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A study of stress response to different ways of indwelling gastric tube in patients with severe craniocerebral injury

Hongsong ZHANG ; Fang FENG ; Chengming DONG ; Chenghua MOU ; Ruixia SONG ; Chaohui YANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):372-375. doi:10.3969/j.issn.1008-9691.2014.05.014

ObjectiveTo observe the effect on stress response to indwelling gastric tube assisted by bronchofiberoscope and traditional way in patients with severe craniocerebral injury in intensive care unit(ICU). Methods 126 patients admitted in Department of Surgery ICU in Lanzhou University Second Hospital were randomly divided into bronchofiberoscope assisted indwelling gastric tube group(experimental group) and the traditional way of indwelling gastric tube group(control group), 63 cases in each group. In the experimental group, the rod of mirror, Olypus BF-P60, was coated with lidocaine gel, through the nasal cavity it was sent into interior, when arrived at epiglottis, the operator adjusted the mirror head and let it go into the esophagus(about 10 cm), then put a steel wire as a guide into a hole for biopsy, and simultaneously, as the operator pulled out the rod, the wire was continuously pushed slowly further inside; after the bronchofiberoscope was completely withdrawn, valelinum liquidum was used to ensure sufficient lubrication to the external and internal walls of the indwelling gastric tube ready to be sent into the stomach, afterwards the tube was slowly pushed along the guide wire to an appropriate location and then the wire was pulled out, the operator injected air, when he or she heard the gurgling sound as the gas passing water, fixed the tube. In the control group, the traditional way of indwelling gastric tube was applied. Before and after indwelling gastric tube for 1, 3, 5 minutes, the changes of systolic pressure(SBP),diastolic pressure(DBP),heart rate(HR), end-expiratory carbon dioxide partial pressure(PETCO2) and plasma concentrations of norepinephrine(NE), adrenaline, angiotensinⅡ(AngⅡ), glucose(GLU) were examined.Results The plasma levels of SBP, DBP, HR, PETCO2, adrenaline, NE, AngⅡ and blood GLU had no statistical significant differences before operation in comparisons between both groups(allP>0.05). Compared to those before indwelling the tube, the levels of SBP, DBP, HR, PETCO2, NE, adrenaline, AngⅡ and GLU at various time points after the indwelling in experimental group were of no statisticalsignificant differences(allP>0.05), while the levels of SBP, DBP,HR, adrenaline, NE, AngⅡand GLU in control group at various time points after indwelling were higher obviously than those before operation, and the level of PETCO2 was decreased significantly compared with that before operation. The differences in the above indexes were significant between the treatment and control groups at 1 minute after indwelling〔SBP(mmHg, 1 mmHg=0.133 kPa): 125.1±15.4 vs. 135.5±13.6, DBP(mmHg): 85.6±16.1 vs. 91.1±17.2, HR(bpm): 99.4±13.8 vs. 107.9±16.5, PETCO2(mmHg): 32.5±2.8 vs. 29.8±4.1, NE(ng/L): 365.4±29.7 vs. 475.7±49.9, adrenaline(ng/L): 75.4±7.2 vs. 83.6±7.4, AngⅡ(ng/L): 65.3±6.9 vs. 73.3±9.1, GLU(mmol/L): 10.1±1.9 vs. 13.4±3.0, allP<0.05〕; the differences in the above indexes remained significant between the treatment and control groups till 5 minutes after indwelling〔SBP(mmHg): 123.7±14.8 vs. 129.7±15.1, DBP(mmHg): 84.3±14.6 vs. 88.4±14.2, HR(bpm): 97.7±13.6 vs. 31.6±3.9, PETCO2(mmHg): 33.5±3.1 vs. 31.6±3.9, NE(ng/L): 363.9±31.3 vs. 457.7±48.4, adrenaline(ng/L): 74.6±7.8 vs. 83.5±8.5, AngⅡ(ng/L): 64.3±8.4 vs. 71.9±5.9, GLU(mmol/L): 9.6±2.3 vs. 12.7±3.1, allP<0.05〕.ConclusionCompared with traditional way, the indwelling of gastric tube assisted by branchofiberoscopy can induce milder stress response.

