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Objective:To explore the immunological characteristics of peripheral blood and genetic variations of 11 immunodeficiency virus(HIV)-negative children with Talaromyces marneffei(TM) infection, thus enhancing the diagnostic and therapeutic levels of TM infection in children. Methods:Clinical data of 11 HIV-negative children with TM infection who presented to Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from January 2010 to December 2022 were retrospectively analyzed, including clinical characteristics, peripheral immune profile and genetic test results.Results:A total of 11 HIV-negative children with TM infections were recruited, involving 9 males and 2 females with a median age of 19 months.The main clinical manifestations were fever (10/11, 90.91%), cough (10/11, 90.91%) and hepatomegaly (7/11, 63.64%). Common severe complications included acute respiratory distress syndrome (7/11, 63.64%) and septic shock (5/11, 45.45%). Finally, 2 children died.Transient neutropenia occurred in 6 cases (6/11, 54.55%), and lymphocytopenia combined with serum immunoglobulin (Ig) G decrease was observed in 4 cases (4/11, 36.36%). IgA decrease, IgM decrease, IgE decrease, IgM increase and IgE increase were observed in 6 cases, 3 cases, 5 cases, 3 cases, and 2 cases, respectively.Both T-lymphocyte and B-lymphocyte counts decreases was observed in 1 case.Genetic testing was performed in all recruited children, and genetic variations were detected in all of them.Inborn errors of immunity (IEIs) were diagnosed in 8 cases, including 4 diagnosed as CD 40 ligand deficiency with CD40LG variation, 1 of severe combined immunodeficiency with IL2RG variation, 1 of Signal transduction and activator of transcription 3(STAT3)-hyper-IgE syndrome with STAT3 variation and 1 of familial candidiasis type 2 with CARD9 compound heterozygous mutations.In the other 3 cases, 2 carried genetic variations that were likely pathogenic, and 1 case was considered uncertain. Conclusions:The clinical manifestations of HIV-negative children with TM infection are atypical, which is characterized as serious complications and high mortality.Early identification and gene testing to detect potential IEIs can improve the prognosis of TM infection.
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As a new class of acid inhibitors, potassium-competitive acid blocker（P-CAB） inhibits the conformational transition of H+, K+-ATPase with subsequent suppression of H+, K+ exchanging by binding reversibly near the K+ binding site of H+, K+-ATPase, which results in the inhibition of gastric acid secretion in a K+-competitive manner. The unique structure and novel mechanism of P-CAB contribute to the pharmaceutical characteristics superior to other PPIs, making it a new alternative for acid-related diseases（ARDs）. Progress on pharmaceutical characteristics of P-CAB were reviewed in this paper.
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Objective:To analyze the clinical features of bronchiectasis in children after severe adenovirus pneumonia and to provide clinical clues for the early diagnosis of bronchiectasis in children after severe adenovirus pneumonia.Methods:A retrospective study was made to analyze the clinical data of 26 children with bronchiectasis after severe adenovirus pneumonia treated in Guangzhou Women and Children′s Medical Center, Guangzhou Medical University from May 2016 to May 2021.Results:A total of 26 cases were reported, including 18 males and 8 females.The median onset age of severe adenovirus pneumonia was 23.0 (15.0, 48.0) months.A total of 23 cases suffered concurrent infections, and bacterial co-infection was the most common (16 cases). High resolution computed tomography (HRCT) showed multiple lobar solids in the lung with/without pleural effusion.During the acute phase, most of the cases were treated with intravenous immunoglobulin (21 cases), mechanical ventilation (20 cases), and systemic glucocorticoids (19 cases). The median age at diagnosis of bronchiectasis was 29.5 (21.0, 56.8) months, and the median time that the patients took to develop into acute adenovirus pneumonia was 6.0 (3.3, 13.0) months.Six cases suffered bronchiectasis alone, and 20 cases had bronchiectasis combined with post-infectious bronchiolitis obliterans (PIBO). Of these 20 cases, 3 cases developed bronchiectasis and PIBO simultaneously, and the remaining 17 cases developed bronchiectasis after PIBO.In the included 26 cases, diffuse bronchiectasis predominated (24 cases), most frequently involving the left lower lobes (21 cases) and right lower lobes (21 cases). Cylindrical bronchiectasis was the most common type (23 cases). All the patients had recurrent cough and wheezing during follow-up, and only 3 cases coughed up pus sputum without hemoptysis.All children had acute exacerbations, which were mostly caused by bacteria (21 cases). Nineteen cases combined with PIBO and 1 case with only bronchiectasis were rehospitalized.There was no cases of surgical resection or death.Conclusions:Bronchiectasis after severe adenovirus pneumonia mostly occurs in patients with or without PIBO.Multiple lobe involvement and co-infection may be a risk factor for PIBO patients to develop bronchiectasis.The clinical manifestations are mostly recurrent cough and wheezing, while sputum and hemoptysis are less common.Pediatricians should promptly perform chest HRCT for early diagnosis of the disease.
