Objective To investigate the clinical efficacy of dexmedetomidine (DEX) combined with pentazocine intravenous anesthesia in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) in the elderly.Methods A retrospective case-control study was performed to analyze 63 elderly OVCF patients treated with PKP and admitted to Tianjin Hospital from June 2018 to December 2018.There were 20 males and 43 females,aged 65-86 years [(74.7 ± 1.1)years].There were 15 patients with thoracic compression fractures and 48 with lumbar compression fractures,in whom the vertebral height loss was ＜ 30％ without posterior ligament complex damage.Nineteen patients received local anesthesia with lidocaine (Group A),21 patients received intravenous anesthesia with pentazocin and propofol (1 mg/kg) (Group B),and 23 patients received intravenous anesthesia with pentazocin and DEX (0.5 μg/kg) (Group C).Heart rate,systolic blood pressure,respiratory rate and blood oxygen saturation (SPO2) were recorded at 5 time points:at rest in the operating room (T0),after intravenous injection of pentazocine (T1),when the balloon dilated (T2),after the injection of cement (T3),and blinking after being called or at the end of the operation (T4).The levels of plasma cortisol were recorded before and at T3 in three groups.Visual analogue score (VAS) at T4 was recorded.The operation time,patient satisfaction and incidence of adverse reactions were recorded.The wake-up time and orientation recovery time of groups B and C were recorded.Results The heart rate,mean systolic blood pressure,respiratory rate in Group A at T2,T3 and T4 were higher than those in Groups B and C (P ＜ 0.05),but there was no significant difference between Groups B and C (P ＞ 0.05).There was no significant difference in SPO2 at only time among the groups (P ＞ 0.05).No significant differences were found in cortisol between the three groups before surgery.The cortisol level of Group A at T3 was higher than those of Groups B and C with significant difference (P ＜ 0.05),but no significant difference was found between Groups B and C (P ＞0.05).The VAS in Group A was significantly higher than those in groups B and C (P ＜ 0.01).The operative time in Group A was longer than those in Groups B and C (P ＜ 0.05),but no significant difference was found between Groups B and C (P ＞ 0.05).There was no significant difference in patient satisfaction between Groups B and C,and both of them were higher than Group A (P ＜0.01).There was no significant difference in the incidence of adverse reactions between the three groups (P ＞ 0.05).The wake-up time and orientation recovery time of Group C were shorter than those of Group B (P ＜ 0.01).Conclusion For elderly OVCF patients,pentazocin combined with propofol or DEX can be applied in PKP,which has satisfactory analgesic effect,slight effect on respiratory and circulatory,less adverse reactions,and good patient feedback.DEX has more advantages of awakening and orientation recovery and is worthy of clinical application.

ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.

ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.