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Clinical observation on efficacy of Ningmitai capsule for treatment of patients with diabetic urinary tract infection

Lei LIU ; Mingqing TIAN ; Wenjie HUANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):368-371. doi:10.3969/j.issn.1008-9691.2014.05.013

ObjectiveTo explore the clinical efficacy of Ningmitai capsule for treatment of patients with diabetic urinary tract infection.Methods A total of 100 diabetes patients with urinary tract infection from Zunyi First People's Hospital in Guizhou Province and Longkou Family Planning Service Station in Shandong Province wereenrolled in the study and randomly divided into control and treatment groups after they were informed and gave consent. With basic therapy to lower blood glucose, 65 cases in the treatment group were treated with Ningmitai capsule(4 granules/time, every grain of 0.38 g), while another 35 cases of the control group were given Sanjin tablets (4 granules/time, every grain of 0.29 g), 3 times a dayfor 2 weeks in both groups. Before and after treatment, the clinical effect, blood routine, urine routine, blood glucose, negative conversion ratio of midstream urine bacteria culture and tradition Chinese medicine syndrome curative effect in both groups were observed.Results The total effective rate of treatment group was significantly higher than that of the control group〔88.52%(54/61) vs. 70.59%(24/34),P<0.01〕. Before treatment, the differences in red blood cell(RBC) and white blood cell(WBC) count in urine samples as well as RBC, WBC, hemoglobin(Hb) and glucose in blood samples had no statistical significance in the comparisons between the two groups(allP>0.05). Compared with those before treatment, after treatment, the urinary RBC and WBC were decreased in treatment group, while in control group WBC was decreased but RBC increased, and in the comparisons of above indexes between the two groups there were statistical significant differences〔RBC(cell/μL): 1.99±0.59 vs. 9.11±3.76, WBC(cell/μL): 23.09±6.18 vs. 63.72±25.76, bothP<0.05〕. The blood RBC was significantly lowered after treatment in control group(×109/L: 3.93±0.40 vs. 4.02±0.39,P<0.05). In both groups, after treatment, WBC, Hb and glucose in blood were reduced in comparisons to those before treatment, and no statistical significant differences were found(allP>0.05). Negative conversion ratio of midstream urine bacterial culture in treatment group was significantly higher than that in control group〔80%(4/5) vs. 0(0/2)〕. Syndromes of traditional Chinese medicine were ameliorated at different degrees after treatment in both groups. The effectiveness of treatment group on urinary urgency, yellowish turbid urine and swelling pain in lower abdomen were obviously more valid than that of control group〔urinary urgency: 90.0%(54/60) vs. 61.8%(21/34), yellowish turbid urine: 75.0%(39/52) vs. 47.6%(10/21), swelling pain in lower abdomen: 74.5%(35/47) vs. 70.6%(12/17),P<0.05 orP<0.01〕, but other symptoms were similar in the two groups(allP>0.05).ConclusionThe clinical efficacy of Ningmitai capsule is better than that of Sanjin tablet for treatment of patients with diabetic urinary tract infection, and no adverse reaction has been seen in clinical observation.

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An observation on efficacy of combined traditional Chinese and western medicine for treatment of patients with deep venous thrombosis in lower extremity

Xiaying CAI ; Yanzhen BI ; Min LIN ; Ling XIAO

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):364-367. doi:10.3969/j.issn.1008-9691.2014.05.011

