Abdominal Pain ; Cough ; Humans

BACKGROUND: Levodopa substitutive therapy is essential and effective method for PD for a long time, but it can not delay the course of PD. Side effect is more and more and severe, for taking levodopa long term. It is benefit to patients to postpone the usage of levodopa or decrease the dosage of it.OBJECTIVE: To systematically investigate the curative effect of the selfmade Bushenpingchan formula combined with madopar on pathogenetic condition of PD patients after onset.DESIGN: Randomized controlled observation.SETTING: Senile Disease Research Center, Xuanwu Hospital, Capital University of Medical Sciences.PARTICIPANTS: Seventy patients diagnosed as having PD were recruited from the Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine between December 1999 and May 2002. Inclusive criteria: The patients must be diagnosed as PD finally; ②be at 1.5-4 grade of modified Hoehn & Yahr measuring scale; ③less than 80 years old; ④The Traditional Chinese Medicine (TCM) diagnosis was deficiency of liver and kidney. Exclusive criteria: ①secondary PD; ②accompanying with other sever central nervous system diseases. ③patients with severe diseases of heart,lung, kidney or multi-viscera-failure; ④mental sickness patients; ⑤drug and alcohol abuse; ⑥severe adverse effect.METHODS: Totally 70 patients were divided into two groups based on the proportion of one to one: There were 35 patients in treatment group containing 22 males and 13 females. The average age was (67.9±16.5)years. There were 35 patients in control group including 25 males and 10females. The average age was (65.5±16.5) years. There was no significant difference in their general condition. Patients in the control group received 62.5-500 mg madopar (250 mg in each pill), 2-4 times a day (to change the dose according to patients' condition). The patients in the treatment group were given with 62.5-500 mg madopar (250 mg in each pill), 2-4times a day orally and 200 mL self-made Bushenpingchan formula (twice a day) in addition, which was composed of 20 g tuber fleeceflower root, 1 g hairy deerhorn, 10 g tall gastrodia tuber, 15 g gambirplant, 12 g Chinese thorowax root, 15 g twolobed officinal magnolia bark, twice a day. The course of medication was 3 month in patients of the two groups. The patients were determined with unified Parkinson disease rating scale (UPDRS) before treatment and at weeks 2, 4, 8 and 12 after treatment, respectively. The symptoms in traditional Chinese medicine after treatment were measured. The dose of madopar before and after medication as well as the adverse effect were observed.MAIN OUTCOME MEASURES: Score of UPDRS before treatment and at weeks 2, 4, 8 and 12 after treatment in patients of the treatment group and control group; the dose of madopar before and after treatment and the adverse effect after treatment.RESULTS: Total effective rate was 69% and 51% in the treatment group and control group, respectively after treatment. There was no significant difference in therapeutic efficacy (x2=0.86, P=0.222 3). ①The score of UPDRS reduced significantly 8 weeks after treatment in the treatment group as compared with that before treatment (t=2.18 ,P ＜ 0.05). ②The daily dosage decreased in the patients of the treatment group after treatment as compared with that before treatment, which had significant difference (t =2.862 8,P ＜ 0.01 ). The daily dosage in the patients of control group had insignificant difference with that before treatment (t=2.320 3,P ＜ 0.01 ). ③There were 2 cases with lightly dry mouth, nausea, dizziness,which could relieve two weeks later in the treatment group; 5 patients with nausea and 2 patients with light dizziness in control group, which could relieve. The blood pressure had no significant change in the two groups before and after treatment.CONCLUSION: The Chinese medicine Bushenpingchan formula combined with western medicine can decrease the UPDRS score in PD patients,can improve the syndromes in Chinese medicine.

