Objective: To observe the lumen structural changes of radial artery (RA) in patients with transradial coronary intervention and the impact of nitroglycerin on the structure by optical coherence tomography (OCT). Methods: A total of 20 patients with transradial coronary intervention were enrolled for OCT imaging to observe and compare the lumen structures of RA between the basic condition and nitroglycerin treated condition. Results: OCT imaging found that 15/20 patients had radial spasm and 1 had intimal tear. Compared to basic condition, with nitroglycerin treatment, the mean lumen diameter, lumen area and total vascular area were increased in the distal, middle and proximal portion of RA, all P<0.001; the intima-media thickness was decreased in the distal, middle and proximal portion of RA, all P<0.001; while the cross section area of tunica media, intimal thickness and extravascular membrane thickness were similar between the basic condition and nitroglycerin treated condition, all P>0.005. Conclusion: Vasodilatation drug may obviously enlarge RA lumen area and total vascular area in patients after transradial coronary intervention.

Traditional Chinese medicine (TCM) orthopedics formula is an important part of the prevention and treatment of orthopedics disease,which has curative effect and the advantages of the whole regulation,but it needs to strengthen its clinical development and reasonable application in clinical.In this paper,by reviewing the current clinical present situation and some problems of the research and development about the TCM orthopedics formula,research and development direction were put forward:the source of prescription,the change of disease spectrum,the clinical location,the apphcation of toxic drugs and animal materials,and the quality control of clinical trials should be paid attentions to,hoping to provide some thoughts for the research and development of TCM orthopedics formula.

Knee osteoarthritis (KOA) is a clinical common and frequent ly-occurring disease,traditional Chinese medicine (TCM) and Chinese medicine have certain advantages for patients in the treatment of early-middle period KOA.In this paper,by reviewingthe clinical feature,evaluation methods and present status of treatment of KOA,the evaluation of traditional Chinese medicine of KOA was proposed.the disease characteristics and clinical localization and clinical characteristics of TCM should be paid attention to,so as to select the evaluation method that can reflect the treatment of characteristics.

Knee osteoarthritis(KOA) is a clinical common and frequently -occurring disease,traditional Chinese medicine (TCM) and Chinese medicine has a certain advantage for patients in the treatment of early-middle period.In this paper,review the clinical feature,evaluation methods and present status of treatment of KOA,offer the evaluation of traditional Chinese medicine of KOA,should pay attention to the disease characteristics and clinical localization and clinical characteristics of TCM,select the evaluation method that it can reflect the treatment of characteristics.

BACKGROUNDThe risk of radial artery occlusion (RAO) needs particular attention in transradial intervention (TRI). Therefore, reducing vascular occlusion has an important clinical significance. The aim of this study was to determine the appropriate puncture site during TRI through comparing the occurrence of RAO between the different puncture sites to reduce the occurrence of RAO after TRI.

METHODSWe prospectively assessed the occurrence of RAO in 606 consecutive patients undergoing TRI. Artery occlusion was evaluated with Doppler ultrasound in 2 days and 1 year after the intervention. Risk factors for RAO were evaluated using a multivariate model analysis.

RESULTSOf the 606 patients, the RAO occurred in 56 patients. Compared with TRI at 2-5 cm away from the radius styloid process, the odds ratio (OR) for occlusion risk at 0 cm and 1 cm were 9.65 (P = 0.033) and 8.90 (P = 0.040), respectively. The RAO occurred in the ratio of the arterial diameter to the sheath diameter ≤1 (OR = 2.45, P = 0.004).

CONCLUSIONDistal puncture sites (0-1 cm away from the radius styloid process) can lead to a higher rate of RAO.

TRIAL REGISTRATIONClinicalTrials.gov, NCT01979627; https://clinicaltrials.gov/ct2/show/NCT01979627?term = NCT01979627 and rank = 1.

