UNLABELLEDOBJECTIVE; To evaluate the efficacy and safety of Jiangtang Xiaozhi Capsule (JTXZC) in treating type 2 diabetes mellitus (T2DM) of qi-yin deficiency phlegm-stasis inter-obstruction syndrome (QYDPSIOS), and to observe its effect on inflammatory factors and fibrinolytic factors.

METHODSBy adopting a randomization grouping, parallel control, and prospective study, 73 T2DM patients of QYDPSIOS were assigned to two groups by random digit table, the Pioglitazone Tablet group (36 cases, as the control) and the JTXZC group (37 cases). All patients maintained their basic therapies and lifestyle as previous after recruitment. Patients in the JTXZC group took JTXZC, 4 pills each time, three times per day, while those in control group took Pioglitazone Tablet, 15 mg each time, once daily. The therapeutic course for all was 8 weeks. The body weight (BW), the height, body mass index (BMI), waist circumference (WC), hip circumference, waist-to-hip ratio (WHR), and scoring of Chinese medicine (TCM) symptoms were observed. Levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), glycated hemoglobin (HbA1c), tumor necrosis factor alpha (TNF-alpha), nuclear factor kappaB (NF-kappaB), and plasminogen activator inhibitor 1 (PAL-1) were detected. The safety indices such as liver and renal functions and adverse reactions were also observed.

RESULTSCompared with before treatment, BW, BMI, HbA1c, and PBG were obviously lower after 8-week treatment than before treatment in the JTXZC group (P < 0.05). There was no statistical difference in post-treatment BW, BMI, HbA1c, or 2 h PBG between the two groups (P < 0.05). Compared with before treatment, levels of TNF-alpha and PAI-1 were lowered after 8 weeks of treatment in both groups (P < 0.01). The level of NF-kappaB was obviously lowered after 8 weeks of treatment in the control groups (P < 0.05), but it also decreased in the JTXZC group with no statistical difference. The scorings of CM symptoms were somewhat improved after treatment in the two groups (P < 0.01). Besides, better effects were obtained in the JTXZC group (P < 0.05). No severe adverse event occurred in either group during the whole therapeutic course.

CONCLUSIONSJTXZC showed similar therapeutic effect to pioglitazone. Both of them could effectively improve patients' clinical symptoms, the inflammation and fibrinolytic activities in different pathways, with no severe adverse reaction.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Qi ; Thiazolidinediones ; therapeutic use ; Yin Deficiency ; drug therapy

OBJECTIVETo compare the efficacy of two surgical techniques for controllong nasal width after Le Fort I osteotomy.

METHODSFifty-five patients who received the Le Fort I osteotomy have been included in this study. They were randomly divided into 2 groups. The experimental group received extraoral ABS, and the control group received traditional intraoral ABS. 3D photos of the patient's face were taken before operation and at postoperative 3 months. Alar width was measured on the 3D photos. Data was reported as means and standard deviations, and statistic analysis was done by using student t test.

RESULTSCompared with presurgical data, G. lat-G. lat increased by (2.66 +/- 1.47) mm, Al-Al increased by (2.20 +/- 1.22) mm and Sbal-Sbal increased by (1.30 +/- 1.33) mm in experimental group. G. lat-G. lat increased by (1.38 +/- 1.29) mm, Al-Al increased by (1.06 +/- 0.95) mm and Sbal-Sbal increased by (0.36 +/- 1.33) mm in the control group. There was significant difference between two groups.

CONCLUSIONSThe surgical technique of ABS is the most important factor for determining the postoperative alar width. Both techniques have better effect on the Sbal-Sbal width control than the G. lat-G. lat and Al-Al width control. Traditional intraoral ABS can more effectively control the alar width. Both techniques cannot completely control the alar base widening after Le Fort I osteotomy.

Face ; Humans ; Nose ; anatomy & histology ; Nose Deformities, Acquired ; surgery ; Osteotomy, Le Fort ; adverse effects ; Photography

