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[Objective]To summarize the academic experience of Director ZHAO Hongli in the treatment of male infertility with six meridians syndrome differentiation.[Methods]By summarizing the clinical cases of male infertility treated by Director ZHAO and combining his interpretation of the six meridians syndrome differentiation,this paper summarizes Director ZHAO's experience in treating this disease with six meridians syndrome differentiation,fully elaborates the characteristics of the disease and the diagnosis and treatment ideas,and verifies and analyzes it with a typical medical case.[Results]Director ZHAO believes that male infertility has many clinical symptoms and can be treated with six meridians syndrome differentiation.The first step in syndrome differentiation is to distinguish between deficiency and excess.Those who belong to the excess category are based on the disease of the six Fu organs and Yang meridians,which are mostly three Yang disease patterns.Those who belong to the deficiency category are based on the disease of the five Zang organs and Yin meridians,which are mostly three Yin disease patterns.Director ZHAO carefully observes the pathogenesis and also establishes cold-heat complex type of male infertility,using Banxia Xiexin Decoction to communicate Yin and Yang.In terms of drug application,attention should be paid to patients'innate physique,combining Chinese and western medicine according to the characteristics of laboratory tests,advocating food therapy at the same time as medication,and paying attention to psychological counseling.In the case presented,the patient experienced erectile dysfunction after marriage,symptoms differentiation was of Yangming Channel syndrome.Treatment involved modified Gegen Qinlian Decoction to clear the Yangming heat,combined with Simiao Powder to clear damp-heat in lower-Jiao.After more than three months of comprehensive treatment based on the evolving symptoms,the patient's wife was successfully conceived.[Conclusion]Director ZHAO deeply verses in the classics,applies the six meridians syndrome differentiation to the treatment of male infertility innovatively,emphasizing individualized treatment based on syndrome differentiation,receiving remarkable efficacy,which offers a new perspective for both the clinical application of classical prescriptions and the treatment of male infertility.
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Objective:To investigate the correlation between diaphragmatic-rapid shallow breathing index (D-RSBI) and lung ultrasound score (LUS) in elderly patients with mechanical ventilation and its predictive value for weaning results.Methods:A retrospective study was conducted. The clinical data of elderly patients (age > 60 years old) with invasive positive pressure ventilation (IPPV) admitted to the department of intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from January 2021 to June 2022 were enrolled. According to the outcome of withdrawal, the patients were divided into successful and failed groups. The differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), D-RSBI and LUS before weaning and extubation were compared between the two groups. Pearson correlation was used to analyze the correlation between D-RSBI and LUS. The predictive value of D-RSBI and LUS on weaning results of elderly patients with IPPV was analyzed by receiver operator characteristic curve (ROC curve).Results:A total of 398 elderly patients with IPPV were enrolled, including 300 successful weaning patients and 98 failed weaning patients. There were no significant differences in gender and age between the failed group and successful group [male: 55.1% (54/98) vs. 59.0% (177/300), age (years old): 67.02±5.03 vs. 66.96±4.99, both P > 0.05]. APACHEⅡ score in the failed group was significantly higher than that in the successful group (17.09±3.30 vs. 16.06±3.81, P < 0.05), and the D-RSBI and LUS score before extubation were significantly higher than those in the successful group [D-RSBI (time·min -1·mm -1): 2.19±0.33 vs. 1.60±0.22, LUS: 17.30±3.04 vs. 11.97±3.20, both P < 0.01]. All patients showed a significant positive correlation between D-RSBI and LUS score ( r = 0.406, P = 0.000). ROC curve analysis showed that the area under the curve (AUC) of D-RSBI for predicting weaning outcomes in elderly IPPV patients was 0.920, with a 95% confidence interval (95% CI) of 0.881-0.958 and P = 0.000. When the cut-off value was 1.85 times·min -1·mm -1, the sensitivity was 88.7% and the specificity was 86.7%. The AUC of LUS score for predicting weaning outcome in elderly IPPV patients was 0.875, with a 95% CI of 0.839-0.912 and P = 0.000. When the cut-off value was 14.50, the sensitivity was 75.7% and the specificity was 84.7%. Conclusion:There is a significant correlation between D-RSBI and LUS score in elderly mechanically ventilated patients, both of them can predict weaning outcome in elderly patients with mechanical ventilation.
