BACKGROUND: Serum uric acid level is associated with some chronic diseases and prognosis of severe infection. This study aimed to investigate the relationship between serum uric acid (SUA) and prognosis of infection in critically ill patients. METHODS: The data from 471 patients with infection admitted from January 2003 to April 2010 were analyzed retrospectively at Huashan Hospital Affiliated to Fudan University, Shanghai, China. The data of SUA, serum creatinine, blood urea nitrogen (BUN) and other relevant examinations within 24 hours after admission were recorded and the levels of SUA in those patients were described, then Student's t test was used to evaluate the relationship between SUA and pre-existing disorders. Different levels of SUA were graded for further analysis. The Chi-square test was used to examine the difference in the prognosis of infection. RESULTS: The mean initial level of SUA within 24 hours after admission was 0.232±0.131 mmol/L and the median was 0.199 mmol/L. Remarkable variations in the initial levels of SUA were observed in patients with pre-existing hypertension (t=–3.084,P=0.002), diabetes mellitus (t=–2.487, P=0.013), cerebral infarction (t=–3.061,P=0.002), renal insufficiency (t=–4.547,P<0.001), central nervous system infection (t=5.096,P<0.001) and trauma (t=2.875,P=0.004). SUA was linearly correlated with serum creatinine and BUN (F=159.470 and 165.059, respectively,P<0.001). No statistical correlation was found between the initial levels of SUA and prognosis of infection (χ2=60.892,P=0.100). CONCLUSION: The current study found no direct correlation between the initial levels of SUA after admission and prognosis of infection in critically ill patients.

Traditional processes are mostly adopted in traditional Chinese medicine (TCM) preparation production and the quality of products is mostly controlled by terminal. Potential problems of the production in the process are unpredictable and is relied on experience in most cases. Therefore, it is hard to find the key points affecting the preparation process and quality control. A pattern of research and development of traditional Chinese medicine preparation process based on the idea of Quality by Design (QbD) was proposed after introducing the latest research achievement. Basic theories of micromeritics and rheology were used to characterize the physical property of TCM raw material. TCM preparation process was designed in a more scientific and rational way by studying the correlation among enhancing physical property of raw material, preparation process and product quality of preparation. So factors affecting the quality of TCM production would be found out and problems that might occur in the pilot process could be predicted. It would be a foundation for the R&D and production of TCM preparation as well as support for the "process control" of TCMIs gradually realized in the future.
Drug Compounding ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Humans ; Medicine, Chinese Traditional ; standards ; trends ; Quality Control ; Research ; standards ; trends ; Research Design ; standards ; Technology, Pharmaceutical ; instrumentation ; methods ; standards

Objective To evaluate the clinical efficacy and safety of memantine combined with olanzapine in treating Alzheimer's disease patients with behavioral and psychological symptoms of dementia (BPSD).Methods One hundred and seventy-six cases of Alzheimer's disease with BPSD were randomly divided into treatment group (n =87) and control group (n =89).The control group received oral administration of memantine 5-20 mg qd.The treatment group was given oral administration of olanzapine 2.5-10 mg qn on the basis of control group.The treatment course was two weeks.Both groups were treated for 6 courses.Clinical efficacy,neuropsychiatric inventory scale (NPI),activities of daily living (ADL) score,and the incidence of adverse drug reactions were compared between the two groups.Results After treatment,the total efficiency of the treatment group and the control group were 90.70％ (78/86 cases)and 75.29％ (64/85 cases) respectively,and the statistically significant difference was shown between the two groups (P＜0.01).Before treatment and at week 2,4,8,12,NPI-1 in the treatment group and were(25.18 ±4.17) (23.02 ± 3.98),(20.51 ± 3.65),(17.85 ± 3.08),(16.56 ± 2.95);NPI-2 were (46.86 ± 4.65) (45.78 ± 4.62),(43.53 ± 4.24),(40.53 ± 4.31),(38.91 ± 4.27);ADL were (44.34 ± 4.59),(44.25 ± 4.53) (42.85 ±4.01),(40.30 ± 3.98),(39.21 ± 3.48).NPI-1 in the control group were(25.27 ±4.23) (24.67 ±4.12),(23.68 ± 3.98),(21.36 ± 3.57),(19.92 ± 3.24);NPI-2 were (46.56 ± 4.72) (46.31 ± 4.51),(45.82 ± 4.42),(43.21 ± 4.37),(42.74 ± 4.33);ADL were (43.62 ± 4.61),(43.36 ± 4.49) (43.08 ±4.25),(42.18 ±4.31),(41.27 ±4.29).Statistical significant differences were found in NPI-1,NPI-2 and ADL between the two groups at week 2,4,8(P ＜0.01).The adverse drug reactions in the treatment group were hypersomnia,weight gain,dry mouth and constipation;and dizziness,sleeplessness,headache,nausea in the control group.The incidence of adverse drug reactions in treatment and control groups were 8.14％ (7/86 cases) and 7.06％ (6/85 cases),without statistically significant difference (P ＞ 0.05).Conclusion Memantine combined with olanzapine achieves better efficacy than memantine alone in treating patients with Alzheimer's disease and BPSD.