Objective To investigate the MRI and echocardiography manifestations of noncompaction of ventricular myocardium(NVM)and assess the role of MRI in the diagnosis of NVM by comparing it with echocardiography.Methods Fourteen cases of NVM diagnosed by echocardiography were examined with MRI,including scanning of black-blood sequences,double inversion recovery fast spin echo (DIRFSE)and triple inversion recovery fast spin echo(TIRFSE),and white blood sequence:fast imaging employ steady state acquisition(FIESTA).Scanning plane includes short axis view,four-chamber view and long axis view.Results Both MRI and echocardiography displayed involvement of left ventricles in thirteen cases and involvement of double ventricles in one case.Apexes of heart and the intermedius are commonly affected.MRI showed 54 segments and echocardiography showed 53 segments affected,and there is no significant difference between the capability of MRI and echocardiography(P=1.000).The affected myocardium consisted of two layers:subendoeardial noncompacted myocardium and epicardial compacted myocardium,and the ratio measurement of N/C by MRI was 3.37?0.89 and it was 3.19?0.82 by echocardiography.Noncompacted myocardium was characterized by prominent and excessive myocardial trabeculations and deep intratrabecular recesses,in which the blood flow was communicated with the ventricle.One case was complicated with ventricular aneurysm,and coronary arteriography was performed with unremarkable findings.One case underwent heart transplantation because of progressive heart failure, Gross findings demonstrated prominent muscular trabeculations with deep intratrabecular recesses,which coincided well with MRI findings.Conclusion The MRI manifestation of NVM is characteristic,and MRI with multiple series and planes is helpful in the diagnose of NVM.Compared with echoeardiography,MRI could display the pathological cardiac muscle more clearly,because of its high soft-tissue resolution and spatial resolution.

Objective To describe the change of practice of ICU advanced practice nurses after attending ICU Clinical Nurse Specialist(CNS) training program in Shanghai. Methods A purposive sampling method was used to recruit 15 ICU advanced practice nurses and semi-structured interviews were conducted. Thematic analysis was used for data analysis. Results Four themes regarding practice change were extracted,including extension of scope of practice,transformation of emphasis in work,promotion of clinical reforms and improvement of self-development. Conclusion The practice of ICU advanced practice nurses has changed after training,while the degree of change varies in different themes. Further quantitative researches should be conducted to provide more information for the development of ICU advanced practice nurses.

OBJECTIVETo evaluate the efficacy and safety of Jiangtang Xiaozhi Capsule (JTXZC) in treating type 2 diabetes mellitus (T2DM) patients of qi-yin deficiency and inter-obstruction between phlegm and stasis.

METHODSAdopting prospective, randomized, controlled trial design, 73 T2DM patients of qi-yin deficiency and inter-obstruction between phlegm and stasis syndrome, were randomly assigned to two groups, the pioglitazone tablet group (36 cases) and the JTXZC group (37 cases). The therapeutic course for all was 8 weeks. The body weight, height, body mass index (BMI), waistline (WC), hipline, waist-to-hip ratio (WHR), and scoring for Chinese medicine (CM) symptoms assessment were observed. The fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), glycated hemoglobin (HbA1c), plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), plasma insulin (FINS) were detected. The HOMA-IR was also calculated. The safety indices such as liver and renal functions, adverse reactions were also observed.

RESULTSThe levels of HbA1c were lowered after treatment in the two groups after 8 weeks of treatment, showing statistical difference when compared with before treatment (-0.59% +/- 1.99% and -0.27% +/- 2.73%, P < 0.05). The PBG level also decreased with statistical difference (-1.71 +/- 2.52 mmol/L and -0.72 +/- 4.17 mmol/L, P < 0.05), but there was no statistical difference between the two groups. The body weight, BMI, TG obviously decreased (P < 0.05). The CM symptoms efficacy and CM symptom scoring were significantly reduced in the two groups (P < 0.01). Besides, better effects were shown in the JTXZC group (P < 0.05). No severe adverse event occurred in either group during the therapeutic course. There was no statistical difference in the incidence of adverse events (P > 0.05).

CONCLUSIONSJTXZC showed similar therapeutic effects to pioglitazone. They both could effectively im- prove clinical symptoms with no severe adverse reaction.

Adult ; Aged ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Prospective Studies ; Thiazolidinediones ; therapeutic use ; Yin Deficiency

The apparatus for intrinsic dissolution test recorded in United States Pharmacopeia (USP) integrating with fiber-optic drug dissolution test system (FODT) were used to real-time monitor intrinsic dissolution processes of alliin in four media which were water, solution of HCl with pH 1.2, buffer solution of acetate with pH 4.5, and buffer solution of phosphate with pH 6.8. The intrinsic dissolution rate (IDR) and the similarity factor (f2) of two intrinsic dissolution curves with two apparatuses were calculated. The IDR values of alliin with rotating disk system were 28.1.3, 33.55, 28.38 and 30.95 mg x cm(-2) x min(-1) in four media, respectively. And the IDR values of alliin with stationary disk system were 44.16, 47.07, 45.11 and 51.34 mg x cm(-2) x min(-1), respectively. The similarity factors were 56.42, 50.75, 40.30 and 40.64, respectively. The results showed that the intrinsic alliin dissolution rates were much greater than 1 mg x cm(-2) x min(-1). It inferred that alliin dissolution would not be the rate limiting step to absorption.
Cysteine ; analogs & derivatives ; chemistry ; Fiber Optic Technology ; Solubility

