[Intervention of traditional Chinese patent medicine based on syndrome differentiation in female patients after percutaneous coronary intervention due to acute coronary syndrome: a nationwide multicenter prospective cohort study].

Objective: To evaluate the efficacy and safety of discriminative application of Chinese patent medicines in female patients after percutaneous coronary intervention (PCI) due to acute coronary syndrome (ACS). Methods: The study population was from the Chinese Patent Medicine (CPM) trial. CPM trial was a multicenter prospective cohort study, which enrolled patients from 40 centers in mainland China between February 2012 and December 2015, with the discriminative use of Chinese patent medicines as the exposure factor. Female patients with ACS after PCI who completed 36-month follow-up were included in this analysis, and were divided into a conventional treatment group (using conventional western medicine recommended by the guidelines) and a group with the discriminative use of proprietary Chinese medicines (on the basis of conventional western medicine treatment, discriminative use of Qishen Yiqi dropping pills for Qi deficiency and blood stasis syndrome, Guanxin Danshen dropping pills for blood stasis syndrome, and Danlou tablets for phlegm and blood stasis syndrome combined with the conventional western medicine). The primary endpoint event was a composite endpoint event including cardiovascular death, nonfatal myocardial infarction, and emergency revascularization surgery. Secondary endpoint events were composite endpoint events including readmission for ACS, heart failure, stroke, and other thrombotic events. Adverse events were collected. Cox proportional risk model was used to assess the effect of discriminatory application of Chinese patent medicine on endpoint events, and sensitivity analysis was performed by comparing the results with propensity score matching analysis. Results: A total of 748 female ACS post-PCI patients were included in the analysis, aged (63.2±8.3) years. There were 370 patients in the group of discriminative application of Chinese patent medicines and 378 patients in the conventional treatment group. There were 37 cases (10.0%) and 58 cases (15.3%) of primary endpoint events in the discriminatory application of Chinese patent medicines group and the conventional treatment group, respectively. Cox analysis showed that the risk of primary endpoint in the discriminatory application of Chinese patent medicines group was lower than that in the conventional treatment group after adjusting for confounding factors (adjusted HR=0.62, 95%CI 0.40-0.96, P=0.031). There were 38 (10.3%) and 57 (15.1%) cases of secondary endpoint events in the two groups, respectively. Cox regression analysis showed that the risk of secondary endpoint events in the discriminatory application of Chinese patent medicine group was lower than that in the conventional treatment group after adjusting for confounders (adjusted HR=0.56, 95%CI 0.37-0.87, P=0.001). The results of propensity score matching analysis also showed that Chinese patent medicines based on discriminatory application could reduce the risk of primary endpoint (HR=0.62,95%CI 0.40-0.97,P=0.033) and second endpoint (HR=0.56, 95%CI 0.37-0.87,P=0.009) significantly. There was no significant difference in adverse events between the two groups (12.4% (46/370) vs. 10.3% (39/378), P=0.362). Conclusion: On the basis of conventional western medicine treatment, discriminatory application of Chinese patent medicines can reduce the risk of endpoints in female patients after PCI due to ACS without significant adverse effects.

[Clinical characteristics and prognostic analysis of sudden sensorineural hearing loss with metabolic syndrome].

Objective:To analyze the clinical characteristics and prognosis of sudden sensorineural hearing loss (SSNHL) with metabolic syndrome (MetS).Method:Records of 212 patients with SSNHL treated in our department were retrospectively reviewed, including gender, age,course of the disease, concomitant time of tinnitus and vertigo, concomitant rate of hypertension and diabetes mellitus, BMI, systolic pressure, diastolic pressure, HDL-C, TG, fasting plasma glucose level, severity of hearing loss and audiograms. All patients were divided into two groups, the MetS group and the Non-MetS group, and the clinical characteristics and prognosis between two groups were compared.Result:In the MetS group, the BMI, systolic pressure, TG, fasting plasma glucose level were higher than that in the Non-MetS group, while the HDL-C level was lower than that in Non-MetS group (P<0.01), and the rates of profound hearing loss, flat audiogram and total deafness audiogram were higher than that in the Non-MetS group (P<0.05). In the MetS group, the overall recovery rate, complete recovery rate and marked recovery rate were 57.8%,6.0% and 14.5%, respectively, which was lower than that in the Non-MetS group (79.8%,19.4% and 27.9%, P<0.05 ).Conclusion:SSNHL patients with MetS suffered a severer hearing loss, the most audiograms were flat and total deafness, and the prognosis of SSNHL patients with MetS was poorer.