Objective To study the relationship between liver pathological changes and serum HBeAg and HBV DNA in patients with chronic hepatitis B. Methods Liver puncture biopsy for histopathological examinations were performed in 1057 patients with chronic hepatitis B. The quantitative analysis of serum HBV DNA by fluorogenic quantitative PCR and HBeAg by chemoluminescence were also conducted. Results The inflammatory grade and fibrosis stage were higher in HBeAg-negative paients (G4 and S4 were 7.83% and 12.17%respectively) than in HBeAg-positive patients (G4 and S4 were 3.39% and 5.44% respectively). The inflammatory grade and fibrosis stage were higher in HBeAg-positive patients with low-level HBV DNA( G3G4 was 45.64% and S3S4 was 30.20% for HBV DNA 104-105 ), whereas they were higher in HBeAg-negative patients with high-level HBV DNA(G3G4 was 54.55% for HBV DNA 106-107 and S3S4 was 42.85% for HBV DNA 108-109). Conclusion There were some correlation between the liver pathological changes and serum HBeAg and HBV DNA levels in patients with chronic hepatitis B. It is important to perform the liver pathological examination and antiviral therapy as early as possible in patients with HBeAg-negative chronic hepatitis B.

OBJECTIVETo study the changes of amino acids in cerebral spinal fluid (CSF) in children with spastic or athetotic cerebral palsy (CP) by examining CSF levels of glutamic acid (Glu), gamma-aminobutyric acid (GABA) and aspartate (ASP).

METHODSCSF samples were obtained from 13 children with spastic CP, from 14 children with athetotic CP, and from 10 children without central nervous system and infectious diseases (control group). CSF levels of Glu, GABA and ASP were determined by high-performance liquid chromatography.

RESULTSCSF levels of GABA, ASP and Glu in the control group were 13.04+/-2.19, 10.21+/-0.45 and 8.41+/-2.26 micromol/L, respectively. Compared with the control group, CSF GABA levels in the spastic and the athetotic CP groups (8.02+/-2.03 and 10.01+/-2.68 micromol/L respectively) significantly decreased (P<0.01), whereas CSF levels of Glu (20.99+/-8.15 and 28.77+/-17.62 micromol/L respectively) and Asp (13.53+/-3.93 and 14.02+/-2.88 micromol/L respectively) in the spastic and the athetotic CP groups significantly increased (P<0.01). There were statistical differences in the GABA level between the spastic and the athetotic CP groups (P<0.05). In children with spastic CPCSF Glu level was positively correlated to muscle tension.

CONCLUSIONSCSF excitatory amino acid levels increased, while CSF inhibitory amino acid levels decreased in children with CP. There were differences for CSF amino acid levels in different types of CP. The changes of amino acid levels may contribute to the pathogenesis of CP.

Amino Acids ; cerebrospinal fluid ; Cerebral Palsy ; cerebrospinal fluid ; physiopathology ; Child, Preschool ; Chromatography, High Pressure Liquid ; Female ; Humans ; Male ; Muscle Tonus

Objective To explore the association between exposure to ambient air pollution during pregnancy and congenital heart disease so as to provide evidence for primary prevention of congenital heart disease.Methods Epidemiologic studies on ambient air pollution and congenital heart diseases were reviewed.Summary risk estimates were calculated at high versus low exposure levels and risk per-unit-increase in continuous pollutant concentration.Meta-analysis was conducted with Stata 12.0 software.Results A total of 20 articles in English were qualified for inclusion.Results from Meta-analysis showed that CO exposures were related to the increase on the risk of tetralogy of fallot (high versus low exposure level OR=1.22,95％CI:1.03-1.44),while the exposures to NO2 were related to the increase on risk of coarctation of aorta (per 10 mm3/m3 OR=1.01,95％CI:1.01-1.20).Exposures to O3 were related to the increase on risk of atrial septal defect (per 10 mm3/m3 OR=1.14,95％CI:1.03-1.26),and PM10 exposures were related to the increase on risk of atrial septal defect (per 10 μg/m3 OR=1.10,95％CI:1.03-1.19).In addition,there were inverse associations between CO and atrial septal defect and between PM10 and ventricular septal defect.Conclusion Exposures to CO,NO2,O3,PM10 during pregnancy seemed to be associated with congenital heart diseases.

