The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.
Adjuvants, Pharmaceutic ; Adult ; Aged ; Angina Pectoris ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Injections ; Male ; Middle Aged ; Randomized Controlled Trials as Topic

In order to investigate the effect of malic enzyme on anaerobic mixed acid fermentation,the gene encoding NAD+-dependent malic enzyme was amplified from E.coli DH5? genome by using PCR and cloned into vector pTrc99a to give an expression vector pTrc99a-sfcA.Malic enzyme was overproduced by E.coli FMJ39(ldh,pfl)harboring pTrc99a-sfcA under the condition of IPTG induction.The results of anaerobic fermentation indicated overexpression of malic enzyme would have influence on the pathway of formate,acetate and succinate of FMJ39.The concentration of formate and acetate was 17.58% and 15.27% higher than FMJ39,the succinate concentration was reduced by 26.87%.There was no obvious citrate concentration change.The experimental results also indicated that high concentration of L-Thr and L-Ser would induce the Tdc operon to convert pyruvate into formate and acetate even when pfl gene encoding the pyruvate formate lyase was inactivated.

ObjectiveTo observe the effect of megace (MA) on the survival condition of cancer patients in chemotherapy (CT) periods.Methods92 patients with cancer were divided into the MA group (treated with MA+CT) and control group (treated only with CT). The changing of the appetite, normal food amount, weight, gastrointestinal reaction and whole body conditions of two groups were evaluated.ResultsIn the MA group, 52.2% patients had appetite improvement, 47.8% had more food amount, 45.7% gained more weight, 50% had no obvious gastrointestinal reaction such as vomiting and nausea, and 50% had improve the survival condition according to the Karnofsky performance status (KPS) scores (increment >10). In the control group, only 6.5% had appetite improvement, 4.3% had more food amount, 13% gained more weight, 28.3% had no vomiting and nausea, and 15.2% had improved the survival condition. There was a significant difference between two groups (P<0.01).ConclusionMegace is able to reduce nausea and vomiting caused by CT, improve appetite, increase patients weight, protect bone marrow from the inhibition of CT, improve the life quality of cancer patients, and has no evident side-effects.

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

Objective To investigate the guidance role and effect of the thoracolumbar injury classification and severity score (TLICS) in the choice of anterior,posterior or combined surgery for thoracolumbar fractures.Methods Thirty-one consecutive patients with acute thoracolumbar burst fractures who were treated in an our unit were selected as our subjects who hospitalized from Oct.2006 to Sep 2010,There were 20 male and 11 female patients.The average age was 44.7 years (range from 35.0 to 56.0 of all patients 3 was injured T11,6 at T12,7 at L1,8 at L 2 and 7 at L3.The reasons of injury include motor vehicle accident (10 cases)and falling from a height (24).All patients had preoperative anteroposterior and lateral radiographs,computed tomography (CT) scan,and magnetic resonance imaging (MRI) examination to more fully assess vertebral pieces and nerve compression.According to the Classification of Maged,there were 8 cases with type A3,8 cases with B1,9 cases with B2,3 cases with C1,3 case with C2.Neurologic status based on Frankel classification showed that 4 cases were with grade A 8 with grade B,9 with grade C 6 with grade D and 4 with grade E.Of the 31 patients,11 received posterior surgeries,12 anterior surgeries,and 8 combined anterior and posterior surgeries.Results Twenty-eight cases were followed up with averaged 13.7 months (range from 12.0-17.0 months).The kyphosis angle was measured from the superior endplate to the inferior end plate of the fractured vertebral body using the Cobb technique.The mean cobb's angle was (23.7 ± 11.3) ° (range,13.0 ～ 38.0°) preoperatively,(5.8 ± 0.6°) (-4.0 ～ 6.0) ° lordotic post operatively and (11.3 ± 10.6) ° lordotic at the final observation.The average surgical time was 190 minutes (range,90-380 minutes).and blood loss was 1680 ml (range,1260-2540 ml),and hospital stay was 17.4 days (range,10-24 days).No eloosening or motion was observed in the final follow-up patients.Conclusion TLICS has facilitate treatment decision making of thoracolumbar spinal column injuries and proved to be an effective treatment for serious thoracolumbar fracture.

Objective To compare the effect of two different treatment approaches on femoral shaft fractures in polytrauma patients.Methods One hundred and forty-eight polytrauma patients were selected as our subjects,who were hospitalized from Jan.2000 to Dec.2009.They were randomly divided into cast group and external fixation group.Patients in cast group were fixed with cast within the first 24 h after the injury and patients in external fixation group were stabilized with a unilateral external fix stent within the first 24 h after the injury.Results In cast group,71 of 75 patients were followed up and follow up periods was 26.4 months.Follow up data showed that 18 patients developed multiple organ failure (MOF) and 26 patients developed ARDS.The average healed periods was 5.9 month.Three patients developed nonunion and 4 cases developed wound infection.The average of the knee motion angle was 107 degrees (60 to 110 degrees).In external fixation group,68 patients were followed up and the follow-up period was 27.5 months.Of which,13 patients developed MOF and 12 patients developed ARDS.The average healed periods was 5.6 months.2 patients developed nonunion and 3 cases developed for.wound infection.The average of the knee motion angle was 120 degrees (60 to 140 degrees).Conclusion The damage control orthopedics surgery was proved as a safe and effective treatment approach for fractures of the shaft of the femur in selected multiply injured patients compared with cast methods.

