OBJECTIVE: To observe the clinical efficacy of Jianpi shoushen decoction in the treatment of cases of impaired glucose tolerance with Qi deficiency and phlegm-dampness constitution. METHODS:62 Patients with impaired glucose tolerance with Qi deficiency and phlegm-dampness constitution were randomized into 2 groups, i.e. trial group were treated with Jianpi shoushen decoction q.d for 3months (p.o.,n=31); control group were treated with 50 mg Acarbose tablet t.i.d for 3 months (p.o.,n=31). Patients in two groups were all received healthy education such as diet guide and sport instruction. The effective rate, glycemic index and weight index of two groups were observed. RESULTS: The rate of hypoglycemic efficacy and weight lose efficacy in trial group were better than in control group(P

Abstract: Objective To analyze the correlation between the thromboelastography (TEG) indexes and the indexes related to liver injury in patients with heat stroke, and explore the diagnostic value of TEG indexes for liver injury in patients with heat stroke. Methods A total of 95 patients with exertional heat stroke (EHS) admitted to 924 Hospital of the Joint Service Support Force of the People's Liberation Army of China from August 2020 to July 22 were selected, and divided into a non-liver injury group (55 cases) and a liver injury group (40 cases) according to whether there was liver injury. TEG instrument was used for the detection of thromboelastography to record the TEG parameters, including reaction time (R), agglutination time (K), α angle, maximum amplitude (MA value), and coagulation complex index (CI). The levels of glutamic transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), albumin (ALB) were detected by automatic biochemical analyzer. Pearson's method was applied to analyze the correlation between thromboelastography indexes R, K, α angle, CI and liver function indexes AST, ALT, TBil, ALB in patients with heat stroke after liver injury. Receiver operating characteristic curve (ROC) was applied to analyze the predictive value of thromboelastography indexes R, K, α angle, CI and combined detection for liver injury in patients with heat stroke. Results Compared with the non-liver injury group, the AST, ALT and TBil levels in patients with heat stroke in the liver injury group were higher (t=26.174, 16.923, 18.414, P<0.05), while the ALB level was lower (t=24.596, P<0.05); compared with the non-liver injury group, the R and K of patients with heat stroke in the liver injury group were higher (t=58.014, 52.862, P<0.05), and the α angle and CI were lower (t=46.853, 60.717, P<0.05); R was positively correlated with AST and ALT (r=0.532, 0.610, P<0.001), and negatively correlated with ALB (r=-0.551, P<0.001) in patients with heat stroke complicated with liver injury; K was positively correlated with AST, ALT and TBil (r=0.661, 0.531, 0.504, P<0.001); α angle was negatively correlated with AST and ALT (r=-0.473, -0.448, P<0.01), and positively correlated with ALB (r=0.539, P<0.001); CI was negatively correlated with AST, ALT and TBil (r=-0.458, -0.505, -0.549, P<0.001); the area under the curve (AUC) of thromboelastography indexes R, K, α angle and CI in predicting liver injury in patients with heat stroke was 0.807 (sensitivity of 70.0%, specificity of 81.6%), 0.831 (sensitivity of 77.5%, specificity of 85.5%), 0.747 (sensitivity of 67.5%, specificity of 74.5%), and 0.788 (sensitivity of 77.5%, specificity of 83.6%), respectively. The AUC of combined detection to predict liver injury in patients with heat stroke was 0.967 (sensitivity of 92.5%, specificity of 91.9%). Conclusions The thromboelastography indexes are correlated with the indexes related to liver injury in patients with heat stroke, and the thromboelastography indexes are helpful to diagnose liver injury in patients with heat stroke.

