ObjectiveTo observe the clinical effect of oral drugs associated with acupuncture on peripheral nervous lesions of diabetes mellitus.Methods60 diabetes mellitus patients with peripheral nervous lesions were randomly divided into the treatment group and control group with 30 cases in each group. Patients of the treatment group were treated with oral drugs and acupuncture, but cases of control group were only taking oral drugs.ResultsThe effective rate of the treatment group was 86.67% higher than that of the control group (43.33%)(P<0.01).ConclusionDrugs associated with acupuncture has a good effect on peripheral nervous lesions of diabetes mellitus.

Objective To investigate the angiogenesis,apoptosis and their mechanisms in septic mice with myocardial injury.Methods Forty male C57BL/6 mice aged 8 weeks were randomly ( random number) divided into two groups:the sepsis group and the control group.The mice of sepsis group were treated with lipopolysaccharide (LPS) ( 10 mg/kg Intraperitoneal injection) while the mice of control group were treated with saline solution instead (10 mg/kg Intraperitoneal injection).Cardiac function of mice (n =40) was evaluated with ultrasound 6 hours after LPS administration.Subsequently,the tissues of heart,lung and kidney of mice (n =6) were taken and treated with Haematoxylin -Eosin staining (H&E) in order to observe the pathological changes and verify the successfulness of modeling.Immunohistochemistry staining with PECAM - 1 and α - SMA was used to identify the angiogenesis in the heart ( n =3 ),while the TUNEL apoptosis assay was applied for detecting the myocardial cell apoptosis ( n =3 ).The mRNA was extracted from heart tissue (n =6) to observe the expression of HIF-1 ot which was proved to be an angiogenesis factor.All the results were analyzed by independent sample t - test.Results Compared to the control group,mice in the sepsis group showed increased in thickness of left ventricular diastolic anterior wall ( t =- 4.60,P ＜ 0.05 ) and thickness of left ventricular systolic anterior wall (t =-3.24,P ＜0.05 ) along with decrease in left ventricular end diastolic diameter ( t =3.57,P ＜ 0.01 ) and stroke volume ( t =5.51,P ＜ 0.01 ).Immunohistochemistry staining with alpha - SAM antibody revealed increase in cardiac angiogenesis in the sepsis group (t =- 11.00,P ＜ 0.01 ).TUNEL apoptosis assay demonstrated apoptosis of the cardiomyocytes [ sepsis group versus control group:( 191.31 ±5.41 ) vs ( 52.24 ±4.32) ] and RT - PCR showed an increase in the expression of HIF - 1 alpha in the mice of the sepsis group ( t =- 8.12,P ＜0.05) Conclusions There were apparent myocardial angiogenesis,apoptosis and cardiac dysfunction in septic animal models.HIF-1α might play a role in the angiogenesis pathway.

Objective To investigate the causes, clinical features, treatment and prognosis of gastrointestinal bleeding (GIB) patients in emergency department.Methods To analyze prospectively the clinical data of 168 GIB patients admitted to the emergency department of Peking Union Medical College Hospital during 2006.1-2006.12.Results (1) General data; male: female = 1.75:1 ( 107: 61) , mean age 13-87(56.5 ±17.8) years with a peak in 60-69 years.The percentage of old patients was significantly higher than that of young and middle age ( 52.4% vs 19.6% and 28.0% , P = 0.000 ).( 2 ) The incidence of acute gastric mucosal lesion in patients taking non-steroidal antiinflammatory drugs ( NSAIDs) ( 18.5% ) was significantly higher than that in patients not taking( 0.7% , P = 0.000 ).( 3 ) 86.9% ( 146/168 ) of the patients had anemia.(4) More patients who took emergency gastroscopy could be diagnosed than those patients who did not (89.4% vs 58.5% , P =0.000), while no significant difference could be seen between patients who took emergency enteroscopy and patients who had non-emergency gastroscopy (20.0% vs 57.9% , P =0.315).(5)The hemostatic ratio in GIB patients due to peptic ulcer was obviously higher than that in GIB patients due to other causes (86.0% vs 40.7% ,P =0.000).The rate of emergency operation for GIB patients was 1.8%.Conclusions Most of the GIB patients admitted to tertiary general hospitals are elderly males.NSAIDs administration is one of the most important causes of upper GIB.Upper GIB patients should have gastroscopy as soon as possible, while emergency coloscopy is of little significance in cases with lower gastrointestinal hemorrhage.

