Consensus on diagnostic criteria for deficiency syndrome in hypertension: a modified Delphi study.

OBJECTIVE: To reach consensus on the diagnostic criteria for deficiency syndrome in hypertension (YDSH) patients by a modified Delphi method. METHODS: Our study was consistent with T/CACM 1032-2017. The methodology of RAND/UCLA appr-opriateness was used to develop consensus guidance statements. A nationwide panel of experienced clinical experts from 19 provinces was constructed. These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases. This con-sensus process consisted of two rounds of ques-tionnaires and a final round of consultation to analyze the weight score of each item. Moreover, the data extraction process is carried out independently by third-party researchers (LIANG Junya, SUN Yang, and DU Xiaona). When there is disagreement in all three rounds, the expert panel group (odd number) are invited to vote, and the one with more votes wins. In the questionnaires, participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale. The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement. And then the diagnostic criteria of YDSH were formed according to the weight score in the final round. RESULTS: Twenty-eight experts (84.8%) participated in the first round, and thirty-one (93.9%) finished the second round. After two rounds, the consensus of YDSH was reached on 11 items (25.6%), including symptoms, signs, and pulse condition. Twenty-one experts (63.6%) com-pleted the final round in which they used a grading system for each item. Red tongue with scanty fur had the highest weighting (22.8%), followed by heat in the palms and soles (20.1%). CONCLUSIONS: The consensus-based diagnostic criteria for YDSH, formed by a modified Delphi method, can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

Effects of propofol combined with nalbuphine on the diaphragmatic movement of patients with colonoscopy / 临床麻醉学杂志

Objective To investigate the effects of propofol combined with nalbuphine on diaphragmatic movement monitored by ultrasound in patients undergoing colonoscopy.Methods Forty patients, males 21 and females 19, aged 18-65 years, BMI 18-25 kg/m2, ASA physical status I or II, were recruited and scheduled to undergo elective painless colonoscopy.All patients were randomly divided into two groups (n =20):propofol group (group P) and propofol combined with nalbuphine group (group F).Patients in group F received nalbuphine 0.1 mg/kg intravenously 1 min before propofol administration, and patients in group P received same volume of normal saline.Propofol was infused by TCI and the initial target plasma concentration was set at 2μg/ml in all patients.The target concentration was adjusted gradually until the Ramsay sedation score reached 5.Then colonoscopy was started.During the colonoscopy, the propofol concentration was adjusted according to the Ramsay score.Ultrasound was used to monitor the movement of the right diaphragm of the patients.SpO2, MAP, HR, PETCO2, RR, diaphragmatic movement (DM), diaphragmatic thickness at the end of inspiration (TEI) and diaphragmatic thickness at the end of expiration (TEE) were recorded under calm breathing after entering the room (T0), Ramsay sedation score 5 points after propofol administration (T1), and Ramsay sedation score 2 after endoscopy (T2).The diaphragmatic thickening fraction (DTF) was calculated:DTF= (TEI-TEE) /TEI.Adverse reactions such as bradycardia, hypotension, body movement, and respiratory depression were recorded.Results Compared with T0, MAP, SpO2, HR and RR decreased, and PETCO2 increased at T1 time point in patients of the two groups (P<0.05).Compared with group F, the dose of propofol increased in group P (P<0.05).DM at T1 and T2, DTF at T1 were obviously higher in group F than those in group P (P<0.05).There were two cases had body movement in group P, and one case had bradycardia in group F.There was no case suffered from hypotension, respiratory depression and reflux aspiration in two groups.Conclusion Compared with propofol alone, propofol combined with nalbuphine can attenuate the dysfunction of the diaphragm.

Clinical Reseach of Yangxinshi Pill on ET,NO,CRP in Treatment of Angina Pectoris Belonging to Manifestation of Qi-deficiency and Blood Stagnation / 中国中医药信息杂志

Objective To observe the influences of Yangxinshi pill on ET, NO, CRP in patients with angina pectoris belonging to manifestation of Qi-deficiency and blood stagnation. Methods 78 patients with angina pectoris were randomly divided into two groups. 40 patients in treatment group were treated with Yangxinshi pill, 4 pills once, three times a day 8 weeks. 38 patients in control group were treated with isosorbide mononitrate 8 weeks. The symptoms and the ET, NO, CRP level before and after treatment were recorded. Results Obvious drop of ET, NO, CRP were observed after treatment in the treatment group. The level of ET was reduced from (67.47?15.72)pg/mL to (37.97?7.82) pg/mL. The level of NO was increased from (78.24?13.81)?mol/mL to (96.25?12.72)?mol/mL. The level of CRP was reduced from (5.31? 2.02)mg/L to (3.42?2.17) mg/L. There was a significant difference between the two drugs (P 0.05). The total efficacy rate in improving symptom was 95%. There was a significant difference between the two drugs (P

Effect of Zhengjian Granule on blood pressure and insulin resistance in spontaneously hypertensive rates / 中成药

Objective: Effect of Zhengjian Granule(ZJ)(Radix Berberidis, Ramulus Euonymi, Radix Scorphulariae Rhizoma Alismatis) on blood pressure(BP) and insulin resistance(IR) in spontaneously hypertensive rats(SHR) was observed. Methods: Twenty four SHR aged 13 weeks were divided into three groups treated with large and small dosage of ZJ and nothing as compared with age matched six Wister Kyoto rats(WKY). BP, glucose(G) and insulin(I) of fasting, G/I and blood lipid were measured before and after treated 8 weeks and compared among groups. Results: While G of fasting had no difference in respective SHR groups compared with WKY, insulin of fasting was markedly higher and G/I were notably lower than WKY( P