Airway Remodeling ; physiology ; Animals ; Asthma ; metabolism ; Disease Models, Animal ; PPAR gamma ; biosynthesis ; Rats

OBJECTIVE:To investigate the prognosis of coronary heart disease complicated with heart failure patients abandon-ing percutaneous coronary intervention (PCI) and receiving drug comprehensive therapy. METHODS:From Dec. 2010 to Jul. 2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group (105 cases) and non-operation group (112 cases). Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography re-checking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovas-cular events were recorded during follow-up period. RESULTS:7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction, heart failure and death in non-operation group was more than operation group,with statistical significance (P<0.05). 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance(P<0.05). The survival time of non-operation group was shorter than that of operation group,with statistical significance(P<0.05). CONCLUSIONS:Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.

Retrospective analysis was performed for the clinical data of 15 chronic insertion achilles tendinitis patients undergoing platelet-rich plasma (PRP) trigger point injection.The scores of Validated Victorian Institute of Sports Assessment-Achilles (VAS-A) and foot function index (FFI) improved greatly versus pre-treatment (all P ＜ 0.05).Tendon insertion structure inflammation decreased significantly on magnetic resonance imaging.At the last follow-up,all patients recovered normal gait and daily activity.The trigger point injection of PRP is efficacious for chronic insertion achilles tendinopathy.

Objective To observe the effects of platelet-rich plasma (PRP) gel in the treatment of [Ⅳ stage pressure ulcers.Methods A total of 12 patients with stage Ⅳ pressure ulcers were treated with PRP gel from December 2012 to December 2013 in our department.The PRP gel was formed by autologous PRP mixed with thrombin and calcium chloride.The PRP gel was applied to the wound after dressing.Time intervals between dressing were 4 days.Overall pressure ulcer improvement was assessed every week until complete wound healing.Results All stage Ⅳ pressure ulcer wound infection was controlled and fresh granulation tissue was found after 2 times of PRP gel covering.The time of ulcer wound healing were 6-10 weeks (mean 8 weeks).The times of changing the PRP gel were 16.No patients experienced adverse reactions during treatment.Conclusions PRP gel can effectively control the pressure ulcer infection and promote ulcer wound healing.

OBJECTIVETo compare the effect of transurethral resection of the prostate combined with endocrine therapy (TURP + ET) with that of αlA-blockers combined with ET ((αlA-b + ET) in the treatment of bladder outlet obstruction (BOO) in patients with advanced prostate cancer (PCa), and to investigate the safety of the TURP + ET for the treatment of PCa with BOO.

METHODSWe retrospectively analyzed 63 cases of PCa with BOO, 28 treated by αlA-b + ET and the other 35 by TURP + ET. We obtained the residual urine volume (RV), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and quality of life score (QoL) before and after treatment along with the overall survival rate of the patients, followed by comparison of the parameters between the two methods.

RESULTSAt 3 months after treatment, RV, IPSS, and QoL in the TURP + ET group were significantly decreased from (137.8 ± 27.6) ml, (22.3 ± 3.6), and (4.2 ± 0.8) to (29 ± 13.6) ml, (7.8 ± 2.1), and (1.6 ± 0.5) respectively (P < 0.05), while Qmax increased from (5.6 ± 2.1) ml/s to (17.6 ± 2.7) ml/s (P < 0.05); the former three parameters in the αlA-b + ET group decreased from (133.6 ± 24.9) ml, (21.5 ± 3.2), and (4.7 ± 1.1) to (42 ± 18.3) ml, (12.8 ± 2.6), and (2.5 ± 0.7) respectively (P < 0.05), while the latter one increased from (6.3 ± 2.4) ml/s to (11.7 ± 2.3) ml/s (P < 0.05), all with statistically significant differences between the two groups (P < 0.05). The overall survival rate of the TURP + ET group was not significantly different from that of the αlA-b + ET group (51.4% vs 46.4% , P > 0.05).

CONCLUSIONTURP + ET is preferable to αlA-b + ET for its advantage of relieving BOO symptoms in advanced PCa without affecting the overall survival rate of the patients.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; methods ; Humans ; Male ; Prostatic Neoplasms ; complications ; drug therapy ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; etiology ; surgery

This study was aimed to observe the improvement of Qiju Runmu Tie (QRT) on experimental dry eye syndrome in rats. The fourth day after the bleomycin hydrochloride (8 g·mL-1) was injected into the intraorbital lacrimal gland (0.06 mL) and extraorbital lacrimal gland (0.12 mL), QRT of large, medium, and small dosage (0.276 g·mL-1, 0.138 g·mL-1, 0.069 g·mL-1) was applied on rat's eyes continuously for 10 days, once a day, 1 hour every time. Rats in the control group and model group were applied with a patch containing distilled water in the same operation. The tear secretions, time of tear film break-up and pathological changes of lacrimal gland were observed from the eleventh day to the thirteenth day after injection. The results showed that compared with the control group, bleomycin hydrochloride can induce atrophy of lacrimal gland, hyperplasia and decrease bubbly mucus in the acinar lumina, significant reduce of tear secretion, and significant shorten the time of tear film break-up. Compared with the model group, QRT can significantly increase the amount of tear secretion (P <0.05), extend the tear film break-up time (P < 0.01). And the medium dosage of QRT can obviously reduce lacrimal gland tissue injury. It was concluded that external application of QRT can improve symptoms of experi-mental dry eye syndrome in rats.

