2.Clinic value of different antiplatelet therapy policies in preventing and treating cardiovascular events in elderly patients with coronary heart disease
Yun TANG ; Bi XIAO ; Ping LI ; Houxun MA
Clinical Medicine of China 2016;32(8):708-712
Objective To understand the use of antiplatelet drugs in patients with coronary heart disease( CHD) ,and to compare the effect of different anti platelet drugs on cardiovascular events in patients with CHD,and to provide clinical evidence for the optimization of anti platelet therapy?Methods One thousand and twenty?three cases patients with CHD who were treated in the First Hospital Affiliated to Chongqing Medical University from April 2010 to June 2014 were chosen?On the basis of conventional treatment,according to the different anti platelet program,the patents were divided into A group(703 cases),B group(211 cases) and C group(109 cases)?Group A was treated with aspirin and clopidogrel,B group was treated with clopidogrel,and C group was given aspirin therapy?Cardiovascular events( MACE) and bleeding events were observed at 1 month,6 months and 1 year after treatment in the 3 groups?Results After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A were 9?1%( 64/703) ,16?6%( 117/703) and 28?4%( 200/703) ,in group B were 14?6%(31/211),25?5%(54/211) and 37?9%(80/211),in group C were 16?5%(18/109),29?4%( 32/109) and 34?0%( 37/109)?After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A was significantly lower than group B and C(P<0?05);after treatment for 1 month,6 months,the incidence rates of MACE in group B were lower than group C,while higher than group C after 1 year,but the differences were not signifiacnt( P>0?05)?There were no significant differences in total incidence of deaths,the recurrence rate of myocardial infarction and stent restenosis rate among the three groups ( P>0?05 )?After treatment for 1 month,6 months,the incidence of angina in group A was lower significantly than that in group B and C( P<0?05) ,but When the treatment time was extended to 1 year,there was no significant difference in the three groups(P>0?05)?At 1 year follow?up,the incidence of gastrointestinal bleeding in group A was slightly higher than that in group B and group C ( 4?3% vs? 2?4% vs?3?7%) , but the difference was not statistically significant ( P>0?05 )?Conclusion In the CHD patients receiving aspirin and clopidogrel dual antiplatelet therapy,the incidence of MACE was lower than that in patients with aspirin or clopidogrel treatment alone, especially a reduction in the incidence of angina,and without increase of the risks in the gastrointestinal bleeding events,but the advantages above waning with treatment time extended to 1 year.
3.Analysis of acute phase side-effects of diphosphonate treatment in elderly patients with primary osteoporosis
Ping LI ; Bi XIAO ; Yun TANG ; Houxun MA
Journal of Chinese Physician 2016;18(3):362-365,369
Objective To investigate the acute phase adverse effects and influencing factors of adverse effects of diphosphonate treatment in the elderly patients with primary osteoporosis.Methods A total of 208 patients [male 25 patients,female 183 patients,age 60 ~ 93 with a average of (75.51 ± 7.73) years] with primary osteoporosis were selected from 1 Jan 2012 to 30 Nov 2015,admitted to Department of Geriatrics.According to the serious condition of osteoporosis and willingness of patients,208 patients were divided into zoledronic acid treatment group,alendronate treatment group,and pamidronic acid group,and received corresponding diphosphonate treatment.All kinds of adverse reactions of diphosphonate in each treatment group were closely to be observed after administration of diphosphonate in 3 days and 7 days.Results The incidence rate of adverse reactions in the zoledronic acid treatment group (59/134,44.03%;60/134,44.78%) was obviously higher than that in the alendronate treatment group (1/57,1.75%;1/57,1.75%),and the pamidronic acid group (3/17,17.65%;3/17,17.65%) after treatment of diphosphonate in three and seven days (P < 0.05).In different generations,the incidence rate of adverse reactions in the zoledronic acid group and the pamidronic acid group after treatment of diphosphonate in three and seven days was not statistically significant (P > 0.05).There were three patients suffering from severe acute kidney injure (AKI) and three patients suffering from hypokalemia in the 134 patients treatment with zoledronic acid.Conclusions There are obvious differences in the incidence rate of acute phase adverse reactions in the osteoporosis patients who received different treatment policy (P < 0.05).The safety issues in the kidney function and electrolyte abnormality (such as hypokalemia) should be paid much enough attention in the primary osteoporosis patients who receive zoledronic acid treatment.