Objective To explore the correlations between septic acute kidney injury (SAKI) and immune condition and provide the clinical basis of predictable diagnosis and treatment in patients with SAKI.Methods Patients diagnosed with sepsis admitted to department of emergency intensive care unit of Peking Union Medical College Hospital between January 1st,2013 and September 30th,2014 were retrospectively studied.A total of 91 patients with sepsis were included,and they were divided into secondary immune deficient (SID) group (n =46) or control group (n =45).According to the diagnostic criteria and stage of the guidelines of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients in each group were divided into non-SAKI group (n1 =16,n2 =23)、KDIGO-1 group (n1 =15,n2 =13)、KDIGO-2 group (n1 =11,n2 =1) or KDIGO-3 group (n1 =4,n2 =8).The morbidity of each stage and the renal index along with the progression of SAKI was also compared in patients with SAKI in two groups.Results While there was a significant difference in the morbidity of KDIGO-2 (23.9％ vs.2.2％,x2 =0.321,P =0.002) in patients with SAKI between immune deficient group and control group,the morbidity of KDIGO-1 and KDIGO-3 had no significant difference (KDIGO-1:32.6％ vs.29.8％,x2 =0.040,P =0.701;KDIGO-3:8.7％ vs.17.8％,x2 =-1.805,P =0.200).There was also no significant difference in the renal index (△Scr、△eGFR) and progression of SAKI (elapsed days from the diagnosis of sepsis to the occurance and most severe stage of SAKI) in patients with SAKI in two groups (P ＞ 0.05).Conclusion There was no significant difference of the severity of septic acute kidney injury in patients with and without secondary immune deficiency.Inflammatory mediators-induced kidney injury in the process of immune response may not be the main mechanism in SAKI.

Objective To explore the correlations between renal artery resistance index (RRI) and renal function in patients with thrombotic microangiopathy (TMA) so as to provide the clinical basis for predictable diagnosis and treatment in patients with acute kidney injury (AKI).Methods Patients diagnosed with thrombotic microangiopathy admitted to department of emergency of Peking Union Medical College Hospital between August 1st,2014 and March 31th,2015 were enrolled.Intrarenal arteries resistive index of right kidney was detected in all cases on admission by color Doppler flow image.The serum creatinine (SCR) and glomerular fihration rate (GFR) were measured at the same time.According to the diagnostic criteria of the guideline of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients were divided into non-AKI group and AKI group.The intergroup difference was compared and the correlation between RRI and SCR as well as between RRI and GFR were assessed.RRI,SCR and GFR were measured again at the most severe stage of kidney injury.The above index were marked as RRI*,SCR and GFRmin.At the same time,△RRI (RRI*-RRI),△SCR (SCRmax-SCR) and △GFR (GFR-GFRmin) were calculated.According to the stage classification of KDIGO-AKI 2012,36 patients diagnosed with AKI during their hospitalization were divided into KDIGO-1 group (n =10),KDIGO-2 group (n =10) or KDIGO-3 group (n =16).The intergroup difference of RRI* was compared and the correlation between △RRI and △SCR as well as between △RRI and △GFR were assessed.Results When RRI ＞ 0.7 was used as the diagnostic threshold for AKI,the sensitivity was 92.3％ and the specificity was 80.1％.RRI was positively correlated with SCR (r1 =-0.728,P＜0.01;r2=-0.709,P＜0.01) and negatively correlated with GFR (r1 =-0.728,P＜0.01;r2 =-0.709,P ＜0.01) in all patients at the time of admission and the most severe stage of kidney injury.While there was a significant difference in the RRI* among KDIGO-1,KDIGO-2 and KDIGO-3 groups (F =37.979,P =0.Q01),and there was no significant difference in △RRI (F =0.634,P =0.537).The △RRI was not correlated with △GFR or △SCR.Conclusions RRI can be used as a marker for diagnosis of AKI and the evaluation of renal function in patients with TMA,but it is not helpful to reflect the trends of renal injury especially for the critically ill patients.

Objective To determine whether left ventricular Tei Index evaluate the cardiac function and prognosis of patients with sepsis-induced cardiomyopathy (SIC).Methods A total of 86 patients with septic shock combined with SIC in the emergency department of Beijing Chaoyang Hospital affiliated to Capital Medical University from July 2014 to June 2016 were recruited and divided into non-survival group (n=35) and survival group (n=51) according to 28-day follow-up.Left ventricular Tei Index, BNP, cTNI and left ventricular ejection fraction within the first 24 h after admisson were detected and compared between the two groups.The correlations of left ventricular Tei Index to BNP, cTNI and ejection fraction were analyzed.The receiver operating characteristic curves (ROC) were constructed to analysize the value of Tei Index in evaluating the cardiac function and prognosis.Results The patientsin the non-survival group had a higher Tei Index compared with that in the survival group [(0.75±0.13) vs.(0.51±0.09), P<0.05].The Tei Index of SIC patients was significantly positively correlated with BNP and cTNI (both P<0.05), and significantly negatively correlated with ejection fraction (P<0.05).The AUC of Tei Index for predicting 28-day mortality in SIC patients was high comapred with that of BNP, cTNI and ejection fraction.Conclusion The left ventricular Tei Index has a reliable value in evaluating the cardiac function and prognosis of patients with SIC.

