Efficacy，safety and cost-effectiveness of edaravone dexborneol and compound porcine cerebroside ganglioside in the treatment of acute ischemic stroke / 中国药房

OBJECTIVE To evaluate efficacy， safety and cost-effectiveness of edaravone dexborneol and compound porcine cerebroside ganglioside in the treatment of acute ischemic stroke， and to provide decision-making reference for clinical treatment selection. METHODS The medical records of 488 patients with acute ischemic stroke hospitalized from Jan. 2021 to Dec. 2021 were collected and divided into two groups according to the treatment plan， i.e. 268 patients in edaravone dexborneol group， and 220 patients in compound porcine cerebroside ganglioside group. After baseline levels of the two groups were balanced using propensity score matching method， curative effect was evaluated according to the changes of NIHSS scores before and after treatment； the occurrence of adverse drug reactions in patients were collected from the hospital adverse reaction reporting system； from the perspective of China’s health system， the cost-effectiveness of the two options were analyzed， and one-way sensitivity analysis was conducted. RESULTS After the propensity score matching， 125 patients were included in the edaravone dexborneol group and compound porcine cerebroside ganglioside group， respectively. The response rates were 81.6% and 74.4%， respectively， with no significant difference. The average costs were 13 560.30 yuan and 14 958.68 yuan， respectively； the cost of edaravone dexborneol group was lower than that of compound porcine cerebroside ganglioside group. No adverse reaction reporting information was retrieved in both groups. Results of one-way sensitivity analysis showed that other drug costs in compound porcine cerebroside ganglioside group was relatively sensitive parameters. CONCLUSIONS Short-term efficacy and safety of edaravone dexborneol are equivalent to those of compound porcine cerebroside ganglioside in treating acute ischemic stroke. But edaravone dexborneol regimen had lower cost and is a more economical scheme.

Validation of the revised mini nutritional assessment short-forms in geriatric internal medicine patients / 肠外与肠内营养

Objective:To validate the revised BMI-MNA-SF and CC-MNA-SF with regard to association and agreement with the full MNA(R),considered as gold standard,in geriatric internal medicine patients.Methods:105 cases of hospitalized elderly patients in internal medicine were recruited for the study.The nutritional status correlation and coherence were evaluated with the revised BMI-MNA-SF、CC-MNA-SF and the full MNA(R),respectively.Results:The BMI-MNA-SF and CC-MNA-SF all correlated strongly with the full MNA(R) (Pearson's correlation coefficient r=0.9080,0.8381 respectively;P ＜ 0.001).High values of sensitivity,specificity and predictive values were observed for the BMI-MNA-SF and CC-MNA-SF against the full MNA(R) as the dichotomized categorizations "malnourished-at risk of malnutrition" vs "well nourished" and "malnourished" vs "at risk of malnutrition-well nourished" were considered.Most of values of those for CC-MNA-SF are lower slightly than BMI-MNA-SF.Areas under the ROC curves also reached high values (BMI-MNA-SF:0.951 and CC-MNA-SF:0.938 for the first categorization;BMI-MNA-SF:1.000 and CC-MNA-SF:0.985 for the second one) showing both tests excellent accuracy with the full-MNA.The agreement between the MNA-SFs and the ful1-MNA was quantified as the percentage of correct classifications.The BMI-MNA-SF classified 83.81％,correctly and the CC-MNA-SF classified 68.57％ correctly.Malnutrition proportions of subjects were not underestimated by both MNA-SFs.Conclusion:The revised BMI-MNA-SF and CC-MNA-SF are rapid、easy and reliable tools are capable to identify malnourished individuals in internal medicine and those who are at risk of malnutrition.Due to the special characteristics of elderly patients,the CC-MNA-SF is a good option to replace the BMI-MNA-SF when BMI is not available.

