AIM To observe the curative effects of Modified Buzhong Yiqi Decoction (Codonopsis Radix,Astragali Radix,Atractylodis macrocephalae Rhizoma,ect.) on perioperative period of intertrochanteric fractures in elderly patients with Qi deficiency and blood stasis type.METHODS One hundred and twenty cases of elderly intertrochanteric fractures were randomly divided into treatment group and control group,60 cases in each group.All patients underwent closed fracture reduction and proximal femoral nail anti-rotation (PFNA) fixation.During the perioperative period,the control group only received conventional treatment,while the treatment group received conventional treatment and Modified Buzhong Yiqi Decoction once a day.The levels of interleukin-6 (IL-6),interleukin-10 (IL-10) and tumor necrosis factor (TNF-α) of both groups in preoperative and in the 1st day,the 7th day,the 14th day of postoperative were observed and compared.The complications and the curative effects according to the Harris score also were observed and compared between the two groups.RESULTS In preoperative,there was no significant difference in levels of IL-6,IL-10 and TNF-α between the two groups (P ＞ 0.05).The levels of IL-6 and TNF-α in the 1 st day of postoperative in the control group were significantly higher than those in the treatment group (P ＜0.05,P ＜0.01).And the levels of IL-10 were similar between the two groups (P ＞0.05).In addition,in the 7th day and the 14th day of postoperative,the levels of IL-6,IL-10 and TNF-α in both groups were all decreased,moreover,the descent degree in treatment group was more significant than those in the control group (P ＜ 0.05,P ＜ 0.01).The treatment group had the lower incidence of complications and the higher curative effects than those in the control group,both differences were statistically significant (P ＜0.05).CONCLUSION Modified Buzhong Yiqi Decoction applying to the perioperative period of femoral intertrochanteric fractures in elderly patients with Qi deficiency and blood stasis,can effectively reduce the perioperative inflammatory response,reduce the incidence of postoperative complications,and improve the curative effects.So it has a positive effect on the rehabilitation for the traumatic patients and is worthy of clinical promotion.

Objective To analyze the death trend of children under 5 years old in Lanzhou and establish the time series model to predict the mortality and incidence of children under 5 years old in Lanzhou in 2019. Methods Descriptive epidemiological method was used to analyze the mortality of children under 5 years old in Lanzhou from January 2010 to December 2018. SPSS 21.0 software was used to construct time series analysis model, selecting the best model and predict the mortality of children under 5 years old in Lanzhou in 2019. Results A total of 1 650 deaths of children under 5 years old were reported in Lanzhou from 2010 to 2018. The number of deaths reported by boys and girls was 871 and 774 respectively, with an average annual mortality rate of 6.23‰. In recent years, the overall mortality rate of children under 5 years old in Lanzhou had declined. The majority of deaths among children under 5 years old were neonates, accounting for 65.27%. Simple seasonal model was the best model by comparing different models. The model could well fit the monthly death cases of children under 5 years old in Lanzhou from 2010 to 2018. It is predicted that the total number of deaths of children under 5 years old in Lanzhou will be 140 in 2019, which is similar to the number of deaths in 2018. Conclusions The mortality rate of children under 5 years old in Lanzhou is decreasing year by year. Simple seasonal model can better reflect the mortality trend of children under 5 years old in Lanzhou and make short-term prediction.

OBJECTIVETo analyze the capacity of personal protection on poison emergency items in Chinese disease control and prevention institutes.

METHODSEvaluation analysis based on data obtained from investigating personal protection equipments and professional knowledge quizzing about personal protection in poisoning control of 57 different level centers for disease control and prevention selected from China by a multi-stage stratified sampling.

RESULTSAll 80.70% of the institutes possessed the protection equipments, provincial, municipal, county level institutes were 100.00%, 95.24%, 66.67%, respectively, with significant statistical difference (H = 7.94, P < 0.05). The average level of the type of individual protective equipments in disease control and prevention institutes was (5.42 +/- 4.00) kinds, the average points in category of provincial, municipal, county level institutes were (11.33 +/- 3.67), (6.52 +/- 3.16), (3.47 +/- 3.10) kinds, being statistically significant (F = 17.30, P < 0.05); type difference counts of disease control and prevention institutes in economic development, secondary, less-developed regions were (6.41 +/- 4.03), (3.55 +/- 3.35), (6.45 +/- 4.07) kinds, with statistical significance (F = 3.70, P < 0.05). Protection equipments chiefly possessed were latex gloves, gauze masks and C-protective clothing. Protective clothing and respiratory protective equipments were insufficient evidently. The average points in testing personal protection basic knowledge were (71.39 +/- 12.52) points; there were no differences between different institutes with different economic regions, levels, technical posts and title degrees.

