OBJECTIVE:To evaluate the efficacy and safety of Qianlie shutong capsule combined with Quinolone antibiotics in the treatment of chronic prostatitis, and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP Database and Wanfang Database,randomized clinical trials(RCT)about the efficacy and safety of Qianlie shutong capsule combined with Quinolone antibiotics(test group)versus only Quinolone antibiot-ics(control group)in the treatment of chronic prostatitis were collected,Meta-analysis was performed by using Rev Man 5.3 soft-ware after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 16 RCTs were enrolled,involving 2 368 pa-tients. Results of Meta-analysis showed the total effective rate [RR=1.56,95% CI(1.29,1.88),P<0.001],US National Institutes of Health Chronic Prostatitis Symptom Index scores(NIH-CPSI scores)[MD=-6.97,95% CI(-8.67,-5.26),P<0.001],pain symptom scores[MD=-3.18,95%CI(-3.92,-2.44),P<0.001)],voiding dysfunction scores [MD=-1.62,95%CI(-1.85,-1.38), P<0.001],life quality scores[MD=-2.16,95% CI(-2.89,-1.43),P<0.001],EPS leukocyte count [MD=-8.90,95% CI (-11.79,-6.02),P<0.001] and recurrence rate[RR=0.22,95%CI(0.12,0.42),P<0.001] in test group were significantly better than control group,there were statistically significant differences between 2 groups;and there was no significant difference in the incidence of adverse reactions between 2 groups [RR=0.49,95%CI(0.11,2.13),P=0.34]. CONCLUSIONS:The efficacy of Qian-lie shutong capsule combined with Quinolone antibiotics is better than only Qianlie shutong capsule or Quinolone antibiotics in the treatment of chronic prostatitis,with similar safety.

Objective To compare the influence of different doses of dexmedetomidine on the haemodynamic response caused by tracheal intubation during general anesthesia induction in senile hypertension patients .Methods Sixty patients with essential hy‐pertension(EH) undergoing general anesthesia operation ,60-75 years old ,ASAⅠorⅡ ,were randomly divided into the group D1 , D2 and control group(C) ,20 cases in each group .4μg /mL dexmedetomidine in the group D1 and D2 was intravenously pumped at 15 min before anesthesia induction with the doses of 0 .2 ,0 .6 μg/kg respectively and completed within 10 min;while the group C was pumped with sodium chloride injection by the same method .Mean artery pressure (MAP) ,heart rate (HR) and O2 saturation (SpO2 ) were monitored at before medication(T0) ,before induction(T1) ,before intubation(T2) ,at 1 min(T3) ,5 min(T4) after tra‐cheal intubation .Meanwhile plasma norepinephrine(NE) and epinephrine(E) values were detected .Results Compared with before medication ,MAP before induction in the group D2 was significantly decreased (P<0 .05) ,however which in the group D1 and C had no obvious change(P>0.05);HR at 1 min after tracheal intubation in the group D2 was significantly decreased (P<0.05) , while which in the group C and D1 was significantly increased(P<0 .05) .Compared with the group C ,MAP and HR before induc‐tion and tracheal intubation ,at 1 ,5 min after tracheal intubation in the group D2 were significantly decreased(P<0.05) ,SpO2 was significantly decreased only before induction (P<0.01);MAP ,HR and SpO2 at each time points in the group D1 had no significant differences compared with the group C(P>0.05) .Compared with T0 ,the plasma levels of NE and E at T1 in the group D2 were decreased (P<0.01);the plasma levels of NE and E at T3 in the group C and D1 were increased ,while which in the group D2 were decreased (P<0.01) .The plasma levels of NE and E at T1 and T3 in the group D2 were decreased compared with the group C(P<0.01) .Conclusion Intravenous injection of dexmedetomidine can safely inhibit the tracheal intubation caused hemodynamic changes and keep the hemodynamic stabilization during general anaesthesia induction and tracheal intubation period in senile hyper‐tension patients .Furthermore dexmedetomidine 0.6μg/kg can more effectively inhibit the tracheal intubation caused stress reac‐tions than dexmedetomidine 0.2μg/kg .

