Objective To analyse the diagnosis characteristics of the aged and non-aged patients with dilated cardiomyopathy (DCM).Methods 192 inpatients suspected DCM from 2004 to 2006 were analysed retrospectively, as the groups of the aged (≥60 y) and non-aged (<60 y). Results The percentage of the aged group with idiopathic dilated cardiomyopathy (IDCM) or ischemic cardiomyopathy (ICM) was obviously higher than that of the non-aged group (P<0.01 and P<0.05, respectively). The percentage of the non-aged group with alcoholic cardiomyopathy (ACM) or viral cardiomyopathy (VCM) was higher than that of the aged group(P<0.01). Conclusion There are various diseases similar to DCM should be identified. The causes leading to DCM are different in the aged and non-aged patients.

Objective To study the clinical effect of Zhuang medicine line point moxibustion in the treatment of psoriasis vulgaris.Methods 60 psoriasis vulgaris patients qualified subjects were randomly divided into observation group and control group.The control group was given routine treatment of psoriasis.The treatment group was given Zhuang medicine line points on the basis of the control group.The patients in two groups were treated for four courses.The clinical efficacy of the two groups were compared,and the changes of PASI score and DLQL score at different time periods were compared.Results The total effective rate of treatment group was 76.7%,which was higher than 50.0% in the control group (χ2 =3.125,P<0.05).After 2,3 and 4 courses of treatment,the PASI scores and DLQL scores between the observation group and the control group at the same time point had statistically significant differences (all P<0.05).Conclusion In this study,the use of Zhuang medicine line point moxibustion treatment for psoriasis vulgaris patients has significant curative effect,which can be used as the treatment for psoriasis vulgaris.

Objective To explore ICSI treatment process in the different proportion of oocytes maturation and dosage of gonadotropin affecting embryo quality and clinical outcome. Methods From Jan. to Dec. 2015,we retrospectively analyzed the patients from the center line of ICSI cycle ,divided them into three groups according to the maturity of oocytes. The 3 groups were due to maturity rate of oocytes in 50% in group A(n = 19),50% 0.05). Group A had the best egg rate,high quality embryo rate,clinical pregnancy rate than the other two groups (P < 0.05). In pregnancy and non-pregnancy groups ,the dosage of gonadotropin in the non-pregnancy group was obviously higher than that in the pregnancy group in oocyte maturation in the same proportion interval(P<0.05). Conclusion In ICSI treatment process,the high dose of gonadotropin and rising rates of oocytes maturation are not conducive to the development potential of the egg and clinical outcome,so the dose of gonadotropin and oocyte maturation ratio should be controlled in a certain range to collect and protect the best dominant egg which matches to the state of the patient.

Objective Experimental Study of balloon catheter injury technique in establishment of atherosclerosis.Methods The healthy New Zealand rabbits were randomly divided into two groups.(ns=20,weight2.5～3kg,4month old) The two groups were fed a cholesterol-supplemented diet and one group were subject to balloon catheter injury of the abdominalaorta by femoral artery.And three New Zealand rabbits were fed ordinary diet.The abdominal aorta were observed by pathology in both groups in order to determined whether there was atherosclerosis of the rabbit model.The thickness was measured and the quality of plaque was identified.Results Comparing with cholesterol-supplemented diet group,balloon catheter injury group,the typical carotid atherosclerosis was observed.The neoiniimal thickening and plaque were signficant in two groups and the P/IM ratio reached 0.56?9.4 and 0.99?26.9.Conclusion The typical carotid atherosclerosis lesion can induced by cholesterol-diet plus balloon catheter injury of the abdominalaorta in rabbit.

Objective To evaluate the effects of combination therapy of probucol and atorvastatin on adjusting lipids.Methods 92 spontaneously hypertensive rats(SHR) were randomly divided into the group C(control group) fed with normal diet and normal saline(NS),and group M,group A,group P and group P+A all fed with high lipids diet.At the same time,group M was added with NS,group P with probucol(150 mg/kg/day),group A with atorvastatin(10 mg/kg/day),and group P+A with probucol(150 mg/kg/day) plus atorvastatin(10 mg/kg/day).After 8 weeks,all rats were killed.The total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glutamic-pyruvic transaminase(GPT) and glutamic-oxal(o)acetic transaminase(GOT) were measured respectively before and after experiment.Results The serum levels of TC,LDL-C,HDL-C in every group with high lipids diet were obviously higher than baseline data(P<0.01),but TG level decreased.The serum levels of TC and LDL-C in the group P,group A and group P+A were significantly lower than that in the group M(P<0.01),especially in the group P+A.The serum level of HDL-C in the group P+A was obviously lower than that in the group M and group A(P<0.01).The serum levels of TG in the group P+A and group A were significantly lower than that in the group M(P<0.01),and that in the group P+A was lower than that in the group P(P<0.05).The serum levels of GPT and GOT in every group with high lipids diet(especially in the group M) were higher than ever(P<0.01),and that in the group P+A was obviously lower than that in the group A(P<0.01).Conclusion High lipids diet may due to the disorder of serum lipids and liver dysfunction.Combination therapy of probucol and atorvastatin can strengthen the effects on adjusting lipids,furthermore the effects are stronger than that of monotherapy.Combination therapy may reduce the hepatic damage that high lipids diet duo to,and decrease the hepatic negative effects of atorvastatin.