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Objective:To observe the clinical efficacy of Shenqi Dihuang Decoction combined with conventional western medicine in the treatment of stage Ⅲ Diabetic Nephropathy (DN).Methods:A total of 96 patients with stage Ⅲ diabetic nephropathy with syndrome of deficiency of qi and yin in our hospital, from January 2019 to January 2021, who met the inclusion criteria, were divided into 2 groups by random number table method, 48 in each group. The control group was given the conventional western treatment. The observation group was given Shenqi Dihuang Decoction on the basic of the control group treatment. Both groups treatment lasted for 3 months. Before and after the treatment, the changes of TCM Syndrome Scores were observed. The levels of soluble intercellular adhesion molecular-1 (sICAM-1) and monocyte chemoattractant protein-1 (MCP-1) were detected by double antibody sandwich ELISA. The levels of BUN, SCr, SOD and Hcy were detected by automatic biochemical analyzer, collect 24-hour urine, 24-hour urine total protein quantity (24 UTP) was detected by immunoturbidimetry, and eGFR was calculated by CKD-EPI formula to evaluate the clinical efficacy.Results:After the treatment, the total effective rate in the observation group was 83.3% (40/48), and the control group was 66.7% (32/40) and the difference was statistically significant ( χ2=3.56, P=0.049). After the treatment, TCM Syndrome Scores in the observation group was significantly better than that of the control group ( t=4.05, P<0.01). After treatment, the systolic blood pressure in the observation group was significantly lower than that of the control group ( t=4.29， P<0.01). After treatment, the levels of 24 hUTP [(1.43 ± 0.54) g vs. (1.86 ± 0.50) g, t=4.05], serum sICAM-1[(396.07 ± 50.61)μg/L vs. (480.11 ± 63.01)μg/L, t=7.20], Hcy [(27.41 ± 3.42) μmol/L vs. (29.76 ± 5.80) μmol/L, t=2.42] in the observation group were significantly lower than those in the control group ( P<0.05), and the levels of SOD [(168.32 ± 41.26) U/ml vs. (143.11 ± 37.02) U/ml, t=3.15] was significantly higher than that of the control group ( P<0.01). Conclusions:Shenqi Dihuang Decoction combined with conventional western medicine can reduce 24 hUTP quantity and kidney damage, delay the development of Ⅲ DN, improve clinical effect and protect the kidney function, and sICAM-1 for the Ⅲ DN patients with the syndrome of qi and yin deficiency combined with blood stasis.
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Plastic bronchitis (PB) is a kind of respiratory emergency that causes severe respiratory distress in children.Bronchoscopy plays an important role in the diagnosis and treatment of PB in children.To enable more PB children to benefit from bronchoscopy examination and treatment, pediatric clinicians should improve their knowledge of bronchoscopy and be familiar with the timing of endoscopic treatment of PB, the choice of rigid bronchoscope or fiber bronchoscopy, the efficacy of bronchoscopy interventional therapy, and the safety of bronchoscopy treatment.