Objective To study the preparation technique for Jiegeng Zaogan capsules (capsules of total saponins from the roots of Platycodon grandiflorum A.DC).Methods The optimal preparation technique for Jiegeng Zaogan capsules was investigated by L9(34) orthogonal test with the Platycodin D content as the observation index.Results The optimized extraction procedure was as follows:extracting for 3 hours each time and 3 times in total,adding 10-fold water,alcohol sedimentation concentration at 65 %,and alcohol sedimentation solution staying for 48 hours.Conclusion The preparation process of Jigeng Zaogan capsules is reliable with stable quality,which offers a feasible method for the industrialization production of the capsules.

Objective To analyze the whole genomic DNA methylation level and estrogen receptor α (ERα) gene promoter methylation status in systemic lupus erythematosus (SLE) with atherosclerosis (AS) in model mouse,and to explore its role in the pathogenesis of SLE with AS.Methods Eleven apoE-/-C57BL/6 mice were randomly divided into the model group (SLE+AS group) and the control group (AS group).Eleven wild C57BL/6 mice were also randomly divided into the model group (SLE group) and the control group (blank group).Single intraperitoneal injection of pristane 0.5 ml for the model group,single intraperitoneal injection of normal saline 0.5 ml for the control group.Eight months after injection,all mice were sacrificed,genomic DNA was extracted from spleen.The total genomic DNA methylation level was detected,and pyrosequencing was performed to determine the methylation status of ERα gene promoter.The differences between groups were compared.ANOVA,LSD-t test,Tamhane's T2 test were used for statistical analysis.Results The total genomic DNA methylation levels were (4.7±1.5)％,(5.1±0.5)％,(6.6±1.6)％,(7.5±1.6)％ respectively in the SLE+AS group,AS group,SLE group,blank group respectively,the average methylation indices of ERα gene promoter were (13.0±3.1)％,(26.7±7.2)％,(15.7±3.8)％ and (21.4±4.2)％ respectively.The total genomic DNA methylation level and the average methylation index of ERα gene promoter in the SLE+AS group and the SLE group was significantly lower than that of the blank group (P＜0.05).Compared with the AS group,the total genomic DNA methylation levels and the average methylation index of ERα gene promoter in the SLE+AS group were significantly decreased (P＜0.05).Conclusion The total genomic DNAs and the ERα gene promoters in SLE with AS model mouse are in low-methylation status.The results of this study suggest that epigenetics may play an important role in the pathogenesis of SLE with AS.

Objective To evaluate the raliability and validity of walking impairment questionnaire applied to assess the walking ability of patients with type 2 diabetes. Methods One hundred and twenty-six patients with type 2 diabetes were selected. WIQ, SF-36 and 6-minute walk test were used to collect da-ta that was conducted for reliability analysis, correlation analysis and independent-samples t test to evaluate the reliability and validity. Results The internal consistency determined by Cronhach's α was 0.867 for the total WIQ score. Significnat correlations were found between WIQ and 6MWD, also between WIQ and physical domains of SF-36. compared with patients over seventy-one years old, the score of WIQ including the distance, speed, stair climbing and total score is significantly higher than that in patients aged seventy-one or less than seventy-one years old. Conclusions The Chinese version of WIQ is a simple, valid and reliable, clinically relevant tool to assess the walking ability of patients with type 2 diabetes.