ObjectiveTo investigate the clinical efficacy of combined traditional Chinese and western medicine for treatment of patients with deep venous thrombosis(DVT)in lower extremity.Methods A retrospective study was conducted. Forty patients with DVT admitted into Mindong Hospital Affiliated to Fujian Medical University were randomly divided into control and treatment groups, 20 cases in each group. Conventional therapy was given in both groups. The patients in control group were hypodermically injected with low molecular heparin 3.075 kU, and orally took warfarin sodium; the former injection was terminated on the 3rd day, and afterwards warfarin was solely administered. On the basis of the treatment in the control group, the patients in treatment group were additionally treated with Huoxue Tongmai decoction(ingredients: peach kernel 15 g, red paeonia 15 g, honeysuckle flower 15 g, rhizoma alismatis 12 g, semen coicis 30 g, semen plantaginis 9 g, suberect spatholobus stem 12 g, radix scrophulariae 9 g, pawpaw 12 g, radix achyranthis bidentatae 12 g), the formula could be modified in accordance with patients' symptoms and signs, and Jiangjun powder was applied at the lesion externally(ingredients of the powder: rhubarb 250 g, mirabilite 200 g, flour 100 g, vinegar 500 g were mixed to form a smooth paste), once a day, 30 days constituting a therapeutic course and totally 2 courses being taken. The perimeter of the affected limb, visual analogy score(VAS), revascularization rate, curative effect and adverse reaction were observed before and after treatment and compared between the two groups.Results The total effective rate in treatment group was higher than that in control group〔90.0%(18/20) vs. 70.0%(14/20),P<0.05〕. After treatment, the perimeter of the affected limb in both groups was significantly smaller than that before treatment, the decrease in treatment group being more marked〔the upper leg(cm):46.21±4.80 vs. 53.18±4.45, the lower leg(cm): 32.57±4.26 vs. 36.21±5.01, bothP<0.05〕. TheVAS scores were significantly decreased in both groups after treatment for 1 month, they reached the valley values after treatment for 2 months, the degree of descent being more significant in the treatment group(2.24±0.58 vs. 3.36±0.61,P<0.01). The revascularization rate of the treatment group after treatment was higher than that of the control group〔85.0%(17/20) vs. 70.0%(14/20),P<0.05〕.ConclusionThe combined treatment of traditional Chinese and western medicine was obviously superior to the sole western medicine for treatment of patients with DVT.

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Effect of tanshinoneⅡ A on expression of protein S100A1in acute myocardial ischemia rats

Maolin WU ; Changlin ZHAI ; Yamei ZHANG ; Feifei WU ; Yingzhi ZHANG

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):350-353. doi:10.3969/j.issn.1008-9691.2014.05.008

ObjectiveTo investigate the protective effect of tanshinoneⅡA on the expression of S100A1 protein after acute myocardial ischemia injury in rats.Methods Sixty Wistar rats were randomly divided into sham operation group, acute myocardial ischemia model group and tanshinoneⅡA pretreatment group by random number table. The acute myocardial ischemia model was established by thoracotomy and penetration of a thread and occlusion around the root part of the left anterior descending coronary artery, while the sham operation group was established only by thoracotomy and penetration of a thread around the root part of that artery but without occlusion; 3 days before the operation, in the tanshinoneⅡA pretreatment group, intraperitoneal injection of tanshinoneⅡA solution(at a dose of 1.5 mg/kg) was applied, while in the sham and acute myocardial ischemia groups, intraperitoneal injection of an equal volume of saline was given. Myocardial cell apoptosis was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL), the levels of serum superoxide dismutase (SOD), malondialdehyde(MDA), creatine kinase(CK), lactate dehydrogenase(LDH) and S100A1 protein were examined and the level of expression of S100A1 protein in myocardial tissue was assayed by immunohistochemical staining and Western Blot.Results Compared with the sham operation group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 expression in myocardial ischemia group and tanshinoneⅡA pretreated group were significantly increased, while SOD activity was decreased obviously; compared with the myocardial ischemia model group, the myocardial cell apoptosis rate, the contents of MDA, CK, LDH, S100A1 and the level of S100A1 protein expression were significantly reduced〔apoptosis rate:(32.1±4.2)% vs.(72.4±5.4)%, MDA(μmol/L): 9.1±2.2 vs. 17.3±5.2, CK(U/L): 83.3±12.2 vs. 107.5±12.4, LDH (μmol·s-1·L-1): 84.0±16.4 vs. 114.4±16.0, S100A1(μg/L): 37.6±6.0 vs. 78.4±8.6,P<0.05 orP<0.01〕, while the activity of SOD was increased markedly in tanshinoneⅡA pretreated group(kU/L:72.8±10.2 vs. 49.6±8.8,P<0.01). TUNEL staining showed that in the myocardial ischemia model group and tanshinoneⅡA pretreated group, the myocardial cells represented positive staining(brown-yellow in color), irregular in shape with nuclear pyknosis, cell detachment from the surrounding tissue and other characteristics. And in sham operation group,the staining of majority of cells was negative. The results of immunohistochemistry showed that S100A1 protein staining was relatively deep in the myocardial ischemia model group and tanshinoneⅡA pretreated group, and in the latter group, the color of S100A1 protein positive staining was not as deep as that in the former group. Western Blot showed that the S100A1 protein expression in myocardial ischemia model group was 2.8 folds of that of the sham operation group, while the S100A1 protein expression in tanshinoneⅡA pretreated group was significantly decreased compared with that of myocardial ischemia model group(bothP<0.05),which was 1.5 folds of that of the sham operation group.ConclusionTanshinoneⅡA may play a role in inhibiting the expression of S100A1 protein to protect against acute myocardial ischemia injury, suggesting that this agent have a potential effect for treatment of myocardial ischemia.