Aged ; Arterial Occlusive Diseases ; etiology ; Cardiac Catheterization ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Punctures ; Radial Artery

Vertebral artery type cervical spondylosis is a common type of cervical spondylosis, also known as cervical vertigo. In recent years, with the increase of people's life pace and the number of office staff, the incidence rate has been rising year by year, with a trend of younger age. Because traditional Chinese medicine has unique advantages in treating cervical vertigo, it is necessary to study the regularity of the Chinese medicine for cervical vertigo. But at present, the research is mainly based on the statistics for frequency and proportion of herbs. In addition, in the process of diagnosis and treatment of Chinese medicine, personal experience also caused differences in prescription compatibility and drug dosage, which makes difficult guarantee for the safety and effectiveness of drug treatment. So, this paper is based on literatures about the traditional Chinese medicine in treatment of cervical vertigo in the past 5 years, by using association rules algorithm, complex system entropy clustering and other non supervised data mining methods. Analysis was made for the use of various drugs in the frequency, the association rules, the core drug combination and the new prescriptions. The traditional Chinese medicine inheritance support system(TCMISS) was utilized to analyze 154 drugs from the 101 prescriptions, determine the use frequency of drugs, analyze the characteristics and the compatibility of core drugs, and dig out 14 core drug combinations and 7 new prescription combinations. The prescription and medication regularities illustrates the drugs for treatment of cervical vertigo, including those for flating liver and suppressing yang, invigorating the circulation of blood to remove blood stasis, reducing water and permeating dampness, increasing qi and activating blood, and nourishing the liver and kidney mainly. Treatment rules are nourishing liver and kidney, invigorating the circulation of blood stasis Tongqiao, reducing phlegm and dampness, flating liver and suppressing yan, dredging collaterals, supplementing qi and nourishing blood. This study aims to summarize frequently used single herbs for vertebral artery type cervical spondylosis, combinations of frequently used herbs and dosage of frequently used herbs with significant efficacy, define the current prescription and medication regularities for treating cervical vertigo and give guidances for clinical mediation.

BACKGROUNDData on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited. The aim of the present study was to investigate the prevalence, awareness, treatment, and control of hypertension in the non-dialysis CKD patients through a nationwide, multicenter study in China.

METHODSThe survey was performed in 61 tertiary hospitals in 31 provinces, municipalities, and autonomous regions in China (except Hong Kong, Macao, and Taiwan). Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol. Hypertension was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, and/or use of antihypertensive medications. BP < 140/90 mmHg and < 130/80 mmHg were used as the 2 thresholds of hypertension control. In multivariate logistic regression with adjustment for sex and age, we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.

RESULTSThe analysis included 8927 non-dialysis CKD patients. The prevalence, awareness, and treatment of hypertension in non-dialysis CKD patients were 67.3%, 85.8%, and 81.0%, respectively. Of hypertensive CKD patients, 33.1% and 14.1% had controlled BP to < 140/90 mmHg and < 130/80 mmHg, respectively. With successive CKD stages, the prevalence of hypertension in non-dialysis CKD patients increased, but the control of hypertension decreased (P < 0.001). When the threshold of BP < 130/80 mmHg was considered, the risk of uncontrolled hypertension in CKD 2, 3a, 3b, 4, and 5 stages increased 1.3, 1.4, 1.4, 2.5, and 4.0 times compared with CKD 1 stage, respectively (P < 0.05). Using the threshold of < 140/90 mmHg, the risk of uncontrolled hypertension increased in advanced stages (P < 0.05).

CONCLUSIONSThe prevalence of hypertension Chinese non-dialysis CKD patients was high, and the hypertension control was suboptimal. With successive CKD stages, the risk of uncontrolled hypertension increased.

Adult ; Aged ; Awareness ; Female ; Humans ; Hypertension ; complications ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic ; complications

BACKGROUNDAcute gout is an intensely painful, inflammatory arthritis. Although the non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for this condition, the efficacy is based on only a few studies, particularly in China. We tried to assess the safety and efficacy of etoricoxib in the treatment of acute gouty arthritis in China.

