Objective To investigate the effects of Sini decoction on function of hypothalamic-pituitary-adrenal axis in patients with sepsis.Methods A prospective single-blind randomized controlled trial was conducted.60 septic patients were divided into three groups with the method of random number table,20 cases in the control group,20 in the Chinese herb group,and 20 in corticoid group.All of them received routine treatment.Patients in Chinese herb group were given Sini decoction in addition (decoction of monkshood 15 g,dried ginger 15 g,honey-fried licorice 10 g) 100 mL/d orally or by nasal feeding,while patients in corticoid group were given hydrocortisone 200 mg/d intravenously instead,both for 7 days.Before the treatment,3 days and 14 days after treatment,blood was collected to determine the levels of adrenocorticotropic hormone (ACTH) and cortisol,and the result of ACTH stimulating test was observed.At the same time,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was recorded,and 3-day shock recovery rate and 28-day death rate were also compared among these groups.Results None of the three groups showed different result in ACTH stimulating test (x2=1.101,P=0.605).ACTH in three groups was gradually decreased.Compared with that before treatment,ACTH in Chinese herb group and corticoid groups began to decrease obviously on day 3 (ng/L:29.90 ± 3.31 vs.33.10 ±.3.31,28.20 ±.2.45 vs.33.30 ± 3.84,both P＜0.01),while in control group declined ACTH appeared later (on day 14) compared with before treatment (ng/L:29.40 ±5.63 vs.33.50 ±4.89,P＜0.05).No obvious difference in ACTH level was showed between the Chinese herb group and the cortical group (both P＞0.05).Cortisol level in both Chinese herb and cortical groups showed a raise-fall biphase trend while there was no change in the control.The cortical levels on day 3 in Chinese herb and cortical groups were much higher than that before treatment (μg/L:343.04 ± 31.20 vs.294.70 ±42.10,331.25 ±42.80 vs.280.36 ± 38.10,both P＜0.01) and that of control group (μg/L:291.61 ± 41.50,both P＜0.01),though no significant statistical difference was observed between two groups (both P＞0.05).APACHE Ⅱ score on day 14 in control,Chinese herb and cortical groups was significantly lower than that before treatment (16.8 ± 5.1 vs.20.1 ± 4.3,13.4 ± 3.2 vs.18.3 ± 3.8,15.1 ± 2.5 vs.19.5 ± 4.0,all P＜0.01),and the score was much lower in Chinese herb group comparing with that of control group (P＜0.05).No statistical difference was observed among control,Chinese herb and cortical groups in lowering 28-day death rate [35.0％ (7/20),25.0％ (5/20),20.0％ (4/20)] and improving 3-day shock recovery rate [40.0％ (8/20),70.0％ (14/20),60.0％ (12/20),all P＞0.05].Conclusions Sini decoction could elevate cortisol while lower ACTH at the early stage of sepsis.Sini decoction could also effectively improve symptoms and hypothalamic-pituitary-adrenal axis function in septic patients without affecting death rate.

To investigate the effect of atorvastatin on lipid metabolism in type 2 elder diabetes patients with hyperlipidemia, 26 patients with type 2 elder diabetes complicated with hyperlipidemia were treated with atorvastatin (10 mg/d) for 8 weeks. The serum triglyceride (TG), high density protein cholesterol (HDL-C) and low density protein cholesterol (LDL-C) were measured before and after the treatment. Meanwhile, the non-denaturing polyacrylamide gradient gel electrophoresis was used for detection of small-sized LDL(SLDL). Our results showed that TG dropped from 4.88 +/- 0.72 mmol/L to 2.65 +/- 0.32 mmol/L; HDL-C was increased from 0.85 +/- 0.31 mmol/L to 1.28 +/- 0.29 mmol/L; LDL-C was declined from 3.71 +/- 2.98 mmol/L to 2.10 +/- 1.22 mmol/L, sLDL-A was increased from (42.49 +/- 8.1)% to (53.27 +/- 7.5)%; LDL-B was decreased from (57.91 +/- 8.1)% to (46.73 +/- 7.5% ) (P<0.05). The level of blood glucose was not changed at the end of 8th week. It is concluded that atorvastatin has satisfactory lipid-regulating effects on type 2 elder diabetes patients with hyperlipidemia.
Anticholesteremic Agents/*therapeutic use ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Diabetes Mellitus, Type 2/*complications ; Diabetes Mellitus, Type 2/drug therapy ; Heptanoic Acids/*therapeutic use ; Hyperlipidemias/complications ; Hyperlipidemias/*drug therapy ; Pyrroles/*therapeutic use ; Triglycerides/blood