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Objective:To analyze the clinical and imaging characteristics of pulmonary artery sling (PAS) in children and to explore its diagnosis and treatment strategies and risk factors.Method:s A retrospective study was performed in 98 pediatric patients with PAS who were admitted to Guangzhou Women and Children′s Medical Center, Guangzhou Medical University, from January 2011 to October 2018.All their clinical features, imaging examination, treatment and prognosis were reviewed and analyzed.Result:s (1) Among the 98 patients with PAS, 56 cases were male and 42 cases were female.The age range of onset was 0-19 months with the median age of 2 months, and the age range of diagnosis was 0-84 months with the median age of 4 months.(2) The main clinical manifestations were cough (61/98 cases, 62.24%), recurrent wheezing(47/98 cases, 47.96%), shortness of breath (43/98 cases, 43.88%), cyanosis (19/98 cases, 19.39%), and laryngeal stridor (8/98 cases, 8.16%) and so on.(3) Ninety-six patients underwent cardiac ultrasonography, and the diagnostic rate was 87.50%(84/96 cases), and 62 cases (62/96 cases, 64.58%) of them were found to be associated with other congenital cardiovascular anomalies, among which atrial septal defect was the most common (32/96 cases, 33.33%). (4) Chest CT and three-dimensional reconstruction were performed in 92 PAS children, and the diagnostic rate was 100.00%.Airway stenosis was mainly in the middle and lower sections of the main bronchus (76/92 cases, 82.61%), and bronchobridge was found in 13 cases (13/92 cases, 39.13%). Bronchoscopy was performed in 77 children with PAS, showing complete tracheal cartilage ring in 43 cases (43/77 cases, 55.84%), and tracheobronchomalacia in 13 cases (13/77 cases, 16.88%). (5) Among 67 cases who had received left pulmonary artery (LPA) reimplantation, 5 cases died after operation because of airway stenosis and weaning failure (LPA reconstruction was performed in 1 case, and both LPA reconstruction and tracheal intervention were performed in the other 4 cases), 24 cases lost to follow-up, 38 cases survived, and the respiratory symptoms were improved in 2 to 96 months of follow-up.There were 31 cases of non-surgical treatment, of which 18 cases died of respiratory failure, 7 cases lost to follow-up, and the rest 6 cases showed respiratory symptoms of different degrees in the follow-up period.(6) Multivariate regression analysis showed that conservative treatment was an independent risk factor affecting the prognosis of PAS ( OR=7.45, 95% CI: 1.23-48.68). Conclusions:The combination of cardiac ultrasound, chest CT and bronchoscopy is important to the diagnosis of PAS.LPA reconstruction is the main method to treat PAS, which can improve respiratory symptoms, but its fusion with tracheal intervention poses a high risk of death.Conservative treatment is an independent risk factor that affects the prognosis of PAS children.
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Insomnia is a common disorder in the elderly and seriously affects life quality of the elderly.This article reviews the efficacy and safety of pharmacological agents for the treatment of insomnia in the elderly, in order to provide a reference for clinical practice.
