Objective To explore the TCM syndrome distribution characteristics of central obesity hypertension patients; To analyze its correlation with urinary microalbumin/creatinine (MA/Cr) ratio; To provide some proof for an efficient way to control central obesity hypertension and prevent and cure its early renal injury with integrated TCM and Western medicine.Methods It was performed in a cross-sectional epidemiological study. The age, gender, height, weight, waist circumference, blood pressure, medical history and symptoms of 359 central obesity hypertension patients were collected in Shanghai. Then according to the four diagnostic methods, TCM syndromes were recorded. The urinary MA/Cr ratio, fasting blood glucose, fasting insulin and hs-CRP levels were detected.Results The urinary MA/Cr detectable rate in Shanghai among central obesity hypertension was 33.4% (120/359), men accounting for 56% and women 44%. Among central obesity hypertension patients, the HOMA-IR and hs-CRP level of urinary albumin group were significantly higher than those of normal group, with statistical significance (P<0.05). Among 359 central obesity hypertension patients, 140 people had phlegm-dampness syndrome, accounting for 39%, the largest part; 108 had liver-yang hyperactivity syndrome, accounting for 30%; 61 had yin-yang deficiency syndrome, accounting for 17%; 50 had yin-deficiency and yang-hyperactivity syndrome, accounting for 14%; the number of four TCM syndromes had statistical difference (P<0.05). Urinary MA/Cr ratio of the patients with phlegm-dampness syndrome was significantly higher than that of other three syndromes (P<0.05).Conclusion The incidence rate of early renal damage with central obesity hypertension patients is high in Shanghai area, and the early stage of renal damage is associated with insulin resistance and inflammatory reaction. Among central obesity hypertension, phlegm-dampness syndrome and liver-yang hyperactivity account for the majority, and patients with phlegm- dampness syndrome are more likely to have early kidney damage.

Objective To compare and quantify the determinants in quantitative electroencephalogram(q-EEG) and heart rate variability power spectrum analysis(HRV-PSA) of ketamme(KTM) anesthesia for preschoolers. Methods Seventy four cases were selected and assigned into 3 groups named A(4-5 years), B(5-6 years), C(6-7 years), 22,28,24 cases in every group respectively. All cases were induced with KTM 5 mg /kg intramuscularly and changes of determinants were recorded continuously. If body movement happened, KTM would be injected with 1 mg/kg. Results On pre- anesthesia, BIS in group A was the least among 3 groups, while LF/HF and HRVI were the largest(P

Objective: To explore therapeutic effect of pitavastatin on young and middle-aged patients with hyperlipidemia complicated carotid plaques and its influence on vascular endothelial function. Methods: A total of 126 young and middle-aged patients with hyperlipidemia complicated carotid plaques [carotid intima-media thickness (IMT) ＞ 1. 5mm]were selected, and were randomly divided into no lipid lowering treatment group (n=62) and pitavastatin group (n=64). Flow-mediated dilation of brachial artery (FMD), carotid IMT and blood lipid levels before and 12 months after medication, and incidence rate of adverse events were recorded and compared between two groups. Results: Compare with before treatment and no lipid lowering treatment group after treatment, there was significant rise in FMD [(6. 70±2. 10) ％, (6. 60±2. 35) ％ vs. (8. 90±3. 60) ％], and significant reductions in levels of total cholesterol [(6. 05±1. 40) mmol/L, (5. 67±1. 90) mmol/L vs. (4. 05±1. 20) mmol/L], triglyceride [(2. 18± 0. 72) mmol/L, (2. 08±0. 68) mmol/L vs. (1. 77±0. 65) mmol/L]and low density lipoprotein cholesterol [(4. 65±1. 50) mmol/L, (4. 41±1. 36) mmol/L vs. (2. 01±1. 30) mmol/L]in pitavastatin group, P＜0. 05 or＜0. 01; there were no significant changes in IMT in two groups. No obvious adverse reaction was found in pitavastatin group. Conclusion: Pitavastatin can significantly improve lipid levels and vascular endothelial function in young and middle-aged patients with hyperlipidemia complicated carotid plaques.

OBJECTIVETo discuss clinical effects of complex acetabular fracture.

METHODSFrom January 2005 to December 2010, totally 31 patients with complex acetabular fracture received surgery. There were 21 males and 10 females with an average age of 38.6 years old (ranged, 31 to 57). X-ray, CT, operation scheme and clinical efficiacy were retrospectively analyzed. American Academy of Orthopaedic Surgery standard was used to evaluate hip joint function.

