Objective: To observe the clinical effects of acupoint application therapy for asthmatic diseases in the hottest of summer days. Methods: 500 cases of patients with asthmatic diseases were treated by applying a herbal drug on the acupoints in the hottest summer days, namely herbal cake stuck on the acupoint with a piece of plaster, for 6 h every time, once respectively in the first, second and third period of the hottest summer days. Six months after the last session, the clinical effects were assessed by questionnaire. Results: In 500 cases of the patients, the results showed a remarkable effect in 267 cases, improvement in 182 cases, failure in 51 cases and the effective rate was 89.9%. Conclusion: The therapeutic effects are positive in the application of a herbal drug on an acupoint for asthmatic diseases. This method is convenient and needs to be popularized clinically.

Objective: To compare the quality of life before and after artificial mechanical heart valve replacement. Methods: From February to June 1998, 115 patients (56 males, 59 females) underwent mechanical valve replacement. The investigation table was filled in one week before the operation and three months postoperatively. Results: There was a notable improvement in patient's physical strength, activity ability, emotion aspect and society home life after operation (P=0.000). In patients with valve-related complications, 64% complained inconvenience in purchasing anticoagulant medicines in the locality, while in patients without valve-related complications, only 39% have such experience. There was significant difference between two groups (P=0.034). 86% of patients with complications worry about the possibility bleeding, while in those with no complications only 55% (P=0.006). Conclusion: Mechanical prosthetic valve replacement significantly improves patient's physical strength, activity ability, emotion and society-home life.

Eight-six heroin addicts were randomly divided into the treatment group by electroacupuncture plus Methadone and the control group by single Methadone for comparison of the therapeutic effects. Statistically there was no significant difference in the therapeutic effect (score reduction rate) between the treatment group and the control group (P＞ 0.05). In the treatment group, the dose of Methadone was half of routine dose, but the therapeutic effect was similar and side effect was less, in comparison with full dose in the control group.

Objective To study the expression and significance of metalloproteinase 2(MMP-2)and tisse inhibitor of metalloproteinase(TIMP-2 ) in the degenerative calcific aortic valve.Methods 15 calcific and 10 non-calcific aortic valve acquired through aortic valve replacement.were studied by immunohistochemistry for MMP-2 and TIMP-2.Morphologic changes were observed by light and transmission electron microscopic.Results The expression of MMP-2 and TIMP-2 in calcific group were significantly higher than in non-calcific group(P<0.01).Positive cells were mostly localized subendothelial and the extracellular matrix.Control valves exhibited very weak staining of MMP-2 and TIMP-2 mostly localized in the extracelluar matrix.Various degree of endothelial damage and interstitial calcification were observed.Conculsion The expression of MMP-2 and TIMP-2 may play an important role in the calcific aortic valve.They may be involved not only in matrix degradation but also in matrix remodeling.The mecha-nism of regulation and activation remain to be elucidated.

Hoarseness ; diagnosis ; etiology ; Humans ; Vocal Cord Paralysis ; complications ; diagnosis

OBJECTIVETo study the efficacy of the low standard oral anticoagulation therapy following St Jude Medical (SJM) valve implantation for Chinese patients.

METHODSTotally 805 patients with a mean age of 42.70 +/- 11.09 years, enrolled into this study. Among them, 230 underwent aortic valve replacements (AVR), 381 mitral valve replacements (MVR), 189 double valve replacements (DVR) and 5 tricuspid valve replacements (TVR). All patients received postoperative oral anticoagulation therapy based on a low standard of international normalized ratio (INR, 2.0 - 2.5). Of the 805 patients, 710 were followed up for 0.25 - 13 years (a median, 4.15 years).

RESULTSPostoperatively, 17 adverse events occurred. Operative mortality was 2.11%. The most frequent cause of operative mortality was a low cardiac output. During follow-up, there were 47 anticoagulant-induced hemorrhages [1.59%/patient-year (pt-yr)], 10 cases of thromboembolism (0.34%/pt-yr), and 3 mechanical valve thromboses (0.19%/pt-yr). There were 44 late deaths and the linearized late mortality rates were 0.51%pt-yr. Estimates of actuarial survival for all patients at 5 and 10 years was 97.45% (0.70%) and 77.96% (17.44%), respectively.

CONCLUSIONSA low target INR range of 2.0 - 2.5 is preferable for Chinese patients so as to reduce the severe bleeding complications in those with conventionally higher levels of INR. The long-term results were satisfactory in terms of the numbers of those who suffered thrombosis, embolism and bleeding.

Administration, Oral ; Adolescent ; Adult ; Aged ; Anticoagulants ; administration & dosage ; Asian Continental Ancestry Group ; Child ; China ; Female ; Follow-Up Studies ; Heart Valve Prosthesis ; adverse effects ; Humans ; Male ; Middle Aged ; Postoperative Complications

OBJECTIVETo observe the clinical characteristics and short-term survival of patients with splenomegaly and acute-on-chronic liver failure related to chronic HBV infection.

METHODSElectronic medical records of patients with acute-on-chronic liver failure were collected to analyze the clinical parameters and 4-week survival of patients with or without splenomegaly.

RESULTSOf the 149 patients enrolled, the overall 28-day mortality rate was 48.3%, which was lower in patients with enlarged spleen than those without (34.2% vs 54.1%, P=0.034). Compared with patients without splenomegaly, patients with splenomegaly had lower platelet counts (P=0.001), lower ALT levels (P=0.005) and lower PT-INR (P=0.010). Although the occurrence of hepatic encephalopathy was comparable between patients with or without splenomegaly, severe conditions were more frequent in those without splenomegaly. Hepatic encephalopathy grades, serum creatinine levels, neutrophil percentages over 70%, PT-INR and splenomegaly were independent factors associated with the 28-day survival, and this novel model was superior to model of end-stage of liver disease in predicting the 4-week survival (P=0.017).

CONCLUSIONPatients with splenomegaly that evolves into acute-on-chronic liver failure have unique clinical characteristics and further clinical observations are warranted.

Acute-On-Chronic Liver Failure ; mortality ; physiopathology ; Chronic Disease ; Hepatic Encephalopathy ; physiopathology ; Humans ; Splenomegaly ; mortality ; physiopathology