CONCLUSIONCertain advances have been achieved in recent years in personal protection capacity of institutes for disease control and prevention, but far from the actual demands, and maybe no enough effective response on emergency occurred.

China ; Emergencies ; Humans ; Occupational Exposure ; Poisoning ; prevention & control ; Protective Clothing

BACKGROUNDThere remains controversy about whether Brugada syndrome (BS) has structural heart changes. We occasionally noted that a patient with BS had a quite unusual regional wall motion abnormality at the basal segment of the interventricular septum (IVS) during echocardiographic examination. The unexpected finding promoted us to reexamine our patients with BS by echocardiographic interrogation in the present study.

METHODSPatients with BS (n = 11), patients with complete right bundle branch block (RBBB) (n = 11), and control subjects (n = 11) were enrolled in this study. Two-dimensional echocardiography (2DE) was performed to obtain parasternal left ventricular long axis view on which M-mode scanning line was adjusted to be perpendicular to the basal segment of IVS for delineation of the segmental motion curve, with a simultaneously electrocardiographic tracing.

RESULTS2DE revealed a rapid swing motion shifting toward the right ventricle of the IVS basal segment at early systole in 73% (8/11) patients with BS, which was further confirmed on the M-mode curve evidenced by an early systolic notch toward the right ventricle. The position of the notch corresponded to C-point on the mitral motion curve, lasting for (53 +/- 5) ms. There were no similar changes both in patients with RBBB and in the control subjects.

CONCLUSIONIVS basal motion abnormalities at early-systolic phase may be the novel finding of BS.

Adult ; Aged ; Brugada Syndrome ; diagnostic imaging ; pathology ; physiopathology ; Echocardiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Systole ; Ventricular Septum ; pathology ; physiopathology

OBJECTIVETo evaluate the sedative and hypnotic effects of Foshouningshen decoction (FSNSD) and study its effects on expressions of 5-hydroxy tryptamine (5-HT) and 5-HT1A receptor (5-HTR) in the hippocampus in a rat model of insomnia.

METHODSMale KM mice were divided into control group, estazolam (0.4 mg/kg daily) group, and low-, moderate-, and high-dose FSNSD groups (daily dose of 12, 24, and 48 g/kg, respectively). After corresponding treatments for 1 week, the mice underwent sleep-inducing test with subthreshold and threshold doses of sodium pentobarbital. Forty-eight male SD rats were randomized into control group, insomnia model group, estazolam group (0.2 mg/kg daily), and low-, moderate-, and high-dose FSNSD groups (with daily dose of 6, 12, and 24 g/kg, respectively). Rat models of insomnia were established by intraperitoneal injection of 4-cholro-dl-phenylalanine (PCPA) at the daily dose of 350 mg/kg for 3 days, after which the rats received corresponding treatments via gavage for 1 week. The performance of the rats in open field test was recorded and the hippocampal expression of 5-HT was detected using ELISA; the expressions of 5-HTR protein and mRNA in the hippocampus were detected using immunohistochemistry and real-time PCR, respectively.

RESULTSIn the sleep-inducing test with a subthreshold dose of sodium pentobarbital, the mice treated with high-dose FSNSD showed a significantly higher rate of sleep onset than the control mice (P<0.05); in the test with a threshold dose of sodium pentobarbital, treatment with moderate- and high-dose FSNSD resulted in significantly prolonged sleeping time (P<0.01) and shortened sleep latency (P<0.05) in the mice. The rats in insomnia model group showed increased total distance in open field test (P<0.05) with significantly decreased content of 5-HT (P<0.01) and expressions of 5-HTR protein and mRNA in the hippocampus (P<0.01). Treatment of the rats with estazolam or high-dose FSNSD obviously decreased the total distance in open field test (P<0.05) and increased the content of 5-HT (P<0.05) and expressions of 5-HTR (P<0.01) in the hippocampus of rats with insomnia.

CONCLUSIONFSNSD can produce therapeutic effects on insomnia possibly by increasing 5-HT content and expressions of 5-HTR in the hippocampus.

OBJECTIVETo evaluate the hemodynamic response to passive leg raising (PLR) indicates fluid responsiveness in patients with septic shock.