Objective To demonstrate the MRI manifestations of congenital cystic adenomatoid malformation(CCAM)and to evaluate the diagnostic value of MRI.Methods Thoracic axial,sagittal and coronal plane scanning were performed with SSFSE in 9 fetuses diagnosed or suspected of CCAM by ultrasound(US)within 1—2 days after US examination.The diagnosis was confirmed by postnatal autopsy or follow-up.Results In nine fetuses,seven cases of CCAM were diagnosed with MRI and confirmed by autopsy,one case was congenital pulmonary sequestration,one was normal on MRI and two weeks late US.In seven cases of CCAM(5 males and 2 females),four cases were in the right side,three in the left.Four cases of macrocystic type CCAM showed single or multiple cystic long T_2 signal in the unilateral lung,three cases of microcystic type CCAM presented long T_2 signal without cyst.Vessels with flow void phenomenon were found in 2 cases of CCAM and 1 case of pulmonary sequestration.Conclusion MRI can clearly show the location,range and contour of CCAM.The vessel originated from the aorta is suggestive of pulmonary sequestration.

OBJECTIVETo study the application of distraction osteogenesis (DO) of the mandibular ramus in hemifacial microsomia.

METHODSFrom 1999 to 2006, 15 patients with hemifacial microsomia were treated with DO of the ramus, including 12 cases of children and juveniles, 3 cases of grown-ups. Maxillary Le Fort I osteotomy, unilateral sagittal split ramus osteotomy, genioplasty and free scapular flaps were selected to perform on the first or secondary stage of treatment.

RESULTSSuccessful distraction was achieved in all patients with an average distraction distance of 21.25 mm. The distractor was removed after consolidation proved by clinical examination and X-ray. Facial appearance and and occlusal relationship were improved greatly. The occlusal plane was almost normal. There was no infection, malunion or permanent injury of inferior alveolar nerve.

CONCLUSIONSDO of the ramus is very effective for the correction of severe hemifacial microsomia. It has much better therapeutic effect than traditional orthognathic procedures.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Humans ; Male ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Young Adult

OBJECTIVETo study the incidence of injuries among residents living in the communities in Zhejiang.

METHODSA household questionnaire survey was conducted to 16 899 residents in four communities.

RESULTSThe incidence of injuries was 16.11% in total, higher in urban area than in rural area and higher in men than in women. The leading causes of injuries were falls (4.80%), knife-cutting or by sharp articles (3.86%), traffic accident (2.07%), collision (1.99%), scalds (1.13%) and animal bites (1.06%). Peak incidence of age group was different in different injuries, such as traffic accident was high in 45 - 60 age group and falls was high in 5 and 60 age group. Direct economic loss for each case with injury would cost 324.21 RMB yuan.

CONCLUSIONInjury was common and frequently occurred among residents at the community level which seriously on danger their health and families.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Animals ; Bites and Stings ; epidemiology ; Burns ; epidemiology ; Child ; China ; epidemiology ; Community Health Services ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Wounds and Injuries ; epidemiology ; mortality

OBJECTIVETo approach the treatment of severe micrognathia accompanying obstructive sleep apnea hypopnea syndrome (OSAHS) with rigid external distractor (RED) in children.

METHODSSix cases patients (4 males, 2 females) aged between 1.5 and 14 years, were diagnosed as ankylosis of temporomandibular joint severe micrognathia, and OSAHS. Under the nasal intubation and general anesthesia, the surgical procedures were performed by submandibular approach and osteotomy was done in mandible body. Mini plate was fixed and connected to RED. The distraction procedure was carried out

RESULTSPatients' profile, posterior airway space, and the results of polysomnography were improved significantly. There were no complications. Four months after removing the RED, the new bone was well formed.

CONCLUSIONSRED technique has advantages of uncomplicated procedures, high quality of new bone formation, and accurate regulation in the treatment of micrognathia. It is especially suitable for the treatment of children with severe micrognathia whose mandibular body is too small to insert the internal distractor.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Mandible ; surgery ; Micrognathism ; complications ; surgery ; Osteogenesis, Distraction ; methods ; Sleep Apnea, Obstructive ; complications ; surgery ; Temporomandibular Joint Disorders ; complications ; surgery ; Treatment Outcome