Objective To explore the effect of perioperative continuous use of aspirin on bleeding in laparoscopic anterior resection for rectal cancer (RC) in patients taking low dose aspirin.Methods The prospective study was conducted.The clinicopathological data of 96 RC patients taking low dose aspirin who were admitted to the Shengjing Hospital of China Medical University from September 2014 to September 2016 were collected.All the 96 patients were divided into the aspirin group (perioperative continuous use of aspirin) and non-aspirin group (discontinuation of aspirin at 7 days preoperatively and taking aspirin at 3 days postoperatively)by random number table.Laparoscopic anterior resection for RC was applied to patients by the same team of doctors.Observation indicators:(1) comparison of surgical and postoperative situations between the 2 groups;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival of patients up to January 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups were evaluated with the t test.Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Comparison of ordinal data was analyzed using the nonparametric test.Results All the 96 patients were enrolled into the study,including 50 in the aspirin group and 46 in the non-aspirin group.(1) Comparison of surgical and postoperative situations between the 2 groups:96patients underwent successful laparoscopic anterior resection for RC,including 1 with conversion to open surgery and 95 undergoing laparoscopic anterior resection for RC,without perioperative death,postoperative blood transfusion and rcoperation.Cases with conversion to open surgery,operation time,volume of intraoperative blood loss,decreasing value of postoperative hemoglobin (Hb),time to anal exsufflation,peritoneal drainage volume from 1-3 days postoperatively,cases with postoperative hematoehezia,cardio-cerebrovascular complications and overall complications (including postoperative hematochezia and cardio-cerebrovascular complications),duration of hospital stay,hospital expenses,cases in stage Ⅰ,Ⅱ and Ⅲ of postoperative TNM stage,postoperative coagulation indexes of platelet,prothrombin time,international normalized ratio,prothrombin activity,activated partial thromboplastin time,thrombin time and fibrinogen were 0,(112± 18) minutes,(39± 18) mL,(4.3±2.8)g/L,(57±24)hours,(22±9)mL/d,6,0,10,(8.6±2.5)days,(6 739±481)yuan,11,35,4,(236±80) × 109/L,(12.7± 1.1) seconds,1.00±0.08,101％ ± 15％,(28 ±4) seconds,(15.5 ± 1.9) seconds,(3.2±1.0)g/L in the aspirin group and 1,(118±16)minutes,(38±22)mL,(3.5±3.0)g/L,(55±29)hours,(20±8)mL/d,4,1,8,(9.1±2.3)days,(6606±510)yuan,5,36,5,(211±49)×109/L,(12.5±0.7)seconds,1.00±0.06,103％±11％,(29±3)seconds,(15.3±1.7)seconds,(3.1±0.7)g/L in the non-aspirin group,respectively,with no statistically significant difference between the 2 groups (t =-1.737,0.204,1.416,0.380,1.365,x2=0.038,0.107,t=-1.082,1.322,Z=-1.370,t=1.850,0.978,0.872,-0.712,-1.291,0.311,0.585,P＞0.05).Ten patients with postoperative hematochezia in the 2 groups were cured,without special treatment.One patient in the non-aspirin group was complicated with deep venous thrombosis and then was cured by single anticoagulant drug.Two and 2 patients in the aspirin group were respectively complicated with urinary retention and urinary tract infection.One,1 and 1 patients in the non-aspirin group were respectively complicated with inflammatory intestinal obstruction,urinary retention and urinary tract infection,and then were cured by conservative treatment.(2) Follow-up situations:of 96 patients,95 were followed-up for 4-27 months,with a median time of 13 months.During the follow-up,3 patients died and 92 had survival.Conclusion The perioperative continuous use of aspirin cannot increase risk of bleeding in laparoscopic anterior resection for RC in patients taking low dose aspirin.

Objective To observe the risk factors for portal vein thrombosis (PVT) in cirrhotic patients prior to receiving endoscopic treatment to prevent gastroesophageal varices rebleeding.Methods A retrospective analysis was conducted on cirrhotic patients admitted to Zhongshan Hospital,Fudan University from 2008 to 2013 for secondary prevention of gastroesophageal varices bleeding via endoscopic treatment.Relevant information and data were collected,followed by an univariate analysis and multiple Logistic regression analysis in attempt to identify potential factors affecting the formation of PVT.Results Totally 591 patients were enrolled in the present study and were classified as present-PVT group (n =122,20.64 ％) and absent-PVT group (n =469,79.36 ％).Univariate analysis showed that MELD score,hemoglobin,platelet count,total bilirubin,alanine aminotransferase,blood urea nitrogen,splenectomy ratio all achieved statistical significance between the two groups (P＜0.05).The multiple Logistic regression showed that MELD score,lowered blood urea nitrogen,elevated D-dimer and history of splenectomy were independent factors associated with the formation of PVT (P values were separately 0.016,0.026,0.014 and ＜0.001).Conclusions Cirrhotic patients should receive regular surveillance for MELD score,liver function,D-dimer and portal vein ultrasonography,especially in patients received with a previous history of splenectomy.