METHODSA randomized, double-blind, active comparator study was conducted at 10 sites in China. Patients (n = 178; ≥ 18 years of age) with acute gouty attack (< 48 hours) were treated for 5 days with etoricoxib (120 mg/d; n = 89) or indometacin (75 mg twice daily; n = 89). The primary efficacy end point was self-assessed pain in the affected joint (0-4 point Likert scale) from days 2 - 5. Secondary end points included investigator assessments of tenderness and swelling, patient/ investigator global assessments of response to therapy, and patients discontinuing treatment. Safety was assessed by adverse events (AEs).

RESULTSEtoricoxib and indometacin had comparable primary and secondary end points. Mean change difference from baseline from days 2 - 5 was 0.03 (95% confidence interval (CI) -0.19 to 0.25; P = 0.6364), which fell within the prespecified comparative bounds of -0.5 to 0.5. No severe AEs were associated with etoricoxib use. Non-severe AEs were mainly digestive and general, and most (73.7%) were mild, although they caused withdrawal of two subjects in the etoricoxib group, due to bilateral renal calculi and uronephrosis of the left kidney (unrelated to etoricoxib) and fever and chills (potentially etoricoxib-related). Overall, AEs were similar, although the absolute number of AEs in the etoricoxib group (n = 31) was less than the indometacin group (n = 34).

CONCLUSIONSEtoricoxib (120 mg once daily) is effective in treating acute gout, is generally safe and well-tolerated, and is comparable in efficacy to indometacin (75 mg twice daily).

Adult ; Aged ; Arthritis, Gouty ; drug therapy ; Cyclooxygenase Inhibitors ; adverse effects ; therapeutic use ; Double-Blind Method ; Female ; Humans ; Indomethacin ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Pyridines ; adverse effects ; therapeutic use ; Sulfones ; adverse effects ; therapeutic use

Objective To investigate the curative effects of different surgical techniques on intradural extramedullary tumors in the foramen magnum.Methods Thirty five patients with intradural extramedullary tumors in the foramen magnum (21 males and 14 females),admitted to and underwent surgeries in our hospital from January 2007 to June 2012,were chosen in our study.Tumors were removed with microsurgeries (27 via suboccipital midline approach and 8 via suboccipital far lateral approach).Their clinical data and curative effects were summarized.Results Total excision was achieved in 32 patients,sub-total excision in 3 patients,and no patient in this study died.Pathological diagnosis showed 15 having schwannoma,3 having neurofibroma,14 having meningioma and 3 having hemangioblastoma.After operation,symptoms of pain in the neck and limb muscle weakness were relieved.All the patients were followed up for 3-48 months showing no cervical spine instability.Conclusion The correct choice of surgical approach and microsurgical skills are keys to remove the intradural extramedullary tumors in the foramen magnum effectively and safely.

BACKGROUNDAnisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.

METHODSA total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) of 60 ml(-1)×min(-1)×1.73 m(-2) or less, who were undergoing coronary angiography or angioplasty, were randomly assigned to receive an infusion of either sodium chloride (control group, n = 128) or anisodamine (treatment group, n = 132). Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 µg×kg(-1)×min(-1) from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group. All patients received intravenous sodium chloride hydration. CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of > 0.5 mg/dl within three days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was a 25% or greater reduction in eGFR.

RESULTSThere were no significant differences between the two groups with regard to age, gender, risk factors, laboratory results, medications and interventions. The incidence of CIN was 9.8% (13/132) in the treatment group and 20.3% (26/128) in the control group (P < 0.05). The secondary end point was 6.0% (8/132) in the treatment group and 16.4% (21/128) in the control group (P < 0.05).

CONCLUSIONThese results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.

Acute Kidney Injury ; chemically induced ; prevention & control ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Contrast Media ; adverse effects ; Coronary Angiography ; adverse effects ; Creatinine ; blood ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; blood ; drug therapy ; Sodium Chloride ; administration & dosage ; Solanaceous Alkaloids ; therapeutic use