Objective:To investigate the factors related to recurrence and prognosis of retroperitoneal liposarcoma.Method:The clinical data of patients with primary retroperitoneal liposarcoma who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from June 2011 to January 2020 were analyzed retrospectively. There were 42 males and 47 females and patients’median age was 53 (26-78). Sixty-five cases were treated by operation in our hospital, and 24 cases were primarily treated by the operation in another hospital. The clinical manifestations of the initial diagnosis included retroperitoneal mass in 41 cases, abdominal distension in 12 cases, abdominal pain in 10 cases, fever in 11 cases, nausea, vomiting and poor appetite in 8 cases, frequent urination and dysuria in 6 cases, and bilateral lower limb edema in 1 case. Preoperative CT imaging showed that the tumor body was located in the retroperitoneal kidney area in 58 cases, while in the retroperitoneal space or the pelvic extraperitoneal space in 31 cases. There were 55 single cases and 34 multiple cases. The median tumor length was 20(3-52) cm. Among the primarily treated 65 patients, 47(72.3%) were considered as primary retroperitoneal liposarcoma by preoperative imaging examination. Among the 89 patients treated by surgery, 78 underwent endoscopic surgery, among which 21 underwent laparoscopic surgery, 38 cases of retroperitoneal laparoscopic surgery, 19 cases of Da Vinci robot-assisted laparoscopic surgery. Open operation was performed in 11 cases. There were 87 patients undergoing radical resection and 2 patients undergoing palliative resection. Forty-two patients underwent intraoperative combined resection of the adjacent organs. The recurrence and survival status of patients were followed up.Results:All the 89 patients underwent the operation successfully, with the median operative blood loss of 200 (10-2000) ml. There were 23 cases being diagnosed of well differentiated liposarcoma, 40 cases of dedifferentiated, 20 cases of myxoid/round, 5 cases of myxoid liposarcoma, and 1 cases of mixed type. Pathologically, there 42 cases with low grade histology and 47 cases with high grade histology. In this study, 89 patients were followed up for 3 to 108 months, and the median follow-up time was 28 months. The 5-year recurrence free survival rate, disease-free survival rate and overall survival rate of the patients were 16.7%, 16.1% and 52.6%, respectively. There were 57 patients presenting local recurrence, 1 patient of lung metastasis, and 1 patient of liver metastasis, and the median disease-free survival time was 24 months. There were 42 patients died of the disease, with a median survival time of 64 months. Univariate analysis showed that intraoperative blood loss( P<0.01), whether multiple cases( P<0.01), pathologic types( P<0.01), and histological grades ( P<0.01) were related to disease-free survival.The intraoperative blood loss( P<0.01), multiple cases( P<0.05), pathologic types ( P<0.05), and recurrence ( P<0.01)were related with overall survival. Gender, age, tumor size, tumor location, whether primary surgery, radical resection or combined resection of adjacent organ had no effect on the prognosis of patients ( P>0.05). Cox regression model multivariate analysis revealed that surgical bleeding ( RR=2.360, 95% CI 1.313-4.241, P=0.004), multiple tumor ( RR=1.899, 95% CI 1.068-3.375, P=0.029), and pathological type ( RR=4.976, 95% CI 1.622-15.264, P=0.005) were independent factors affecting disease-free survival. The recurrence was an independent factor affecting the overall survival of patients ( RR=31.495, 95% CI 1.062-933.684, P=0.046). Conclusions:Retroperitoneal liposarcoma is a rare disease with high recurrence rate. The intraoperative blood loss, whether multiplicity and pathological type are independent factors affecting the disease-free survival, and recurrence is independent factors affecting the overall survival.

OBJECTIVETo investigate the influence of enteral administration of carbachol on the intestinal dysfunction of both severely burn patients and rabbits with partial intestinal ischemia/reperfusion (I/R) injury.

METHODSSeventy-five white rabbits were inflicted with I/R injury and randomized into intestinal I/R (I, n=25), carbachol [C, n=25, with 3g/L carbachol (3 mg/kg) injection into duodenum 1 h after SMA occlusion] and sham operation (SO, n=25, with SMA isolation but no occlusion) groups, and 5 other as normal controls. The blood flow of intestinal mucosa was detected before and after SMA occlusion or admission of carbachol. Changes in diamine oxidase (DAO), D-lactate, xylopyranose absorption, blue dextran discharging time were measured at 2, 4, 6, 8, 24, 48, 72 h after SMA occlusion. In addition, eight severe burn patients with TBSA of 84 +/- 12% were enrolled in the study, and carbachol (15 microg/kg) was administered to patients when abdominal distension or bowel sound was lower than 2 times/min, then the number of abdominal distension and bowel sounds per minute were observed.