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Objective To explore the effect and safety of two chemotherapy regimens in the treatment of small cell lung cancer. Methods Ninety-eight patients with extensive small cell lung cancer admitted to Liuzhou People's Hospital of Guangxi Zhuang Autonomous Region from March 2013 to March 2016 were ran-domly divided into two groups by random number table method,49 of whom were treated with lobaplatin + eto-poside (EL group),and another 49 cases were treated with cisplatin + etoposide (EP group). The short-term efficacy,2-year survival rate and adverse reactions of the two groups were observed. The serum levels of gas-trin-releasing peptide precursor (ProGRP),neuron-specific enolase (NSE),Ki-67,vascular endothelial growth factor (VEGF)were compared between the two groups before and after treatment. Results The effec-tive rates of the EL group and the EP group were 48. 98％ (24 / 49)and 40. 82％(20 / 49)respectively,and the difference between the two groups was not statistically significant (χ2 = 0. 660,P = 0. 417). The 2-year sur-vival rates of patients in the EL group and the EP group were 17. 07％ and 11. 11％ respectively. The median survival time of the EL group was 17. 00 months,and that of the EP group was 15. 00 months. There was no significant difference between the two groups (χ2 = 1. 094,P = 0. 228). The serum level of ProGRP was (978. 4 ± 225. 7)ng/ L and (940. 2 ±237. 1)ng/ L,NSE was (43. 9 ±10. 3)ng/ ml and (41. 7 ±11. 6)ng/ ml, Ki-67 was (287. 5 ± 55. 3)pg/ ml and (279. 8 ± 62. 6)pg/ ml,and VEGF was (566. 8 ± 109. 4)pg/ ml and (538. 1 ±144. 0)pg/ ml in the EL and EP group before chemotherapy respectively,and there were no significant differences between the two groups (t = 0. 817,P = 0. 416;t = 0. 993,P = 0. 323;t = 0. 645,P = 0. 520;t =1. 111,P = 0. 269). The serum level of ProGRP was (167. 3 ± 68. 5)ng/ L and (180. 6 ± 62. 1)ng/ L,NSE was (17. 5 ±4. 8)ng/ ml,(19. 0 ±5. 3)ng/ ml,Ki-67 was (98. 0 ± 18. 6)pg/ ml and (101. 4 ± 20. 8)pg/ ml, VEGF was (430. 4 ±95. 8)pg/ ml and (442. 8 ±91. 0)pg/ ml in the EL and EP group after chemotherapy,and there was no significant difference between the two groups (t = - 1. 007,P = 0. 316;t = - 1. 468,P = 0. 145;t = - 0. 853,P = 0. 396;t = - 0. 657,P = 0. 513). The serum levels of ProGRP,NSE,Ki-67 and VEGF in EL group and EP group were significantly lower than those before chemotherapy (t = 24. 072,P < 0. 001;t =21. 694,P < 0. 001;t = 16. 263,P < 0. 001;t = 12. 459,P < 0. 001;t = 22. 736,P < 0. 001;t = 18. 931, P < 0. 001;t = 6. 566,P < 0. 001;t = 3. 916,P < 0. 001). During chemotherapy,the incidences of diarrhea and myelosuppression (≥grade 2)in the EL group [26. 53％ (13 / 49)and 61. 22％ (30 / 49)]were lower than those in the EP group [48. 98％ (24 / 49)and 81. 63％ (40 / 49)],and the differences were statistically significant (χ2 = 5. 254,P = 0. 022;χ2 = 5. 000,P = 0. 025). Conclusion Lobaplatin + etoposide is less toxic than cisplatin +etoposide in the treatment of small cell lung cancer,and adverse reactions of its is relatively slighter.
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Objective@#To explore the effect and safety of two chemotherapy regimens in the treatment of small cell lung cancer.@*Methods@#Ninety-eight patients with extensive small cell lung cancer admitted to Liuzhou People′s Hospital of Guangxi Zhuang Autonomous Region from March 2013 to March 2016 were randomly divided into two groups by random number table method, 49 of whom were treated with lobaplatin + etoposide (EL group), and another 49 cases were treated with cisplatin + etoposide (EP group). The short-term efficacy, 2-year survival rate and adverse reactions of the two groups were observed. The serum levels of gastrin-releasing peptide precursor (ProGRP), neuron-specific enolase (NSE), Ki-67, vascular endothelial growth factor (VEGF) were compared between the two groups before and after treatment.