Objective To explore the clinical efficacy of Chinese herbal medicine with the actions of invigorating spleen,activating blood and resolving phlegm in the treatment of senile insomnia based on the theory of"muscular atrophy,qi-passage blockage"recorded in Huang Di Nei Jing(The Yellow Emperor's Inner Classic,shortened as Nei Jing).Methods A total of 120 elderly patients with insomnia were randomly divided into observation group and control group,with 60 cases in each group.The control group was treated with oral use of Dexzopiclone Tablets,and the observation group was treated with oral use of decoction of Chinese herbal medicine for invigorating spleen,activating blood and resolving phlegm.The course of treatment covered 4 weeks.Before and after treatment,the two groups were observed in the changes of Pittsburgh Sleep Quality Index(PSQI)score,Insomnia Severity Index(ISI)score,polysomnography(PSG)related parameters of total sleep time(TST),number of awakenings(AN)and sleep latency(SL),mean blood flow velocity of anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral artery(PCA),and serum levels of 5-hydroxytryptamine(5-HT)and melatonin(MT).After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 93.33%(56/60),which was slightly higher than 90.00%(54/60)of the control group,but the difference was not statistically significant(P＞0.05).(2)After treatment,the item scores and total scores of PSQI in the two groups were lower than those before treatment(P＜0.05),and the decrease of the scores of sleep quality,sleep time,sleep efficiency,and daytime function as well as total scores in the observation group was significantly superior to that in the control group(P＜0.05).However,there was no significant difference of time for falling asleep and sleep disorder scores between the two groups(P＞0.05).After 4 weeks of drug withdrawal,the item scores of PSQI in the observation group continued to decrease compared with those after treatment(P＜0.05),but there was no significant difference in the control group(P＜0.05).(3)After treatment,the ISI scores in the two groups were decreased when compared with those before treatment(P＜0.05),and the decrease in the observation group was superior to that in the control group(P＜0.05).After 4 weeks of drug withdrawal,the ISI score of the observation group continued to decrease compared with that after treatment(P＜0.05),while the control group had no significant change,and the difference was not statistically significant(P＞0.05).(4)After treatment,the PSG related parameters such as TST,AN and SL in the two groups were improved when compared with those before treatment(P＞0.05),and the improvement of TST and AN in the observation group was superior to that in the control group(P＞0.05).(5)After treatment,the mean blood flow velocity of ACA,MCA and PCA in the observation group was improved compared with that before treatment(P＜0.05),while there was no significant change in the control group compared with that before treatment(P＞0.05).The improvement of the mean blood flow velocity of ACA,MCA and PCA in the observation group was significantly superior to that in the control group(P＜0.05).(6)After treatment,the levels of serum 5-HT and MT in the two groups were increased when compared with those before treatment(P＜0.05),and the increase in the observation group was superior to that in the control group(P＜0.05).(7)The incidence of adverse reactions in the observation group was 5.00%(3/60),which was slightly lower than 13.33%(8/60)in the control group,but the difference was not statistically significant(P＞0.05).Conclusion Based on the theory of"muscular atrophy,qi-passage blockage"recorded in Nei Jing,the Chinese herbal medicine for invigorating spleen,activating blood and resolving phlegm exerts certain effect in treating senile insomnia.It can effectively improve the sleep quality and daytime function of patients,enhance sleep efficiency,increase sleep time,reduce the number of awakenings,alleviate the severity of insomnia,improve brain function,and regulate the level of neurotransmitters,with remarkably long-term effect and reliable safety.