[Course and prognosis analysis of intratympanic dexamethasone in the treatment of sudden sensorineural hearing loss].

Objective:To compare the recovery of different times of intratympanic dexamethasone in the treatment of sudden sensorineural hearing loss(SSNHL) and investigate the related prognostic factors. Method: Ninety patients with SSNHL were randomly divided into group A(3 times, every 2 days) and group B(5 times, every 2 days) according to the times of intratympanic dexamethasone. All patients were treated with blood flow promoting agents and neural nutrients. After 2 weeks of treatment, the recovery was compared. Based on treatment outcomes, patients were divided into two groups: recovery and no recovery, we evaluated the possible prognostic factors. Result:In the group A, the threshold improvement was(20.2±16.7) dB HL and the overall recovery rate was 78.7%(complete recovery rate, marked recovery rate and recovery rate were 17.0%, 21.3% and 40.4%, respectively), in the group B, the threshold improvement was(20.4±17.4) dB HL and the overall recovery rate was 81.4%, the complete recovery rate, marked recovery rate and recovery rate were 20.9%, 32.6% and 27.9%, respectively, the differences of recovery variables between the 2 groups were not statistically significant. After 2 weeks of treatment, 71 patients got overall recovery(78.9%), 19 patients(21.1%) resulted in no recovery, Interval between onset of symptoms and therapy of recovery group was shorter than that in no recovery group ï¼»(5.6±3.6）days vs. （7.7±4.0）days, P<0.05ï¼½, the presence rate of vertigo in recovery group was lower than that in no recovery(14.1% vs. 68.4%, P<0.01). Gender, ear side, age, concurrence of tinnitus, initial hearing threshold, times of intratympanic dexamethasone and audiogram have no influence on the prognosis of SSNHL. Conclusion:SSNHL patients treated with 3 times and 5 times of intratympanic dexamethasone got similar results. Earlier treatment and absence of vertigo lead to favorable hearing results.

Simvastatin monotherapy as a potential option for statin-associated muscle symptoms: a case report.

WHAT IS KNOWN AND OBJECTIVES: Choosing an alternative statin is recommended when managing statin-associated muscle symptoms (SAMS) and new hydrophilic statins are often suggested. We report on a case of statin-associated muscle damage that was successfully managed by simplifying the patient's combination therapy with simvastatin-ezetimibe to simvastatin alone. CASE SUMMARY: The patient experienced SAMS when he was successively treated with atorvastatin, rosuvastatin, Xuezhikang capsule and combined simvastatin/ezetimibe therapy. However, the patient tolerated simvastatin therapy well even at a dose of 40 mg/day. WHAT IS NEW AND CONCLUSION: Our case suggests that patients with SAMS who are intolerant to a wide variety of statins may be successfully managed with simvastatin monotherapy.

Retrospective epidemiological analysis of sparganosis in mainland China from 1959 to 2012.

In this study, epidemiological factors of sparganosis cases reported in mainland China from 1959 to December 2012 were analysed. A total of 1061 valid cases were distributed throughout most of the provinces of mainland China, with most cases occurring in Southern and Eastern China. The average age of patients was 29 years (range 0-80 years). Modes of transmission to humans were via contact (54·6%), mainly by application of frog meat as a poultice, foodborne (33·8%), mainly through ingesting frogs or snakes, and waterborne (11·5%) through drinking raw water. The tissue/organs involved were subcutaneous/muscle (43·1%), eyes (31·0%), central nervous system (CNS) (17·9%), urogenital system (3·9%) and visceral organs (3·2%). Obvious differences existed in main risk factors for different areas. Close correlation was found between tissue/organs and risk factors. Main modes of transmission changed during the past decades, from contact (83·8% pre-1979) to foodborne (63·9% post-2000). The tissue/organs involved also changed at the same time. Cases involving eyes fell from 50·0% pre-1979 to 8·3% post-2000, and cases involving CNS increased from 0% pre-1979 to 47·8% post-2000. These results illustrate that China is one of the main epidemic countries of sparganosis in the world. Consumption of frog/snake meat was the main risk factor, although application of frog flesh as a poultice was the main risk factor before 2000. Sparganosis has become one of the neglected but important foodborne/waterborne parasitic diseases in mainland China.