@*Results@#The effective rates of the EL group and the EP group were 48.98% (24/49) and 40.82%(20/49) respectively, and the difference between the two groups was not statistically significant (χ2=0.660, P=0.417). The 2-year survival rates of patients in the EL group and the EP group were 17.07% and 11.11% respectively. The median survival time of the EL group was 17.00 months, and that of the EP group was 15.00 months. There was no significant difference between the two groups (χ2=1.094, P=0.228). The serum level of ProGRP was (978.4±225.7) ng/L and (940.2±237.1) ng/L, NSE was (43.9±10.3) ng/ml and (41.7±11.6) ng/ml, Ki-67 was (287.5±55.3) pg/ml and (279.8±62.6) pg/ml, and VEGF was (566.8±109.4) pg/ml and (538.1±144.0) pg/ml in the EL and EP group before chemotherapy respectively, and there were no significant differences between the two groups (t=0.817, P=0.416; t=0.993, P=0.323; t=0.645, P=0.520; t=1.111, P=0.269). The serum level of ProGRP was (167.3±68.5) ng/L and (180.6±62.1) ng/L, NSE was (17.5±4.8) ng/ml, (19.0±5.3) ng/ml, Ki-67 was (98.0±18.6) pg/ml and (101.4±20.8) pg/ml, VEGF was (430.4±95.8) pg/ml and (442.8±91.0) pg/ml in the EL and EP group after chemotherapy, and there was no significant difference between the two groups (t=-1.007, P=0.316; t=-1.468, P=0.145; t=-0.853, P=0.396; t=-0.657, P=0.513). The serum levels of ProGRP, NSE, Ki-67 and VEGF in EL group and EP group were significantly lower than those before chemotherapy (t=24.072, P<0.001; t=21.694, P<0.001; t=16.263, P<0.001; t=12.459, P<0.001; t=22.736, P<0.001; t=18.931, P<0.001; t=6.566, P<0.001; t=3.916, P<0.001). During chemotherapy, the incidences of diarrhea and myelosuppression (≥grade 2) in the EL group [26.53% (13/49) and 61.22% (30/49)] were lower than those in the EP group [48.98% (24/49) and 81.63% (40/49)], and the differences were statistically significant (χ2=5.254, P=0.022; χ2=5.000, P=0.025).@*Conclusion@#Lobaplatin+ etoposide is less toxic than cisplatin+ etoposide in the treatment of small cell lung cancer, and adverse reactions of its is relatively slighter.
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Objective To analyze the clinical and anatomic characteristics of bridging bronchus (BB) malformation in children,and to explore its diagnostic strategy,treatment and risk factors.Methods A retrospective study was performed in 23 pediatric patients with BB who were admitted to Guangzhou Women and Children's Medical Center form May 2010 to October 2016.All their clinical features,imaging examination,treatment and prognosis were reviewed and analyzed.Results (1) Among the 23 patients with BB,15 were males and 8 were females.The age range of onset was 0 to 4 years old with a median age of 3.17 months.(2)The main clinical manifestations were cough (23/23 cases,100.0％),recurrent wheezing (20/23 cases,87.0％),cyanosis (8/23 cases,34.8％) and feeding diffficulty/slow body weight growth (6/23 cases,24.6％).(3) There were 17 cases of type Ⅰ and 4 cases of type Ⅱ according to Wells,and the other 2 cases were anterior BB.There were 2 cases with atypical anatomical morphology in type Ⅰ and type Ⅱ respectively.(4) Twenty-one cases were associated with bronchial stenosis in which the origin of left main bronchus complicated with BB stenosis was the most common(5 cases).Bronchoscopy revealed bronchomalacia in 5 of the 16 patients.Sixteen patients associated with cardiac or vascular anomalies,11 of whom were compound anomalies,and the most common type was sling left pulmonary artery (SLPA) (12 cases).(5) Nine of 12 patients with SLPA received surgical management,ages ranging from 1 month to 8 years old.The respiratory symptoms remitted gradually or disappeared from 4 to 17 months after surgical management.Two died and one has been lost to follow-up among the remaining 3 patients with SLPA.Conclusions BB is a rare tracheobronchial malformation that is often associated with stenosis or bronchomalacia,and cardiac or vascular anomalies.The severity of the disease mainly depends on whether there is airway stenosis or malacia and its extent.The definitive diagnosis of BB requires the combination of different imaging modalities.The combination with simple SLPA could get better curative effect.