OBJECTIVE: Current clinical evidence on the effects of home blood pressure telemonitoring (HBPT) on improving blood pressure control comes entirely from developed countries. Thus, we performed this randomized controlled trial to evaluate whether HBPT plus support (patient education and clinician remote hypertension management) improves blood pressure control more than usual care (UC) in the Chinese population. METHODS: This single-center, randomized controlled study was conducted in Beijing, China. Patients aged 30-75 years were eligible for enrolment if they had blood pressure [systolic (SBP) ≥ 140 mmHg and/or diastolic (DBP) ≥ 90 mmHg; or SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg with diabetes]. We recruited 190 patients randomized to either the HBPT or the UC groups for 12 weeks. The primary endpoints were blood pressure reduction and the proportion of patients achieving the target blood pressure. RESULTS: Totally, 172 patients completed the study, the HBPT plus support group ( n = 84), and the UC group ( n = 88). Patients in the plus support group showed a greater reduction in mean ambulatory blood pressure than those in the UC group. The plus support group had a significantly higher proportion of patients who achieved the target blood pressure and maintained a dipper blood pressure pattern at the 12th week of follow-up. Additionally, the patients in the plus support group showed lower blood pressure variability and higher drug adherence than those in the UC group. CONCLUSION HBPT plus additional support results in greater blood pressure reduction, better blood pressure control, a higher proportion of dipper blood pressure patterns, lower blood pressure variability, and higher drug adherence than UC. The development of telemedicine may be the cornerstone of hypertension management in primary care.
Humans ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Hypertension/therapy* ; Telemedicine/methods* ; Hypotension

OBJECTIVE: To investigate the efficacy and safety of venetoclax (VEN) combined with demethylating agents (HMA) in the treatment of relapsed/refractory acute myeloid leukemia (R/R AML). METHODS: The clinical data of 26 adult R/R AML patients who received the combination of VEN with azacitidine (AZA) or decitabine (DAC) in Huai'an Second People's Hospital from February 2019 to November 2021 were retrospectively analyzed. The treatment response, adverse events as well as survival were observed, and the factors of influencing the efficacy and survival were explored. RESULTS: The overall response rate (ORR) of 26 patients was 57.7% (15 cases), including 13 cases of complete response (CR) and CR with incomplete count recovery (CRi) and 2 cases of partial response (PR). Among the 13 patients who got CR/CRi, 7 cases achieved CRm (minimal residual disease negative CR) and 6 cases did not, with statistically significant differences in overall survival (OS) and event-free survival (EFS) between the two groups (P=0.044, 0.036). The median OS of all the patients was 6.6 (0.5-15.6) months, and median EFS was 3.4 (0.5-9.9) months. There were 13 patients in the relapse group and refractory group, respectively, with response rate of 84.6% and 30.8% (P=0.015). The survival analysis showed that the relapse group had a better OS than the refractory group (P=0.026), but there was no significant difference in EFS (P=0.069). Sixteen patients who treated for 1-2 cycles and 10 patients who treated for more than 3 cycles achieved response rates of 37.5% and 90.0%, respectively (P=0.014), and patients treated for more cycles had superior OS and EFS (both P<0.01). Adverse effects were mainly bone marrow suppression, complicated by various degrees of infection, bleeding, and gastrointestinal discomfort was common, but these could be all tolerated by patients. CONCLUSION VEN combined with HMA is an effective salvage therapy for patients with R/R AML and is well tolerated by patients. Achieving minimal residual disease negativity is able to improve long-term survival of patients.
Adult ; Humans ; Retrospective Studies ; Neoplasm, Residual/drug therapy* ; Bridged Bicyclo Compounds, Heterocyclic/adverse effects* ; Recurrence ; Leukemia, Myeloid, Acute/drug therapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

Objective:To explore the relationship between diffusion tensor imaging (DTI) parameter of fractional anisotropy (FA) and recovery of upper-extremity motor function in patients with ischemic stroke. Methods:From January to December, 2019, 20 ischemic stroke patients accepted routine medication and rehabilitation for three weeks. They received DTI examination and were measured FA of the infarct and the corresponding area on the contralateral side, the cerebral foot and the posterior limb of internal capsule of affected and unaffected sides, while the bilateral FA ratio (rFA) of them were calculated, before and after treatment. Meanwhile, all the patients were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Results:The FMA-UE score improved after treatment (t = 9.074, P < 0.001), while FA and rFA increased in infarct area (t > 14.519, P < 0.001). The difference before and after treatment of FA and rFA in all of the areas positively correlated with that of FMA-UE scores (r = 0.445~0.565, P < 0.05), which was the most in posterior limb of internal capsule of the affected side. Conclusion:FA of DTI alters with the recovery of motor function of the upper extremity after ischemic stroke, especially in the posterior limb of internal capsule.

