Objective To investigate the security of mechanical filter in mechanical ventilation for ICU patients.Methods 60 patients treated with mechanical ventilation and conventional airway humidification were selected and randomly divided into treatment group(mechanical filter treatment) and control group(non filter treatment) ,30 cases in each group.The changes of respiratory function(airway plateau pressure,endogenous PEEP and arterial carbon dioxide partial pressure of 2h,12h,24h at the first day of mechanical ventilation) ,and the incidence and mortality of ventilator-associated pneumonia were observed.Results The study showed airway resistance and the work of breathing in treatment group did not increase,and no hypercapnia due to congestion occurred.The incidence of ventilator-associated pneumonia in treatment group was significantly lower than that of the control group (26.7% vs 56.7% ,x2 = 5.554,P = 0.018).Conclusion Mechanical filer applied in patients with mechanical ventilation was safe and could decrease the incidence of ventilator-associated pneumonia.

Objective To discuss the influence of Danshen Chuanxiongqin injection on renal function and relevant indexes of urine in rats with sepsis -induced acute kidney injury(AKI))caused by cecal ligation and punc-ture (CLP).Methods Seventy male Sprague Dawley(SD)rats were randomly divided by random number table into normal group,sham -operation group,sepsis group and Danshen Chuanxiongqin group.The three latter groups were divided into groups of 6,12,24,48 -hour subgroups,five rats in each subgroup.Danshen Chuanxiongqin group was injected with Danshen Chuanxiongqin injection at 0,24,48h from caudal vein seperately,and the other groups were injected with saline solution.The blood and urine were collected in the set four time points.The relevant indexes like serum creatinine (SCr),blood urea nitrogen(BUN),IL -6 and TNF -αwere tested and kidney injury molecule -1 (KIM-1)and neutrophil gelatinase associated lipocalin (NGAL)were detected.Changes of renal pathology were observed under light microscope.Results In the sepsis group,the concentrations of SCr and BUN 6h after CLP star-ted to rise,reached peak in 24h to (96.31 ±12.64)μmol/L and (27.17 ±4.98)mmol/L,and decreased in 48 h, while concentrations of IL -6 and TNF -αwere reached peak in 12h (28.45 ±3.22)pg/mL and 6h (72.35 ± 10.84)pg/mL respectively,and then decreased,which were all higher than those in the normal group and sham -operation group (P <0.05).After Danshen Chuanxiongqin injection therapy,the concentrations of Scr,BUN,IL -6 and TNF -αin 6h,12h,24h and 48 h were all lower than those in the corresponding points in time in the sepsis mod-el group,and reached minimum values[(14.89 ±2.41)μmol/L,(17.29 ±3.37)mmol/L,(14.89 ±2.41)pg/mL, (17.29 ±3.37)pg/mL,all P <0.05].The contents of KIM-1 and NGAL 6 h after CLP started to increase,reached peak in 24h (5.47 ±0.39)ng/mL and 12h (6.35 ±0.81)ng/mL respectively,and decreased in the sepsis group were all remarkably higher than those in the normal group and sham -operation group.After given Danshen Chuanx-iongqin injection,the contents of KIM-1 and NGAL in 6h,12h,24h and 48h were greatly lower than those in the corresponding points in time in the sepsis group,reached minimum values[(2.27 ±0.16)ng/mL,(2.03 ±0.27)ng/mL,all P <0.05)].In the Danshen Chuanxiongqin group,the change of renal pathology was better than that of the sepsis group in 12h.Conclusion Danshen Chuanxiongqin injection plays the role of renal protection in AKI caused by sepsis.

Objective:To investigate the clinical efficacy of Qianjin Weijing Decoction in the treatment of severe pneumonia with the accumulation of phlegm and heat in the lung. Methods:Eighty patients with severe pneumonia with the accumulation of phlegm and heat in the lung received treatment in Wenzhou Hospital of Traditional Chinese Medicine from December 2018 to December 2020. They were randomly allocated to undergo routine treatments (control group, n = 40) or routine treatments combined with Qianjin Weijing Decoction (observation group, n = 40) for 7 days. Clinical efficacy, blood gas analysis, oxygenation index, inflammatory factors (C-reactive protein and procalcitonin), and sequential organ failure score were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [87.50% (35/40) vs. 65.00% (26/40), χ2 = 5.59, P < 0.05]. Partial pressure of carbon dioxide (PaCO 2) post-treatment was significantly lower in the observation group than that in the control group [(30.24 ± 2.68) mmHg vs. (39.95 ± 3.27) mmHg, t = 14.52, P < 0.05]. The partial pressure of blood oxygen (PaO 2) and oxygenation index (PaO 2/FiO 2) in the observation group were (76.85 ± 4.56) mmHg and (326.84 ± 8.49) mmHg, respectively, which were significantly higher than those in the control group [(68.39 ± 4.12) mmHg, (284.16 ± 15.56) mmHg, t = -8.70, -15.22, both P < 0.05). Serum levels of C-reactive protein and procalcitonin post-treatment in the observation group were (23.12 ± 6.56) mg/L and (0.31 ± 0.08) μg/L, respectively, which were significantly lower than those in the control group [(38.92 ± 5.62) mg/L, (0.78 ± 0.20) μg/L, t = 11.56, 13.80, both P < 0.05]. Sequential organ failure score was significantly lower in the observation group than in the control group [(2.31 ± 0.46) points vs. (5.12 ± 1.25) points, t = 13.34, P < 0.05)]. Conclusion:Qianjin Weijing Decoction has a good therapeutic effect on severe pneumonia with the accumulation of phlegm and heat in the lung. The treatment can improve blood gas analysis and decrease inflammatory factor levels with a good prognosis.