4.Effect of modified xiaoyao powder for improving sleep in patients with psychological stress insomnia.
Yan LI ; Bi-yun XU ; Fang XIAO
Chinese Journal of Integrated Traditional and Western Medicine 2009;29(3):208-211
OBJECTIVETo subjectively and objectively assess the effect of Jiawei Xiaoyao Powder (JXYP) on sleep in patients with psychological stress insomnia. METHHODS: A randomized controlled study was conducted in 33 patients with psychological stress insomnia. They were assigned to 4 groups, 4 in the TCM group treated with JXYP, 5 in the Western medicine (WM) group treated with Estazolam, 9 in the integrated medicine (IM) group treated with JXYP plus Estazolam, and 10 in the control group treated with placebo. Quality of sleep in patients was assessed subjectively and objectively before treatment and 6 weeks after treatment by Pittsburgh sleep quality index (PSQI), self-rating scale of sleep (SRSS) and polysomnography (PSG), respectively.
RESULTSSubjective assessment on sleep showed that after 6-week treatment, the scores of PSQI and SRSS remarkably reduced in the TCM, IM and control groups (P < 0.05), while the decrease was insignificant in the WM group (P > 0.05), but no significant difference between groups was shown. The objective assessment by PSG showed that no significant change was found after treatment in parameters of total sleep time (TST), sleep time of phase 1 and 2, slow wave phase, rapid-eye-movement (REM) phase, sleep latency, REM sleep latency, also in long waking and short waking times in all group (P > 0.05), but a significant increase of sleep efficacy (P < 0.05) and an increasing trend of TST (P > 0.05) were shown in the IM group, and an increasing trend of both in the TCM group (P > 0.05).
CONCLUSIONJXYP, combined with or without Estazolam, can improve the quality of sleep subjectively, and the combination of the two could enhance the efficacy of sleep in patients with psychological stress insomnia.
Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Estazolam ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; drug therapy ; psychology ; Stress, Psychological ; complications ; Young Adult
5.Analysis of risk factors in elderly type 2 diabetes mellitus with cerebral infarction
Hong LI ; Man-Yun ZHANG ; Xiao-Zheng FANG ; Bi-Ma WEN ; Qing ZHANG ; Yong-Fang ZHU ;
Chinese Journal of Primary Medicine and Pharmacy 2005;0(11):-
Objective To explore the risk factors in elderly type 2 diabetes mellitus with cerebral infarction. Methods Retrospective investigarion was performed on 148 elderly hospitalized patients with type 2 diabetes.The patients were classified based on the presence or absence of cerebral infarction and compared with 60 controls.Logis- tic regression analysis was used to reveal the risk factors for cerebral infarction.Results The levels of systolic blood pressure(SBP),body mass index (BMI),fasting blood glucose (FBG),total cholesterol (TC),triglyceride (TG) and plasma fibrinogen(Fg) were higher in the patients with cerebral infarction[141.15?17.46)mmHg,(23.81?3.53)kg/m~2,(8.82?2.81)mmol/L,(5.69?1.15)mmol/L,(2.08?0.75)mmol/L and (4.08?0.65)g/L] than those without cerebral infarction[(129.78?14.65) mmHg,(22.18?3.22)kg/m~2,(7.06?1.72 )mmol/L,(5.09?1.12)mmol/L,(1.62?0.43)mmol/L and (3.48?0.58)g/L].The logistic analysis showed COUR,SBP,FBG, TC,TG and Fg were the independent risk factors for cerebral infarction.Conclusion Early intervention of the inde- pendent risk factors including SBP,FBG,TC,TG and Fg in elderly patients with type 2 diabetes was important for reduction and postponement of cerebral infarction.