The diagnostic value of six-slice coronal reformation in patients with acute midepigastric pain / 实用放射学杂志

Objective To evaluate the diagnostic value of six-slice coronal reformations in patients with acute midepigastric pain. Methods A total of 974 patients with acute midepigastric pain were included in this study and divided into group A(coronal reformation)and group B(non-coronal reformation).For group A,reconstructed coronal and oblique-coronal images were acquired.A comprehensive diagnosis was made based on coronal reformations and axial planes.Anatomical nomenclature was adopted,including kidney-ureter plane,abdominal aorta plane,superior mesenteric artery plane,ascending colon-appendix plane,stomach-cholecyst plane and colon-small intestine plane.For group B,the diagnosis was made based on axial planes.Finally,a comprehensive analysis was made,missed cases in these two groups were counted and compared,and statistical analysis was performed using the SPSS software(version SPSS V17).Results For group A,the missed diagnosis was made in 12 cases(1.23%)and it was 53 cases(6.58%)for group B.There was a statistically significant difference between two groups(P<0.05).Conclusion Combined with axial planes or oblique coronal reformations,six-sclice coronal reformation can reduce the the rate of missed diagnosis of acute midepigastric pain.

Clinical observation of dog days moxibustion plaster therapy in treatment of allergic rhinitis of different patterns/syndromes / 中国针灸

<p><b>OBJECTIVE</b>To explore the efficacy and feasibility of dog days moxibustion plaster therapy in treatment of allergic rhinitis of different patterns/syndromes.</p><p><b>METHODS</b>Allergic rhinitis of lung deficiency and invasion of cold, spleen qi deficiency and kidney yang deficiency, 56 patients for each pattern/syndrome were randomized into a plaster therapy group and a nasal spray group, 28 cases in each one. In the plaster therapy group, according to the pattern/syndrome differentiation, with literature retrieval method, 3 acupoints of high frequency utility in clinic were selected as one group in acupoint plaster therapy. For lung deficiency and invasion of cold pattern/syndrome, Feishu (BL 13), Fengmen (BL 12) and Hegu (LI 4) were selected. For spleen qi deficiency pattern/syndrome, Pishu (BL 21), Zusanli (ST 36) and Dazhui (GV 14) were selected. For kidney yang deficiency pattern/ syndrome, Shenshu (BL 23), Dingchuan (EX-B 1) and Bailao (EX-HN 15) were selected. Separately, on July 13, 2013, July 23, 2013, August 2, 2013 and August 12, 2013, the aucpoint plaster therapy was applied, 2 to 4 h (1 to 2 h for children) each time. In the nasal spray group, beclometasone dipropionate aqueous nasal spray, 2 presses one nostril each time, 2 to 3 times a day, continuously for 4 weeks. The symptom score and efficacy were compared before and after treatment in the patients of the two groups.</p><p><b>RESULTS</b>The symptom scores of 3 patterns/syndromes were all apparently improved after treatment as compared with those before treatment in the patients of the two groups (all P<0.05), and the result in the plaster therapy group was better than that of the nasal spray group (P<0.05, P<0.01). For lung deficiency and invasion of cold pattern/syndrome, the total effective rate was 87.3% (20/24) in the plaster therapy group, better than 84.6% (22/26) in the nasal spray group (P<0.05). For spleen qi deficiency pattern/syndrome, the total effective rate was 83.3% (20/24) in the plaster therapy group, obviously better than 76.9% (22/26) in the nasal spray group (P<0.05). For kidney yang deficiency pattern/syndrome, the total effective rate was 79.2% (19/24) in the plaster therapy group, better than 76.9% (22/26) in the nasal spray group (P<0.05).</p><p><b>CONCLUSION</b>The dog days moxibustion plaster therapy achieves definite efficacy on allergic rhinitis at the acupoints selected based on the differentiation of different patterns/syndromes and the efficacy is better than beclometasone dipropionate aqueous nasal spray.</p>