Objective To investigate the relationship between refractory hypertension and renal hemodynamics in end stage renal diseases (ESRD) patients.Methods ESRD patients were classified into:patients with refractory hypertension (group A) and patients with normal blood pressure(group B).Renal hemodynamic indices were ex- amined by duplex ultrasonography.Fasting serum lipid (TC,TG,HDL-C,LDL-C,Lp(a),ox-LDL) and serum parathyroid hormane (PTH) were determined in all patients.Results Significant differences were found in renal hemodynamic indices such as peak systolic velocity (PSV),mean flow velocity (MV),pulsatility index (PI),renal- aortic ratio (RAR) and in clinical index such as Lp(a) and ox-LDL between the two group.Refractory hyperten- sion patients had lower renal hemodynamic indices and higher Lp(a) and ox-LDL levels than in patients with con- trolled BP.Logistic regression analysis revealed that refractory hypertension was related with PSV,EDV,Pl and RAR,but not relevant with sex,age,dialysis time,hematocrit,BUN,creatinine,TC,TG,HDL-C,LDL-C, PTH,MV and RI.Conclusion Atherosclerotic renal artery stenosis and severe disorder in renal hemodynamics is likely the cause for refractory hypertention in ESRD patients.The rise of serum Lp(a) and ox-LDL might acceler- ate renal artery atherosclerosis.

Homocysteine ; analogs & derivatives ; blood ; Humans ; Infant ; Infant Nutrition Disorders ; complications ; Male ; Methylmalonic Acid ; urine ; Skin Diseases ; etiology ; Vitamin B 12 ; administration & dosage

OBJECTIVE: To investigate the effect of continuous veno-venous hemofiltration (CVVHF) for acute hypernatremia. METHODS: Seven patients with hypernatremia were studied and treated with CVVHF. The serum sodium concentration and its remedy speed, creatinine, osmolarity, and blood pressure, etc were observed before and after CVVHF. RESULTS: The patients were treated with CVVHF averagely for 40 hours. The serum sodium concentration, creatinine, osmolarity after the treatment decreased significantly and the APACHE II scores significantly improved. Among the 5 coma patients, 2 patients's consciousness was improved. CONCLUSION CVVHF is effective and can be a new method for treating acute hypernatremia.
Acute Disease ; Adult ; Female ; Hemofiltration ; methods ; Humans ; Hypernatremia ; therapy ; Male ; Middle Aged

Objective To analyze variations of hepatic vein in healthy people with 64-slice spiral CT.Methods Seventy-five healthy subjects underwent multi-slice spiral computed(MSCT)hepatic venography.The anatomy of the junction of the hepatic veins with the inferior vena cava and the intrahepatic drainage territory of the hepatic veins and tributaries were evaluated.The hepatic veins were classified according to three anatomic classification(Nakamura's,Marcos's and Kawasaki's classification)methods respectively.Results There was a common trunk of the middle and left hepatic veins before joining the IVC in 86.7%(65/75)of the cases.In 13.3%(10/75)of the cases,the three main hepatic veins joined the IVC separately.The ratios of Nakamura's classification type A,B,C of hepatic veins were 49.4% (37/75),37.3%(28/75),and 13.3%(10/75)respectively.The ratios of Marcos's classification type A,B,C of hepatic veins were 56.0%(42/75),24.0%(18/75),and 20.0%(15/75)respectively. The ratios of Kawasaki's classification type Ⅰ,Ⅱ of hepatic vein were 40.0%(30/75)and 60.0% (45/75).Conclusion Multi-slice spiral CT hepatic venography can provide visualization of peripheral hepatic venous branches in details.