RESULTSAll patients were followed up from 12 to 36 months with an average of 17.6 months. No complications and neurovascular injury occurred. One case received total hip replacement arthroplasty. There were 17 cases obtained anatomical reduction, 12 cases got satisfied reduction and 2 cases not satisfied. According to American Academy of Orthopaedic Surgery standard, 18 cases got excellent result, good in 9 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONComplex acetabular fracture combine with lots of complications and easily had occurre postoperative complications. It can improve curative effect by accurate reduction and reliable fixation and maximize restoring function of hip joint.

Acetabulum ; diagnostic imaging ; injuries ; surgery ; Adult ; Female ; Fracture Fixation, Internal ; Hip Fractures ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Treatment Outcome

Objective To explore the imaging characteristics of hemiplegic patients with intractable epilepsy before and after modified hemispherectomy and their clinical significances.Methods The clinical data of 29 patients,admitted to and underwent hemispherectomy in our hospital from 1996 to 2010,were retrospectively analyzed.The characteristics ofpre-and post-surgical imaging of these patients were analyzed.Results Pre-surgical imaging showed that the crus cerebri of healthy lateral was enlarged for compensation and another lateral was atrophy with illed hemisphere.Hemispherectomy succeed in all the patients on the illed hemisphere; post-surgical imaging showed that operative cavity was reduced through healthy hemisphere shiftting to operative lateral,frontal sinus enlarging and skull becoming thickness.Follow-up was performed for 2-15 years; the disturbance of the nervous function was not worsened and there was no late complication in all the patients; Engel grading showed grade Ⅰ and Ⅱin 93.1％ patients and grade Ⅲ in 6.9％.Conclusion The CT/MR imaging is more valuable in localizing of the lesions as compared with EEG; the imaging changes before and after hemispherectomy can explain the shrunk cacity and few late complications.

Objective To explore the effect of ambroxol hydrochloride combined with budesonide on the airway inflammation and lung oxidative stress in allergized rats.Methods Forty cases of clean health level SD male rats were randomly divided into blank control group,model group,positive control group and test group,10 rats in each group.Except blank control group,the rats of other groups were treated with ovalbumin to build the asthma model.Model group was intraperitoneally injected 10％ ovalbumin 1 mL on 1,8 d,and 1％ ovalbumin was inhaled on 15 d,once a day for 0.5 h,till the rats appear abdominal muscle contraction,nodding and so on.Positive control group was inhaled 0.02％ budesonide 30 min before nebulization for 1 h before nebulization.The test group was intraperitoneal injected ambroxol hydrochloride 60 mg · kg-1 at 25 min before inhalation of budesonide on the basis of positive control group.Each group were intervention for 10 weeks.The numbers of lymphocytes and eosinophils in bronchoalveolar lavage fluid of rats in each group were measured by cell counting method.The airway histopathological and morphological changes were observed by hematoxylin-eosin (HE) staining.Colorimetric method was used to detect the levels of oxidative stress in lungs of each group.Results The percentages of eosinophils in blank control group,model group,positive control group and test group were (1.29 ±0.41)％,(81.44 ±5.15)％,(37.51 ±5.38)％,(20.14±4.65)％,the percentages of lymphocytes were (4.01 ± 0.87) ％,(17.38-± 2.99) ％,(11.59 ± 2.01) ％,(7.96 ± 1.43) ％.The difference betweent test group and model group and positive control group was statistically significant (P ＜0.01).HE staining showed that the most obvious pathological changes in model group,followed by positive control group.The levels of glutathione (GSH) in lung tissue of blank control group,model group,positive control group and test group were (1.54±0.15),(0.53 ±0.18),(0.79 ±0.09),(1.15 ±0.11) μmol · L-1,and reactive oxygen species (ROS) were (1643 ±163),(4986 ±195),(3619 ± 184) and (2348 ± 171) U mg-1 pro.The GSH,ROS in test group and positive control group had significant difference (P ＜ 0.01).Conclusion Ambroxol hydrochloride combined with budesonide can relieve the airway inflammation and lung oxidative stress in rats with asthma,which can be used for the treatment of acute asthma attacks.