Objective To explore the value of endothelial dysfunction assessment in predicating major adverse cardiac and cerebrovascular events (MACCE) in peritoneal dialysis (PD) patients.Methods A prospective cohort study included 136 end stage renal disease (ESRD) patients from Jan 1,2009 to Dec 31,2011 was conducted.Endothelial function was assessed by flowmediated dilation (FMD) of brachial artery.Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared by the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of MACCE.Results In the follow-up period,18 patients in low FMD (FMD≤2.7％) group occurred MACCE,and 13 patients in high FMD (FMD ＞ 2.7％) group occurred MACCE.Compared with high FMD group,MACCE-free survival rate in the low FMD group had a significantly decreased (x2=4.190,P=0.041).Multivariate Cox proportional hazards regression analysis showed that higher level of total cholesterol,lower FMD,longer PD time and higher levels of hs-CRP were all independent predictors of MACCE.Conclusion Reduced brachial artery FMD is an independent risk factor of MACCE,and the application of FMD contributes to the risk stratification of cardiac and cerebrovascular disease in PD patients.

Objective To make a system evaluation regarding the effect and safety of the"Nourishing Kidney and Activating Blood"method in the treatment of diabetic cognitive impairment.Methods According to the requirements of evidence-based medicine,the domestic and foreign databases were searched comprehensively,and the time limit was from the establishment of databases to June 2022,so as to find out the clinical randomized controlled trials of"Nourishing Kidney and Activating Blood"method in treating diabetic cognitive impairment.Revman5.3 was used for meta-analysis and risk bias evaluation,TSA0.9 for sequential analysis,Stata15.0 for publication bias evaluation,and GRADE3.6 for evidence quality evaluation.Results Eventually,14 RCTs were included with a sample size of 1126 cases.Meta-analysis showed that compared with conventional western medicine treatment,the"Nourishing Kidney and Activating Blood"method could significantly improve the effective rate of treating cognitive dysfunction in diabetes[OR=5.06,95%CI(3.38,7.57),P<0.00001],and significantly improve the total MoCA score of patients[MD=2.11,95%CI(1.76,2.47),P<0.00001],MMSE score[MD=1.86,95%CI(1.13,2.59),P<0.00001],MQ score[MD=13.40,95%CI(11.23,15.57),P<0.00001]and HDS score[MD=-3.36,95%CI(2.61,4.11),P<0.00001].Meanwhile,the"Nourishing Kidney and Activating Blood"method could reduce the level of glycosylated hemoglobin in DCI patients[MD=-0.84,95%CI(-1.37,-0.32),P=0.002].However,since the drugs used in the control group have no hypoglycemic effect,this conclusion needs to be further verified.In addition,the ability of the"Nourishing Kidney and Activating Blood"method to improve CDR score[MD=-0.01,95%CI(-0.08,0.07),P=0.84],ADL score[MD=2.10,95%CI(-1.62,5.82),P=0.27],TCM syndrome score[MD=-4.46,95%CI(-10.94,2.02),P=0.18]and reduce adverse reactions[OR=0.36,95%CI(0.08,1.60),P=0.18]was equivalent to that of conventional western medicine.Begg's test and Egger's test suggested that there might be some publication bias in the research.Metaninf command chart and sequential analysis of experiments indicated that the stability of research results was relatively good.The quality evaluation of evidence showed that the evidence of effective rate,glycosylated hemoglobin,MoCA scale score,MMSE score and MQ score was medium quality,the evidence of fasting blood glucose,CDR score and HDS score was low quality,and the evidence of ADL score,TCM syndrome score and adverse reactions was extremely low quality.Conclusion The existing literature evidence showed that the"Nourishing Kidney and Activating Blood"method had a good clinical effect in treating diabetic cognitive impairment,and it could reduce the blood glucose level and improve the cognitive function of patients,with certain safety.However,the above conclusions still needed more large samples and multi-center RCT to be further verified due to the limitation of the quality and quantity of the included literature.

By analysing the conceptual connotations of phenotype and traditional Chinese medicine （TCM） symptoms， the relationship between TCM symptoms， phenotypes and diseases is explained. It is believed that phenotypes and TCM syndromes have certain similarities， both of which elaborate the physiological and pathological mechanisms of the human body through external manifestations， and have the temporal and spatial characteristics of both phases and wholeness， as well as focusing on the connection between the innate and the acquired. Summarising the current status of the application of phenomics technology in the studies of TCM syndromes， it is concluded that the study of the intrinsic biological mechanisms of TCM syndromes with the help of phenomics technology has achieved certain results， but there are still problems such as difficulties in matching between traditional Chinese medicine syndromes and phenotypes， the incompleteness of the existing disease phenotype system， and the inconsistency of the understanding about "syndromes". It is proposed that in the future， large-scale clinical databases could be used to collect a wide range of TCM syndromes and phenotypes that are closely related to specific diseases. The phenomics technology could make preliminary correspondence and identification between a single syndrome and the corresponding phenotype， and then further carry out a more accurate phenotypic detection of the composite syndromes， and finally realise the standardization and intelligence of the diagnosis of TCM syndromes with the help of the artificial intelligence technology. By elaborating the modern scientific connotation of TCM syndromes from the perspective of phenotypes， we can provide scientific basis for the determination of TCM syndromes and the clarification of modern biomarkers of syndromes， as well as ideas for the modernisation research of TCM syndromes.