Glucometabolic abnormalities survey among outpatients without previous diabetes diagnosis and with coronary artery disease and hypertension / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the status of glucometabolic abnormalities in cardiological outpatients without previous diabetes diagnosis and with coronary artery disease (CAD) and hypertension.</p><p><b>METHODS</b>Patients without previous diagnosis of diabetes but with hypertension and CAD aged 18 years or above were recruited from cardiology departments of 11 general hospitals in China. Demographic data, disease diagnosis and medical history were collected. Physical examination and questionnaire survey were performed after the random blood glucose test. Oral glucose tolerance test (OGTT) examination was made for patients with fasting blood glucose ≥ 6.1 mmol/L or postprandial random glucose ≥ 7.8 mmol/L. Adjusted prevalence rates were used in the study.</p><p><b>RESULTS</b>A total of 7778 patients were included in 11 centers. After preliminary screening by fasting blood glucose and random blood glucose tests, 3861 patients were required to take OGTT, and 3019 (78.2%) patients actually took the test. 1287 out of 3019 patients screened with OGTT were diagnosed with diabetes, and the adjusted diabetes prevalence rate was 18.64% (1287/6904). The prevalence rate of diabetes was 19.87% (95/478), 9.22% (352/3819) and 14.81% (153/1033) in patients with CAD, hypertension, and CAD combined with hypertension, respectively. A total of 996 patients were diagnosed with impaired glucose tolerance (IGT) and its prevalence was 14.43% (996/6904). Of the enrolled population, 153 patients with random blood glucose lower than 7.8 mmol/L were also screened with OGTT test, 26.14% (40/153) patients met the diagnostic criteria of diabetes.</p><p><b>CONCLUSION</b>A high prevalence of diabetes is found in patients without previous diagnosis of diabetes and with hypertension and CAD consulting at cardiology departments. We thus suggest to perform OGTT in this patient cohort to improve the early diagnosis of IGT and diabetes, and prevent missed detection of type 2 diabetes mellitus or IGT in cardiovascular patients with normal fasting blood glucose. Our results indicate that it was feasible to use OGTT as a screening tool for detecting diabetes in these patients and the patient compliance is satisfactory.</p>

Association between diastolic dysfunction evaluated by left ventricular flow propagation velocity and outcome in patients with hypertrophic cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>Left ventricular diastolic dysfunction is common in cardiovascular diseases. Hypertrophic cardiomyopathy(HCM) is a typical disease with diastolic dysfunction. We analyzed the association between the left ventricular flow propagation velocity (FPV), quantified by color M-mode Doppler and as an indicator for diastolic dysfunction, and clinical outcome in patients with HCM.</p><p><b>METHODS</b>Standard echocardiography including FPV was performed in 43 cases with HCM and 22 control cases without a clear history of heart disease. All eligible cases were followed up to more than 1 year.</p><p><b>RESULTS</b>Hospitalization rate due to emerging atrial fibrillation/flutter was 21%, due to emerging ventricular tachycardia was 16%, due to heart failure was 26%, and due to other events was 14% in HCM patients. FPV [(31.6 ± 11.5) cm/s vs. (68.3 ± 18.3) cm/s, P < 0.01] and FPV/E (0.49 ± 0.20 vs. 1.18 ± 0.41, P < 0.01) were significantly lower in HCM group than in control group. PV/E was an independent predictor for atrial fibrillation/flutter and heart failure, IVST was independent predictor for VT (χ(2) = 5.181, P = 0.0228), LAD (χ(2) = 6.172, P = 0.0130) and FPV/E (χ(2) = 3.932, P = 0.0474) were independent risk factors for total cardiac events.</p><p><b>CONCLUSION</b>The incidence of atrial fibrillation and heart failure were closely related with left ventricular diastolic dysfunction in HCM patients and FPV/E was independent predictor for clinical cardiovascular events.</p>