Objective To observe the effect of glycoprotein receptor blockade tirofiban in acute anterior myocardial infarction patients without ST segment resolution after primary percutaneous coronary intervention (PCI). Methods From April 2006 to April 2008, 157 acute anterior myocardial infarction patients without ST segment resolution after PCI were randomly allocated to tirofiban (intravenous bolus 10 fig/kg followed by intravenous infusion of 0. 15 μg·kg-1·min-1 for 48 h, n =80) or equal volume saline (control group, n =77). Baseline characteristics, PCI features and clinical outcomes during hospitalization, left ventricular ejection fractions (LVEF) and major adverse cardiac events (MACE, including death, re-infarction and target vessel revascularization) at 30 and 180 days after discharge were compared between the two groups. Results The baseline clinical characteristics were comparable between the two groups. Compared to control group, the MACE rates and re-infarction rates at 30 days (6. 3% vs. 18. 2% , P < 0.05; 1.3% vs. 9. 1%, P<0.05, respectively) and 180 days (10.0% vs. 23. 4% , P<0.05; 2.5% vs. 10.4% , P < 0. 05, respectively ) were significantly reduced in tirofiban group. LVEF value was significantly higher in tirofiban group at 30 days and 180 days compared with those in control group [ (51 ± 6)% vs. (46±8)%, P<0.05; (57±7)% vs. (50±9)%, P<0.05]. Hemorrhagic complications were similar between the two groups. Conclusion Use of tirofiban for acute anterior myocardial infarction patients without ST segment resolution after PCI is safe and can significantly improve 30 and 180 days clinical outcomes after discharge.

OBJECTIVETo study the effect of highly active antiretroviral therapy (HAART) on plasma levels of MSP and MCP-1 in AIDS patients.

METHODSForty Chinese AIDS patients were treated with HAART for 3 months and 84 German AIDS patients with HAART for 3 to 6 years. The pre-treatment and post-treatment plasma levels of MSP and MCP-1 were measured by enzyme-linked immunosorbent assay (ELISA), and their correlations with CD4+ cell counts and viral loads were analyzed.

RESULTThe mean levels of MCP-1 were significantly higher and MSP were significantly lower in HIV-infected patients compared with the HIV-negative controls (P <0.01). After HAART for three months, there were no significant changes in the levels of these cytokines. But after long-term HAART (for 3 to 6 y), the level of MCP-1 was increased and that of MSP decreased significantly (P<0.01). There was a negative correlation between MSP and MCP-1 levels, and the same for MSP level and CD4+ cell counts; while there was a positive correlation between MCP-1 levels and CD4+ cell counts.

CONCLUSIONThe changed plasma levels of MSP and MCP-1 are associated with HIV-1 infection and HAART may reverse the levels of these two cytokines.

Acquired Immunodeficiency Syndrome ; blood ; drug therapy ; Adult ; Anti-HIV Agents ; therapeutic use ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Chemokine CCL2 ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Macrophage-Activating Factors ; blood ; Male ; Middle Aged ; Time Factors ; Treatment Outcome

A 78-year-old man presented with an eight-hour history of chest distress. Electrocardiograph and serum cardiac enzymes were suggestive of acute inferior myocardial infarction with right ventricular infarction. The patient, who underwent emergency percutaneous coronary intervention, suffered from thrombocytopenia presenting with cerebral infarction and myocadial reinfarction during haparin exposure. The laboratory test for heparin-induced thrombocytopenia (HIT) specific antibodies (heparin-platelet factor, PF4) was positive. The case was diagnosed as arteries thrombosis due to heparin-induced thrombocytopenia; the patient died after cessation of heparin.
Aged ; Coronary Thrombosis ; diagnosis ; etiology ; metabolism ; Heparin ; adverse effects ; Humans ; Male ; Platelet Factor 4 ; metabolism ; Thrombocytopenia ; chemically induced ; complications

OBJECTIVETo investigate the effect of Longbishu Capsule (, LBS), doxazosin, and combination therapy on benign prostatic hyperplasia (BPH).

METHODSA randomized, double-blind, multi-center parallel trial was conducted involving 360 patients in hospitals in Beijing (108 cases), Heilongjiang (90 cases), Sichuan (90 cases), Shanghai (72 cases), China. They were randomly assigned with central randomization method to group A (LBS placebo plus doxazosin), group B (LBS plus doxazosin) or group C (LBS plus doxazosin placebo), 120 cases for each group. The international prostate symptom score, maximum urinary flow rate, postvoid residual urine volume and prostate volume were measured for evaluating the efficacy of the three treatments.

RESULTSAt baseline, there was no significant difference in the measured variables among the three groups. After 12-month treatment, the three groups showed significant improvements in IPSS and maximum urinary flow rate from baseline (P<0.01). Although postvoid residual urine volume was not significantly different from the baseline in group A (P>0.05), it significantly decreased in group B and C (P<0.05). The incidence of adverse events were similar among the three groups.

CONCLUSIONSThe treatment of LBS alone or LBS plus doxazosin was able to significantly improve IPSS in patients with BPH. The treatments may reduce the increase in prostate volume and postvoid residual urine volume as well.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Double-Blind Method ; Doxazosin ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Placebos ; Prostatic Hyperplasia ; drug therapy