6.Dynamic Changes of Chlorogenic Acid and Luteoloside from Donghai County of Honeysuckle at Different Blossoming Stages
Yongxiang WANG ; Yun WU ; Jin MENG ; Juan SHEN ; Yu'an BI ; Zhengzhong WANG ; Wei XIAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2013;(9):1975-1979
This study was aimed to acquire the dynamic changes of chlorogenic acid and luteoloside of honeysuckle at different collecting periods in order to decide the best harvesting time of honeysuckle in Donghai County, Jiangsu Province. The content determination method used in the detection of chlorogenic acid and luteoloside of honeysuckle was from the 2010 edition of the Chinese Pharmacopoeia. The skills of HPLC fingerprint characteristic features, and the yield of pressed flowers were combined in the evaluation of honeysuckle at the three-green period, two-white pe-riod, great-white period, silver-flower period and the golden-flower period. The results showed that the content of honeysuckle at different blossoming stages had obvious changes in content of chlorogenic acid and luteoloside, as well as the pressed flower quality and yield of the flower. It was concluded that the optimal harvest time of honey-suckle was for the two-white period and the great-white period, which was consistent with the real origin.
7.Inhibition of acetamide-45 on airway smooth muscle contraction induced by electric field stimulation and methacholine in vitro.
Yun-bi LU ; Zhong CHEN ; Xiao-yu LAI ; Yun GAO
Journal of Zhejiang University. Medical sciences 2005;34(2):137-140
OBJECTIVETo investigate the effects of the new antiallergic agent N-(pyridin-4-yl)-(indol-3-yl) acetamide-45 (acetamide-45) on electric field stimulation (EFS)-and methacholine-induced contraction of airway smooth muscle in vitro.
METHODSContractions were induced by EFS in isolated trachea and bronchus of rats or by cumulative methacholine concentrations in isolated trachea of guinea pigs. Changes in isometric force of isolated airway smooth muscle were measured by force transducers and recorded on a multi-channel polygraph recorder.
RESULTSAcetamide-45 inhibited the contraction induced by EFS in isolated rat airway. The IC50 was 10.74 (95% CI 8.87-13.00) micromol.L(-1) and 18.83 (95% CI 14.57-24.33) micromol.L(-1) in tracheae and bronchi, respectively. Acetamide-45 also inhibited methacholine-induced contractile response of isolated guinea pig trachea in a concentration-dependent manner. At concentrations of 3, 10, 30 micromol.L(-1) acetamide-45 significantly decreased maximal contractile response of methacholine by 24.6%-43.2% and increased EC50 of methacholine by 3.1-to 21.4-fold.
CONCLUSIONAcetamide-45 inhibits EFS-or methacholine-induced contraction of isolated airway smooth muscle, and these effects might be non-specific inhibition on cholinergic receptor.
Acetamides ; pharmacology ; Animals ; Depression, Chemical ; Electric Stimulation ; Guinea Pigs ; In Vitro Techniques ; Male ; Methacholine Chloride ; pharmacology ; Muscle Contraction ; drug effects ; Muscle, Smooth ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Trachea ; drug effects
8.Clinical characteristics and treatment of severe encephalitis associated with neurogenic pulmonary edema caused by enterovirus 71 in China
Yu-Cai ZHANG ; Xing-Wang LI ; Xiao-Dong ZHU ; Su-Yun QIAN ; Yun-Xiao SHANG ; Bi-Ru LI ; Xiao-Lin LIU
World Journal of Emergency Medicine 2010;1(2):108-113
BACKGROUND:Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with severe encephalitis associated with NPE caused by enterovirus 71. METHODS:The study was conducted in 2 pediatric intensive care units (PICUs) over a 2-month period. Clinical records were reviewed of critically ill children with severe encephalitis associated with NPE caused by EV71 who were admitted to PICUs during the period of May to June 2008 in Fuyang. RESULTS:We reviewed the complete records of 36 children, of whom 23 (63.9%) were male and 13 (36.1%) female. Their age ranged from 4 to 48 months, with an average of 15.8 months. Al children except one were under 3 years of age. The overal mortality in these children was 19.4%. The average duration of critical life threatening signs and symptoms was 2.1 days (12 hours-5 days). Nervous system diseases included brainstem encephalitis in 27 children (75%), brainstem encephalitis associated with myelitis in 6 children (16.7%), and general encephalitis in 3 chidren (8.3%), respectively. In 12 patients of NPE (33.3%) pink or bloody bubble sputum and asymmetric pulmonary edema or hemorrhage was the primary manifestation but no typical exanthema was observed. Five children died of acute onset of NPE and / or pulmonary hemorrhage with rapid progression of cardiopulmonary failure within hours after admission. Therapeutic management consisted of mechanical ventilation and administration of mannitol, methylprednisolone, intravenous immunoglobulin (IVIG) and vasoactive drugs, associated with the need of fluid volume resuscitation in 9 (25%) of the 36 children. CONCLUSIONS:In children less than 3 years of age found to be affected by severe EV71 encephalitis associated with NPE, one fifth may die. The major organ systems infected by severe EV71 include the central nervous system, the respiratory system, and the cardiovascular system. Early diagnosis and evaluation, respiratory support, treatment of intracranial hypertension, and mainttenance of function of the cardiovascular system are the most important therapeutic measures.