10.3969/j.issn.1000-3606.2013.06.009

Objective To explore the mechanism of Exenatide-induced rat pancreatic tissue lesion.Methods Thirty SD male rats were divided into three groups according to complete random design,and each group had 10 rats,namely Exenatide group,diabetes-model group and control group.Diabetes-model rats were induced by streptozotocin (STZ,35mg/kg) and high-sugar and high-fat diet.The Exenatide group and diabetes group were subcutaneously administered with Exenatide at a dose of 5 μg/kg twice a day.The control group was treated with same amount of saline.Ten weeks later,all the rats were sacrificed and the pancreatic tissues were harvested for routine pathological examination.Immunohistochemical method was used to detect the expression of α-smooth muscle actin (α-SMA) and type Ⅲ collagen protein in pancreatic tissue,and ELISA was applied to measure the expression of matrix metalloprotei-nase-2 (MMP-2) and MMP-9 in pancreatic tissue.Results In control group,there was no pathological change in pancreatic tissue.In Exenatide group,chronic inflammatory changes were observed; and the degree of inflammatory changes were much severe in diabetes group,and the pathological scores were gradually increased in the 3 groups (P ＜0.05).The expressions of MMP 2 in pancreatic tissue in control group,Exenatide group,diabetes group were (186.98 ± 23.24),(306.07 ± 59.82),(365.08 ± 89.55) μg/L,and the expressions of MMP-9 were (49.37 ± 7.08),(67.24 ±14.73),(87.37 ±13.39)μg/L.The values were significantly higher in Exenatide group and diabetes group than those in control group (P ＜ 0.05),but the difference between the two groups was not statistically significant.The numbers of α-SMA positive cells per high power field were (13.4 ± 5.97),(29.5 ± 8.80),(79.3 ± 27.23) in control group,Exenatide group,diabetes group,and the numbers of type Ⅲ collagen positive cells were (10.6 ± 4.93),(29.3 ± 12.95),(56.0 ± 27.21).The values were significantly higher in Exenatide group than those in control group,and the values were significantly higher in diabetes group than those in Exenatide group (P ＜ 0.05).Conclusions Long-term subcutaneous injection of Exenatide may activate pancreatic stellate cells and cause expression of α-SMA,Ⅲ collagen protein,and MMP-2,MMP-9,then induce chronic inflammatory changes.

Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.

Objective To study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P <0.01).The differ-ences of the three indexes had no statistical significance between the normal control group and the ordinary infection group(P >0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.

Objective To study the changes and clinical value of platelet(PLT)parameters and coagulation indicators in children with severe pneumonia.Methods 97 children were divided into severe pneumonia groupⅠand severe pneumonia groupⅡ according to whether children were associated with other diseases besides severe pneumonia,and 30 healthy chil-dren were in control group.The levels of PLT count,mean platelet volume(MPV),prothrombin time(PT),activated par-tial thromboplastin time(APTT),fibrinogen(FIB),antithrombin-Ⅲ(AT-Ⅲ),and D-dimer(DD)among three groups were compared.Results The differences of PLT,MPV,DD and AT-Ⅲ activities were all significant among three groups (all P < 0.05).PLT,MPV and DD levels in group Ⅰ were all significantly higher than those of control group ([454.00±157.00]×109/L vs [300.00±63.00]×109/L ;[9.66±1.24]fL vs [8.90±0.37]fL;[0.47±0.37] mg/L vs [0.27±0.06]mg/L,respectively);AT-Ⅲ activity in groupⅠ was lower than control group([79.91 ± 20.34]% vs[107.03±8.11]%)(both P <0.05).AT-Ⅲ activity and PLT level in group Ⅱwas (66.11±11.12)%and (279.00±185.00)×109/L respectively,which were both significantly lower than group Ⅰ,MPV and DD level was (10.37± 1.51)fL and (0.70±0.46)mg/L respectively,which were both higher than groupⅠ (both P <0.05).Conclusion There is obvious coagulation dysfunction in children with severe pneumonia.The changes in PLT,MPV,AT-Ⅲ and DD levels are associated with the severity of pneumonia.