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Objective:To investigate the correlation between dead space fraction and lung ultrasound score (LUS) and their prognostic value in patients with acute respiratory distress syndrome (ARDS).Methods:The data of 98 patients with ARDS treated in the intensive care unit (ICU) of the First Affiliated Hospital of Jinzhou Medical University from January to December 2020 were collected and analyzed. The gender, age, acute physiology and chronic health evaluationⅡ(APACHEⅡ), oxygenation index, dead space fraction and LUS score immediately and 24, 48, 72 and 96 hours after ICU admission and 28-day outcomes of all patients were collected. Pearson correlation was used to analyze the correlation between dead space fraction and LUS score. Binary Logistic regression was performed to analyze whether the dead space fraction and LUS score could be the risk factors of the prognosis in patients with ARDS. Receiver operator characteristic curve (ROC) was used to analyze the predictive effect of dead space fraction and LUS score on 28-day mortality in patients with ARDS.Results:A total of 98 patients with ARDS were included, of which 76 cases survived and 22 cases died within 28 days. With the prolongation of ICU stay, the dead space fraction and LUS score in the survival group increased first and then decreased. The dead space fraction and LUS score in the death group continued to increase to 96 hours, and were significantly higher than those in the survival group (dead space fraction: 0.569±0.019 vs. 0.491±0.021, LUS score: 20.09±2.39 vs. 15.13±1.91, both P < 0.05). There was a positive correlation between the dead space fraction and LUS score at 48, 72 and 96 hours in ICU ( r values were 0.200, 0.471 and 0.677, all P < 0.05). Binary Logistic regression analysis showed that dead space fraction and LUS score were independent risk factors affecting the prognosis of patients with ARDS [dead space fraction: odds ratio ( OR) was 69.064, 95% confidence interval (95% CI) was 22.680-123.499, P = 0.008; LUS score: OR was 4.790, 95% CI was 1.609-14.261, P = 0.005]. The results of ROC curve analysis showed that the dead space fraction at 48, 72 and 96 hours after ICU admission could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 59.1%, 90.9% and 95.5%, and the specificity was 89.5%, 80.3% and 98.7%. The area under the curve (AUC) of dead space fraction predicting 28-day mortality was 0.802, 0.952 and 0.998, all P < 0.01. The LUS score of 72 hours and 96 hours in ICU could be used to predict the 28-day mortality of patients with ARDS, the sensitivity was 77.3%, 77.3% and 100.0%, and the specificity was 68.4%, 88.2% and 80.3%, respectively. The AUC of the LUS score to predict the 28-day mortality of patients were 0.935 and 0.959, both P < 0.01. Conclusion:There was significant correlation between dead space fraction and LUS score, both of which were risk factors of 28-day mortality and be used to evaluate the 28-day prognosis of patients with ARDS.
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Objective:To investigate the clinical effect of Chaihu Shugansan combined with abdominal acupuncture on depression caused by chronic pain，and to explore its mechanism. Method:A total of 97 patients with depression caused by chronic pain were randomly divided into control group （49 cases） and observation group （48 cases）. Patients in both groups received routine western medicine treatment，including necessary psychological intervention and taking paroxetine. Control groupobservation groupcontrol group Patients in control group were treated with Xiaoyaowan，and patients in observation group were treated with Chaihu Shugansan combined with abdominal acupuncture. Both groups were treated for 6 weeks. The levels of serum neurotransmitters，cytokines and Hamilton depression rating scale（HAMD） before and after treatment were compared between two groups<bold>.</bold> Result:There was no significant difference in HAMD scores of the two groups before treatment and the HAMD scores of two groups after treatment were significantly lower than those before treatment （<italic>P</italic><0.05），and the HAMD scores in observation group were significantly lower than those in the control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum 5-hydroxytryptamine （5-HT），norepinephrine （NE），and brain-derived neurotrophic factor （BDNF） between two groups before treatment. After treatment，the levels of serum 5-HT，NE，and BDNF in two groups were significantly higher than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum interleukin-6 （IL-6），interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） before treatment. After treatment，the levels of serum IL-6，IL-1<italic>β</italic> and TNF-<italic>α</italic> were significantly lower than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. Conclusion:On the basis of psychological intervention and paroxetine administration，the combination of Chaihu Shugansan and abdominal acupuncture exerts their respective advantages. It treats both symptoms and root causes of depression，relieves the degree of depression，reduces the classification of depression，and regulates the levels of neurotransmitter and cellular inflammatory factors，and inhibits inflammatory response. The clinical effect is significant.
