Objective To analyze the distribution of traditional Chinese medicine (TCM) syndromes and characteristics of patients with acute respiratory distress syndrome (ARDS), and to provide reference for further clinical study of ARDS. Methods The clinical data of ARDS patients admitted to the Department of Critical Care Medicine of Affiliated Hospital of Chengdu University of TCM from November 2017 to February 2019 were retrospectively analyzed. The general data (gender and age) and inducing cause of disease, clinical manifestations, intensive care unit (ICU) stay time, total hospitalization time, outcome in ICU, outcome in 28-day follow-up and TCM syndromes were recorded. The different degrees of disease severity, the clinical manifestations and distribution characteristics of TCM syndromes were analyzed. Results A total of 110 patients with ARDS were enrolled, including 2 patients in mild ARDS group, 33 patients in moderate ARDS group and 75 patients in severe ARDS group. In the etiology analysis of ARDS, infection was the commonest cause, including 46 cases of pulmonary infection (41.8%), 27 cases of sepsis (24.5%), 4 cases of abdominal cavity infection (3.6%), 2 case of urinary tract infection (1.9%), and 13 cases had surgical histories (11.8%). The stay in ICU was 9.00 (3.00, 18.00) days and the total hospital stay was 18.00 (10.00, 30.00) days. The mortality in ICU was 32.7% (36/110), and that in 28-day follow-up was 60.0% (66/110). The clinical symptoms of the patients in moderate and severe groups ARDS were mainly dyspnea, cough, fever, sputum, chest tightness, and palpitations, accounting for 75.0% (81/108), 43.5% (47/108), 28.1% (31/108), 26.9% (29/108), 22.2% (24/108) and 25.9% (28/108), respectively. Compared with the ARDS moderate group, the proportions of patients with dyspnea, cough and palpitation in severe ARDS group were significantly higher [80.0% (60/75) vs. 63.6% (21/33), 50.7% (38/75) vs. 27.3% (9/33), 33.3% (25/75) vs. 9.1% (3/33), respectively, all P < 0.05]. The main TCM syndromes were yang deficiency, exuberant heat-toxin, and wind-heat invading lung, accounting for 53.7% (58/108), 28.7% (31/108), and 25.0% (27/108) respectively. The proportion of patients with exuberant heat-toxin syndrome in severe ARDS group was obviously higher than that in the moderate ARDS group [34.7% (26/75) vs. 15.2% (5/33), P < 0.05], while the proportion of patients with wind-heat invading lung syndrome in moderate ARDS group was more than that in the severe ARDS group [42.4% (14/33) vs. 17.3% (13/75), P < 0.05]. Conclusion ARDS is a critical illness with high mortality and various complicated clinical symptoms, the TCM syndromes of ARDS are mainly yang deficiency, exuberant heat-toxin, wind-heat invading lung, and intermingling of deficiency and excess easily leading to collapse syndrome.

: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians' subjective evaluation. The most suitable parameters were 3.5 times magnification and working distance. The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and working distance.
Efficiency ; Humans ; Lenses ; Surveys and Questionnaires

Background: and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. Methods: This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. Results: Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). Conclusion In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.