Abstact:Objective To investigate the clinical value of mean platelet mass(MPM)and the procalcitonin(PCT)in diagnosis of Kawasaki disease (KD).Methods A Total of 117 children with KD in the acute stage and 126 children of the control group were detected respectively and compared each other.The indexes contain MPM,PLT,MPV,PDW and PCT.Mean-while,the comparison of each index’s positive rate and the linear correlation analysis of each index were conducted.Results①The level of MPM of the KD group was significant lower than that of the control group,PLT,MPV and PCT significant higher than those (P<0.05,α=0.05).The difference of PDW between the two groups was no statistical significance (P>0.05,α=0.05).②The positive rate of the MPM was significant higher than that of the other indexes (P<0.05,α=0.05). Conclusion The detection of MPM is helpful to the diagnosis of KD and can be used as an indicator of KD clinically.

Objective To investigate the differences of hepatic pathology between the chronic hepatitis B (CHB) with pulmonary tuberculosis patients and CHB patients.Methods Seventy-nine treatment-naive patients with CHB complicated with pulmonary tuberculosis (co-infection group) were collected from January 2009 to December 2014,and 79 CHB patients were selected randomly during the same period as CHB group.Hepatic tissue inflammation and fibrosis between the two groups were compared according to Ishak scoring system.Comparison between two groups were conducted by t test when the variance was equal and Mann-Whitney U test when the variance was unequal.Categorical data were compared by x2 test.Results A total of 59 (74.7％) patients in co-infection group had inflammation≥ G2,compared to 59.5％ in the CHB group.The difference between the two groups was statistically significant (x2=4.128,P=0.042).Forty-one (51.9％) patients in co-infection group had fibrosis≥S2,compared with 44.3％ in the CHB group.The difference was not statistically significant (x2 =0.913,P=0.339).Ishak scoring system showed that piecemeal necrosis,portal area inflammation score and totalscore in co-infection group were all significantly higher than those in CHB group (2.45± 1.19 vs 2.05± 1.28,2.70±1.22 vs 2.32±1.08,13.16±6.51 vs 11.22±5.72,respectively),with all the differences statistically significant (t=2.055,2.068 and 1.984,respectively;P=0.042,0.040 and 0.049,respectively).However,the confluent necrosis in co infection group was 2.60±1.91 compared to 2.13± 1.68 in CHB group (Z=1.137,P=0.257),focal (dot) soluble necrosis was 2.35± 1.06 versus 2.16± 0.86 (Z=-1.148,P=0.251),and fibrosis was 3.03±1.63 versus 2.45±1.53 (Z=I.541,P=0.125).Conclusion The liver damage in co-infection patients is more severe compared with CHB patients.

Objectives To study the signiifcance of ifbrin related markers such as ifbrin monome (FM), D-dimer (D-D), fibrinogen and fibrin degradation products (FDP) in diagnosis of pre-disseminated intravascular coagulation (pre-DIC) state in children with severe pneumonia. Methods A total of 213 children with severe pneumonia in pediatric intensive care unit were divided into pre-DIC group and case control group according to the occurrence of pre-DIC. And 40 healthy children were included as normal control group. FM、D-D、FDP、prothrombin time (PT)、activated partial thromboplastin time (APTT)、ifbrinogen (FIB)、platelet count (PLT)、thrombomodulin (TM) levels were analyzed. Receiver operating characteristic curve was used to evaluate the above indexes. Results All the markers but FIB showed signiifcant difference among the three groups (P<0 . 05 ). The differences of FM、D-D、FDP、APTT in paired comparison among the three groups were also signiifcant (P<0.01), Pre-DIC group had the highest level and case control group was the second. Pre-DIC group had higher PT than that of the other two groups (P<0 . 05 ), but PT levels in normal control group and the control group are of no signiifcant difference (P>0 . 05 ). Compared with those in normal control group, TM and PLT levels were signiifcantly higher in the other two groups (P<0 . 01 ), but the differences of TM and PLT in pre-DIC group were not signiifcant in comparison to those in case control group (P>0 . 05 ). FM、D-D、FDP had larger area under curves (AUC) for pre-DIC than other indexes ( 0 . 84、0 . 76、0 . 64 , respectively). The AUC for the joint detection of the three indexes was 0 . 85 . Conclusions Fibrin related markers such as FM、D-D and FDP are valuable indexes in diagnosis of pre-DIC state in children with severe pneumonia, the joint detection of the three indexes would help to improve diagnostic accuracy.