Objective To analyze the efficacy of Astragalus membranaceus and Draba nemorosa in the treatment of chronic heart failure(CHF),the change of cardiac color ultrasound parameters and its predictive value for adverse end events.Methods A total of 92 patients with Qi-deficiency and blood-stasis combined with Shuiyin CHF treated in Wenzhou Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were randomly selected and divided into two groups by random number table method,with 46 cases in each group.Patients in control group were received conventional Western medicine treatment,and patients in observation group were received the addition and subtraction treatment of Yiqi Huoxue Lishui prescription based on Astragalus membranaceus and Draba nemorosa.The clinical efficacy,TCM syndrome score,heart color ultrasound parameters and the incidence of adverse endpoint events within 6 months were compared between the two groups.Cardiac color doppler ultrasound parameters were compared between the occurrence group and the non-occurrence group,and receiver operating characteristic curve was drawn to analyze the predictive value of cardiac color Doppler ultrasound parameters for adverse end events.Results The total clinical effective rate of the observation group(95.65%)was higher than that of the control group(71.74%)(P<0.05).After treatment,palpitation,weakness,shortness of breath,lethargy and lip purple score in observation group were lower than those in control group(P<0.05).The left ventricular end-diastolic diameter(LVEDD)and left arial diameters(LAD)of the observation group were lower than those of the control group after treatment(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)of the observation group was higher than that of the control group(P<0.05);The incidence of adverse endpoint events within 6 months in the observation group(2.17%)was lower than that in the control group(19.57%)(P<0.05).The LVEDD and LAD in the adverse end point event group were higher than those in the without adverse end point event group(P<0.05),and the LVEF was lower than that in the without adverse end point event group(P<0.05).The area under the curve(AUC)of LVEDD,LAD and LVEF combined to predict the occurrence of adverse endpoint events was 0.812,and the 95%CI confidence interval was 0.734-0.968;The sensitivity of combined detection(93.42%)was higher than that of single detection(71.52%,75.11%,79.62%)(P<0.05).The specificity of combined detection(82.27%)compared with that of single detection(70.19%,73.07%,77.28%)(P>0.05).Conclusion Supplementing qi and promoting blood circulation and rehydrating water based on Astragalus membranaceus and Draba nemorosa can effectively improve the cardiac function of CHF patients,alleviate symptoms such as palpitations and fatigue,and reduce the incidence of adverse endpoint events.In addition,the combined detection of cardiac ultrasound parameters can improve the prediction efficiency of adverse endpoint events,which has certain clinical value.

ObjectiveTo observe the efficacy and safety of Uyghur medicine Yangxin Dawayimixike Honey Paste （养心达瓦依米西克蜜膏， YDMHP） in the treatment of stable angina pectoris （SAP） of qi stagnation and blood stasis syndrome. MethodsA randomized ， double-blind， positive-controlled，multi-center clinical trial was conducted， in which 370 patients with SAP of qi stagnation and blood stasis syndrome were randomly divided into treatment group（279 cases）and control group（91cases）at a ratio of 3∶1. The treatment group was orally administered with YDMHP， 3 g each time， and placebo of Xuefu Zhuyu Capsule （血府逐瘀胶囊）， 2.4 g each time， while the control group was treated with Xuefu Zhuyu Capsule， 2.4 g each time， and placebo of YDMHP， 3 g each time， both twice a day for a course of 12 weeks. The primary outcome was the effect of angina pectoris symptom. The secondary outcomes include single angina symptom scores such as number of attacks， duration of attacks， pain intensity and usae of nitroglycerin scores， the total angina symptom score before and after the treatment， the usage of nitroglycerin， the exercise duration in treadmill exercise test （TET） and the Duck treadmill score among patients，the scores of Seattle Angina Questionnaire （SAQ） on five dimensions including physical limitations， anginal stability， anginal frequency， treatment satisfaction， and disease perception， and efficacy of TCM syndrome and of each single TCM symptom after treatment. The safety were evaluated by examine blood routine， urine routine， liver and kidney function， fasting blood sugar， electrocardiogram， adverse events. ResultsThe total effective rate of angina symptom in the treatment group was 71.69% （200/279）， significantly higher than 51.64% （47/91） in the control group （P＜0.01）. The curative and markedly effective rate of TCM syndrome in the treatment group was 53.05% （148/279）， which was significantly higher than 25.27% （23/91） in the control group （P＜0.01）. After treatment， scores of the number as well as duration of angina attacks and pain severity， the total score of angina symptoms， and the usage of nitroglycerin significantly decreased in both groups， and more changes were seen in the treatment group than in the control group； the scores of physical limitations， anginal stability， anginal frequency， treatment satisfaction， and disease perception in both groups significantly increased， and more improvement were shown in the experimental group regarding the anginal stability， anginal frequency and treatment satisfaction （P＜0.05 or P＜0.01）. The effects of chest pain， chest tightness， palpitation， shortness of breath and fatigue in experimental group were significantly higher than those in control group （P＜0.05 or P＜0.01）. There was no significant difference in the exercise duration of treadmill test and Duke score among patients between the two groups either before or after treatment （P＞0.05）. Adverse events occurred in 66 cases （23.66%） of the experimental group and 16 cases （17.58%） of the control group， with no statistical significance between the two groups （P＞0.05）. ConclusionThe Uyghur medicine YDMHP can effectively improve symptoms of angina pectoris， reduce the number， duration， and intensity of attacks， decrease the dosage of nitrogly-cerin and improve the individual TCM symptoms and has good safety in the treatment of SAP patients of qi stagnation and blood stasis.