Effects of valsartan on myocardial calcium/calmodulin-dependent protein kinase-II expression and activity in a rabbit model of heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of valsartan on myocardial expression and activity of calcium/calmodulin-dependent protein kinase-II (CaMK II) in a rabbit model of heart failure.</p><p><b>METHODS</b>Rabbits were divided into sham-operated group, heart failure group (volume overload by aortic valve destruction induced aortic insufficiency plus pressure overload induced by abdominal aortic banding) and heart failure plus valsartan (20 mg x kg(-1) x d(-1), n = 9 each). Seven weeks later, echocardiography and hemodynamic examinations were performed and myocardial CaMK II expression and activity were detected by Western blot and CaMK II activity assay kit, respectively.</p><p><b>RESULTS</b>Compared with the sham operated rabbits, left ventricular mass index [LVMI (3.61 +/- 0.09) g/kg vs. (1.32 +/- 0.06) g/kg, P<0.05] and end-diastolic pressure [LVEDP (23.00 +/- 2.37) mm Hg (1 mm Hg = 0.133 kPa) vs. (-1.50 +/- 0.5) mm Hg, P<0.05] were significantly increased while left ventricular shortening fractions [LVFS (17.38 +/- 3.13)% vs. (37.83 +/- 3.58)%, P<0.05] and ejection fraction [LVEF (38.50 +/- 6.07)% vs. (71.92 +/- 4. 56)%, P<0.05] were significantly decreased (all P<0.05) in heart failure rabbits, these changes could be significantly attenuated by valsartan treatment: LVMI [(2.07 +/- 0.14) g/kg vs. (3.61 +/- 0.09) g/kg, P<0.05], LVEDP [(2.17 +/- 0.72) mm Hg vs. (23.00 +/- 2.37) mm Hg, P<0.05], LVFS [(33.83 +/- 2.85)% vs. (17.38 +/- 3.13)%, P<0.05] and LVEF [(64.45 +/- 3.66)% vs. (38.50 +/- 6.07)%, P<0.05]. CaMK II expression (1.45 +/- 0.13 vs 0.89 +/- 0.05, 1.13 +/- 0.12, P<0.05) and activity [(3.54 +/- 0.17) pmol x min(-1) x microg(-1) vs. (2.18 +/- 0.13) pmol x min(-1) x microg(-1), (2.79 +/- 0.14) pmol x min(-1) x microg(-1), P<0.05] in heart failure rabbits were significantly increased than those sham operated rabbits which could be significantly attenuated by valsartan treatment.</p><p><b>CONCLUSION</b>Valsartan improved cardiac function in heart failure rabbits probably via downregulating myocardial CaMK II expression and activity.</p>

Effects of valsartan on sarcoplasmic reticulum calcium adenosine triphosphatase, protein kinase A and protein phosphatase 1 alpha in a rabbit model of heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of valsartan on expressions of myocardial sarcoplasmic reticulum calcium adenosine triphosphatase (SERCA2), protein kinase A (PKA) and protein phosphatase 1 alpha (PP1alpha) in a rabbit model of heart failure.</p><p><b>METHODS</b>Rabbits were divided into sham-operated group, heart failure group (volume overload by aortic valve destruction induced aortic insufficiency plus pressure overload induced by abdominal aortic banding) and heart failure plus valsartan (20 mgxkg(-1)xd(-1), n = 6 each). Seven weeks later, echocardiography examination was performed and SERCA2, PKA, PP1alpha protein and mRNA expressions were detected by Western blot and RT-PCR.</p><p><b>RESULTS</b>Compared with the with sham operated rabbits, LVMI and LVEDP in heart failure rabbits were significantly increased while left ventricular shorten fraction (LVFS) and ejection fraction (EF) were significantly decreased (all P < 0.05), these changes could be significantly attenuated by valsartan treatment (all P < 0.05). SERCA2, PKA expressions at protein and mRNA levels were significantly downregulated and PP1alpha expressions significantly upregulated in heart failure rabbits than sham operated rabbits (all P < 0.05) and these changes could be significantly attenuated by valsartan (all P < 0.05).</p><p><b>CONCLUSION</b>Valsartan improved cardiac function in volume and pressure overload induced heart failure rabbits possibly by upregulating expressions of myocardial SERCA2, PKA and downregulating expression of myocardial PP1alpha.</p>