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A study on Changduqing enema combined with plasma exchange for treatment of endotoxemia in 34 cases with acute-on-chronic hepatic failure

Zhaolan ZHANG ; Feng SHI ; Xiaoyan LU ; Suping MA ; Jinglan FEI

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):382-385. doi:10.3969/j.issn.1008-9691.2014.05.016

ObjectiveTo observe the effect of enema with Chinese medicine Changduqing combined with plasma exchange for treatment of endotoxemia in patients with acute-on-chronic liver failure.Methods A prospective randomized controlled trial was conducted, and 68 patients with acute-on-chronic hepatic failure who were hospitalized from January 2009 to June 2012 in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were randomly divided into treatment and control groups, 34 cases in each group. The patients in control group were treated with plasma exchange combined with western medicine comprehensive treatment such as protecting liver, reducing enzyme, removing jaundice, and in cases with hepatitis B, antiviral therapy was added. The treatment in patients of treatment group was the same as that in the control group, but additionally Changduqing enema of TCM decoction was given(ingredients: radix et rhizoma ginseng 10 g, flos magnolia officinalis 6 g, radix et rhizoma rhei 6 g, fructus aurantii immaturus 6 g, radix paeoniae rubra 10 g),twice a day combined with 3-4 times of plasma exchange treatment, once every 72 hours. The course of treatment of both groups was 4 weeks. The changes of total bilirubin (TBil), alanine aminotransferase(ALT), albumin(ALB), prothrombin activity(PTA), endotoxin, the improvement of clinical symptoms and signs such as lacking in strength, poor appetite, abdominal distension, oliguria, bleeding tendency, hepatic encephalopathy, infection and ascites were observed before and after treatment, and the survival rate in 24 weeks of follow-up was also investigated.Results Before treatment, the comparisons of TBil,ALT, ALB and PTA between the two groups were of no statistically significant differences(allP>0.05); compared with those before treatment, the levels of TBil and ALT were obviously decreased, and PTA was markedly increased after treatment in both groups, the degree of change being more prominent in treatment group〔TBil(μmol/L): 89.6±52.3 vs. 124.6±64.4, ALT(U/L):52.4±32.1 vs. 98.3±42.5, PTA:(53.8±11.5)% vs.(41.2±10.2)%, allP<0.05〕. The ALB levelsbefore and after treatment of both groups showed no significant difference(bothP>0.05). After treatment, the endotoxin(kU/L) in both groups were decreased in inchoate, developing and fully-developed stages and the descent being more significant in treatment group(inchoate stage: 0.094±0.015 vs. 0.109±0.032, developingstage: 0.102±0.019 vs. 0.146±0.062, fully-developed stage: 0.124±0.022 vs. 0.196±0.074, allP<0.05). The 24-week survival rates of developing and fully-developed stages in patients of both groups were lower than the rate in patients of inchoate stage, and the rates of treatment group in inchoate and developing stages were remarkably higher than the rate in control group〔inchoate stage: 94.1%(16/17) vs. 83.3%(15/18), developed stage: 85.7%(12/14) vs. 42.9%(6/14),bothP<0.01〕.ConclusionEnema with TCM Changduqing combined with plasma exchange for treatment of patients with acute-on-chronic liver failure can remove bilirubin, ameliorate endotoxemia, elevate PTA level and increase the survival rate of patients in 24 weeks of follow-up.