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Aim To investigate the effect of curcumin against high-fat-diet induced C57BL/6J mice bone changes and the correlation between the expression of cathepsin K and curcumin.Methods Curcumin treated C57BL/6J mice had been on high fat diet for 12 weeks.The HE, Alizarin red S staining and Safranin O/fast green staining of femur were employed to evaluate bone microstructure, bone metabolism and bone development.The expressions of cathepsin K were assessed by Western blot and immunohistochemical staining.Results Histopathological results showed that curcumin could improve the destruction of trabecular bone structure, cartilage development and bone calcification.Biomechanical results proved that curcumin could improve the bone strength of the type 2 diabetic mice induced by high fat.The results of immunohistochemistry and Western blot assay indicated that curcumin could significantly inhibit the expression of cathepsin K in bone tissues of mice.Conclusion Curcumin can increase bone strength, improve bone microstructure, and enhance the degree of bone calcification, which may be achieved by inhibiting the expression of cathepsin K.
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Objective To investigate the influence of hydroxyethyl starch combined with strengthening anti -platelet therapy on the short-term clinical efficacy,TCD index and recurrence rate of patients with TIA secondary to cerebral artery stenosis.Methods 80 patients with TIA secondary to cerebral artery stenosis were chosen,and they were randomly divided into two groups according to the digital table,each group in 40 cases.The control group received strengthening anti-platelet therapy alone,and the observation grouP received hydroxyethyl starch on the basis of control group.The short-term clinical efficacy,the blood flowvelocity of ACA and MCA before and after treatment,the TIA recurrence rate,the incidence of cerebral infarction and adverse reactions of both two groups were compared.Results The short-term effective rates of the control group and observation group were 77.50％,97.50％,respectively.The short-term effective rate of the observation group was significantly higher than that of the control group(x2 =12.33,P ＜ 0.05).The blood flow velocity of ACA and MCA of the control group after treatment were (51.05 ± 9.83) cm/s,(54.88 ± 6.62) cm/s,respectively,which were significantly lower than those of the observation group [(59.12 ± 12.07) cm/s,(62.65 ± 8.09) cm/s,t =3.17,2.96,4.03,4.74,3.67,4.05,all P ＜ 0.05].The TIA recurrence rate and the incidence rate of cerebral infarction of the control group were 22.50％,12.50％,respectively,which were significantly higher than those of the observation group(5.00％,0.00％,x2 =11.75,14.06,all P ＜ 0.05).The incidence rates of adverse reactions of the control group and observation group were 12.50％,10.00％,respectively.There was no significant difference in the incidence rate of adverse reactions between the two groups (x2 =1.75,P ＜ 0.05).Conclusion Hydroxyethyl starch combined with strengthening anti-platelet therapy in the treatment of patients with TIA secondary to cerebral artery stenosis can efficiently relieve the symptoms of neurological function,higher the level of cerebral blood perfusion,reduce the risk of TIA recurrence and cerebral infarction,and not increase the incidence of adverse reactions.
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Objective To investigate the comparison of blood uric acid and bilirubin levels on patients with acute cerebral infarction and the clinical curative effect of Donhong injection.MethodsA total of 68 patients with acute cerebral infarction from our hospital neurology, according to different therapeutic methods were divided into control group and experimental group with 34 cases in each group, two groups were treated by conventional treatment, patients in the control group were treated by blood flux injection 400 mg+5% glucose injection 250 mL intravenous drip, once a day;patients in the experimental group were treated by Dan red injection 40 mL+5% glucose injection 250 mL intravenous drip, once a day,2 groups of patients were treated for 2 cycles,a cycle with 7 d.Compared the clinical efficacy, blood uric acid, bilirubin, blood homocysteine, hyperensitive C-reactive protein, serum inhibition C and adverse reactions in the two groups after treatment.ResultsCompared with the control group, the experimental group clinical total effective rate was higher after treatment (P< 0.05).Compared with the control group, the experimental group blood uric acid, blood homocysteine, hypersensitive C-reactive protein, serum inhibition C levels were lower (P< 0.05), bilirubin level was higher(P< 0.05).Adverse reactions compared between the two groups, there was no statistically significant difference.ConclusionDonhong injection in the treatment of acute cerebral infarction clinical curative effect is distinct, dacrease blood uric acid level and increase bilirubin level, improve endothelial cell damage, protect the brain tissue.