[Effect of xiongshao capsule on vascular remodeling in porcine coronary balloon injury model].

OBJECTIVE: To study the effect of Xiongshao Capsule (XS) on vascular remodeling in porcine coronary balloon injury model. METHODS: Restenosis model was established by oversized balloon injury at mid-region of the left anterior descending coronary artery. The effect of drugs on late lumen loss and vascular remodeling was evaluated with quantitative histological method by combining results from histopathological analysis and coronary arteriography. RESULTS: Vascular remodeling explained (59 +/- 20)% of late lumen loss. All drugs significantly reduced late lumen loss 4 weeks after balloon injury (P < 0.05 or 0.01). Both low-dose and high-dose XS markedly reduced late lumen loss resulting from vascular remodeling, as compared with the control group (P < 0.05 and P < 0.01 respectively). CONCLUSION: Vascular remodeling played an important role in late lumen stenosis after balloon injury of coronary artery. XS could significantly inhibit pathological vascular remodeling after balloon injury, thus reduce late lumen loss and prevent restenosis.

A study on the culture medium antigens of Cystcercus cellulosae for detecting antibodies of cysticercosis by means of ABC-ELISA.

Two antigens of Cysticercus cellulosae, cystic fluid antigen (CFA) and the culture medium antigen (CMA), were used in Avidin-Biotin Peroxdase Complex-ELISA (ABC-ELISA) to detect IgG antibodies in 45 cases of cysticercosis treated with praziquantel. The results revealed the total positive rates as 51.11% with CMA and 82.22% with CFA. The positive rates in the cases treated within 2 courses of treatment were 79.17% for CMA and 87.50% for CFA, and only 19.05% for CMA and 71.43% for CFA in the cases treated for more then 3 courses. The fact that the positive rates decreased as the courses of treatment increased showed that the sensitivity of CMA might be related to the vital conditions of the worms in the body, whether alive or dead. It is, therefore, recommended that CMA has the potential to be employed in ABC-ELISA both as an indicator for diagnosing cysticercosis and as a reference for the evaluation of the treatment.

[Effect of yuxintong on ECE, NOS gene expression and immunohistochemical studies on cooper-zinc-SOD in ischemic myocardium in experimental dogs].

OBJECTIVE: To explore the effect of Yuxintong (YXT) on the endothelin converting enzyme (ECE) and the nitric oxide synthase (NOS) gene expression levels and cooper-zinc-superoxide dismutase (SOD) activity. METHODS: The acute myocardial ischemia models were reproduced in anesthetized dogs by ligating the left coronary artery at the middle of anterior descending branch. The ECE and NOS gene expressions were observed by in situ hybridization and the cooper-zinc-SOD was studied by immunohistochemical and image analysis. RESULTS: It was found that the transfer of ECE mRNA was greatly increased, while that of NOS mRNA was greatly decreased in ischemic my ocardium, but the YXT could enhance the expression levels of NOS mRNA and inhibit the over expression of ECE mRNA in ischemic myocardium in dog. Meanwhile, the cooper-zinc-SOD immunohistochemistry was significantly weakened in ischemic myocardium, but the YXT could evidently increase SOD activity in experimental ischemic myocardium. CONCLUSIONS: It suggested that YXT had notable protection on experimental ischemic myocardium and was definitely valuable on prevention and treatment of coronary heart disease.