Objective To investigate the neurological and cerebrospinal fluid interleukin-6 effects of butylphthalide on brain hemorrhage.Methods Ninety cerebral hemorrhage patients in principle based on a random draw were equally divided into the treatment group (45 cases) and the control group (45 cases).Two groups were given basic treatment, the control group were treated with nimodipine tablets adjuvant therapy, the treatment group were treated with butylphthalide soft capsules adjuvant therapy, all patients were treated for 30 days.Results After treatment, the national institutes of health stroke scale (NIHSS) score was shown significant downward trend in the two groups((9.45±0.44) to (2.09±0.45) scores;(9.44±0.21) to (4.58±0.65) scores) and compared with pre-treatment differences were significant (t=16.983, P=0.000;t =8.112, P =0.000), and the NIHHS score in treatment group was significantly lower than in control group(P =0.000).The mini-mental state examination (MMSE) score and activities of daily living (ADL) scores were shown significant upward trend in the two groups,compared with pre-treatment differences were significant(P ＜0.05).MMSE score(26.98±3.91) and ADL scores(34.29±6.42) scores in the treatment group were significantly lower in the control group((23.09±5.33) scores, (30.28±5.33)scores) after treatment(t =6.498, P =0.000;t =8.123, P =0.000).After treatment, the values cerebrospinal fluid interleukin-6 (IL-6) expression in the two groups were significantly reduced (P ＜ 0.05), while the value of cerebrospinal fluid IL-6 expression in the treatment group were significantly lower than the control group ((45.38 ± 13.02) ng/L vs (122.87± 17.42) ng/L, t =18.334, P =0.000).The adverse reactions of the two groups were mild, and were significantly improved after symptomatic treatment.Conclusion Butylphthalide adjuvant treatment of cerebral hemorrhage can improve nerve function, cognitive function and activities of daily living, its safety is also better.It plays its role may related to effectively reduce the IL-6 expression.

Objective Through the analysis of the special thromboelastography (TEG) graphics to improve the ability of analysis and identification the TEG and provide more valuable results for clinical practice.Methods This study is a retrospective study.Retrospectively analysis of 15 430 cases of TEG results from People's Liberation Army General Hospital,using the parametrs as reaction time (R),the clotting time (K),the solidification angle (Angle),the maximum amplitude (MA),the percentage of blood clot dissolution (EPL),the rate of 30 minutes clot amplitudereduce (LY30),the coagulation index (CI) and other parameters to analyze the hyperfibrinolysis group,the heparin graphics group,the secondary activation of fibrin group,the platelet function group and the anti-platelet drug monitoring group.Results In the hyperfibrinolysis group,the EPL value,LY30 value and CI value of primary hyperfibrinolysis group was 19.3,19.3 and 0.4 respectively and the secondary hyperthyroidism group was 11.6,11.6 and 3.2 respectively.In the heprin application graphic group,R value of CKH group was shorter than that of CK group (10.9 vs.50.8),R value of CKH group was longer than that of CK group (12.2 vs.15.7).In fiber protein secondary activation graphics groups,the MA value of the first time detection was 35.2,then replacing the channel repetition MA value was 34.7 in true functional fiber protein secondary activation group.For the pseudo fiber protein secondary activation group the first time detection MA value was 73.4,then replacing the channel repetition MA value was 20.0.The MA value of platelet function reduce group and hyperfunction group was 21.6 and 79.2 respectively in platelet function group.In anti-platelet drug monitoring group,the inhibition rate of adenosine diphosphate (ADP) of ADP inhibitor (clopidogrel) ineffective group was 10.9％ ; And the inhibition rate of arachidonic acid (AA)of AA metabolic pathway inhibitor (aspirin) ineffective group was 7.5％.Conclusions The correct judgment on the abnormal thromboelastography graphics is helpful to ensure the accuracy of the results andto reduce the occurrence of adverse events.