METHODSTwenty patients with septic shock, considered for fluid challenge (FC), were enrolled in the study from June 2009 to May 2010. Hemodynamic changes were determined by pulse-contour derived cardiac index at baseline, before and after PLR, return to baseline for 10 min, before and after fluid challenge (250 ml saline for 10 min). An increase of SV after fluid challenge (FC-ΔSV) ≥ 10% were defined responders.

RESULTSTwenty patients with septic shock were included in the study. PLR and fluid challenge were performed 46 instances, among which 15 instances were defined as response group. SV and pulse pressure induced by PLR (PLR-ΔSV and PLR-ΔPP) were increased significantly in response group [(76 ± 19) ml vs. (65 ± 18) ml, (73 ± 20) mmHg vs. (62 ± 20) mmHg (1 mmHg = 0.133 kPa), P < 0.05], while in nonresponse group there were no significant change. PLR-ΔSV and PLR-ΔPP were correlated with FC-ΔSV (r = 0.51, P = 0.001; r = 0.45, P = 0.006), central venous pressure (CVP) were unrelated with FC-ΔSV. Area under curve (AUC) for PLR-ΔSV, PLR-ΔPP and stroke volume variation (SVV) were 0.846, 0.791 and 0.708. PLR-ΔSV ≥ 12.5% predicted fluid responsiveness with sensitivity of 80% and specificity of 93.5%. PLR-ΔPP ≥ 9.5% predicted fluid responsiveness with sensitivity of 73.3% and specificity of 83.9%.

CONCLUSIONSPLR-ΔSV and PLR-ΔPP can predict fluid responsiveness in patients with septic shock. PLR-ΔSV and PLR-ΔPP have a greater ability in predicting volume responsiveness than CVP and SVV.

Adult ; Aged ; Aged, 80 and over ; Female ; Hemodynamics ; physiology ; Humans ; Leg ; Male ; Middle Aged ; Posture ; Sensitivity and Specificity ; Shock, Septic ; physiopathology

Objective To discuss the clinical curative effect of percutaneous vertebroplasty(PVP)combined with percutaneous pedicle screw fixation for thoracolumbar fracture.Methods Retrospectively analyzed the clinical data of 43 patients with thoracolumbar fracture who underwent PVP combined with percutaneous pedicle screw fixation in our hospital from November 2015 to June 2017.Those patients included 28 males and 15 females,and the age of patients ranged from 50 to 66 years old,with an average age of(58.26 ±3.67)years old.The func-tional outcome were evaluated by VAS scores and ODI scores before and after the operation.The sagittal Cobb angle was used to evaluate the reduction of fracture.Results All these patients all successfully completed the operation,and there was no complications after operation.The operation time ranged from 60 to 126 min,with an average time of(96.07 ±15.69)min;the blood loss ranged from 60 to 180 min,with an average time of(113.26 ±24.7)min.All the patients were followed up for 4 to 23 months,with an average time of(12.07 ±4.01)months. The VAS score,ODI score and sagittal Cobb angle were significantly decreased in the last follow -up period compared with those before surgery,and the difference was statistically significant(P<0.05).Conclusion PVP combined with percutaneous pedicle screw fixation in the treatment of thoracolumbar fracture has smaller incision,less blood loss,shorter operation time and better improvement of local pain,func-tional movement and kyphosis.

Objective To evaluate the clinical efficacy of Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate plus traditional Chinese medicine(TCM)bone-setting manipulations for the treatment of moderate hallux valgus.Methods A retrospective study was conducted.A total of 49 patients(62 feet)with moderate hallux valgus were treated with Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate,and were given TCM bone-setting manipulations before the operation,during the operation,and after the operation.The efficacy was evaluated by using the Visual Analogue Scale(VAS)score and the American Orthopedic Foot and Ankle Society(AOFAS)forefoot score after the operation.Before the operation and 12 months after the operation,the hallux valgus angle(HVA),intermetatarsal angle(IMA)between the first and second metatarsal bone,and the distal metatarsal articular angle(DMAA)showed by X-ray imaging in the weight-bearing position of the foot were recorded.Results(1)All of the 49 patients were followed up for 12 to 24 months,with a mean of(20.6±3.1)months.(2)The X-ray imaging assessment showed that 12 months after the operation,the mean HVA,IMA and DMAA values of the 49 patients(62 feet)were significantly lower than those before the operation,and the differences were all statistically significant(P＜0.01).(3)Twelve months after the operation,the pain VAS score of 49 patients was(3.14±1.21)points,which was significantly lower than the preoperative score points(7.26±2.52),and the difference was statistically significant(P＜0.01).(4)The assessment of joint function showed that 12 months after the operation,the scores of various AOFAS items of pain,function and hallux alignment as well as the overall AOFAS scores of 49 patients were significantly higher than those before the operation,and the differences were statistically significant(P＜0.01).(5)For the 62 feet in 49 patients,the excellent efficacy was achieved in 53 feet,good efficacy was achieved in 7 feet,and fair efficacy was achieved in 2 feet,with the fine rate of 96.77%(60/62).Conclusion For the treatment of moderate hallux valgus,the application of Chevron minimally-invasive osteotomy and internal fixation with ISO intramedullary plate plus TCM bone-setting manipulations is effective on promoting the reset of hallux-metatarsophalangeal joint,restoring the balance of the joint,and maintaining the equilibrium state of the joint through postoperative rehabilitation guidance.The combined therapy exerts certain efficacy,reduces the recurrence rate,and eventually achieves the early rehabilitation after the operation.