9.Application of near-infrared spectroscopy technology in extraction and concentration process of Reduning injection.
Ya-Fei ZHANG ; Xiang-Yun ZUO ; Yu-An BI ; Jian-Xiong WU ; Zhen-Zhong WANG ; Ping L ; Wei XIAO
China Journal of Chinese Materia Medica 2014;39(16):3069-3073
OBJECTIVETo establish a rapid quantitative analysis method for the content of chlorogenic acid and solid content in the extraction liquid concentration process during the production of Reduning injection by using the near-infrared (NIR) spectroscopy, in order to reflect the concentration state in a real-time manner and really realize the quality control of concentrating process of the extraction and concentration process.
METHODThe samples during the Jinqing extraction liquid concentration process were collected. After the removal of abnormal samples, the spectra pretreatment and the wave band selection, the quantitative calibration model between NIR spectra and chlorogenic acid HPLC analytical value and solid content was established by using PLS algorithm, and unknown samples were predicted.
RESULTThe correlation coefficients between the chlorogenic acid content and the solid content were respectively 0.992 1 and 0.994 0, and the correlation coefficients of the verification model were respectively 0.994 4 and 0.998 4, with the root mean square error of calibration (RMSEC) of 0.814 6 and 2.656 1 and the root mean square error of prediction (RMSEP) of 0.704 6 and 1.876 7 respectively, and the relative standard errors of predictions (RSEP) were 6.01% and 2.93% respectively.
CONCLUSIONThe method is simple, rapid, nondestructive, accurate and reliable, thus could be adopted for the fast monitoring of the chlorogenic acid content and the solid content during the concentration process of Reduning injection extraction liquid.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Quality Control ; Spectroscopy, Near-Infrared ; methods
10.The therapeutic effects of low frequency ultrasound enhanced thrombolysis on acute cerebral infarction in rats
Jian-Zhong BI ; Hong-Xia YANG ; Zhao-Hong XIE ; Zheng-Yu ZHU ; Xiao-Yun WANG ; Zhen LIU ;
Chinese Journal of Physical Medicine and Rehabilitation 2003;0(12):-
Objective To observe the therapeutic effects of low frequency ultrasound enhanced thrombolysis (LFUET) on acute cerebral infarction (ACI) in rats.Methods The ACI animal models were established by injec- ting auto-thrombus into the rats' left middle cerebral arteries.They were then treated with urokinase,and received transcranial LFUET treatment at the same time.Nervous system functioning was assessed using NSS,and infarct vol- umes (IVs) were measured through tetrazolium chloride (TTC) staining.Results The NSS scores in the large- dose urokinase group (LDU group),the ultrasound plus small-dose urokinase group (USMU group) and in the in- farct group (Ⅰgroup) at 24 h after treatment were significantly lower than those before treatment.IVs in the two treat- ment groups are lower than those in theⅠgroup,but there was no significant difference between the LDU group and USMU group volumes.Conclusion LFUET can accelerate the recovery of nervous system function in rats after ACI,minimize IVs,and reduce the required dosage of urokinase.