Objective To observe the effect of Shenqi Decoction on inflammation and immune reaction, immune state, restenosis (RS) after implantation of stents in patients with coronary artery disease, and to investigate its mechanism. Methods Eighty-eight patients with coronary artery disease after implantation of stents were randomly divided into the treatment group (45 cases) and the control group (43 cases). The control group was treated with routine treatment, and the treatment group was treated with Shenqi Decoction additionally for six months. RS rate, the level of hs-CRP, the marker of activation of T lymphocytes (CD3+/HLA-DR+), sIL-2R and the scores of blood-stasis syndrome and deficiency of Qi syndrome were observed. Results The RS rate in the treatment group was lower than that in the control group (P

Objective To explore the correlation between brain natriuretic peptide (BNP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia. Methods Plasma BNP levels and serum natrium were assessed at 4 different time periods (1 to 3 days, 4 to 6 days, 7 to 9 days, and 10 to 12 days after SAH) in 30 patients with SAH. Correlation analysis was carried out between plasma BNP and blood sodium level. Plasma BNP levels were compared according to patients with or without CVS, and with or without symptom. The plasma BNP levels of 18 healthy controls were measured meanwhile.Results Plasma BNP levels in SAH patients were significantly elevated compared with control subjects ( P

Objective To explore the value of transcranial Doppler ultrasonography (TCD) on diagnosing the cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH). Methods TCD was used to detect and monitor the cerebral blood flow status to estimate CVS following SAH in 30 cases, then the results of TCD were analyzed by combining with clinical manifestation and SAH severity on CT. Results 17 patients (56.7%) had the evidence of CVS confirmed by TCD, 10 of them were nonsymptomatic and 7 were symptomatic. The incidences of CVS in patients with Fisher grade Ⅲ and Ⅳ were more higher than gradeⅠandⅡ(P

OBJECTIVE:To probe into the mechanism of Shenqi decoction on inhibiting apoptpsis of myocardial cell in?duced by ischemic reperfusion.METHODS:The mice were randomly divided into Shenqi decoction group(high,middle and low dosage groups),isosorbide dinitrate control group,blank control group and model group.The Shenqi decoction group and isosorbide dinitrate group were respectively administered with drugs by lavage for5days while the blank control group and model group were respectively administered with normal sodium by lavage for5days.Except the blank control group the is?chemic reperfusion model of each group was made,then the activity of superoxide dismutase(SOD),the level of malondi?aldehyde(MDA)of cardiac muscle tissues were determined;the apoptotic index of myocardial cells and the expression of apoptosis-correlated protein Bcl-2and Bax were analyzed.RESULTS:Compared with the model group,the SOD activity and Bcl-2express index have been increased,but MDA level and bax express index have been decreased in Shenqi decoction group.CONCLUSION:Shenqi decoction does have a good protection effect on myocardial ischemia and myocardial cell injury induced by postischemia reperfusion.

Objective To evaluate 3D visualization technology in the preoperative planning of hepatic malignancy surgery.Methods The clinical data of 42 patients with hepatic malignancy undergoing radical resection after 3D reconstruction assessment from Feb 2015 to Feb 2018 in our center was retrospectively studied.The predicted resected liver volume were compared with that of resected specimen.Results Surgery was successful in all the 42 patients,and there were no operative deaths.The average operation time was (303 ± 109) minutes,the average intraoperative blood loss was (510 ±482) ml,and 28 patients had intraoperative hepatic inflew occlusion.Postoperative Clavien Ⅲ complications occurred in 4 cases.In terms of the resection liver volume,there was no significant difference between the predicted results (PELV) and actual results [resection liver volume (AELV):(1 143 ± 584) ml vs.(1 091 ± 570) ml,t =0.414,P ＞ 0.05].There is a strong positive correlation between AELV and PELV (r =0.996,P ＜ 0.01).PELV was highly consistent with AELV data (ICC =0.998).Conclusion Three-dimensional visualization technology can accurately reflect the anatomic relationship between intrahepatic tumors and vessels,and correctly assess liver volume,guide surgical resection,thus,it can instruct radical resection of liver malignancy.

Objective The psychometric hepatic encephalopathy scale (PHES),including five psychometric tests,is a standard for the diagnosis of minimal hepatic encephalopathy (MHE) and enjoys predictive value of overt hepatic encephalopathy (OHE).We investigate whether a simplified PHES is as useful as the whole PHES.Methods Seventy consecutive hepatitis B cirrhotic patients without OHE,admitted to our hospital from October 2012 to June 2013,and other 72 healthy volunteers were chosen in our study.PHES was performed in both groups.Expected normal reference value formula were established based on the 5 psychometric tests in healthy controls,and backward logistic regression was performed by eliminating stepwise variables of PHES to get a simplified PHES (SPHES).Then,SPHES was performed on the 70 patients and followed up for a year to detect the prevalence rate of MHE and OHE.Results PHES was easily influenced by age and educational level.In patients with liver cirrhosis,44.29％ patients (31/70) had MHE based on PHES and 41.43％ (9/70) had MHE based on SPHES,without significant differences (P＞0.05).According to the follow-up study,21 patients developed OHE; the number of developing OHE showed no significant difference between MHE patients dignosed by PHES and SPHES (P＞0.05).Conclusion SPHES is as good as PHES in diagnosing MHE and predicting the occurrence of OHE,which consumes less time and is more suitable for clinical screening.