This study was purposed to evaluate the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on hematopoietic reconstruction and survival in beagles exposed to mixed fission neutron and γ-ray. 13 beagles were unilaterally exposed to single dose of 2.3 Gy 90% neutrons. The experiments were divided into 3 groups: irradiation control group (no any treatment, n = 4), supportive care group (n = 5) and rhG-CSF plus supportive care group (n = 4, abbreviated as rhG-CSF group) in which the beagles were subcutaneously injected with 200 µg/kg of rhG-CSF early at half an hour and 24 hours post-irradiation respectively. The results showed that 2.3 Gy 90% neutron irradiation induced a severe acute radiation sickness of bone marrow type. The administration of rhG-CSF increased the survival rate from 60% in supportive care group to 100%. Twice injection of rhG-CSF in the first 24 hours reduced duration of neutropenia, enhanced neutrophil nadir and promoted neutrophil recovery when compared with control cohort administered clinical support. The number of colony-forming cells (CFU-GM, CFU-E, and BFU-E) in peripheral blood of rhG-CSF treated canines increased 2-to 5-fold relative to those of the supportive care group on day 3. All canines treated with rhG-CSF achieved hematopoietic reconstruction as evidenced by the pathological section of sternum while severe shortage of hemopoietic cells remained in the cohorts given supportive care alone. It is concluded that the combination of supportive care and high-dose rhG-CSF can accelerate hematopoietic recovery and enhance survival of dogs exposed to 2.3 Gy mixed neutron and gamma ray.
Animals ; Dogs ; Gamma Rays ; adverse effects ; Granulocyte Colony-Stimulating Factor ; administration & dosage ; pharmacology ; Hematopoietic System ; drug effects ; radiation effects ; Neutron Diffraction ; Recombinant Proteins ; administration & dosage ; pharmacology ; Survival Rate

The aim of this study was to investigate the effect of recombinant human granulocyte stimulating factor (rhG-CSF) on blood coagulation of beagles irradiated by 2.3 Gy neutron so as to provide new therapy for blood coagulation disorder after neutron irradiation. 10 beagles were exposed to 2.3 Gy neutron, and then randomly assigned into supportive care group and rhG-CSF-treated group. The rhG-CSF-treated cohorts were injected subcutaneously with rhG-CSF (10 µg/kg·d) beginning at the day of exposure for 21 consecutive days. Peripheral blood platelet counts were examined once every two days. In vitro platelet aggregation test, thromboelastography and blood clotting tetrachoric tests were also performed. The results indicated that the blood clotting system of irradiated dogs was in hypercoagulable state in the early days after 2.3 Gy neutron irradiation, and became hypocoagulable at crisis later and were mainly on intrinsic coagulation pathway. Blood fibrinogen increased markedly during the course of disease, while platelet counts and aggregation function were decreased remarkably. rhG-CSF administered daily could correct hypercoagulable state induced by 2.3 Gy neutron irradiation at the early time post exposure, shortened the thromboplastin generation time and clotting formation, down-regulated the abnormal high fibrinogen in blood, and improved platelet aggregation function. It is concluded that rhG-CSF can improve coagulation disorders of irradiated dogs.
Animals ; Blood Coagulation ; drug effects ; Bone Marrow ; radiation effects ; Dogs ; Granulocyte Colony-Stimulating Factor ; pharmacology ; therapeutic use ; Humans ; Leukocyte Count ; Neutron Diffraction ; Platelet Count ; Radiation Dosage ; Radiation Injuries, Experimental ; physiopathology ; Recombinant Proteins