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Effects of Xuebijing injection on vascular endothelial cell function in rats with heat stress

Zongbao YIN ; Chao JI ; Qun XIANG ; Yu HOU ; Bin XIE

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):360-363. doi:10.3969/j.issn.1008-9691.2014.05.010

ObjectiveTo investigate the mechanism of protective effect of Xuebijing injection on vascular endothelial cells in rats with heat stress.Methods Ninety Sprague-Dawley(SD) rats were randomly divided into control, model and Xuebijing injection treatment groups, 30 rats in each group. Heat stress model was reproduced by placing rats in constant temperature box at 40℃, 60% relative humidity for 1 hour, Xuebijing injection group was treated by intraperitoneal injection of Xuebijing 2.5 g/kg, while the control and model groups were treated by intraperitoneal injection of normal saline 2 mL/kg, once a day only in 1 day for both groups. After model establishment, the rectum temperature, heart rate and the mean arterial pressure(MAP) were recorded at 2, 6, 12 hours in each group. At the same time, the rat abdominal aortic blood was collected and serum was separated, the enzyme-linked immunosorbent assay(ELISA) was used to determine the aortic serum levels of lipopolysaccharide(LPS), nuclear factor-κB(NF-κB) and p53, and the prothrombin time(PT), activated partial thromboplastin time(APTT) and D-dimer of venous blood were detected by automatic blood coagulation analyzer(ACLTOP).Results Compared with those in control group, the rectum temperature, heart rate, LPS, NF-κB, p53, PT, APTT, D-dimer were significantly increased, and MAP was obviously decreased in model group(P<0.05 orP<0.01). Compared with model group, the above indexes were improved significantly in Xuebijing injection treatment group at 2 hours〔rectum temperature(℃): 38.02±0.22 vs. 39.32±0.33, heart rate(bpm): 507±14 vs. 562±35, MAP(mmHg, 1 mmHg=0.133 kPa): 98±6 vs. 87±13, LPS(ng/L): 0.65±0.03 vs. 0.82±0.05, NF-κB(ng/L): 1.10±0.04 vs. 1.33±0.05, p53(ng/L): 1.33±0.03 vs. 1.73±0.02, PT(s):15.47±1.03 vs. 20.28±2.01, APTT(s): 40.26±2.46 vs. 47.46±3.51, D-dimer(μg/L): 238.54±8.32 vs. 323.12±8.14,P<0.05 orP<0.01〕.Conclusion Xuebijing injection can correct the disorders of blood PT, APTT, D-dimer via decreasing the secretion of the levels of NF-κB, p53 from vascular endothelial cells in rats with heat stress, thus the integrity of the vascular endothelium can be protected, and LPS entering into the blood stream can be inhibited.

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A analyse on negative risk factors for acute heart failure syndrome with poor outcomes

Jiahua PENG ; Qiaoxia TAN ; Yuguang XIAO ; Weifeng DENG ; Zuokun XU

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):354-359. doi:10.3969/j.issn.1008-9691.2014.05.009