Objective To observe the MRI characteristics in subacute combined degeneration (SCD)of the spinal cord.Methods The data of 1 9 SCD patients were retrospectively analyzed by the clinical characteristics and MR images.Results Among the 1 9 pa-tients of SCD,1 6 cases showed abnormal findings.Most of intramedullary lesions located in posterior column of thoracic and cervical spinal cord,and only one case located in cerebellar cortex and medulla oblongata.Lesions were involved in muti-segmental spinal cord,and mainly located in the dorsal or lateral spinal cord,and only two cases located in the anterior spinal cord.Different segmental spinal cord lesions had a different morphological characteristics with no enhancement.After treatments with vitamin B1 2 ,the lesions diminished and even disappeared in 2 cases.Conclusion MRI has important value in the diagnosis and treatment monitor of the SCD.

Objective To investigate blood gas analysis and lactic acid evaluation in aerobic forearm exercise and the significance of aerobic forearm exercise for the auxiliary diagnosis of mitochondrial myopathy and encephalopathy patients.Methods Forty-two patients with mitochondrial myopathy and encephalopathy patients, 40 healthy control, and 40 patients control were studied.They performed a protocol under aerobic exercise conditions, consisting of intermittent forearm exercise for 4 minutes at 40% of intented maximal voluntary contraction force.Blood samples were collected to monitor blood gas and plasma lactate before, during arid after exercise.Results During exercise venous PO_2(mm Hg, 1 mm Hg=0.133 kPa)decreased in mitochondrial myopathy and encephalopathy patients from 41.2?12.6 to 39.5?16.2, whereas PO_2 fell from 50.5?14.4 to 30.8?13.1 in healthy control and from 50.1?7.9 to 44.3?35.5 in patient control.Venous PO_2 decreased much more in healthy control group than the other 2 groups(F= 6.34,P

Objective To analyze the features of nerve conduction in patients with amyotrophic lateral sclerosis (ALS),and explore the correlation between compound muscle action potential (CMAP)amplitude and disease duration and revised amyotrophic lateral sclerosis functional rating scale (ALSFRSR).Methods Standard motor and sensory nerve conduction studies were performed in 154 patients with ALS.The following parameters were collected including CMAP amplitude,distal motor latency (DML),motor conduction velocity,sensory conduction velocity and sensory nerve action potential amplitude.Regression study was done to explore the correlation between CMAP amplitude and disease duration and ALSFRS-R.Results Motor nerve conduction abnormalities were presented in a majority of the patients with prolonged DML in the tibial nerve,median nerve and ulnar nerve as the most common form (61.06％-81.42％),followed by decreased CMAP amplitude (30.12％-53.98％),decreased MCV (12.05％-16.81％) and absence of CMAP (2.65％-9.73％).Sensory nerve conduction abnormalities were detected in a small proportion of patients and the decreased SCV,decreased SNAP amplitude and absence of SNAP in the sural nerve,median nerve and ulnar nerve were found in 1.22％-2.73％,0-1.82％ and 0-1.22％patients respectively.No correlation was found between CMAP of the common peroneal nerve,tibial nerve,median nerve and ulnar nerve and the disease duration (P ＞ 0.05),while significant positive correlation was established between CMAP amplitude of the median nerve and ulnar nerve and ALSFRS-R (r =0.273,P =0.016;r =0.357,P =0.001).Conclusions Motor nerve conduction is abnormal in a majority of ALS patients with prolonged DML as the most common form,while abnormal sensory nerve conduction is only found in a few of ALS patients.CMAP amplitude of the median nerve and ulnar nerve might be of certain clinical value in evaluating the severity of ALS.