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Objective To evaluate the influence of atopy on exhaled nitric oxide in chronic persistent asthmatic children. Methods A total of 52 chronic persistent asthmatic children who completed FeNO measurements and skin prick testing were enrolled. Patients were divided into non-atopic group and atopic group by skin prick testing results, and subdivided into non-allergic rhinitis and rhinitis group according to whether combined with allergic rhinitis. At the same time 78 healthy children were chosen as control group. Moreover, 32 chronic persistent asthmatic children who completed FeNO measurements twice interval of three months were enrolled. Results The FeNO level was signiifcantly different among the atopic group (n=40), the non-atopic group (n=12) and the control group (H=33.29, P=0.000);The FeNO level was signiifcantly higher in the atopic group than that in the non-atopic group (P0.05).There were no correlations between FeNO levels of chronic persistent asthmatic children and the wheal diameter of house dust mites or dust mites (r=2.05, P=0.135;r=1.58, P=0.312). Moreover, the FeNO level was signiifcantly lower after 3 months ICS treatment (z=-2.05, P=0.041). Conclusions Atopy had major inlfuence on the FeNO level of chronic persistent asthmatic children, and the FeNO level declined with the theatment of ICS.
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Through referring to relevant works and the latest literature, the application and research progress of the traditional Chinese medicine inducing mesenchymal stem cells were summarized. The researching results focusing on induction and proliferation of mesenchymal stem cell by salvia, notoginseng, tortoise plastron, pilose antler, ginseng, astragalus were introduced.
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Osteoporosis is a progressive metabolic disease. In traditional Chinese medicine (TCM), deficiency of the liver, spleen and kidney and blood stasis can induce osteoporosis. The main etiology was kidney deficiency which harmed the liver and spleen and causeqi-blood deficiency and blood stasis. The insufficiency of natural endowment and postnatal malnutrition caused poor nutrition of tendons and vessels, which induced debility of bone. This article discussed the etiology and pathogenesis of TCM understanding on osteoporosis in details. Opportunities and challenges of TCM in osteoporosis treatment were explored. The homology of Chinese medicine and food as well as the long-term of osteoporosis showed that TCM had incomparable superiority in osteoporosis treatment. While, the scientific research methods and reasonable evaluation of TCM safety were important to display its advantages in osteoporosis treatment.
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Objective To investigate the clinical effects of alprostadil combined with butylphthalide in treatment of cerebral infarction. Methods Ninety-four patients with cerebral infarction treated in our hospital from November 2011 to January 2014 were selected as the study subjects and randomly divided into the control group with 47 patients and the observation group with 47 patients. The control group received alprostadil treatment and the observation group re-ceived alprostadil combined with butylphthalide treatment. The changes of treatment efficacy and NIHSS scores, im-provement of quality of life, changes of laboratory parameters and safety of the two groups were observed. Results The observation group had significantly higher total effective treatment rate than the control group (P<0.05). The two groups were not significantly different in the NIHSS score before treatment (P>0.05); both groups improved gradually after 7 days of treatment and recovered well after 2 weeks; the observation group had significantly better recovery effect than the control group(P<0.05). After treatment, the quality of life of both groups was evaluated, which showed that the obser-vation group had significantly higher quality of life than the control group(P<0.05). The two groups were not significantly different in PT (P>0.05), and the observation group had significantly higher APTT and PLT and significantly lower Fb than the control group, with statistically significant differences (P<0.05). The incidence of complications of the observa-tion group was 8.51%, which was significantly lower than the 19.15% of the control group, with statistically significant difference (P<0.05). Conclusion Both alprostadil and butylphthalide have good treatment effects on cerebral infarction and their combination generates a synergistic effect, which can rapidly improve neurological function, enhance efficacy and help improve the patients' quality of life, thereby worthy of clinical promotion.
