Climacteric ; Depression ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; Syndrome

Objective:To make clear the present situation of treating chronic renal failure(CRF) by TCM in our hospital. Methods: Adopting a retrospective survey of medical records in a row. Results: In total of 76 cases of patients,74 cases took herbal decoction. 19 prescriptions were used which focused on Shenqidihuang Decoction 37 cases (50.00%), Huanglianwendan Decoction 9 cases (12.16%) and Dangguishaoyao Powder 7 cases (9.46%). Herbs such as Radix Salviae Miltiorrhizae,Radix et Rhizoma Rhei,Radix Achyranthis Bidentatae and Rhizoma Coptidis were the main medicines. Herbal medicine accompanied with Shenqidihuang Decoction were Cortex Eucommiae, Radix Acanthopanacis Bidentatae(62.16%), Pericarpium Citri Reticulatae, Fructrs Amomi,Radix Aucklandiae, folium perillae, caulis perillae (59.46%) and Rhizoma Coptidis, Caulis Bambusae in Taeniam, fortune eupatorium herb (48.57%) respectively. With the main methods of tonifying qi and enriching yin, activating blood and detoxifing and regulating the middle energizer. The herbal decoction had a good effect on CRF patients in the near future. Conlusion: The prescriptions used in our hospital had the characteristics of giving consideration to deficiency and excess, takes both deficiency and excess, tonification and discharge, and paying attention to spleen. The prescriptions had some effect on CRF in the near future, but the long-term effect need further observation.

Drugs, Chinese Herbal ; therapeutic use ; Humans

OBJECTIVETo explore the significance of pelvic hemodynamics as an index in evaluating efficacy of TCM treatment for chronic pelvic inflammation (CPI).

METHODSSixty patients with CPI received treatment with Penyanping, a self-formulated TCM recipe, for 30 days, and the changes of pelvic hemodynamic indexes in them were measured before and after treatment within the 3 - 7 days after menstruation using color Doppler.

RESULTSImprovement of pelvic hemodynamics indexes were shown after treatment in ovarian left arteriopalmus index, bilateral resistance index, maximal speed of left arterial blood flow and score of time-velocity, as compared with those before treatment, the difference was significant respectively (P < 0.05).

CONCLUSIONPelvic hemodynamic indexes could be taken as one of the objective parameters for evaluating efficacy of TCM treatment of CPI according to principle of activating blood circulation to remove stasis, clearing heat and detoxifying.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pelvic Inflammatory Disease ; drug therapy ; physiopathology ; Pelvis ; blood supply ; diagnostic imaging ; Phytotherapy ; Time Factors ; Ultrasonography, Doppler, Color

Objective To discuss the accuracy and objectivity of student standardized patients (SSP) in objective structured clinical examination(OSCE). Methods On March 30 and 31, 2013, 168 seven-year program medical students of class 2006 and 2007 took part in OSCE. Differences in as-sessment results between SPP and those given by professional doctors at 3 SP sites(angina pectoris SSP station, acute cholecystitis SSP station, depression SSP station) were analyzed. Each site had 4 items for assessment, with a total score of 100. Scores were given in strict accordance with a set of unified scoring rules. Counting data were presented as x±s. Data were verified using t test. P<0.05 was considered statis-tically considerable. Results At angina pectoris station, respective scores of SSP and professional physi-cians were 85.2±7.1 and 85.5±6.6, P=0.688. At acute cholecystitis station, respective score of SSP and professional physicians were 89.1±5.2 and 88.2±6.2, P=0.150. At depression station, respec-tive score of SSP and professional physicians were 79.8±7.5 and 78.2±7.0, P=0.078. Conclusion There is no statistical difference between scores given by SSP and those given by the physicians in OSCE. This proves that SSP who received standardized training delivers fair and accurate results in OSCE , and therefore is recommended for future application.

Utilizing standardized patient(SP) for classroom simulation is common in current medical education. In this paper, incentive measures and combination of SP with theoretical examination, simulated people and clinical practice were proposed after in-depth analysis of advantages and disadvan-tages of using medical students as SP in terms of recruitment, training, and application. All these mea-sures were intended to promote the development of simulative medical education that in turn to cultivate students to be competent in practice.

BACKGROUNDRegulatory T-cells (Treg) play key roles in suppressing cell-mediated immunity in cancer patients. Little is known about perioperative Treg fluctuations in nonsmall cell lung cancer (NSCLC). Video-assisted thoracoscopic (VATS) lobectomy, as a minimal invasive procedure for treating NSCLC, may have relatively less impact on the patient's immune system. This study aimed to observe perioperative dynamics of circulating Treg and natural killer (NK) cell levels in NSCLC patients who underwent major lobectomy by VATS or thoracotomy.

METHODSTotally, 98 consecutive patients with stage I NSCLC were recruited and assigned into VATS or thoracotomy groups. Peripheral blood samples were taken on 1-day prior to operation, postoperative days (PODs) 1, 3, 7, 30, and 90. Circulating Treg and NK cell counts were assayed by flow cytometry, defined as CD4 + CD25 + CD127 low cells in CD4 + lymphocytes and CD56 + 16 + CD3- cells within CD45 + leukocytes respectively. With SPSS software version 21.0 (SPSS Inc., USA), differences between VATS and thoracotomy groups were determined by one-way analysis of variance (ANOVA), and differences between preoperative baseline and PODs in each group were evaluated by one-way ANOVA Dunnett t-test.

RESULTSIn both groups, postoperative Treg percentages were lower than preoperative status. No statistical difference was found between VATS and thoracotomy groups on PODs 1, 3, 7, and 30. On POD 90, Treg percentage in VATS group was significantly lower than in thoracotomy group (5.26 ± 2.75 vs. 6.99 ± 3.60, P = 0.012). However, a higher level of NK was found on all PODs except on POD 90 in VATS group, comparing to thoracotomy group.

