OBJECTIVETo explore the distribution features of Chinese medicine syndrome types in immunoglobin A (IgA) nephropathy patients complicated with hypertension and its correlation with main prognostic indicators of hypertension classification and chronic kidney disease (CKD) staging, thus providing the diagnostic standards of Chinese medicine syndrome types and reliance for accurate syndrome differentiated medication.

METHODSBy on-the-spot survey, the Chinese medicine syndrome and laboratory testing data of 154 IgA nephropathy patients complicated with hypertension confirmed by the pathology of kidneys were collected to analyze the distribution of Chinese medicine syndrome types, its correlation with hypertension classification and CKD staging.

RESULTSAsthenia was the most common syndrome in the 154 patients (146 cases, 94.81%), covering Pi-Shen deficiency syndrome (58, 37.66%), Shen qi-yin deficiency syndrome (48, 31.17%), and Gan-Shen yin deficiency syndrome (40, 25.97%). Of them, asthenia accompanied by asthenia was seen in 80 cases (54.79%) and pure asthenia in 8 cases (5.2%). Shen qi-yin deficiency syndrome and Gan-Shen yin deficiency syndrome were mostly seen in hypertension III, while Pi-Shen deficiency syndrome was mostly seen in hypertension I. Pi-Shen deficiency syndrome was mostly seen in CKD stage 4, Shen qi-yin deficiency syndrome mostly seen in CKD stage 1-2, and Gan-Shen yin deficiency syndrome mainly distributed in CKD stage 1-3. No obvious correlation was seen between Chinese medicine syndrome types and 24-h urine protein quantitation.

CONCLUSIONSPi-Shen deficiency syndrome, Shen qi-yin deficiency syndrome, and Gan-Shen yin deficiency syndrome were main Chinese medicine syndrome types in IgA nephropathy patients complicated with hypertension. Asthenia accompanied by asthenia was mostly seen. Pi-Shen deficiency syndrome was mostly seen in hypertension I. Shen qi-yin deficiency syndrome and Gan-Shen yin deficiency syndrome were mostly seen in hypertension III, Shen qi-yin deficiency syndrome mostly seen in CKD stage 1-2, and Gan-Shen yin deficiency syndrome mainly distributed in CKD stage 1-3. Pi-Shen deficiency syndrome was mostly seen in CKD stage 4 patients.

Adolescent ; Adult ; Aged ; Causality ; Female ; Glomerulonephritis, IGA ; classification ; complications ; diagnosis ; Humans ; Hypertension ; classification ; complications ; diagnosis ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Young Adult

OBJECTIVETo explore the distribution laws of TCM syndrome types and to analyze the distribution of dynamic blood pressure curve, atherosclerosis, and age in senile hypertension patients.

METHODSTotally 1 131 senile hypertension patients were recruited from 7 provinces and municipal cities. Features of TCM syndromes, classification and distribution curves, and syndrome distribution laws were observed. The distribution curves of dynamic blood pressure, carotid atherosclerosis, and age were compared in each TCM syndrome types.

RESULTSThere were four main syndrome types in 736 cases (56.15%), i.e., excessive accumulation of phlegm-dampness syndrome (210 cases, 16.02%), yin deficiency and hyperactivity of yang syndrome (177 cases, 13.50%), Gan-Shen yin deficiency syndrome (79 cases, 6.03%), and deficiency of qi and yin syndrome (252 cases, 19.22%). Besides, there were two more sub-types, i.e., collateral obstruction by blood stasis syndrome and collateral obstruction by phlegm and stasis. Circadian blood pressure monitor was completed in 211 cases. Of them, abnormal circadian blood pressure occurred in 152 cases (accounting for 72. 38%); yin deficiency and hyperactivity of yang syndrome, excessive accumulation of phlegm-dampness syndrome, deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome were most often seen. Color ultrasound of carotid artery was performed in 660 patients of main syndromes. The incidence was quite higher in those of excessive accumulation of phlegm-dampness syndrome (182 cases, 27. 58%), deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome or collateral obstruction by phlegm and stasis (322 cases, 48.79%). Yin deficiency and hyperactivity of yang syndrome was dominant in patients 60 -79 years old, while deficiency of qi and yin syndrome and Gan-Shen yin deficiency syndrome were dominant in patients older than 80 years.

CONCLUSIONSExcessive accumulation of phlegm-dampness syndrome, yin deficiency and hyperactivity of yang syndrome, Gan-Shen yin deficiency syndrome, and deficiency of qi and yin syndrome were main syndrome types in senile hypertension patients. There was statistical difference in the distribution curves of blood pressure, atherosclerosis, and age of various TCM syndrome types.

Aged ; Asian Continental Ancestry Group ; Atherosclerosis ; epidemiology ; Biomedical Research ; Blood Pressure ; Humans ; Hypertension ; epidemiology ; Medicine, Chinese Traditional ; Qi ; Research Design ; Risk Factors ; Yin Deficiency ; epidemiology

Adolescent ; Adult ; Aged ; Arrhythmias, Cardiac ; diagnosis ; etiology ; Child ; Child, Preschool ; Ebstein Anomaly ; complications ; pathology ; Humans ; Infant ; Middle Aged ; Young Adult

BACKGROUNDPatients with persistent or permanent atrial fibrillation (AF) often need direct current cardioversion after radiofrequency ablation. The aim of this study was to investigate the effectiveness and safety of ibutilide for cardioversion of persistent or permanent atrial fibrillation after radiofrequency ablation and the factors related to conversion.

METHODSPatients with persistent or permanent atrial fibrillation were treated with combined ablation strategy including circumferential pulmonary vein isolation, linear ablation and CAFÉ potential ablation. If AF was not terminated after ablation, ibutilide was used for cardioversion (1 mg, intravenous injection in 10 minutes). These patients were divided into a conversion group and a non-conversion group according to whether AF was converted to sinus rhythm within 30 minutes after administration. ECG monitoring was performed during the injection of ibutilide. Atrial waves recorded by coronary sinus electrodes were measured for calculating average wavelength of AF waves in six seconds. The QT interval was measured immediately after conversion and 2 hours after injection of ibutilide.

RESULTSForty patients whose AF was not converted to sinus rhythm after radiofrequency ablation were given an intravenous injection of ibutilide. Of the 40 patients, 29 cases were converted to sinus rhythm, with a conversion rate of 72.5%. The average conversion time was (13.2 ± 5.5) minutes. Compared with the conversion group, patients in the non-conversion group had a longer history of AF (9.4 ± 5.3) years vs. (4.3 ± 2.8) years, P < 0.05), and a markedly enlarged left atrium (47.3 ± 2.9) mm vs. (42.1 ± 4.5) mm, P < 0.05). There were no significant differences in gender, age, body mass index and left ventricular function between the two groups. Ibutilide significantly prolonged the average wavelength of the AF wave (171.8 ± 29.5) ms vs. (242.0 ± 40.0) ms, P < 0.001). Two hours after ibutilide treatment, the QT interval was significantly shortened (421.0 ± 24.7) ms vs. (441.0 ± 37.4) ms, P < 0.05). No cases of serious arrhythmias or other adverse reactions were found.

CONCLUSIONSA single dose of ibutilide for conversion of persistent or permanent AF after radiofrequency ablation is safe and effective.

Adult ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; therapy ; Electric Countershock ; methods ; Female ; Humans ; Male ; Middle Aged ; Sulfonamides ; therapeutic use ; Treatment Outcome