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OBJECTIVE@#To study the effect of hyperoxic exposure on the dynamic expression of heme oxygenase-1 (HO-1) and glutamate-L-cysteine ligase catalytic subunit (GCLC) in the lung tissue of preterm neonatal rats.@*METHODS@#Cesarean section was performed for rats on day 21 of gestation to obtain 80 preterm rats, which were randomly divided into air group and hyperoxia group after one day of feeding. The rats in the air group were housed in room air under atmospheric pressure, and those in the hyperoxia group were placed in an atmospheric oxygen tank (oxygen concentration 85%-95%) in the same room. Eight rats each were selected from each group on days 1, 4, 7, 10, and 14, and lung tissue samples were collected. Hematoxylin and eosin staining was used to observe the pathological changes of lung tissue at different time points after air or hyperoxic exposure. Western blot and RT-qPCR were used to measure the protein and mRNA expression of HO-1 and GCLC in the lung tissue of preterm rats at different time points after air or hyperoxic exposure.@*RESULTS@#Compared with the air group, the hyperoxia group had a significant reduction in the body weight (P<0.05). Compared with the air group, the hyperoxia group had structural disorder, widening of alveolar septa, a reduction in the number of alveoli, and simplification of the alveoli on the pathological section of lung tissue. Compared with the air group, the hyperoxia group had significantly lower relative mRNA expression of HO-1 in the lung tissue on day 7 and significantly higher expression on days 10 and 14 (P<0.05). Compared with the air group, the hyperoxia group had significantly lower mRNA expression of GCLC in the lung tissue on days 1, 4, and 7 and significantly higher expression on day 10 (P<0.05). Compared with the air group, the hyperoxia group had significantly higher protein expression of HO-1 in the lung tissue on all days, and the protein expression of GCLC had same results as HO-1, except on day 1 (P<0.05).@*CONCLUSIONS@#Hyperoxia exposure may lead to growth retardation and lung developmental retardation in preterm rats. Changes in the protein and mRNA expression of HO-1 and GCLC in the lung tissue of preterm rats may be associated with the pathogenesis of hyperoxia-induced lung injury in preterm rats.
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Animals , Female , Humans , Infant, Newborn , Pregnancy , Rats , Animals, Newborn , Catalytic Domain , Cesarean Section , Cysteine , Glutamates , Heme Oxygenase-1 , Hyperoxia , Lung , Rats, Sprague-DawleyABSTRACT
OBJECTIVES@#To study the urinary metabolic profile in rats with deep venous thrombosis （DVT） based on metabolomics and to screen out small molecular biomarkers for the diagnosis and forensic identification of DVT.@*METHODS@#Inferior vena cava of rats was ligated to construct DVT models. The rats were randomly divided into three groups： DVT, sham, and control groups, 10 in each group. The urine of DVT and sham rats was collected during 24 hours in the metabolic cage at 48 hours after operating, meanwhile, 24 hours urine was collected in control group. The metabolic profile was analyzed by nuclear magnetic resonance. SIMCA-P 14.1 software was used for pattern recognition. The variable importance in projection （VIP） value from orthogonal PLS-DA （OPLS-DA） model combined with Mann-Whitney U test were used to search the different metabolites in the urine.@*RESULTS@#The metabolic profiles of urine from DVT, sham, and control groups had significant differences. The DVT, sham, and control groups could be distinguished by the partial least squares method-discriminant analysis （PLS-DA） model. Compared with the urine of the rats in control groups, the levels of leucine, glutamine, creatine, creatinine and sucrose in the urine of DVT rats were up-regulated, and the levels of 3-hydroxybutyrate, lactate, acetone, α-oxoglutarate, citrate and hippurate were down-regulated.@*CONCLUSIONS@#The different metabolites in the urine of DVT rats are expected to become its candidate biomarkers. The results can provide a research basis for the diagnosis, treatment and forensic identification of DVT.