Objective To assess the value of Stroop smartphone application (EncephalApp-Stroop) in screening minimal hepatic encephalopathy (MHE).Methods Ninety hepatitis B cirrhotic patients without overt hepatic encephalopathy (OHE),admitted to our hospital from January 2015 to February 2016,and other 90 healthy volunteers were chosen in our study.Psychometric hepatic encephalopathy scale (PHES) and EncephalApp-Stroop were performed.Normal reference value formulas were established based on the 5 psychometric tests at PHES in healthy controls.EncephalApp-Stroop contained "off'state (neutral stimuli) and "on" state (incongruent stimuli).The time of completing five correct runs and the number of rtms in "on" and "off'states were calculated.PHES was used to diagnose MHE as gold standard to compare the results of OHE patients and healthy subjects and the results of patients with/without MHE.EncephalApp-Stroop results were compared with PHES results by receiver operator characteristic analysis.Results OHE patients had significantly longer time than healthy subjects in Stroop "on" and "off'states (P＜0.05).Traditionally,the total scores of PHES below-4 were diagnosed as MHE,and all the 90 patients taking PHES as gold standard,52 patients were diagnosed as MHE.The time at Stroop "on" and "off'states and the number of trials completing 5 correct runs were longer/larger in patients with MHE as compared with those in patients without MHE,with significant differences (P＜0.05).The validation cohort of EncephalApp-Stroop showed 87％ sensitivity and 79％ specificity.Conclusion The EncephalApp-Stroop is a valid,short and reliable tool for screening MHE.

Objective:To compare proximal humerus internal locking system (PHILOS) and Multiloc intramedullary nail in the treatment of proximal humerus fracture-anterior dislocation.Methods:A retrospective study was performed to analyze the data of 33 patients with proximal humerus fracture-anterior dislocation who had been treated by open reduction and internal fixation from June 2015 to April 2021 at Department of Upper Limbs, Zhengzhou Orthopaedic Hospital. According to methods of internal fixation, the patients were divided into an extramedullary group and an intramedullary group. In the extramedullary group of 18 cases subjected to internal fixation with PHILOS, there were 8 males and 10 females with an age of (53.3 ± 10.6) years, and 1 2-part fracture, 15 3-part fractures and 2 4-part fractures by the Neer classification. In the intramedullary group of 15 cases subjected to internal fixation with Multiloc intramedullary nail, there were 8 males and 7 females with an age of (51.5 ± 11.2) years, and 14 3-part fractures and 1 4-part fracture by the Neer classification. The 2 groups were compared in terms of incision length, operation time, intraoperative blood loss, postoperative complications, and visual analog scale (VAS), range of shoulder motion, and Constant-Murley score at postoperative 12 months.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data ( P>0.05). All patients were followed up for (20.8 ± 4.7) months. The incision length in the intramedullary group [(11.6 ± 1.7) cm] was significantly shorter than that in the extramedullary group [(17.6 ± 2.0) cm], and the intraoperative blood loss in the former [(106.7 ± 34.4) mL] was significantly lower than that in the latter [(151.7 ± 45.7) mL] ( P<0.05). The VAS scores at 1 week and 1 month after surgery [2.0 (2.0, 3.0) and 0.0 (0.0, 1.0) respectively] in the intramedullary group were significantly lower than those in the extramedullary group [3.0 (3.0, 3.3) and 1.0 (0.0, 1.3) respectively] ( P<0.05). The external rotation of the shoulder at the last follow-up in the intramedullary group (65.3° ± 15.5°) was significantly larger than that in the extramedullary group (50.6° ± 13.9°) ( P<0.05). There were no significant differences in operation time, incidence of postoperative complications, VAS score at 12 months after operation, Constant-Murley score or range of shoulder motion at the last follow-up between the 2 groups ( P>0.05). Conclusions:In the treatment of proximal humerus fracture-anterior dislocation, open reduction and internal fixation with both PHILOS and Multiloc intramedullary nail can result in a favorable prognosis when the fracture-dislocation is well reduced and fixated. However, the Multiloc intramedullary nail may lead to better early pain relief, less surgical invasion, and better functional recovery of the external rotation of the shoulder.

Objective:To explore the clinicopathological characteristics of the primary hepatic adenosquamous carcinoma(ASC).Methods:A retrospective analysis was performed on the clinical data of 5 ASC patients admitted to the First Affiliated Hospital of Anhui Medical University from 2006 to 2019 who underwent surgical resection and were pathologically confirmed.Results:Among the 5 ASC cases, there were 4 males and 1 female. The age ranged from 48 to 73 years. As for the initial symptoms, there were 5 cases complaining upper abdominal pain, 2 cases presenting fever, 1 case presenting weight loss and 1 case presenting jaundice. CA19-9 was significantly higher than normal in 4 cases, while AFP was normal in all. None had definite preoperative diagnosis.All the 5 patients underwent surgical resection with pathology proved primary hepatic ASC. Lymph node metastasis was found in 4 cases and nerve invasion in 2 cases. There were 4 cases at TNM stage ⅣA, one at stage ⅠB. The median disease-free survival (DFS) was 5 months and the overall survival (OS) was 9 months.Conclusions:Primary hepatic adenosquamous carcinoma is a rare type of liver malignant tumor with an extremely poor prognosis. Surgical resection helps little in improving the prognosis.