OBJECTIVE: To establish the model of antibody-induced immune hemolytic disease in SD rats so as to provide an experimental platform for the exploration of its pathogenesis, course of disease and evaluation of drug efficacy. METHODS: The red blood cells(RBC) of SD rats were isolated and intraperitoneally injected into BALB/c mice to induce production of the antiserum to SD rat RBC. Twenty SD rats were randomly divided into 2 groups. The rats in the model group were injected with 0.1 ml antiserum via tail vein; the rats in the control group were injected with 0.1 ml saline via tail vein.The symptoms of rats, hemolysis-related indexes and histopathological changes of the main organs were observed in both groups after injection. RESULTS: After the injection of antiserum, the SD rats in the model group displayed nasal flaring, laziness, decrease of ingestion and water intake, skin and mucosal jaundice, and gross hemoglobinuria. At the 4th day after the injection, the body weight of SD rats in the model group was significantly lower than that in the control group (P＜0.01), and the coefficiens of liver and spleen increased significantly (P＜0.01); The levels of WBC, MCV, MCH, DBIL, DBIL/TBIL and FHb all increased statistically significantly, and RBC, Hb, HCT, MCHC and Plt levels decreased significantly in comparison with the control group (P＜0.01). In the SD rats of model group, the hemolytic pathological changes were observed in liver, spleen, kidney, lung and small intestine, and erythroid proliferation was observed in bone marrow smears. CONCLUSION The immune hemolytic disease model of SD rats can be successfully established by injecting the serum aginst SD rat red blood cells into the tail vein of SD rats, showing the high success rate, good reproducibility and low cost.
Animals ; Hemolysis ; Liver ; Mice, Inbred BALB C ; Rats ; Rats, Sprague-Dawley ; Reproducibility of Results

PURPOSE: The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years. MATERIALS AND METHODS: Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome. RESULTS: After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods. CONCLUSION: The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.
Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Retrospective Studies ; Survival Rate

PURPOSE: The purpose of this study was to subdivide M1 stage nasopharyngeal carcinoma (NPC) patients with bone-only metastases for prognosis prediction while identifying the treatment effect of locoregional radiotherapy (LRRT) and metastasis radiotherapy (MRT) among patients with different risk. MATERIALS AND METHODS: From November 2006 to October 2016, a total of 226 patients with bone-only metastasic NPC were retrospectively enrolled. All patients developed distant lesions before receiving treatment. All potential prognostic factors were considered and the correlation of the M1 subdivisions with overall survival (OS) was determined by Cox regression hazards model. Kaplan–Meier curves were used to appraise survival condition and log-rank testing was used to compare the differences. RESULTS: The median follow-up time was 33.9 months (range, 3 to 126 months). According to multivariate Cox proportional hazard analysis, the number of metastatic lesions and Epstein-Barr virus (EBV) DNA status after palliative chemotherapy (PCT) were independent prognostic factors for OS. Thus, we subdivided patients into three risk groups according to these two factors. Systemic chemotherapy combined with LRRT may benefit patients in low- and intermediate-risk groups but not in the high-risk group. Further aggressive MRT based on systemic chemotherapy showed no survival benefit in any risk group. CONCLUSION: The stratification of NPC patients with bone-only metastasis based on EBV DNA after PCT and the number of metastatic lesions provided promising prognostic value and could aid clinicians in person-specific treatment.
Diagnosis ; DNA ; Drug Therapy ; Follow-Up Studies ; Herpesvirus 4, Human ; Humans ; Neoplasm Metastasis ; Prognosis ; Proportional Hazards Models ; Radiotherapy ; Retrospective Studies