ObjectiveTo assess negative risk factors associate with short-term and long-term poor outcome of acute heart failure syndromes(AHFS) and provide evidence to emergently proceed to AHFS low risk stratification.Methods A retrospective cohort study was conducted. 125 AHFS patients who met research criterion were enrolled from Guangxi Baise People's Hospital and Youjiang District People's Hospital of Baise City. The patients were divided into poor outcome and relatively low-risk groups by the results of short- and long-term follow-up of their outcomes. The patient's vital signs and disease history were collected at the first time after admission, and auxillary examination parameters were recorded. The poor outcomes occurring in the follow-up periods from the admission to after discharge for 30 days(short-term) and 1 year(long-term)were recorded, and Cox hazard regression was used to analyze the negative risk factor in the short- and long-term.Results There were 58 cases(46.4%)with poor outcome and 30 cases(24.0%)dead in short-term, and there were 111 cases(88.8%) with poor outcome and 39 cases(31.2%) dead in the long-term follow up. Seven negative risk factors were identified by Cox regression. They were no previous or de novo myocardial infarction〔short-term: hazard ratio(HR)=0.36, 95% confidence interval (95%CI)=0.20-0.65,P=0.001〕, lymphocyte ratio 0.20-0.40(short-term:HR=0.13, 95%CI=0.04-0.47, P=0.002; long-term:HR=0.42, 95%CI=0.26-0.68,P=0.001),oxygenation index(PaO2/FiO2)>300 mmHg (1 mmHg=0.133 kPa,short-term:HR=0.23, 95%CI=0.09-0.54,P=0.001),estimated glomerular filtration rate (eGFR)>60 mL·min-1·1.73 m-2(short-term:HR=0.31, 95%CI=0.16-0.64,P=0.002;long-term:HR=0.54, 95%CI=0.36-0.83,P=0.004),left ventricular ejection fraction(LVEF)>0.50(short-term:HR=0.29, 95%CI= 0.10-0.85,P=0.024), P wave terminal force in lead V1(PtfV1)>-0.04 mm·s(short-term:HR=0.29, 95%CI= 0.14-0.60,P=0.001), planar QRS-T angle<90°(long-term:HR=0.46, 95%CI=0.27-0.77,P=0.003). ConclusionsOur patients with AHFS cohort have very poor outcomes both in short-term and long-term follow up. Those with the following characteristics: no previous or de novo myocardial fraction, lymphocyte ratio 0.20-0.40, PaO2/FiO2>300 mmHg, eGFR>60 mL·min-1·1.73 m-2, PtfV1>-0.04 mm·s, LVEF>0.50 and planar QRS-T angle<90°are more likely to have optimal short-term and long-term outcome.

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Effect of Baihu Renshen decoction combined with Fufang Xiebai capsules on serum micro RNA expression profiles in patients with severe pulmonary infection

Yimin LU

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2014;(5):340-344. doi:10.3969/j.issn.1008-9691.2014.05.006

ObjectiveTo study the differences in expression profiles of peripheral blood specific serum micro RNA(miRNA) in the comparison between those before and after Baihu Renshen decoction combined with Fufang Xiebai capsules for treatment of patients with severe pneumonia.Methods 136 patients with severe pulmonary infection accompanied by heat-phlegmand sthenic-fu syndrome admitted in the Department of Respiratory Medicine of Kunshan First People's Hospital Affiliated to Jiangsu University from January 2012 to December 2013 were enrolled in the study. They were treated with basic treatment and Baihu Renshen decoction〔gypsum 30 g(broken, wrapped in cotton cloth, firstly put in water to be boiled), American ginseng 4 g, fritillaria 10 g, bupleurum chinense 10 g, skullcap 10 g, fried gardenia(pittosporm root) 10 g, forsythia 12 g, honeysuckle 10 g, spiderwort grass(dayflower) 15 g, prepared licorice root 4 g〕 combined with Fufang Xiebai capsules〔mainly composed of longstamen onion bulb(macrostem onion)12 g, melon wilt(fructus trichosanthis) 12 g, pinellia 10 g, coptis chinensis 3 g〕. The changes of serum miRNA expression profiles before and after treatment were analyzed by Solexa sequencing. The peripheral blood serum specific miRNAs were confirmed by real-time fluorescent quantitation-polymerase chain reaction(qRT-PCR). Before and after treatment, the receiver operating characteristic curve(ROC curve) of patients with severe pulmonary infection was drawn, and the ROC curve was used to analyze the sensitivity and specificity of serum miRNA to the efficacy of the combination therapy and evaluate its clinical value.Results Solexa sequencing suggested that 42 kinds of miRNA appear to have over 2-fold in difference in the comparison between profiles before and after Baihu Renshen decoction combined with Fufang Xiebai capsules treatment. Real-time qRT-PCR confirmed miR-146a, miR-125b and miR-155 expressions were significantly decreased over 10 fold, suggesting that they should be specific miRNAs. The area under the ROC curve(AUC) of miR-146a was 0.81,95% confidence interval(95%CI)=0.73 - 0.89,miR-125b AUC=0.77,95%CI=0.71 - 0.83 and miR-155 AUC=0.89, 95%CI=0.83 - 0.95. Then, through selected clinical truncated(cut off)value,the sensitivity and specificity of three kinds of serum miRNA were calculated: 63% and 87% of miR-146a, 53% and 73% of miR-125b and 56% and 83% of miR-155.ConclusionAddition of Baihu Renshen decoction combined with Fufang Xiebai capsules on the basic treatment can induce significant changes of peripheral blood serum miRNA expression profiles in patients with severe pneumonia, and miR-146a, miR-125b and miR-155 among miRNAs could be their specific changes.