ObjectiveTo study the effect of menbranous milkvetch root parenteral solution on insulin resistance of gerontism cerebral infarction in recovery stage.Methods66 patients with gerontism cerebral infarction were randomly divided into therapy group(33 cases) which received membranous milkvetch root parenteral solution and control group(33 cases).Both groups adopted routine treatment at the same time, the period was 20 days. Insulin(Ins), free blood sugar(FBS), total cholesterol(CH), triglyceride(TG), hemorheology and insulin resistance(indicating by index of insulin sensitive) of blood on empty stomach were evalutated before and after treatment. ResultsAfter treatment there was decrease in CH, FBS, FINS in therapy group than in control group(P<0.01 or P<0.05); the clinical effect in therapy group was better than in control group(P<0.01).ConclusionMembranous milkvetch root parenteral solution can significantly decrease insulin resistance, blood lipin, blood viscosity in recovery stage of gerontism cerebral infarction, and improve clinical efficiency.

OBJECTIVETo evaluate the imaging features of MR Imaging (MRI) and MR cholangiopancreatography (MRCP) and their clinical value in the diagnosis of extrahepatic cholangiocarcinoma.

METHODSMRI was performed in 54 patients with extrahepatic cholangiocarcinoma proved surgically and pathologically, MRCP in 44 patients, Gadolinium-enhanced in 29 patients. MRI, MRCP and pathological findings were analyzed retrospectively.

RESULTSBy MRI, the mass was shown (n = 39) and all bile duct thickened (n = 13) in extrahepatic cholangiocarcinoma. Gadolinium-enhanced ones revealed calcified focus (n = 22). By MRCP, interrupted, abruptly cut-off or cone-like changes of the bile duct (n = 16), beak-like or mouse tail changes (n = 26) or tumbler mouth appearance (n = 2) were shown. The bile duct distal to the obstruction was observed in 29 patients. Of the 54 patients examined by MRI in combination with MRCP, correct tumor localization was made in 52 (96.3%) and correct judgement of tumor nature in 50 (92.6%).

CONCLUSIONConventional MRI is an effective supplement to MRCP in the diagnosis of extrahepatic cholangiocarcinoma. MRCP combined with MRI is able to significantly improve the diagnostic accuracy of MR examination.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Extrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies

Animals ; Arsenites ; therapeutic use ; Catheter Ablation ; Liver Neoplasms ; therapy ; Male ; Rabbits

OBJECTIVETo explore the onset cycle of scarlet fever in Beijing and its association with theory of five evolutive phases and six climatic factors (FEPSCF).

METHODSBased on the monthly scarlet fever data from 1970 to 2004, Complex Morlet wavelet was adopted to analyze the annual incidence and the incidence of six climatic factors in the past 35 years. Its association with the cycles of FEP-SCF was explored. The features of heavenly stems and earthly branches in the year that the wave peak corresponded and their correlations with doctrine of FEPSCF were analyzed.

RESULTSThe annual incidence of scarlet fever and the incidence of FEPSCF had two main cycles, i.e., 5 years and 28 years. The 5-year primary cycle was consistent with 5-year cycle of FEPSCF theory. The high incidence year of 5-year primary cycle was Jinyun.

CONCLUSIONSThe cycle of five evolutive phases was consistent with the onset cycle of scarlet fever. The quasi-periodic phenomenon and multi-cycle superimposed phenomenon of FEPSCF theory existed in the incidence of scarlet fever.

China ; epidemiology ; Climate ; Humans ; Incidence ; Medicine, Chinese Traditional ; Scarlet Fever ; diagnosis ; epidemiology ; Wavelet Analysis