphologic changes of uterus and appendages, detecting the weight of uterus and appendages and the content of serum estradiol (E(2)). The degeneration of intervertebral discs was determined by detecting the histopathology, the expressions of type II collagen and type X collagen proteins, and the expressions of aggrecan-1 (Agc1), type II procollagen gene (Col2a1), matrix metalloproteinase-13 (MMP-13) and tissue inhibitor of metalloproteinases-1 (TIMP-1) mRNAs. RESULTS: Compared with those in the normal control group and CS group, the rats in the combined group were noted with the uterus atrophied, the caliber of oviduct thinned, the weight of uterus and appendages diminished obviously, the content of serum E(2) decreased, cervical intervertebral disc degenerated more seriously, type II collagen protein expression decreased, type X collagen protein expression increased, Agc1 and Col2a1 mRNA expressions in intervertebral disc decreased, and the MMP-13 mRNA expression increased. CONCLUSION: The rat model of CS with kidney deficiency is established. Kidney deficiency can aggravate cervical intervertebral disc degeneration.

To establish a rat model of cervical syndrome with qi deficiency, blood stasis and kidney deficiency.

Objective:To evaluate the efficacy of continuous infusion of lidocaine via urinary catheter for postoperative analgesia in patients undergoing urological surgery.Methods:Forty male American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients, aged 65-75 yr, with body mass index of 18-25 kg/m 2, scheduled for elective percutaneous nephrolithotomy, were divided into 2 groups ( n=20 each) using a random number table method: continuous infusion of lidocaine through urinary catheter group (group L) and patient controlled intravenous analgesia (PCIA) group (group PCIA). All the patients underwent total intravenous anesthesia, and a matched type of sterile urethral irrigation catheter was inserted after the operation.In group L, 0.5% lidocaine was continuously infused at a rate of 5 ml/h via the urinary catheter, while the equal volume of 0.9% normal saline was continuously infused via the urinary catheter, and PCIA was connected in group PCIA.PCIA solution contained sufentanil 125 μg (diluted to 250 ml in normal saline), and the PCA pump was set up with a 5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 5 ml/h.When visual analogue score was>4, sufentanil 0.05 μg/kg was injected intravenously as rescue analgesic.The development and severity of catheter-related bladder discomfort (CRBD) were recorded immediately at the end of the operation (T 1), and at 6 h (T 2), 24 h (T 3) and 48 h (T 4) after the operation, respectively.Riker sedation-agitation scale (SAS) score was recorded at T 1, 2, and QoR-9 scale was recorded at T 3, 4.The concentrations of serum cortisol (Cor), norepinephrine (NE), epinephrine (E) and blood glucose (Glu) were measured by enzyme linked immunosorbent assay.First off-bed time, exhaust time, length of hospital stay after surgery, and the requirement for rescue analgesia and adverse reactions (nausea and vomiting, respiratory depression, hypotension, skin itching) within 48 h after the operation were recorded. Results:Compared with group PCIA, the incidence of CRBD and the severity were significantly decreased at T 1-4, SAS score was decreased at T 1, 2, QoR-9 score was increased at T 3, 4, Cor, NE, E and Glu concentrations were decreased at T 1-4, the incidence of postoperative rescue analgesia was decreased, first off-bed time, exhaust time and length of hospital stay after surgery was shortened, and the incidence of postoperative nausea and vomiting, respiratory depression, hypotension, skin itching was decreased in group L ( P<0.05). Conclusion:Continuous infusion of lidocaine through the urinary catheter can provide good postoperative analgesia, reduce postoperative stress response and adverse reactions, and facilitate early postoperative recovery in patients undergoing urological surgery.

Kartagener syndrome is a rare autosomal recessive disease with low incidence.Clinically,typical visceral inversion,bronchiectasis and sinusitis triad are typical.The pathogenesis of the disease is not clear.The principle of treatment is mainly symptomatic treatment,postponing the progress of bronchiectasis,Lack of fundamental treatment.The disease generally has a good prognosis.This article reviews recent advances in the diagnosis and treatment of Kartagener syndrome at home and abroad.

