OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Many factors are reported to be involved in regulating the immunopathogenesis of schistosome infection. CD4⁺ T cell is one of the key players in the regulation of the liver granuloma formation by differentiation into different effector subsets including T helper (Th) 1, Th2, Th17, and T regulatory cells (Treg cells). Treg cells play an important suppressive role in immunopathology control and favor the pathogen to escape from the host immune assault. The functional activity of Tregs has been related to some autoimmune diseases including asthma and inflammatory bowel disease, which suggests that the manipulation of Tregs to restore their numbers and function may be therapeutic. However, interleukin-17 (IL-17) is a pro-inflammatory cytokine involved in the pathogenesis of many inflammatory and infectious conditions, including schistosomiasis. Therefore, a deeper understanding of the mechanisms of these immune regulations is necessary for the better control of pathology in schistosomiasis. In this paper, we review the Treg/Th17 balance and the immunology of schistosome infection.

OBJECTIVE:To explore the effects of sufentanil combined with remifentanil on the hemodynamics,stress re-sponse and analgesic effect of elderly patients with abdominal surgery by general anesthesia. METHODS:170 elderly patients with abdominal surgery by general anesthesia were randomly divided into control group and observation group,85 cases in each group. All patients received general anesthesia. Control group induced anesthesia by 4 ng/kg remifentanil and maintained by 5 ng/kg;obser-vation group induced anesthesia by 3 ng/kg sufentanil and 2 ng/kg remifentanil,maintained by 0.15 mg/(kg·h)remifentanil and 3 ng/kg remifentanil. Heart rate(HR)and mean arterial pressure(MAP)before anesthesia induction,immediately intubation,1 min after intubation,abdominal entry and 1 min after extubation,norepinephrine and epinephrine levels before anesthesia induction,1 min after intubation,1 min after extubation,6 and 12 h after surgery in 2 groups were observed,restlessness and alertness/seda-tion scores after extubation,6,12,24 h postoperative visual analogue scede (VAS) score and the incidence of adverse reactions were compared. RESULTS:HR and MAP levels in 2 groups immediately intubation,1 min after intubation,abdominal entry and 1 min after extubation significantly changed,HR and MAP levels in observation group 1 min after intubation,abdominal entry and 1 min after extubation were significantly lower than control group,the differences were statistically significant(P<0.05);nor-epinephrine and epinephrine levels in 2 groups 1 min after intubation,1 min after extubation,6 and 12 h after surgery significant-ly changed,and observation group was lower than control group,the differences were statistically significant(P<0.05);restless-ness and alertness/sedation scores after extubation,6,12,24 h VAS score in observation group were significantly lower than con-trol group,the differences were statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Sufentanil combined with remifentanil can effectively stabilize hemody-namics of elderly patients with abdominal surgery,reduce the stress response levels and improve the postoperative analgesic ef-fect,with good safety.

BACKGROUND:Ankle joint fracture combined with triangular ligament injury is a common type of injury, and is easy to have an impact on the anatomy of the ankle joint, leading to the occurrence of joint instability; the treatment is extremely easy to lead to a variety of complications. For injured triangular ligament, it is controversial whether it is necessary to repair in the clinic. OBJECTIVE:To investigate the effect of a wire anchor for repairing triangular ligament in ankle joint fracture fixation. METHODS:The clinical data of 36 cases of ankle fractures combined with triangular ligament injury, who were treated in the Department of Orthopedics of the Seventh People’s Hospital of Zibo City from May 2013 to May 2014, were retrospectively analyzed. The ankle fractures combined with triangular ligament injury were treated with open reduction plate fixation. The patients were folowed up for 12 months. The recovery of ankle joint function was evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and foot function score. Gravity stress X-ray examination was performed before and after treatment. Space of medial maleolus was measured. Adverse events were observed. RESULTS AND CONCLUSION:The patients were folowed up 3, 6 and 12 months after treatment. AOFAS score of the ankle joint was increased and significantly higher at 12 months than that before surgery (P< 0.05). Gravity stress X-ray examination revealed that the space of medial maleolus of the affected side was smaler at 12 months than that before treatment (P < 0.05). No injuries to nerves and blood vessels were found during surgery, and the incision was healed in the first stage, and no infection was observed. Adverse events such as fixator breakage and loosening were not visible. However, partial function of the ankle joint was limited after repair in triangular ligament injury. Results confirmed that open reduction and internal fixation combined with a wire anchor obtained good effects in the repair of ankle joint fracture with triangular ligament injury.