[Effect of refined xuefu capsule on mRNA expression of nitric oxide synthase of hypoxic ischemic myocytes evaluated by northern blotting].

Comparative study on effect of refined Xuefu capsule, Xuefu Zhuyu capsule and diltiazem on mRNA expression of nitric oxide synthase (NOS) and release of LDH-L, CK, GOT of hypoxic hypoglycemic cultured myocytes were studied by using the serum pharmacological method, reverse transcriptase-polymerase chain reaction (RT-PCR) and Northen blotting. It was shown that the three drugs can reduce release of LDH-L,CK,GOT of myocytes (P < 0.01), the effect of refined Xuefu capsule and diltiazem were obvious than that of Xuefu Zhuyu capsule in reducing LDH-L release and NOS mRNA expression (P < 0.01), and effect of refined Xuefu capsule was the strongest (P < 0.01). These findings indicated that all 3 drugs have significant effect in protecting myocytes which related to their effect on NO production of myocyte particularly the refined Xuefu capsule and diltiazem.

[Clinical observation of wenxin decoction in treating 82 patients with spontaneous angina pectoris].

One hundred twenty-two patients with spontaneous angina pectoris (SAP) were randomly divided into treated group (82 cases) and control group (40 cases), and treated with Wenxin decoction and isosorbide dinitrate respectively. Results showed that in treated group the total effective rate of SAP was 95.12% and that of electrocardiographic findings were 74.39%. These results were all superior to those of control group (P < 0.01). Moreover, results of extracorporeal thrombosis test showed after Wenxin decoction treatment, the length of thrombus decreased from 23.56 +/- 5.47 mm to 20.04 +/- 5.17 mm, the wet weight of it decreased from 92.65 +/- 18.45 mg to 76.94 +/- 15.08 mg and the dry weight from 21.76 +/- 7.30 mg to 16.90 +/- 5.35 mg. The submaximal exercise test revealed an increase of exercise time from 474.66 +/- 96.33 seconds to 548.83 +/- 99.93 seconds, increase of acting quantity from 104.16 +/- 19.65 W to 123.61 +/- 24.96 W and a decrease of ST segment depression from 0.183 +/- 0.041 mV to 0.139 +/- 0.038 mV. These results suggested that Wenxin decoction is valuable in treating SAP.

[Research on the relation between intrauterine infection and intrauterine growth retardation].

To investigate the relationship between intrauterine infection and IUGR, the following studies have been carried out: (1) measurement of specific antibodies of Toxoplasma (Toxo) and Cytomegalovirus (CMV) in the umbilical serum samples from 30 cases of IUGR with 26 normal newborn infants as controls; (2) follow-up exam on 14 positive cases in 17-25 months. The results showed that in 30 IUGR cases 14 were found to have Toxo and CMV infection, with an incidence significantly higher than that in the control group. One third of the infected patients were found to have retarded growth afterbirth and 63.63% of them appeared to have an increase in BAEP. This suggested that regular follow-up is indicated in these cases.

Morphometric diagnosis of bladder tumor.

This paper reports the morphometric analysis results of 100 cases of bladder tumor cells with a Q-900 computer-assisted image analysis system. According to the nuclear area, axis ratio and area ratio of tumor nuclei, bladder transitional cell tumors were divided into 4 grades. This system is called the morphometric grading system (M grading). The results show that the higher the M grading, the lower the survival rate and the higher the recurrence rate. As the M grade increases the tumors could be accompanied by muscular invasion. When recurring, the tumor has a poor prognosis if M grading increases. We conclude that the morphometric grading system is able to yield a quantitative pathologic diagnosis and can predict the biological behavior of bladder tumors. Recently, new techniques for diagnosing and predicting the biological behavior of bladder tumors have been developed. One such technique is morphometric analysis of bladder transitional cell carcinoma with computer-assisted image instruments [1]. Because this morphometric method is easily applicable to pathological section routinely stained with HE and the results are reproducible and more objective, the studies about morphometric analysis of bladder tumor have increased in recent times. This paper reports the preliminary morphometric analysis results of bladder tumor cells examined by a Q-900 image analysis instrument for 100 cases.