Objective:To confirm the relative humidity conditions of preparation of Hericium Erinaceus and Lumbricus ( HD) bio-transformation and the longest operation time under the conditions through the study on hygroscopicity of dry extract powder. Methods:The solution was prepared respectively in the environment with various humidity, and the moisture absorption rate and critical relative humidity ( CRH) of dry extract powder of HD biotransformation were measured, and then the mathematical model was built and the curves of moisture percentage vs relative humidity was drawn. The parameters of moisture absorption rate, and the relative humidity and operation time with the moisture percentage up to 5% were calculated. The analytic geometry and linear regression method were used to calculate CRH, so as to determine the air humidity control range and the conditions for the production and storage process. Results:The moisture absorption of HD dry extract powder could reach 5% when exposed to the air respectively with the relative humidity of 66. 0%, 80. 8%, 88. 2% and 99. 0% for 7. 088, 3. 953, 2. 892 and 0. 661 h. When the moisture percentage reached 5%, the rela-tive humidity and the shortest time was 50. 84% and 9. 937 h, respectively. The CRH of the dry extract powder of HD biotransforma-tion was 68. 12%. Conclusion:When the dry extract powder of HD biotransformation is under preparation, the relative humidity of en-vironment should be controlled below 50. 84% with the operation time shorter than 9. 937 h, or the relative humidity is controlled below 68. 12% with the operation time shorter than 6. 810 h. Under the above conditions, the moisture absorption rate of HD dry extract pow-der can be controlled below 5%, which does not affect the preparation.

Objective To establish the enzyme-linked immunosorbent assay (ELISA) for the detection of serum alcohol dehydrogenase (ADH) antibody and evaluate its role in its diagnosis of autoimmune hepatitis( AIH ). Methods The reactivity between yeast ADH and human anti-ADH serum antibody was tested by Western blot analysis. ELISA was established using yeast ADH. The method was applied in serums of 67 AIH patients,94 primary biliary cirrhosis(PBC) patients, 199 chronic hepatitis B (CHB) patients, 132 chronic hepatitis(CHC) patients, 24 alcohol hepatitis disease(ALD) patients, 99 connective tissue disease(CTD) patients and 31 healthy individuals. The positive rate of ADH antibody in the patients and healthy individuals was measured. The χ2 test was used to compare the positive rates. Results The ELISA method for detecting human anti-ADH serum antibody was established successfully and the optimum reaction conditions were defined. Western blot showed that yeast ADH has cross reactivity with human anti-ADH antibody. The positive rate of anti-ADH antibody in the AIH group [59. 7% ,40/67 ] was higher than that in the normal control group(0,χ2 = 31. 271 ,P <0. 05), PBC group (6. 4% ,χ2 =54. 492,P <0. 05), CHB group( 14. 1% ,χ2 =54. 848,P <0. 05) ,CHC group(21.2% ,χ2 = 29.269,P<0.05), ALl) group ( 25. 0% ,χ2 =8.512,P <0.05)and CTD group ( 43. 4% ,χ2 =4.229, P <0. 05). Conclusions Compared with the PBC, CHB, CHC, ALD and CTD group, the anti-ADH antibody positive rate in the serums of AIH was significantly increased. The antibody may be helpful to the diagnosis of autoimmune hepatitis.

Objective To reveal the mechanisms of immunological infertility,the method of coimmunoprecipitation(CO-IP) and liquid chromatogram mass/mass (LC-MS/MS) was used to screen sperm membrane proteins which interacting with antisperm antibodies (ASA).Methods This study was designed as a case-control.The disease group including 56 serum samples from 521 cryptogenic infertile patients were screened ASA positive by ELISA and conformed with mixed antiglobulin reaction(MAR).The controls were 31 serum samples which ASA is negative and already possessed healthy offspring.All subjects were enrolled from September 2015 to December 2015 in China PLA General Hospital.Spermatozoa samples from 48donors with normal sperm parameters were from January 2016 to April 2016 in China PLA General Hospital.The purified human sperm membrane proteins were then mixed with serum from disease group (positive for ASA) and control group (not containing ASA).The binding proteins of antisperm antibodies were enriched using CO-IP assay.The immunoprecipitates were separated on sodium dodecyl sulfate-polyactylamide gel (SDS-PAGE),then the binding proteins were cut from the gel and analyzed by LC-MS/MS after the enzymolysis.These proteins could bc idcntified as definition,biological function (s) and subccllular localization with Uniprot database.Results The serum samples from infertile persons (39 females and 17males) were screened ASA positive by ELISA and conformed with MAR.The healthy controls (17 females and 14 males) were ASA-negative in ELISA.Forty proteins that interact with ASA were obtained from the study and these could be divided into three groups:11 antigens detected by control serum samples only,14antigens recognised by both infertile patients and control sera,and 15 antigens specific for patients with ASA.These 15 proteins are Sperm Cation channcl protein 1,Sperm Cation channel protein 3,Sperm Cation channel protein 4,Sperm associated antigen 9,Apolipoprotein A-I,Dynein heavy chain 14,Cylicin-2,Izumo sperm-egg fusion protein 4,Thioredoxin domain-containing protein 2,IQ domain-containing protein H,IQ domain-containing protein F1,Spermatogenesis-associated protein 5,Spermatogenesis-associated protein 5-like protein 1,Sperm acrosome membrane-associated protein 1,E3 ubiquitin-protein ligase RNF 114.Conclusion Fifteen proteins discovered with CO-IP technology and LC-MS/MS analysis could be referred as male immunoinfertility-related antigens and they may hold the great importance in revealing the secret of immunological infertility.