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Animals , Humans , Rats , Biomarkers/blood , Discriminant Analysis , Magnetic Resonance Spectroscopy/methods , Metabolome , Metabolomics/methods , Nuclear Magnetic Resonance, Biomolecular/methods , Rats, Sprague-Dawley , Urine/chemistry , Venous Thrombosis/urineABSTRACT
Objective To summarize regularities in acupoint prescriptions for acupuncture treatment of stroke disorders by using data mining techniques to analyze 150 ancient acupuncture books from the Han dynasty to the end of Qing dynasty. Method A standard database and a ancient book database were established by a manual entry and proofreading method. The sentences containing stroke disorders, acupoints, meridians and needling moxibustion method in the ancient books were selected according to the key words in the standard database using a variety of data mining techniques and a regular relation to establish corresponding disease, acupoint, needling moxibustion method and meridian databases. They were classified into two types: prescriptions for stroke disorders and acupoint indications containing stroke disorders. The results from selection were reviewed manually and standardized. A multilevel analysis of regularities in acupuncture prescriptions for stroke disorders in the ancient books was performed by statistical analysis and apriori algorithm on association rules with support degree and confidence level. Result There were a total of 536 records on acupuncture point prescription for stroke disorders. Single acupoint prescriptions accounted for 34.89% of the total number of prescriptions. The single acupoint that was used most frequently was Baihui(GV20). Thedouble acupoints that were combined most frequently were Quchi(LI11) and Baihui. In three acupoint combination, Quchi and Fengshi(GB31) were separately combined most frequently with Baihui, Jianyu(LI15) and Xuanzhong(GB39). The three meridians that were used most frequently were the Du Meridian, the Large Intestine Meridian of Hand-Yangming and the Gallbladder Meridian of Foot-Shaoyang. The two meridians that were combined most frequently were the Gallbladder Meridian of Foot-Shaoyang and the Stomach Meridian of Foot-Yangming. Crossing points and Five-Shu points were selected most frequently in specific points. He-Sea points were used most frequently in Five-Shu points. Conclusion The prescriptions for stroke disorders in ancient acupuncture books focus on selecting the confluence of all yang meridians and yang meridian points. Specific points are the important composition of the prescriptions. Crossing points and He-Sea points are mainly used in specific points.
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Objective To observe the high-flow nasal cannulae can reduce indoor postoperative intensive care patients with tracheal intubation in offline acute respiratory failure after extubation reintubation rates. Methods 53 cases of postoperative acute hypoxia type patients with respiratory failurein the ICU in offline after extubation were divided into two groups, control group of 24 patients, 29 cases of observation group patients. Control group patients in the event of a failure after using non-invasive mechanical ventilation (NIMV) and observation group of patients using HFNC. All other patients with same treatment and nursing. Compare two groups of patients reintubation rates. Results Observation group of reintubation rate was 20.69%(6/29), the control group was 45.83%(11/24), reintubation rate difference of two groups of patients were statistically significant (χ2=3.81, P < 0.05). Conclusions HFNC can reduce postoperative extubation after weaning reintubation rates in patients with acute respiratory failure.
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Objective To evaluate effect of preventing ventilator associated pneumoia (VAP) of patients with oral cavity endotracheal intubation by air impulse clearing away secretion drainage. Methods 348 patients with oral trachea cannula and mechanical ventilation (MV) in intensive care unit (ICU) were divided into control group (n=174) and observational group (n=174). The control group adopted conventional airway management methods without the subglottic secretion drainage while the observational group adopted conventional airway management methods on the basis of combining air impact method remove stranded on airbags. Other treatment and care for all of patients were basically the same. The MV time, duration in ICU and incident rate on VAP were compared between the two groups. Results The average of MV time in control group was (5.25±1.18) days, (5.62±3.20) days in ICU and the rate of VAP was 10.34%(18/174). In observational, it was (8.96 ±5.43) days, (10.43 ±4.96 ) days and 34.48%(60/174), respectively. The MV time, duration in ICU and incident rate on VAP were significantly different (P<0.05), with statistical significance. Conclusions The air impact method to remove airbags retentate could shorten time of MV and during time in ICU, and could reduce the rate of VAP.