OBJECTIVE: To observe the effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the 2nd stage of labor in the primiparas so as to improve the clinical delivery quality. METHODS: A total of 146 primiparas who accepted the natural delivery willingly were collected. According to the visit sequence, they were divided into an observation group (72 cases) and a control group (74 cases). The free position and the unprotected perineal delivery were adopted in combination during the labor in both of the two groups. Additionally, in the observation group, the auricular-point pressure with semen vaccariae was intervened when entering the active phase. The points were pengqiang (TF), zigong (uterus), neishengzhiqi (TF), pizhixia (AT), shenmen (TF), jiaogan (AH), pi (CO) and wei (CO). Each point was pressed for 1 to 2 min each time, repeated once every 10 to 20 min until the end of the 2nd stage of labor. The episiotomy rate, perineal laceration degree, perineal pain degree, the duration of the 2nd labor stage, postpartum hemorrhage, postpartum urine retention and neonatal asphyxia rate were recorded and compared in the primiparas between the two groups. RESULTS: The perineal laceration of the degree Ⅲ and Ⅳ did not occur in the two groups. Compared with the control group, the effect on the perineal laceration was better in the observation group (<0.05). The episiotomy rate was 5.6% (4/72) in the observation group, lower than that in the control group (<0.05). The total perineal laceration rate was 68.1% (48/72) in the observation group, similar to the control group (>0.05). In the observation group, the neonatal asphyxia rate was 1.4% (1/72), the postpartum hemorrhage 6.9% (5/72) and the incidence of urine retention 5.6% (4/72), all lower than 10.8% (8/74), 18.9% (14/74) and 17.6% (13/74) in the control group respectively (all <0.05). In the observation group, on the 1st, 2nd and 3rd days after labor, the perineal pain degree and the duration of the 2nd stage of labor were superior to the control group (all <0.001). CONCLUSION The combined therapy of the auricular-point pressure intervention at the free position and the unprotected perineal delivery technique effectively reduces the episiotomy rate and perineal laceration degree, relieves the perineal pain, reduces the neonatal asphyxia rate and improves the delivery quality during the 2nd stage of labor in the primiparas.
Female ; Humans ; Labor, Obstetric ; Parity ; Perineum ; Pregnancy ; Pressure

AIM: To investigate the clinical value of serum vitamin A(Vit A)and basic fibroblast growth factor(bFGF)levels predicting retinopathy of prematurity(ROP).METHODS: Prospective cohort studies. A total of 411 premature or low birth weight infants with gestational age less than 37 wk or birth weight less than 2 500 g who were delivered in Hainan Branch, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were selected as subjects. The Vit A and bFGF levels in peripheral blood were detected at 7 d and 35 d after birth, respectively.RESULTS: A total of 392 premature infants or low birth weight infants completed clinical study, including 51 cases in stage 1-2 ROP group, 23 cases in stage 3-5 ROP group and 318 cases in the group without ROP. At 7 d postnatal, the serum Vit A(0.44±0.17 μmol/L)and bFGF(0.53±0.16 ng/L)levels in stage 1-2 ROP group were lower than those in the group without ROP(0.50±0.12 μmol/L and 0.63±0.15 ng/L; all P<0.05). The serum Vit A(0.34±0.18 μmol/L)and bFGF(0.44±0.18 ng/L)levels in stage 3-5 ROP group were lower than those in the group without ROP(P<0.05). The serum Vit A and bFGF levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(P<0.05). At 35d postnatal, the serum Vit A(0.33±0.19 μmol/L)and bFGF(0.39±0.19 ng/L)levels in stage 3-5 ROP group were lower than those in stage 1-2 ROP group(0.43±0.16 μmol/L and 0.48±0.17 ng/L; all P<0.05). According to the ROC curve drawn by serum Vit A, the AUC value was 0.853, the maximum Youden index was 0.68, the best sensitivity was 73%, and the best specificity was 95%. According to the ROC curve drawn by serum bFGF, the AUC value was 0.828, the maximum Youden index was 0.58, the best sensitivity was 90%, and the best specificity was 68%. According to the ROC curve drawn by serum Vit A combined with bFGF, the AUC value was 0.917, the maximum Youden index was 0.70, the best sensitivity was 70%, and the best specificity was 100%.CONCLUSION: Serum Vit A and bFGF levels are sensitive and effective indicators for predicting ROP. If the serum Vit A or bFGF levels are lower in premature infants or low birth weight infants, it may indicate the higher probability of ROP and its pathological stages. In addition, the clinica value of serum Vit A combined with bFGF in the diagnosis of ROP is higher than that of Vit A or bFGF alone, and the misdiagnosis rate is reduced.