BACKGROUND:Bone grafting is one of the important steps in the treatment of thoracolumbar burst fractures.Because the fracture involves the spinal canal or is accompanied by spinal cord nerve damage,severe fracture bleeding and other factors,minimally invasive bone grafting for thoracolumbar burst fractures is restricted.At present,the minimally invasive treatment of thoracolumbar burst fractures is limited to percutaneous screw fixation under the tunnel.Minimally invasive percutaneous bone grafting of injured vertebrae is rarely reported,and percutaneous precise bone grafting under the endplate has not yet been reported. OBJECTIVE:To investigate the clinical effect of subcutaneous endplate bone graft support reduction combined with percutaneous pedicle screw short-segment fixation in the treatment of A3+B2 thoracolumbar burst fractures. METHODS:From June 2017 to December 2021,90 patients with A3+B2 type asymptomatic thoracolumbar burst fracture were randomly divided into 3 groups according to admission time.In group A,33 patients received the bone graft funnel accurately placed through the pedicle channel by percutaneous puncture under C-arm fluoroscopy,bone graft support reduction under the fracture endplate,percutaneous pedicle screw fixation.In group B,30 patients received multifissure intermuscular approach through pedicle bone graft support reduction combined with pedicle screw fixation.In group C,27 patients received percutaneous pedicle screw short-segment fixation under postural reduction.All patients were followed up for at least 18 months after surgery.The clinical data of the three groups,including preoperative,postoperative and last follow-up Cobb angle,anterior edge height ratio and visual analog scale pain score,were compared and analyzed. RESULTS AND CONCLUSION:(1)There were no significant differences in age,sex,injury segment and causative factors among the three groups(P>0.05).(2)All patients at follow-up had no neurological impairment,no obvious lumbar posterior deformity or intractable low back pain.(3)The operation time of group C was less than that of group A and group B(P<0.05).Intraoperative blood loss was less in group A and group C than in group B(P<0.05).(4)There were no significant differences in the anterior edge height ratio and Cobb angle among the three groups(P>0.05).Postoperative data in groups A and B were better than that in group C.At last follow-up,group A and group B outperformed group C(P<0.05).The height and Cobb angle of the vertebral body lost in the three groups were smaller in groups A and B than those in group C(P<0.05).(5)Visual analog scale pain score was better in groups A and C than that in group B after surgery(P<0.05).There was no significant difference in visual analog scale pain score among the three groups at last follow-up(P>0.05).(6)In group C,there was one case of loose internal fixation and displacement in 1 month after surgery,and the vertebral height was lost again with back pain,and after strict bed rest for 6 weeks,the vertebral height loss was not aggravated,the pain was relieved,and the internal fixation was removed after 1 year,and the height loss at the last follow-up was not aggravated.There were no cases of failure of internal fixation in groups A and B.(7)It is indicated that subcutaneous endplate bone graft support reduction combined with percutaneous pedicle screw short-segment fixation in the treatment of A3+B2 thoracolumbar burst fracture has the advantages of less trauma,less bleeding and light postoperative pain symptoms,and the effect of injury vertebral reduction and height maintenance is the same as the reduction through pedicle bone grafting support and short segment fixation with pedicle screws through the multifidus space approach.