OBJECTIVE: To observe the effect of abdominal penetrating moxibustion on strength and endurance of core muscle group in patients with stroke. METHODS: Sixty-two patients with stroke were randomly divided into an observation group (31 cases, 2 cases dropped off) and a control group (31 cases, 2 cases dropped off). The patients in the control group were treated with routine basic treatment, acupuncture treatment and rehabilitation training; based on the treatment of the control group, the patients in the observation group were treated with abdominal penetrating moxibustion, approximately 50 min each time, once a day. The treatments in the two groups were given 5 times a week for 4 weeks. The root mean square (RMS) and median frequency (MF) of bilateral transverse abdominis and multifidus of performing sitting-standing and making steps were measured by surface electromyography before and after treatment. The postural assessment scale for stroke (PASS), Berg balance scale (BBS) and lower-limb Fugl-Meyer motor assessment (FMA) scores were observed before treatment, 2 weeks into treatment and 4 weeks into treatment. RESULTS: Compared before treatment, when performing different postures, the RMS and MF of bilateral transversus abdominis and multifidus in the two groups were increased after treatment ( CONCLUSION The abdominal penetrating moxibustion could effectively improve the strength and endurance of core muscle group, improve the posture control, balance ability and lower-limb motor function in patients with stroke.
Abdominal Muscles ; Acupuncture Therapy ; Electromyography ; Humans ; Moxibustion ; Stroke/therapy* ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVE: To observe the clinical efficacy of 's external treatment combined with long-snake moxibustion at the governor vessel for neurogenic bladder after spinal cord injury. METHODS: A total of 64 patients with neurogenic bladder after spinal cord injury were randomly divided into an observation group and a control group, 32 cases in each group. The patients in the control group were treated with routine acupuncture and rehabilitation of bladder function; based on the treatment in the control group, the patients in the observation group were treated with 's external treatment combined with long-snake moxibustion at the governor vessel, twice a week for 8 weeks. Urodynamic test, including residual urine volume (RUV), maximum flow rate of urination (Qmax), bladder pressure at filling phase (Pves), maximum detrusor pressure (Pdet-max) and maximum urinary bladder volume (VMCC), was performed before and after 8-week treatment. RESULTS: The urodynamic indexes in the two groups were improved compared with before treatment (<0.01, <0.05); after treatment, VMCC in the observation group was significantly higher than the control group (<0.01), while RUV and Pves in the observation group were significantly lower than the control group (<0.05). After treatment, there was no significant difference in Qmax and Pdet-max between the two groups (>0.05). CONCLUSION Based on routine acupuncture and rehabilitation of bladder function, 's external treatment combined with long-snake moxibustion at the governor vessel could effectively improve urodynamic indexes, reduce residual urine, reduce bladder pressure and increase the maximum capacity of bladder, thereby improving bladder compliance and bladder function.
Acupuncture Therapy ; Animals ; Humans ; Moxibustion ; methods ; Spinal Cord Injuries ; complications ; Urinary Bladder, Neurogenic ; etiology ; therapy ; Urodynamics

OBJECTIVE: To observe the clinical effect of electronic moxibustion on dysphagia in patients with achalasia of cricopharyngeus muscle after stroke. METHODS: Sixty patients with dysphagia of achalasia of cricopharyngeus muscle were randomly divided into an observation group and a control group, 30 cases in each group. One patient in the observation group and 2 cases in the control group dropped off. The patients in the control group were treated with routine medical treatment, acupuncture treatment and swallowing rehabilitation training; the patients in the observation group were additionally treated with electronic moxibustion at Lianquan (CV 23), Tiantu (CV 22), Tianding (LI 17) and Futu (LI 18), 30 min each treatment. Both groups were treated 5 times a week for 4 weeks. The musculoskeletal ultrasound (MSUS) was applied to test the activity of parapharyngeal wall and the dysphagia score of Ichiro Fujishima was compared before and after 4-week treatment. RESULTS: After treatment, the activity of the parapharyngeal wall and the dysphagia score of Ichiro Fujishima were increased in both groups (<0.01, <0.05). The changes of activity of parapharyngeal wall and dysphagia score of Ichiro Fujishima in the observation group were greater than the control group (<0.05, <0.01). CONCLUSION Electronic moxibustion can improve the impaired swallowing function and reconstruct the normal swallowing process.