RESULTSThe blood flow in intestinal mucosa of rabbits without SMA occlusion was (102 +/- 5) PU, reduced to (48 +/- 6) PU after SMA occlusion, and increased to (77 +/- 3) PU after injection of carbachol. The plasma DAO activity and D-lactic acid content in I group began to increase 4 hours after SMA occlusion, and they reached the peak 24 hours after SMA occlusion (4.63 +/- 0.27 U/ml, 7.9 +/- 2.4 mg/L) , after that they decreased gradually, but still higher than the normal value (0.89 +/- 0.14 U/ml, 2.0 +/- 1.1 mg/L, P < 0.05). In carbachol group, data showed the same trends as that in intestine I/R group with lower values, while no obvious changes were in sham operation group (P > 0.05). The content of D-lactic decreased dramatically 2 hours after D-lactic administration in both I and C groups, increased 6 hours after SMA occlusion, then decreased gradually, but it in C group was always higher than normal values, and little fluctuation was in sham operation group. There was no blue dextran discharge 2 hours after SMA occlusion. The discharging distance increased 6 hours later, but it was obviously shorter than the normal value 24 hrs after operation (P < 0.05) , then it returned to normal 48 to 72 hrs after operation. In the C group, blue dextran discharge was found immediately after its injection, with obvious increase in the discharging distance to peak value (43 +/- 6 cm) 6 hours after injury, and returning to normal (28 +/- 3 cm) gradually. In severe burned patients, the bowel sounds was (1.6 +/- 1.1) per minutes before carbachol administration, then increased dramatically to (6.9 +/- 1.7) per minutes 10 mins after administration, reached to a higher level 30 minutes after administration (8.3 +/- 2.4 ) times/min, and it maintained to (6.1 +/- 1.3) times/min 1 hour after administration. Abdominal distension was ameliorated 2 hours after carbachol administration, six patients were able to defecate.

CONCLUSIONEnteral administration of Carbachol can increase the blood flow of intestine mucosa, help to improve the movement, absorption and barrier functions of intestine, and ameliorate intestinal dysfunction in patients with severe burns.

Adolescent ; Adult ; Animals ; Burns ; drug therapy ; physiopathology ; Carbachol ; therapeutic use ; Disease Models, Animal ; Female ; Humans ; Intestinal Mucosa ; blood supply ; metabolism ; Intestines ; physiopathology ; Male ; Rabbits ; Reperfusion Injury ; drug therapy ; physiopathology

Objective:To observe short-term therapeutic effect and prognosis of levosimendan or milrinone on patients with decompensated heart failure(DHF).Methods:A total of 120 DHF patients treated in our hospital were equal-ly divided into levosimendan group(received levosimendan based on routine anti-HF treatment)and milrinone group (received milrinone based on routine anti-HF treatment),both groups were treated for one week continuously.Lev-el of brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)and 6min walking distance(6MWD) were compared between two groups before and after treatment.Results:Compared with before treatment,on one week after treatment,there was significant reduction in BNP level and significant rise in LVEF in two groups,P=0.001 all;compared with milrinone group after one-week treatment,there was significant reduction in BNP level [(224.45 ± 29.45)pg/ml vs.(197.41 ± 27.65)pg/ml]and significant rise in LVEF[(37.72 ± 2.03)% vs.(44.33 ± 1.94)%]in levosimendan group,P=0.001 both.Compared with before treatment after three-month treatment, there was significant rise in 6MWD in two groups(P=0.001),and 6MWD of levosimendan group was significantly longer than that of milrinone group[(441.76 ± 75.45)m vs.(409.63 ± 73.56)m],P=0.02. Conclusion:Short-term therapeutic effect and prognosis of routine anti-HF medication combined levosimendan are significantly better than those of combined milrinone treatment in DHF patients.

Objective To investigate the effects of Ganlu Xiaodu Pills and its residues on PSGL-1 and proinflammatory cytokines in Coxsackie virus A16 (CoxA16) mouse model; To discuss its antiviral mechanism of action. Methods Totally 150 ICR mice at age of 7 days were randomly divided into normal group, model group, all-side group, aromatic residual group, clearing residual group and removing residual group, with 25 mice in each group. Except for normal group, other groups were injected intraperitoneally with 20 μL of 107TCID50 CoxA16 standard stock solution to establish models. Except for normal group and model group, other groups were given relevant medicine for intervention. The expressions of PSGL-1, TNF-α, IL-1β and IL-4 and histopathological observation were detected after 10 days of medication. Results Except for the normal group, the existence of a large number of CoxA16 in other groups of mouse muscle tissues proved successful modeling. HE staining showed that Ganlu Xiaodu Pills and residual could reduce damage to the muscle by CoxA16 virus. Compared with the normal group, the expression of PSGL-1 protein in the model group increased (P<0.01); compared with the model group, all-side group, aromatic residue group, clearing residual group, removing residual group inhibited the expression of PSGL-1 protein, reduced the inflammatory factors of TNF-α, IL-1β, and IL-4 (P<0.01). Conclusion Ganlu Xiaodu Pills and its residues have anti-inflammatory effects, and the all-side group shows the best efficacy.