The design principles of a noninvasive ventilator's turbine are studied and discussed in this paper. The design is completed from its several aspects and in combination of related theories, using SolidWorks tools. Abundant experimental results prove that this design's technical specifications meet all the requirements.
Equipment Design ; Respiration, Artificial ; instrumentation ; methods ; Ventilators, Mechanical

OBJECTIVETo study the possibility of mandibular alveolar ridge augmentation by distraction osteogenesis using TiNi-SMA (shape memory alloy) distractor.

METHODSAll of the mandibular premolars and the first molar were extracted from ten adult mongrel canines. One month later, box-shaped osteotomies of the alveolar bone were performed out and TiNi-SMA distractors were buried in experimental group. The bone height was measured before and 1, 5, 13 weeks after the operation. The radiographs were taken on the day of, and 1, 5, 13 weeks after operation. The animals were killed at one or three months after distraction and examined histologically.

RESULTSThe bone segments were lifted up immediately after the insertion of distractors and the height achieved 7.5 - 11.5 mm one week after the operation. One month after distraction, the radiographs showed there was regeneration of bone in distraction gap. The new bone and the normal bone could not be differentiated clearly three months after distraction. No bone resorption was found during this period. In histological sections, there were collagen bundles in early distraction, then these bundles were calcified and became traeculaes.

CONCLUSIONIt suggests that the canine mandibular posterior alveolar ridge can be augmented by distraction osteogenesis using TiNi-SMA distractor, and the new bone is formed by intramembranous ossification.

Alloys ; Alveolar Ridge Augmentation ; Animals ; Dogs ; Male ; Nickel ; Osteogenesis, Distraction ; instrumentation ; Titanium

BACKGROUNDThe Toll-like receptors (TLRs) represent a group of single-pass transmembrane receptors expressed on sentinel cells that are central to innate immune responses.The aim of this study was to investigate the presence of soluble TLRs in pleural effusions, and the diagnostic values of TLRs for pleural effusion with various etiologies.

METHODSPleural effusion and serum samples were collected from 102 patients (36 with malignant pleural effusion, 36 with tuberculous pleural effusion, 18 with bacterial pleural effusion, and 12 with transudative pleural effusion). The concentrations of TLR1 to TLR10 were determined in effusion and serum samples by enzyme linked immunosorbent assay. Four classical parameters (protein, lactate dehydrogenase, glucose and C-reactive protein (CRP)) in the pleural fluid were also assessed. Receiver-operating characteristic curves were used to assess the sensitivity and specificity of pleural fluid TLRs and biochemical parameters for differentiating bacterial pleural effusion.

RESULTSThe concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups, respectively. Analysis of receiver operating characteristic curves revealed that the area under the curves of TLR1, TLR3, TLR4, TLR7 and TLR9 were 0.831, 0.843, 0.842, 0.883 and 0.786, respectively, suggesting that these TLRs play a role in the diagnosis of bacterial pleural effusion. Also, the diagnostic value of TLRs for bacterial pleural effusions was much better than that of biochemical parameters (protein, lactate dehydrogenase, glucose and CRP).

CONCLUSIONSThe concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 appeared to be increased in bacterial pleural effusion compared to non-bacterial pleural effusions. Determination of these pleural TLRs may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Male ; Middle Aged ; Pleural Effusion ; metabolism ; microbiology ; Prospective Studies ; Toll-Like Receptor 1 ; metabolism ; Toll-Like Receptor 3 ; metabolism ; Toll-Like Receptor 4 ; metabolism ; Toll-Like Receptor 7 ; metabolism ; Toll-Like Receptor 9 ; metabolism ; Toll-Like Receptors ; metabolism ; Young Adult

Objective:To analyze the dynamic variety of serum Nesfatin-1in the patients with status epilepticus (SE) , and to explore the clinical values of the serum Nesfatin-1in evaluation on the illness condition and short-term prognosis in the patients with epileptic seizure.Methods:A total of 43patients diagnosed as primary epilepsy were collected as the subjects and received the regular clinical therapy.The serum levels of Nesfatin-1of the patients were detected before treatment and at the end of the 1st week after treatment, the end of the 2nd week therapy after treatment and the end of the 1st month after treatment, respectively.Liverpool Seizure Severity Scale 2.0 (LSSS2.0) was used to evaluate in the patients.The correlations of the serum levels of Nesfatin-1of the patients at each time point with the scores of LSSS were analyzed.After one year of follow-up, all patients were divided into two groups according to the prognosis, which were survival group (31cases) and death group (12cases) .The risk factors of one-year prognosis were analyzed by multivariate Logistic regression analysis.The sensitivity and specificity of the serum values of Nesfatin-1to the one-year prognosis were analyzed by receiver operating characteristic (ROC) curve.Results:Compared with before treatment, the LSSS scores and the serum Nesfatin-1levels of the patients in two groups were decreased with the increasing of treatment time (P＜0.05) .The LSSS scores and the serum levels of Nesfatin-1of the patients were not different between two groups before treatment (P＞0.05) .The LSSS scores and the serum levels of Nesfatin-1of the SE patients in survival group were lower than these in death group from the end of the 1st week after treatment to the end of the 1st month after treatment (P＜0.05or P＜0.01) .The positive correlations of the serum levels of Nesfatin-1and the LSSS scores of the patients at each time point were confirmed (r=0.617-0.726, P＜0.05) .The serum high level of Nesfatin-1was the risk factor of the one-year prognosis analyzed by multivariate Logistic regression analysis.The ROC curve identified the cutoff level of serum Nesfatin-1 (2.7μg·L-1) to the one-year prognosis with the sensitivity of88.5％and specificity of 79.6％.Conclusion:The dynamic variety of serum Nesfatin-1can reflect the condition of illness, and the serum level of Nesfatin-1is decreased gradually with the prolongation of time, and has application value in predicting the prognosis of the patients with epileptic seizure.