This article reported the treatment of 3 cases of frequent recurrent intractable nephrotic syndrome by XIE Chang-sen. On basis of the therapeutic method of invigorating the spleen and kidney, other methods should be used according to individual difference and special clinic signs and symptoms, such as other invigorating qi and consolidation of superficies, nourishing blood and dispersing stagnated liver qi, warming kidney qi to invigorate yang, replenishing essence and dispersing turbid and so on. And partner treatment is the key for cure.

Objective To study the effec of nursing intervention on the quality of life in convalescent schizophrenia patients. Method 80 patients with schizophrenia were divided into observed group (n=40) and control group (n=40).The patients in observe group received nursing intervention.Patients were evaluated by Positive and Negative Symptoms Scale (PANSS) and General Quality of Life Inventory (GQOLI) at the time of beginning the trial and after half of a year of the intervention respectively. Results After the nursing intervention,the PANSS scores in observe group are significant lower than those of control group (P

Objective To evaluate the accuracy of stoke volume variation (SVV) determined using FloTrac/Vigileo and Picco-plus technologies in prone position for assessment of the blood volume in the patients undergoing spine surgery,Methods Forty-three ASA physical status Ⅰ-Ⅲ patients of both sexes,aged ＞ 18 yr,weighing 40-100 kg,scheduled for elective posterior approach to lumbar spinal fusion or scoliosis surgery were studied.After induction of anesthesia,a volume expansion was performed in supine and prone positions.Hydroxyethyl starch 130/0.4 sodium chloride injection 5 ml/kg was rapidly infused intravenously over 10 min to carry out the test for fluid responsiveness.Picco-plus and FloTrac/Vigileo systems were simultaneously applied in every subject to measure SVV (SVVP and SVVF).Positive fluid responsiveness was defined as the changing rate of stroke volume index ≥ 10％ as measured by using Piccoplus system.The patients were divided into response group (Rs group) and non-response group (NRs group) according to the changing rate of stroke volume index ≥ 10％ and ＜ 10％.The receiver operating characteristic (ROC) curve for SVV was plotted,and the diagnostic threshold,area under the ROC curve and 95％ confidence interval (CI) were calculated.Results Forty-one patients were included for analysis in this study.In supine position,the area under the ROC curve for SVV in predicting the fluid responsiveness was 0.740 (95％ CI:0.568-0.913),the diagnostic threshold was 12％,and the sensitivity and specificity in determining fluid responsiveness were 86％ and 54％,respectively,for SVVF,and the area under the ROC curve was 0.637 for SVVP.In prone position,the area under the ROC curve was 0.451 for SVVF,and 0.634 for SVVP.Compared with Rs group,the baseline value of SVVFwas significantly lower,and no significant change was found in the other hemodynamic parameters before volume expansion in supine position in NRs group.There was no significant difference in the hemodynamic parameters before volume expansion in prone position between the two groups.Conclusion SVV determined by using FloTrac/Vigileo and Picco-plus systems in prone position can not accurately assess the blood volume in the patients undergoing spine surgery.

Objective To investigate the protective effect of desflurane preconditioning on human umbilical vein endothelial cells against anoxia-reoxygenation(A/R)injury.Methods The human umbilical vein endothelial cell line(ECV304)was provided by the Liver Cancer Institute,Zhongshan Hospital,Fudan University.ECV304 cells were randomly divided into 5 groups:group Ⅰ normal control;group Ⅱ A/R;group Ⅲ A/R+rhTNF-α;group Ⅳ Des + A/R and group Ⅴ Des + A/R + rhTNF-α.In group Ⅱ-Ⅴ the cells were exposed to 95% N2 + 5% CO2 in an incubator for 30 min followed by 60 min reoxygenation.In group Ⅲ and Ⅴ rhTNF-α(10 ng/ml)10 μl was added to the cells as soon as reoxygenation was started,while in group Ⅳ and Ⅴ the cells were pretreated with 7.2% desflurane for 30 min followed by 10 min washout before A/R.Apoptosis in endothelial cells was detected by fluorescence flow cytometry and TUNEL.Endothelial cells were examined with electron microscope for apoptosis and necrosis.Results The rates of apoptosis in the endothelial cells were significantly higher in A/R group and A/R + rhTNF-α group than in control group.Desflurane preconditioning significantly attenuated apoptosis in the endothelial cells induced by A/R and A/R + rhTNF-α respectively.Electron microscopy showed that there were significantly more necrotic cells in A/R group and A/R + rhTNF-α group.However in the two desflurane preconditioning groups(Ⅳ and Ⅴ)the cells were in a state of duplication and self-repairing.Conclusion Preconditioning with 30 min 7.2% desflurane can attenuate the A/R-induced injury to human umbilical vein endothelial cells.

Objective:To compare the antihypertensive effects of tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) to screen the best tuina protocol for primary hypertension due to liver-fire flaming-up.Methods:A total of 102 patients with primary hypertension due to liver-fire flaming-up were randomly divided into a Taichong (LR 3) group,a Neiguan (PC 6) group and a Qiaogong (Extra) group according to the random number table,with 34 cases in each group.Patients in the three groups received 4-week tuina treatment with the corresponding acupoint respectively.The blood pressure was recorded by benchtop mercury sphygmomanometer before tuina,immediately after tuina treatment,30 min and 60 min after tuina treatment with the patient in a supine position in a quiet treatment room.The total effective rate was observed.Results:The systolic and diastolic blood pressures of the three groups all decreased after treatment (all P＜0.05).The decrease of systolic and diastolic blood pressure at different time points after treatment in the Qiaogong (Extra) group and the Taichong (LR 3) group were better than those in the Neiguan (PC 6) group (all P＜0.05).Qiaogong (Extra) group had the highest total effective rate though there was no statistical difference in the total effective rate among the three groups (P＞0.05).Conclusion:Treating primary hypertension due to liver-fire flaming-up with tuina at Taichong (LR 3),Neiguan (PC 6) and Qiaogong (Extra) can reduce systolic and diastolic blood pressure respectively,among which Qiaogong (Extra) has the highest total effective rate.

Objective: To observe and evaluate the clinical efficacy and safety of using pediatric Tuina (Chinese therapeutic massage), Tui-Pushing chest-back manipulation, in treating children with cough variant asthma (CVA).Methods: Seventy-two kids with CVA were divided into two groups using the random number table method, with 36 cases in each group. The control group received the conventional Tuina treatment, and the observation group received additional Tui-Pushing chest-back manipulation. The clinical efficacy and adverse reactions were observed and recorded for the two groups. Results: After three treatment courses, compared with the control group, the observation group showed advantages in the total effective rate, reducing the number and intensity of cough and improving the nature of cough (P<0.05). However, at the one-month follow-up, there were no significant differences between the two groups in these parameters (P>0.05). Regarding the adverse reaction rate, there was no significant between-group difference (P>0.05). Conclusion: It is effective and safe to use pediatric Tuina, Tui-Pushing chest-back manipulation, plus the conventional treatment protocol to treat CVA in children.

Objective To investigate the effects of inhalation of different concentrations of sevoflurane combined anesthesia on somatosensory evoked potentials (SEPs) in the adolescent patients undergoing scoliosis surgery.Methods Forty-five adolescent patients of both sexes,aged 12-17 yr,with body mass index of 15-23 kg/m2,undergoing scoliosis surgery under general anesthesia,were randomly divided into 3 groups ( n =15 each):low concentration sevoflurane group ( group S1 ),moderate concentration sevoflurane group ( group S2 ) and high concentration sevoflurane group (group S3 ).Anesthesia was induced with fentanyl 4 μg/kg,midazolam 0.03 mg/kg,propofol 2.0 mg/kg,and rocuronium 0.6 mg/kg.The patients were endotracheal intubated and mechanically ventilated.Anesthesia was maintained with propofol infusion at 8 mg· kg-1 · h-1 and remifentanil infusion at 0.25 mg· kg-1 ·min-1.After beginning of the surgery,1.8％,4.0％ and 6.0％ sevoflurane were inhaled for 10 min in groups S1-3 respectively,SEPs were measured by stimulating the posterior tibial nerve and significant SEP suppression was detected and recorded.The wave P40 latency,wave P40-N50 amplitude,and time for P40 waveform changes were recorded before sevoflurane inhalation (baseline) and at 10 min of sevoflurane inhalation,and the time for recovery of P40 waveform was recorded after sevoflurane inhalation was stopped.The prolonged percentage of P40 latency and decreased percentage of P40-N50 amplitude were calculated.Results The rates of significant SEP suppression were 80％,100％ and 100％ in groups S1,S2 and S3 respectively ( P ＞ 0.05).Compared with group S1,the prolonged percentage of P40 latency and decreased percentage of P40-N50 amplitude were significantly increased,the time for P40 waveform changes was significantly shortened,and the time for recovery of P40 waveform was significantly prolonged in groups S2 and group S3 ( P ＜ 0.05).Compared with group S2,the decreased percentage of P40-N50 amplitude was significantly increased,the time for P40 waveform changes was significantly shortened,and the time for recovery of P40 waveform was significantly prolonged in group S3 ( P ＜ 0.05).Conclusion 1.8％,4.0％ and 6.0％ sevofiurane combined anesthesia can suppress SEPs in the adolescent patients undergoing scoliosis surgery,and they are not suitable for the surgeries requiring SEP monitoring.

OBJECTIVETo observe the therapeutic effect of a drug pair of Radix Astragali and Rehmanniae Radix combined with glucocorticoid (GC) in treating lupus nephritis (LN) patients and its influence on some experimental indices.

METHODSTotally 52 LN patients were randomly assigned to the treatment group (treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix, 25 cases) and the control group (treated by Western medicine, mainly by GC and cyclophosphamide, 27 cases). All patients received 6-month therapy. The GC dosage, the withdrawal and reduction dosage of GC, clinical efficacy, systemic lupus erythematosus disease activity index (SLEDAI) score, adverse reactions, and laboratory indicators were recorded.

RESULTS(1) All patients got relieved to some degree with the dosage of GC reduced. The total withdrawal and reduction dosage of GC was slightly higher in the treatment group than in the control group [(50.23 +/- 12.43) mg vs (48.76 +/- 13.61) mg, P > 0.05]. Besides, the prednisone dosage in the treatment group was lower than that in the control group, but without statistical difference (P > 0.05). The ratio of patients in need of adding prednisone for aggravating disease was 24.0%, significantly lower than that in the control group (44.44%, P < 0.05). (2) There was no statistical difference in the SLEDAI score, inflammatory indicators, liver and renal functions, blood electrolytes, blood glucose, blood and urine routines between the two groups (P > 0.05). The 24-h urinary protein count was (1.06 +/- 0.22) g/L in the treatment group, obviously lower than that in the control group (1.43 +/- 0.55 g/L, P < 0.05). (3) There was no statistical difference in the incidence rate of infection, gastrointestinal hemorrhage, psychoneuroses, Cushing's syndrome, cardiovascular anomalies, and femoral head necrosis between the two groups (P > 0.05). But the incidence of adverse reactions such as insomnia, tidal fever, spontaneous sweat, and obesity was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONSUsing a drug pair of Radix Astragali and Rehmanniae Radix combined with GC in treating LN could withdraw the dosage of GC and relieve symptoms it induced. It was advantageous in reducing the dosage of GC and stabilizing patients' conditions.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Lupus Nephritis ; drug therapy ; Treatment Outcome ; Young Adult

Objective To investigate the relationship between the quantified electroencephalograph (EEG) and end-tidal desflurane concentration and characteristics of desflurane absorption during low-flow desflurane anesthesia. Methods Fifteen ASA I - Ⅱ patients with a mean age of (51.6?11.9)yr, weighing (59.6?7.9)kg scheduled for operation performed under combined general and epidural anesthesia were studied. The patients were premedicated with phenobarbital 0.1g and atropine 0.5mg.Epidural catheter was placed and a test dose of 1.0% lidocaine and 0.2% tetracaine was given before induction of general anesthesia. General anesthesia was induced with fentanyl 2-3?g?kg-1, thiopental 4-7mg?kg-1 and succinyl choline 1.5-2.0 mg?kg-1 and maintained with desflurane, intermittent iv boluses of vecuronium and epidural anesthesia. Desflurane anesthesia was started with high-flow for 15min followed by low flow. During high-flow wash-in, FGF was 4L/min, VT was set at 8-10ml?kg-1, PETCO2 was maintained at 4.2-4.6kPa(32-35mm Hg) and desflurane vaporizer was set at 5% .During low-flow FGF 0.5L/min. End-tidal desflurane concentration(Fa) and inspired desflurane concentration (Fi), BIS, SEF90 were recorded at 3,9, 12 and 15min during high-flow wash-in and at 3%, 4.5% and 6% Fa during low-flow. Each Fa was maintained for at least 15min.Results Before induction of anesthesia BIS was 86.0?8.3, SEF95 20.2? 1.8 and SEF90 18.0 ? 2.3 and at the end of 15min high-flow induction they were reduced to 50.4 ? 5.4 (BIS),13.0?1.6(SEF95) and 12.2?1.1(SEF90).The differences were statistically different (P

65yrs, diabetes mellitus, chronic renal failure, etc; of which 7 were independent risk factors associated with death (P