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Objective To assess the effects of inhaled corticosteroids on growth velocity in children with asthma .Methods We searched the Cochrane Airways Group Specialised Register of trials (CAGR) ,which was derived from systematic searches of bibliographic databases including CENTRAL ,MEDLINE ,EMBASE ,CINAHL ,AMED and PsycINFO .We also searched Wan Fang Chinese periodical Database and VIP Chinese periodical Database from the establishment of the database to October 2014 .Articles which were parallel‐group randomised controlled trials comparing daily used of ICS ,delivered by any type of inhalation device ,ver‐sus placebo or non‐steroidal drugs in children up to 18 years of age with persistent asthma are selected .The data analysis was used by RevMan 5 .2 software .Results A total of 18 randomized control trials were included .Meta analysis showed that inhaled cortico‐steroids for 6-8 months ,1 year significantly slowing down growth velocity in children with asthma (MD= -0 .77 ,-0 .55 ,respec‐tively ,P0 .05) .Conclusion This systematic review showed that ICS therapy had temporarily inhibition on growth velocity in children with asthma ,the peak inhibition happen within half a year ,its inhibitory effect decrease with time .
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Objective To explore the diagnosis and treatment of cystic dilatation of the cystic duct in adults.Method Clinical data of 25 cases of the cystic dilatation of cystic duct in adults in 3 hospitals in Songhuajiang river drainage area from 1991 to 2012 confirmed by surgery were analyzed retrospectively.Results The 25 cases were with manifestations of chronic cholecystitis,and 14 patients with right upper quadrant recurrent biliary colic and nausea,vomiting and other gastrointestinal symptoms,9 patients with yellowish discoloration of sclera and skin,and fever.Ultrasonography was done in 25 cases,ERCP in 16 cases and MRCP in 9 cases,displaying liquid dark area of diameter from 1.6 cm × 1.6 cm to 2.5 cm ×2.5 cm in the gallbladder tube suspective of calculi,and characteristic dumbbell shape image.Preoperative diagnosis was cystic duct cyst with stones or gallstones which was confirmed by surgery.Gallbladder and cyst resection was performed in all 25 cases,and bile duct jejunum Roux-en-Y anastomosis was done in 2 of these cases because of introgenic bile duct injury.Conclusions Cysts of the cystic duct is the special type (Ⅵ type) of choledochocele,and its prognosis is good after surgical treatment.
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Larrea nitida is a plant that belongs to the Zygophyllaceae family and is widely used in South America to treat inflammatory diseases, tumors and menstrual pain. However, its pharmacological activity remains unclear. In this study we evaluated the property of selective estrogen receptor modulator (SERM) of Larrea nitida extracts (LNE) as a phytoestrogen that can mimic, modulate or disrupt the actions of endogenous estrogens, depending on the tissue and relative amount of other SERMs. To investigate the property of SERM of LNE, we performed MCF-7 cell proliferation assays, estrogen response element (ERE)-luciferase reporter gene assay, human estrogen receptor (hER) binding assays and in vivo uterotrophic assay. To gain insight into the active principles, we performed a bioassay-guided analysis of LNE employing solvents of various polarities and using classical column chromatography, which yielded 16 fractions (LNs). LNE showed high binding affinities for hERalpha and hERbeta with IC50 values of 1.20x10(-7) g/ml and 1.00x10(-7) g/ml, respectively. LNE induced 17beta-estradiol (E2)-induced MCF-7 cell proliferation, however, it reduced the proliferation in the presence of E2. Furthermore, LNE had an atrophic effect in the uterus of immature rats through reducing the expression level of progesterone receptor (PR) proteins. LN08 and LN10 had more potent affinities for binding on hER alpha and beta than other fractions. Our results indicate that LNE had higher binding affinities for hERbeta than hERalpha, and showed SERM properties in MCF-7 breast cancer cells and the rat uterus. LNE may be useful for the treatment of estrogen-related conditions, such as female cancers and menopause.