Single-center report of 5-year follow-up on 94 patients underwent transmyocardial laser revascularization / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transmyocardial laser revascularization (TMLR) has been used in the treatment of patients with end-stage coronary artery disease (CAD) since 1990. The aim of this study was to evaluate the long-term effectiveness of TMLR in patients with diffuse CAD.</p><p><b>METHODS</b>Ninety-four consecutive patients underwent TMLR in one center from July 1997 to December 2000. The follow-up data of these patients were obtained through face-to-face, mail questionnaires, or telephone interviews in July 2004 and December 2004. Four cases failed to respond. Mean follow-up time was (5.5 +/- 1.0) years.</p><p><b>RESULTS</b>Mean Canadian Cardiovascular Society (CCS) angina scores of TMLR patients were 3.1 +/- 0.8 at baseline, 1.7 +/- 0.9 at 1 year (P < 0.05), 1.7 +/- 0.9 at 3 years (P < 0.05), and 1.9 +/- 0.9 at 5 years (P < 0.05). At an average of 5 years, 69% of the patients had > or = 1 angina class reduction, mean NYHA class level (1.9 +/- 0.9) ameliorated compared to the baseline (2.5 +/- 0.7, P < 0.001), the rate of re-hospitalization was 2.7 times/person. Kaplan-Meier survival rate was 87% at 1 year, 69% at 3 years and 64% at 5 years. The causes of death were attributed more to heart failure (58.9%) and myocardial infraction (14.7%) after TMLR. The patients with no angina relief, or who died after TMLR, had a higher percentage of preoperative unstable anginas or prior myocardial infraction compared to the survivors. The assorted shapes of myocardial laser channels were detected in some patients by the color Doppler velocity technique.</p><p><b>CONCLUSIONS</b>TMLR provided a long-term improvement in the quality of life, including CCS angina class or NYHA heart functional class for about 70% of Chinese patients with severely disabling angina pectoris. The various myocardial laser channels would always be visible after TMLR. 5-years after TMLR as a sole therapy, the survival rate of the patients was 64%.</p>

A new echocardiographic system for assessment of epicardial and intramyocardial coronary flow in a swine model / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To visualize epicardial and intramyocardial coronary blood flow by using a noninvasive echocardiography system.</p><p><b>METHODS</b>In five juvenile swines, coronary flow imaging was used to visualize the different segments of epicardial coronary and intramyocardial arteries. Pulsed-Doppler spectrums were recorded and analyzed. The left anterior descending artery (LAD) and intramyocardial coronary blood flow signals were recorded at baseline and during dipyridamole administration.</p><p><b>RESULTS</b>Epicardial and intramyocardial coronary arteries could be visualized by coronary flow imaging. The systolic component of coronary flow in the right coronary artery (RCA) was greater than in the LAD. The intramyocardial blood flow was characterized by persistent retrograde blood flow velocity during systole. Vasodilation with dipyridamole produced exaggerated differences in the phasic pattern of coronary blood flow in epicardial and intramyocardial vessels.</p><p><b>CONCLUSION</b>Color Doppler coronary flow imaging provides a noninvasive method to study the coronary blood flow.</p>

Immunohistochemical study on interstitial cells of cajal in Hirschsprung’s disease / 中国现代普通外科进展

Objective:To investigate the role of interstitial cells of cajal(ICC) in the pathogenesis of HD through observing the distribution of the cells in normal colon and HD's different segments.Methods:The aganglionic、transitional and dilated segments were collected in operations from 25 children with Hirschsprung’s disease.Another 6 normal segmengts were also collected.Each sections was stained by c-Kit immunohistochemistry.The distribution of the interstitial cells of Cajal was observed by light microscope.Results:The ICC in aganglionic segments of colon from Hirchsprung’s disease were decreased significantly and statistically than that in dilated and normal colon.Moreover,whole mount preparations showed that,not only the number of ICC-IM was decreased down,but also the branches of ICC-IM and the cellular network were also broken down.Conclusion:The pathogenesis of HD is related to the abnormal distribution of ICC,which lead to or aggravate the bowel spasm in HD.