Objective To discuss thk curk kffkct and sidk kffkcts of donor anti-CD19 chimkric antigkn rkckp-tor T lemphocetks(CD19 CLA-T)for trkating rkcurrknt acutk B-ckll lkuckmia aftkr allogknkic hkmatopoiktic stkm-ckll transplantation(Lllo-HSCT),and to analezk thk influkncing factors for this thkrape. Methods Thk clinical data of 5 acutk B-ckll lkuckmia patiknts wkrk analezkd rktrospkctivkle who rklapskd aftkr Lllo-HSCT and rkckivkd donor CD19 CLA-T thkrape at Bkijing Childrkn＇s Hospital from Jule 2015 to Octobkr 2017. Diskask status bkfork infusion, conditioning rkgimkn,rkinfusion ckll dosk,and sidk-kffkct of CLA-T infusion,changks in thk rklatkd immunological indicators,and follow-up trkatmknt rksults wkrk invkstigatkd. ResuIts Onk patiknt had no kffkct,othkr patiknts got rk-mission or minimal rksidual diskask(MAD)nkgativk within 4 wkkcs aftkr CLA-T infusion,and thk middlk timk was 14 daes. Pkriphkral CLA-T pkac happknkd 2 wkkcs aftkr CLA-T infusion. Be thk last follow,2 patiknts dikd of lkuckmia, 3 patiknts wkrk alivk,and 1 cask of thkm livkd with tumor aftkr CD19 nkgativk rklapsk,othkrs livkd with diskask-frkk condition. Cetocink rklkask sendromk(CAS)was thk most common sidk kffkct,happkning in 1 to 2 wkkcs aftkr infusion, 1 patiknt had nkurologic toxicitiks,and 2 patiknts had suspicious graft -vkrsus -host diskask. ConcIusions Donor CD19 CLA-T thkrape has a good short-tkrm kffkct for rklapskd B -ckll lkuckmia patiknts aftkr Lllo -HSCT,but long-tkrm kffkct rkquirks furthkr obskrvation;CAS is thk most common sidk-kffkct. Off-targkt and ckll kxhaustion ark thk main rkasons for dkfkat.

Objective To evaluate the application effect of positive end-expiratory pressure(PEEP)guided by driving pressure on intraoperative oxygenation and postoperative complications in patients undergoing orthotopic liver transplantation(OLT).Methods A total of 118 patients underwent OLT from January 2020 to September 2023,89 males and 29 females,aged 18-70 years,BMI＜28 kg/m2,ASA physical status Ⅲ or Ⅳ.Patients were divided into two groups using the random number table method:drive pressure group(group D)and PEEP group(group P),59 patients in each group.Volume controlled ventilation was used during general anesthesia in two groups,I:E 1:2,VT 6 ml/kg(ideal body weight),RR 10-15 beats/minute.In group D,the PEEP titration test was started after 5 minutes of mechanical ven-tilation,gradually increasing PEEP from 2 to 10 cmH2O,selecting the PEEP that produced the lowest driv-ing pressure,and maintaining this PEEP until the end of the surgery.In group P,the PEEP was maintained at 5 cmH2O during surgery.The amount of intraoperative out put and intake,and the use of vasoactive drugs were recorded.The HR,SBP,DBP,peak airway pressure(Ppeak),airway plateau pressure(Pplat),PEEP,and blood gas analysis results were recorded 5 minutes after intubation(T1),during the anhepatic phase(T2),during the neohepatic phase(T3),and at the end of the operation(T4),and driving pres-sure,dynamic pulmonary compliance(Cdyn),oxygenation index(OI),and dead space fraction(VD/VT)were calculated.The occurrence of postoperative pulmonary complications(PPCs)within 7 days after opera-tion was recorded.Results Compared with group P,the amount of crystalloid and the usage frequencies of norepinephrine,phenylephrine,and epinephrine in group D were significantly increased(P＜0.05).Com-pared with T2,HR was significantly decreased,SBP and DBP were significantly increased at T1,T3,and T4 in the two groups(P＜0.05).Compared with T1,Ppeak,Pplat,driving pressure,and OI were signifi-cantly increased at T2-T4,and Cdyn was significantly decreased at T3 and T4 in the two groups(P＜0.05).Compared with group P,the incidence of PPCs in group D was significantly decreased(P＜0.05).There were no significant differences in other indexes between the two groups.Conclusion The driving pressure guided PEEP ventilation improves intraoperative oxygenation and reduces the incidence of PPCs in patients undergoing OLT,but the use of intraoperative vasoactive drugs increases.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.