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Discussions on ischemic stroke basic pathogenesis, blood stasis caused by deficiency of both Qi and Yin, and its therapeutic application of Yangyin Yiqi Huoxue

Haitong WAN

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2019;26(1):1-4. doi:10.3969/j.issn.1008-9691.2019.01.001

Based on our research team's clinical and basic research results of traditional Chinese medicine (TCM) in the prevention and treatment of ischemic stroke, and combined with TCM syndrome standard manifestations of this disease, wind, phlegm, fire, deficiency and blood stasis, this paper points out definitely that the basic pathogenesis of ischemic stroke is blood stasis caused by deficiency of both Qi and Yin. The pathogenic characteristics are deficiency in origin and excess in superficiality, and the wind, fire, phlegm, deficiency and blood stasis are related one another resulting in this disease; it is established that the basic syndrome types of this disease are deficiency of both Qi and Yin and static blood blocking the collaterals, and the therapeutic regime is a recipe including the TCM ingredients having the actions of nourishing yin, tonifying Qi and improving blood circulation (Yangyin Yiqi Huoxue) and according to the patient's individual variation of syndrome differentiation, the ingredients in the recipe can be added or subtracted. In this report, a new system of treatment for ischemic stroke based on syndrome differentiation is proposed.

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A clinical study of Linggui Zhugan decoction for treatment of typeⅡ cardiorenal syndrome

Haiyun ZHU ; Qiang DING ; Yuru CHU

Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care.2015;(4):412-414. doi:10.3969/j.issn.1008-9691.2015.04.019

Objective To approach the therapeutic effect of modified Linggui Zhugan decoction for treatment of patients with type Ⅱ cardiorenal syndrome (CRS).Methods Thirty patients with CRS admitted to Affiliated Hospital of Tianjin Institute of Chinese Medicine were selected. By a random number table and double-blind method, they were divided into two groups: treatment and control groups, 15 cases in each group. The patients in both groups were treated with conventional western medicine, and those in the treatment group were additionally given traditional Chinese medicine (TCM) modified Linggui Zhugan decoction (including the following ingredients: Poria 30 g, Cinnamomi Cortex 10 g, Atractylodis Macrocephalae Rhizoma 15 g, Glycyrrhizae Radix et Rhizoma Preparata cum Melle 10 g, Morindae Officinalis Radix 15 g, Arecae Pericarpium 30 g, Astragali Radix 30 g, Zingiberis Rhizoma 10 g, Descurainiae Semen 15 g), one dose daily for consecutive 30 days. Before and after treatment the changes in levels of B-type natriuretic peptide (BNP), serum creatinine (SCr), blood urea nitrogen (BUN), amount of urine, clinical efficacy and TCM syndrome score efficacy were observed in two groups.Results After treatment, the levels of BNP, SCr, and BUN were significantly decreased, while urine volume was obviously increased compared with those before treatment in the two groups, and the degrees of changes in the treatment group were superior to those in control group [BNP (ng/L): 297.3±75.1 vs. 344.2±56.3, SCr (μmol/L): 139.7±62.1 vs. 154.4±39.7, BUN (mmol/L): 10.1±6.4 vs. 13.2±8.7, urine volume (mL/d): 847.2±32.7 vs. 786.4±13.6, allP < 0.05]. The total effective rates of patients and TCM syndrome scores in treatment group were significantly higher than those in control group [both 86.7% (13/15) vs. 66.7% (10/15), bothP < 0.05]. Conclusions Modified Linggui Zhugan decoction can alleviate the symptoms of yang deficiency of heart and kidney and heart failure due to the attack of heart by retained fluid, and can also ameliorate the complicated renal function impairment; the therapeutic effect of integrative traditional Chinese and western medicine for treatment of patients with type Ⅱ CRS is superior to that of conventional western medicine treatment.

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