Objective To demonstrate the nuclear orphan receptor Nur77 agonist fungal polyketone (Cytosporone B,Csn-B) protects the neurons in Parkinson's disease cell model.Methods The SH-SY5Y cells were divided into blank group,control group (Csn-B),model group (MPP +) and experimental group (MPP + + Csn-B).The relative viability of human neuroblastoma cells SH-SY5Y induced by 1-methyl-4-pehny1-pyridine (MPP+) was measured with MTT assay.The expression of microtubule associated protein 1 light chain3 (LC3)-Ⅱ / Ⅰ and α-synuclein protein was detected by Western blotting.The expression of LC3 mRNA and α-synuclein mRNA were detected by qPCR.Immunofluorescence was used to observe the expression of LC3 and α-synuclein in each group.Results The MTT results showed that MPP + significantly inhibited proliferation of SH-SY5Y cells in a dose dependent manner.Western blotting showed that,LC3-Ⅱ and LC3-Ⅰ gray scale in blank group,control group,model group and experimental group were 0.21 ±0.02,0.23 ±0.03,0.32 ±0.03,0.69 ±0.05,LC3-Ⅱ/Ⅰ in model group and experimental group was significantly higher than that in blank group(P ＜ 0.01),and LC3-Ⅱ/Ⅰ in experimental group was significantly higher than that in model group (P ＜ 0.01).The α-synuclein in blank group,control group,model group and experimental group were 0.30 ± 0.05,0.51 ± 0.06,2.18 ± 0.12,0.73 ± 0.08,the expression of α-synuclein in model group and experimental group were significantly higher than that in blank group (P ＜0.01).The expression of α-synuclein protein in experimental group was significantly lower than that in model group (P ＜ 0.01).The relative expression of LC3 mRNA in blank group,control group,model group and experimental group were 3.94 ±0.18,4.04 ±0.13,6.01 ±0.21,7.43 ±0.35,the LC3 mRNA in model group and experimental group were significantly higher than that in blank group (P ＜ 0.01),LC3 mRNA in experimental group was significantly higher than that in model group (P ＜0.01).The α-synuclein mRNA in blank group,control group,model group and experimental group were 3.09 ±0.19,3.47 ±0.24,7.18 ±0.30,4.60 ±0.27,the expression of α-synuclein mRNA in model group and experimental group were significantly higher than that in blank group (P ＜0.01).The expression of α-synuclein mRNA in experimental group was significantly lower than that in model group (P ＜0.01).Immunofluorescence showed that LC3 protein was mainly located in cytoplasm.The expression of LC3 in model group and experimental group were significantly higher than that in blank group,and the expression level of LC3 in experimental group was higher than that in model group.oα-synuclein protein was distributed evenly in the cytoplasm and nucleus.The expression of α-synuclein in model group and experimental group was higher than that in blank group,experimental group was lower than that in model group.Conclusion In Parkinson' s disease cell model,Nur77 agonist can promote the degradation of α-synuclein,the mechanism may be related to increase autophagy level.

OBJECTIVETo analyze the frequency distribution of single nucleotide polymorphisms (SNPs) of four asthma-related gene loci (ACE I/D; ADRB2 Arg16Gly; TNF-α G-308A; MS4A2 Glu237Gly) in 198 asthmatic children, and to investigate its association with genetic susceptibility to childhood asthma and some clinical phenotypes of asthma.

METHODSPolymerase chain reaction product electrophoresis identification and real-time quantitative PCR detecting system were used to determine the frequency distributions of the SNPs of the four asthma-related gene loci in 198 asthmatic children and 110 healthy controls. The serum total IgE (TIgE) levels and blood eosinophil proportion (%EOS) of the asthmatic children were measured. Different genotypes at the four asthma-related gene loci were compared in terms of TIgE and %EOS.

RESULTSThe genotype DD of angiotensin-converting enzyme (ACE) had a significantly higher frequency in the asthmatic children than in the healthy controls (χ2= 30.667, P<0.01), and the frequency of D allele was also significantly higher in the asthmatic children than in the healthy controls (χ2=7.151, P<0.01). No correlation was found between the polymorphism of each gene locus and serum TIgE level and %EOS (P>0.05).

CONCLUSIONSGenotype DD of ACE is related to genetic susceptibility to childhood asthma and may be the risk factor for childhood asthma.

Asthma ; etiology ; genetics ; Child, Preschool ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Single Nucleotide ; Receptors, Adrenergic, beta-2 ; genetics ; Receptors, IgE ; genetics ; Tumor Necrosis Factor-alpha ; genetics