Object To investigate the preparation technique and optimal formulation of Breviscapin Sustained release Pellets (BSP) and the release mechanism of breviscapin from the pellets. Methods BSP was prepared by extrusion spheronization method. Based on the studies of influential factors, optimal formulation modified to release drug over 12 h was obtained by the orthogonal design. And release mechanism of breviscapin from BSP was established by equation fitting. Results Prepared BSP has such advantages as simple technique, uniformity in diameters and high loading with even contents. They can release drug for 12 h. And the release of breviscapin could be mainly controlled by diffusion associated with slight erosion. Conclusion Extrusion spheronization method is simple for the preparation of BSP, and useful for the large scale prodution.

Objective:To observe the therapeutic effects of Tongyushu capsules on dysmenorrhea. Methods:With the intravenous injection of oxytocin in rats, the influence of Tongyushu capsules on rat uterine smooth muscle was observed in vivo. With the intraper-itoneal injection of oxytocin to replicate the mouse model of dysmenorrhea, the effect of Tongyushu capsules on dysmenorrhea was ob-served. Using acetic acid writhing method, the effect of relieving pain Tongyushu capsules in mice was observed. By the method of ear swelling induced by xylene in mice, the anti-inflammatory effect of Tongyushu capsules was observed. By the method of ice water bath and subcutaneous injection of adrenaline, the influence of Tongyushu capsules on the acute blood stasis model in rats was observed. Results:Compared with those of the model group, the contraction of uterine smooth muscle of the groups treated with Tongyushu cap-sules at various dosage was decreased obviously (P<0. 05), the number of body torsion reaction induced by oxytocin and acetic acid in mice was obviously decreased in 15 min (P<0. 05), the degree of ear swelling in mice treated with Tongyushu capsules was signifi-cantly reduced (P<0. 05), and the whole blood viscosity, plasma viscosity, hematokrit, erythrocyte sedimentation rate and erythro-cyte electrophoresis time were significantly decreased (P<0. 05). Conclusion:Tongyushu capsules have obvious effects of the inhibi-tion of excessive contraction of uterine smooth muscle, dysmenorrhea alleviation, anti-inflammation and relieving pain, which show good therapeutic effect on dysmenorrhea.

Objective To compare the effects of levosimendan (Levo) and recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF). Methods Seventy-five patients were included into this randomized positive-controlled and parallel-group study to receive either Levo (Levo group), rhBNP (rhBNP group) or dobutamine therapy (control group). Heart rate, respiratory rate, 24-hour urine volume,improvement in six-minute walk-test after 72-h treatment were compared between three groups. The blood level of BNP and values of left ventricular end dia?stolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) after one-week treatment were compared between three groups. Results After 72-h treatment, heart rate and respiratory rate were significantly decreased, and 24-hour urine volume, six-minute walk-test were significantly increased in three groups (P<0.05). The NT-proBNP and LVEF were im?proved after one week treatment (P>0.05), but the LVEDD was improved barely (P>0.05). The improvements were more significant in Levo group and rhBNP group compared to those of control group (P<0.05). There were no significant differenc?es in improvements between Levo group and rhBNP group. The common adverse reactions were hypotension and ventricular premature beats. There were no significant differences in adverse event rates between three groups (P<0.05). Conclusion As compared with dobutamine, Levo and rhBNP have optimized efficacy, fewer side effects and good safety in the treatment of ADHF. They are worth of clinical application.

Objective To investigate the effect and safety of early intervention and delayed intervention therapy on elderly patients and younger patients with non-ST segment elevation acute coronary syndrome. Methods The patients with non-ST segment elevation acute coronary syndrome were randomly divided into early intervention group (coronary angiography taken within 24 hours after grouping) and delayed intervention group ( coronary angiography taken after 36 hours after grouping). The primary endpoint was a composite endpoint of death, myocardial infarction and stroke during 180 days follow-up. Results A total of 815 patients were enrolled, including 198 elderly patients aged 75 years and above, and 617 younger patients aged below 75 years. The elderly patients had a greater incidence of the primary endpoint than that of younger patients ( P = 0. 00). The primary endpoint of early intervention group were obviously lower than that of delayed intervention group of younger patients ( P = 0. 01 ). There was no significant difference in primary endpoint incidence of early intervention group and delayed intervention group of the elderly patients (P =0. 39). Conclusions The elderly patients with non-ST segment elevation acute coronary syndrome who underwent intervention had greater incidence of death and myocardial infarction. Early intervention reduced the rate of myocardial infarction for the younger patients. There was no significant difference in primary endpoint incidence between early intervention and delayed intervention among elderly patients.