CONCLUSIONSLower Treg level on POD 90 and higher NK levels on PODs 1, 3, 7, 30 in VATS group might imply better preserved cell-mediated immune function in NSCLC patients, than those in thoracotomy group.

Aged ; Carcinoma, Non-Small-Cell Lung ; immunology ; surgery ; Female ; Flow Cytometry ; Humans ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Postoperative Period ; T-Lymphocytes, Regulatory ; immunology ; Thoracic Surgery, Video-Assisted ; methods ; Thoracotomy ; methods

From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood trans- fusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.
Blood Transfusion, Autologous ; Female ; Hemothorax ; surgery ; Humans ; Male ; Retrospective Studies ; Thoracic Injuries ; surgery ; Thoracoscopy ; methods

OBJECTIVETo study the pathologic changes of the palatopharyngeal muscles with transmission electronmicroscopy (TEM) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), the role of the above muscle in OSAHS pathogenesis was discussed.

METHODSThirty-eight palatopharyngeal muscle from OSAHS patients receiving uvulopalatopharyngoplasty (UPPP) were collected in in-patient department of Chinese Medical University and five palatal tumor patients receiving resection without snoring were chosen as the control. The palatopharyngeal muscle fiber and the feature of changes in mitochondrial morphology were observed by TEM.

RESULTSThe pathological changes were not observed in the normal control group. The muscle fibers were regularly arranged, and the mitochondrial between muscles were normal. The palatopharyngeal myofibrillar in mild OSAHS group was regularly arranged. The Z lines were straight, and most mitochondria structure were normal. In the moderate group, the myofibrillar was disorganized, and the Z lines were shortened or distorted. The myofibrillar in severe group was disorganized, similar to point-like or flake, and the Z lines and the structures of sarcomeres were disappeared. And organelle were disintegrated and mitochondria were disappeared similar to flocculent. There existed obvious fatty infiltration in the palatopharyngeal muscle. In the control, mild, moderate and severe group, pharyngeal muscle fiber disarrangement of the occurrence rate was 0, 2/10, 8/13, 14/15, the occurrence rate of mitochondrial degeneration was 0, 2/10, 8/13, 14/15, increased with the severity of the ultrastructural changes in the trend of increasing incidence.

CONCLUSIONSThe degree of OSAHS is correlated with the pathological changes of palatopharyngeal muscles. Incidence of myopathy is an important part of OSAHS secondary to chronic intermittent hypoxia in OSAHS and other pathological lesions, but also an important reason for increasing pharyngeal collapse.

Adult ; Humans ; Male ; Microscopy, Electron, Transmission ; Middle Aged ; Mitochondria, Muscle ; pathology ; ultrastructure ; Muscle Fibers, Skeletal ; pathology ; ultrastructure ; Pharyngeal Muscles ; pathology ; ultrastructure ; Sleep Apnea, Obstructive ; physiopathology

OBJECTIVETo find out a set of practical,objective, and quantitative laboratory indices of climacteric syndrome (CS) patients of Shen deficiency syndrome (SDS), thus studying the essence of SDS from the perspective of laboratory medicine.

METHODSRecruited were 40 CS patients of SDS (or of SDS as main syndrome) as the SDS group, while another 40 healthy subjects were recruited as the control group. Their serum samples were collected. Serum levels of total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TESTO), estradiol (E2), prolactin (PRL), progesterone (PROG), cortisol (CORT), immunoglobulin M (IgM), immunoglobulin G (lgG), Complement 3 (C3), complement hemolysis 50% (CH50), angiotensin converting enzyme (ACE), aldosterone (ALD), serum alkaline phosphatase (ALP), and bone Gla-protein (BGP) were measured by automatic electrochemical luminescence assay analyzer, automatic chemiluminescence assay analyzer, automatic biochemistry analyzer, and automatic enzyme-linked immunosorbent assay (ELISA) analyzer. The correlation between syndrome types and laboratory indices were judged by gradual discriminant analyses.

RESULTS(1) Compared with the control group,serum levels of CORT, TESTO, E2, TT3, FT3, FT4, TSH, C3, CH50, ALP, and BGP significantly decreased in the SDS group (P < 0.01, P < 0. 05), while FSH, LH, and ACE significantly increased (P < 0.05). (2) The index with stronger capacity for diagnosing CS patients of SDS was ranked from high to low as CH50, PROG, TSH, TESTO, BGP, CORT, and C3, with their contribution rate of the discriminant function being 95.9%. (3) Discriminant analysis equation of CS patients of SDS was Y = -25.904 - 0.468CH50 + 0.002PROG + 0.182TSH + 9.690TESTO + 1.015BGP + 0.016CORT + 33.581 C3.

CONCLUSIONS(1) CS patients of SDS were closely correlated with thyroid hypothalamus-pituitary-adrenal axis, hypothalamus-pituitary-adrenal axis, renin-renin-angiotensin-aldosterone system,the immune function, and bone formation, and etc. (2) CH50 might be of a high sensibility marker for diagnosing CS patients of SDS. (3) Discriminant analysis equations of laboratory medicine index may be used in preliminary diagnosis and auxiliary certificate of CS patients of SDS.

Case-Control Studies ; Climacteric ; metabolism ; Discriminant Analysis ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Hydrocortisone ; blood ; Luteinizing Hormone ; blood ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Pituitary-Adrenal System ; Progesterone ; metabolism ; Prolactin ; blood ; Renin-Angiotensin System ; Testosterone ; blood ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood