OBJECTIVETo observe the efficacy of Chinese herbs for supplementing qi and activating blood circulation (CHSQABC) on patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM) after successful percutaneous coronary intervention (PCI).

METHODSIn this ChiCTR-TRC-00000021, a total of 281 ACS patients complicated with type 2 DM after successful PCI were randomly assigned to the Western medicine treatment group (the control group, treated by routine Western medicine treatment) and the combined treatment group (the treatment group, treated by CHSQABC + routine Western medicine treatment). Patients in the combined treatment group took Xinyue Capsule (2 pills each time, 3 times per day) and Compound Chuanxiong Capsule (2 pills each time, 3 times per day for half a year and 1-year follow-ups). Primary endpoints covered incidence of death, nonfatal myocardial infarction (MI), ischemia-driven revascularization, and secondary endpoints included stroke, heart failure, and rehospitalization for ACS. At the same time scores for blood stasis syndrome (BSS) and the incidence of angina pectoris were evaluated before treatment, at month 1, 3, 6, 9, and 12 after treatment.

RESULTSThe incidence of ischemia-driven revascularization was obviously less in the treatment group than in the control group (P < 0.05). No patient had nonfatal MI in the treatment group, while 5 patients in the control group had it. The incidence of non-fatal MI showed an obvious lowering tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). Four patients readmitted to hospital in the treatment group, while 12 patients readmitted. There existed obvious tendency in the treatment group, but with no statistical difference when compared with that in the control group (P > 0.05). The incidence of angina was significantly lower in the treatment group at month 6, 9, and 12 than that at month 1 , but it was lower in the control group at 9 months (P < 0.05). The incidence of angina was 15. 4% in the treatment group, obviously lower than that in the control group (26.2%, P < 0.05). Compared with before treatment, scores for BSS were obviously lowered in the treatment group at 1, 3, 6, 9, and 12 months of treatment and in the control group at 3, 6, 9, and 12 months of treatment (P < 0.05). It was obviously lower in the treatment group than in the control group at 3, 6, 9, and 12 months of treatment (P < 0.01).

CONCLUSIONAdministration of CHSQABC combined routine Western medicine treatment could reduce the event of revascularization and post-PCI recurrent angina, and improve scores for BSS of ACS patients complicated with DM after PCI.

Acute Coronary Syndrome ; complications ; surgery ; therapy ; Angina Pectoris ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Incidence ; Medicine, Chinese Traditional ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Qi

OBJECTIVETo investigate the clinical effects and prevent the complications of posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure.

METHODSFrom 2008 January to 2011 December, 17 patients with cervical anterior internal fixation failure were treated with posterior and anterior decompression and internal fixation. There were 12 males and 5 females, aged from 26 to 68 years old with an average of 44.1 years. The lower screw loosening was found in 6 cases, the upper screw loosening in 5 cases, titanium mesh caving in 3 cases, the upper screw breakage in 2 cases, the lower screw breakage in 1 case. Informations of bone fusion were observed by X-ray, CT, MRI. Clinical effects were evaluated by modified JOA score.

RESULTSAll the revision operations were successfully completed. One case with poor blood coagulation function before operation resulted in postoperative hematoma and occurred neurological symptoms; after hematoma removal and fresh frozen plasma infusion later, neurological symptoms of the patient disappeared. All patients were followed up from 6 to 38 months with an average of (22.4±10.0) months. Postoperative at 2 weeks, 3 months, and final follow-up, JOA score had obviously improved and respectively was 13.1±1.6, 13.4±1.6, 14.2±1.5. All internal fixation locations were good after revision,and obtained bone fusion at 10 months after operation, with an average fusion time of 6 months.

CONCLUSIONThe combined posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure is safe, can achieve thoroughly decompression, maintain the cervical curvature, reconstruct the three column stability, and it may be used for the patients of cervical anterior fixation failure.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the effects of selective hepatic vascular exclusion (SHVE) on prevention of serious hemorrhage and air embolism during hepatectomy and on the liver function after operation.

METHODSFrom January 2004 to March 2007, 29 huge hepatic tumors were resected in our department. Both SHVE and Pringle maneuver were used to control the blood loss during hepatectomy. They were divided into two groups: SHVE group (15 cases) and Pringle group (14 cases). Data regarding the intraoperative and postoperative courses of the patients were analyzed.

RESULTSThere was no significant difference between the two groups regarding the age, sex, tumor size, cirrhosis, HbsAg positive rate and operating time (P > 0.05). Intraoperative blood loss was reduced significantly in the SHVE group (P < 0.05). The serum prealbumin levels on the postoperative day 1, 3 and 7 in SHVE group were significantly higher than those in the Pringle group (P < 0.05). The serum ALT value in SHVE group was significantly lower than that in the Pringle group on postoperative day 1, 3 and 7. The mean drainage volume in SHVE group was significantly less than that in the Pringle group on postoperative day 1 and 2. Liver failure occurred in two cases of the Pringle group, while no one in the SHVE group. Rupture of hepatic vein with massive blood loss occurred in 3 cases and air embolism in one case of the Pringle group, but did not occur in any case of the SHVE group.

CONCLUSIONWhen the selective exclusion of hepatic outflow and inflow is applied in hepatectomy, the resection rate of huge hepatic tumors and operative tolerance of hepatectomy are improved. It is a safe and rational operation type, and provides an optimal choice for hepatectomy.

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Bile Duct Neoplasms ; blood ; blood supply ; surgery ; Bile Ducts, Intrahepatic ; Blood Loss, Surgical ; Carcinoma, Hepatocellular ; blood ; blood supply ; surgery ; Cholangiocarcinoma ; blood ; blood supply ; surgery ; Female ; Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Intraoperative Care ; Liver ; blood supply ; surgery ; Liver Neoplasms ; blood ; blood supply ; surgery ; Male ; Middle Aged ; Prealbumin ; metabolism ; Young Adult

OBJECTIVETo explore a method of extracting tumor interstitial fluid (TIF) which is similar to muddy phlegm in Chinese medicine (CM), interleukin-8 (IL-8) in concentration was taken as the representative of the content of TIF, analyzed in the extracted TIF and the original tumor tissue, and examined to see whether TIF has an interfering effect on tumor recurrence.

METHODSTumor tissue was ground, centrifuged, and filtered for intercellular substances. Tumor-bearing Kunming S180 mice were raised for 21 days and then the tumors were removed to observe the influence of intervention with TIF, normal saline (NS) and a blank control on tumor recurrence.

RESULTSThe content of IL-8 in the filtered and unfiltered tumor tissue was not significantly different (P>0.05). Postoperative tumor recurrence in TIF intervention group was significantly higher than that in the NS intervention and control groups (60%, 12/20 vs. 20%, 4/20. vs. 15%, 3/20, χ(2) =11.058, P<0.01). Tumor cells grew vigorously and infiltrated to muscular tissue in TIF intervention group. Large numbers of tumor cells were seen necrotic in the NS intervention group, and small numbers of tumor cells were seen necrotic in the blank control group.

CONCLUSIONSTIF can be effectively extracted by the means described. It does not contain tumor cells, but its contents such as IL-8 may stimulate tumor cell growth and promote postoperative tumor recurrence, which provided preliminary experimental basis for hypothesis of "tumor-phlegm microenvironment".

Animals ; Enzyme-Linked Immunosorbent Assay ; Extracellular Fluid ; Interleukin-8 ; analysis ; Mice ; Neoplasms, Experimental ; pathology ; Postoperative Period ; Recurrence

Disaster Relief Medicine (DRM), a newly developed science, not only crosses Emergency Service and Critical Health Care, but also relates to other various fields such as Nursing, Clinical examination and Clinical Medicinal Engineering etc, all of which require competent Clinical Medicinal Engineers. Thus, a key subject of Clinical Engineering is to provide quality support to medical equipments, and to offer engineers educational training on this diverse science, in order to improve their professional and managerial skills. Based on DRM characteristics, specifically, based on our first hand experience during disaster relief effort in Wen-Chuan Earthquake, we documents our thoughts and discussion over the issues we found in above areas as listed in the article below.
Biomedical Engineering ; Disaster Medicine ; Earthquakes ; Emergency Medical Services

OBJECTIVETo evaluate the clinical value of magnifying endoscopy in diagnosis and treatment of colorectal benign neoplastic lesions.

METHODSSeventy-eight colorectal lesions in 61 patients were examined with magnifying colonoscopy after indigo carmine dyeingìand pit pattern diagnosis was made for every lesion according to Kudos classification to differentiate neoplastic lesions from non-neoplastic lesions. The lesions were resected by endoscopic polypectomy and mucosectomy or surgical treatment. The diagnoses made by magnifying colonoscopy were compared with pathologic results.

RESULTSThe diagnostic sensitivity of magnifying endoscopy for neoplastic lesions was 98.4% and specificity was 85.7%. The overall accuracy for adenoma and early colorectal cancer was 96.2%. 89.7% of adenomatous lesions were treated by endoscopic resection.

CONCLUSIONThe magnifying colonoscopy can provide instantaneous and accurate diagnosis of neoplastic lesions in colon and rectum,as well as minimally invasive treatment.

Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; pathology ; therapy ; Coloring Agents ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the toxicity of Radix Aristolochiae and Radix Inulae, and to supply the toxicity experimental data that Radix Inulae supersedes Radix Aristolochiae in clinic.

METHODA long dose of Radix Aristolochice and Radix Inulae was given intragastrically to rats for six months, then drug withdrawal for a month. The hematology and biochemical indicators were measured, and the pathologic changes of kidney, liver, stomach and urinary bladder were examined.

RESULTThe rats of Radix Aristolochice showed serious toxic responses of renal tubule atrophy and necrosis, meanwhile, the levels of BUN, Cr and NAG were increased obviously. Hepatonecrosis, renal tubular necrosis, gastric carcinoma and bladder carcinoma were discovered with pathologic assaying. But the rats of Radix Inulae did not.

CONCLUSIONRadix Aristolochiae could damage kidney and liver, and cause gastric carcinoma and bladder carcinoma by intensive toxicity. Radix Inulae could take the place of Radix Aristolochiae to use in clinic.

Acetylglucosaminidase ; urine ; Animals ; Aristolochia ; chemistry ; Blood Urea Nitrogen ; Creatinine ; blood ; Drugs, Chinese Herbal ; isolation & purification ; toxicity ; Female ; Inula ; chemistry ; Kidney Tubules ; drug effects ; pathology ; Liver ; drug effects ; pathology ; Male ; Necrosis ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stomach ; drug effects ; pathology ; Stomach Neoplasms ; chemically induced ; Urinary Bladder ; drug effects ; pathology ; Urinary Bladder Neoplasms ; chemically induced

OBJECTIVETo evaluate the toxicity of Radix Aristolochiae supplied experimental evidence of rational use of drug in clinic.

METHODAfter treatment with small dose Radix Aristolochiae, Guanxin Suhe Wan (with Radix Aristolochiae) and Guanxin Suhe Wan (without Radix Aristolochiae) in different group for a long- term, respectively, the biochemical indicator of PT, ALT, AST, ALB, ALP, Crea and BUN were detected, and the kidney, liver, stomach and urinary bladder were examined by pathologic assaying.

RESULTIn Radix Aristolochiae group and Guanxin Suhe Wan (with Radix Aristolochiae) group, all of biochemical indicator were changed significantly, and hepatonecrosis, renal tubular necrosis, gastric carcinoma and bladder carcinoma were discovered.

CONCLUSIONRadix Aristolochiae and Guanxin Suhe Wan (with Radix Aristolochiae) can damage kidney and liver, and cause gastric carcinoma and bladder carcinoma by intensive toxicity.

Animals ; Aristolochia ; chemistry ; toxicity ; Drugs, Chinese Herbal ; toxicity ; Kidney ; drug effects ; metabolism ; pathology ; Liver ; drug effects ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Stomach Neoplasms ; chemically induced ; Urinary Bladder ; drug effects ; metabolism ; pathology ; Urinary Bladder Neoplasms ; chemically induced

To investigate the effects of sanguinarine (Sang) combined with cisplatin (Cis) in accelerating the apoptosis of bladder cancer EJ cells, CCK-8 method was used to detect the proliferation of bladder cancer EJ cells treated with different concentrations of Sang with the IC50 values calculated. Annexin V FITC/PI method was used to detect cell apoptosis in the control group, Sang group, Cis group and the combination group. Flow cytometer was used to detect cell cycle arrested. Western blot was used to detect the influence of Bcl-2 expression in the control group, Sang group, Cis group and the combination group. Nude mouse subcutaneous tumor model was constructed to verify that the combination group could accelerate the apoptosis of bladder cancer EJ cells and reduce the side-effects on mice. The safety of the Sang was evaluated by HE staining of vital organs in mice. In vitro, Sang could significantly inhibit the proliferation of EJ cells. Compared with the control group, the number of apoptosis EJ cells in the combination group was significantly increased (P < 0.05), and more cells were arrested in G2/M phase. The expression of Bcl-2 was significantly down-regulated in the combination group (P <0.001). In vivo, compared with the control group, the tumor growth was significantly slower, and a large number of apoptotic cells were inspected (P < 0.05) of the combination group. The side effects of cisplatin were reduced in the combination group. Sang has high biosafety and little side effect. Combined Sang and Cis can increase cell cycle G2/M block, down-regulate Bcl-2 expression, promote cell apoptosis and inhibit tumor growth.

OBJECTIVETo observe the regulatory effect of Chinese drugs for activating blood circulation (ABC) and for activating blood circulation and detoxifying (ABCD) on indices of thrombosis, inflammatory reaction, and tissue damage in a rabbit model of toxin-heat and blood stasis syndrome.

METHODSFifty-four rabbits were randomized into the normal control group, model group, simvastatin group (simvastatin, 0.93 mg/kg per day), ABC group [Xiongshao Capsule, 0.07 g/kg per day], and ABCD group [Xiongshao Capsule, 0.07 g/kg per day, and Huanglian Capsule, 0.14 g/kg per day]. All except the normal control group received a single injection of bovine serum albumin and were fed with high-fat diets for 6 weeks. At the end of week 4 of giving high-fat diets, a dose of endoxitin was given by ear vein injection, and a randomized 2-week treatment was initiated. At the end of treatment, blood lipids, circulating endothelial cells, and the pathological changes of the aortic arch were assessed. The serum levels of matrix metalloproteinases (MMP-9), tissue inhibitors to metalloproteinase (TIMP-1), granule membrane protein-140 (GMP-140), plasminogen activator inhibitor-1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α) were determined.

RESULTSCompared with the model group, ABCD group showed decreased serum triglyceride (TG) level, improvement in the pathological change in the aortic arch, and reduction in the number of circulating endothelial cells (4.00 ± 1.41 per 0.9 μL for ABCD group vs 7.83 ± 1.72 per 0.9 μL for the model group). In addition, the levels of serum GMP-140, PAI-1, and IL-6 in ABCD group were also significantly reduced [0.79 ± 0.20 ng/mL, 5.23 ± 1.39 ng/mL, 40.64 ± 10.11 pg/mL for ABCD group vs 1.08 ± 0.31 ng/mL, 7.28 ± 2.01 ng/mL, 54.44 ± 13.56 pg/mL for the model group, respectively, P < 0.05]. A trend showing improvement in the indices of thrombosis, inflammatory reaction, and tissue damage was observed in the ABC group when compared to the model group, but the changes were not statistically significant (P > 0.05).

CONCLUSIONSChinese drugs for activating blood circulation and detoxifying have beneficial effects on regulating indices of thrombosis (GMP-140 and PAI-1) and inflammatory reaction (IL-6) in rabbit model with toxic-heat and blood stasis. The effect of the activating blood circulation and detoxifying drugs in regulating the levels of serum GMP-140, PAI-1, and IL-6 was superior to that of the activating blood circulation drugs.

Analysis of Variance ; Animals ; Atherosclerosis ; drug therapy ; pathology ; Blood Circulation ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Endothelium, Vascular ; drug effects ; pathology ; Immunohistochemistry ; Inflammation ; drug therapy ; pathology ; Male ; Rabbits ; Random Allocation ; Sensitivity and Specificity ; Simvastatin ; administration & dosage ; Systemic Inflammatory Response Syndrome ; drug therapy ; pathology ; Thrombosis ; drug therapy ; pathology