Seventy-two Cases of Antidiabetic-Induced Hepatopathy Treated by Huatan Yigan Decoction

In order to observe the therapeutic effects of Huatan Yigan Decoction (化痰益肝汤 Decoction for resolving phlegm and replenishing the liver) on antidiabetic-induced hepatopathy, 129 cases were divided into two groups, 72 cases in the treatment group were administrated with Huatan Yigan Decoction and 57 cases in the control group with the liver-protecting drugs. Their liver function, plasma prothrombin time (PT), blood urea nitrogen and symptoms of the patients before and after treatment were observed during the three therapeutic courses. Results: The total effective rate and cured rate of the treatment group manifested an obvious difference in comparison with those of the control group (P＜0.05 or P＜0.01). Even though the liver function, blood urea nitrogen (BUN) and symptoms in both groups were improved markedly, these indicators in the treatment group were improved more markedly than those in control group (P＜0.01). No adverse effect was found during the treatment. Conclusion: Huatan Yigan Decoction shows a repair action on hepatic injury.     

Clinical Efficacy and Safety of Bathing with Chinese Medicine Taohong Siwu Decoction (桃红四物汤) for Treatment of Diffuse Cutaneous Systemic Sclerosis: A Randomized Placebo-Controlled Trial

Objective:To examine the efficacy and safety of bathing therapy with Taohong Siwu Decoction(桃红四物汤,TSD) in the treatment of early-stage,mild-moderate diffuse cutaneous systemic sclerosis(dc SSc).Methods:This randomized,placebo-controlled trial enrolled 148 men and women(18–60 years) with dc SSc(disease duration 12 months) and baseline modified Rodnan skin score(MRSS) 10.Patients were randomized into a TSD group(71 cases bathing with TSD plus oral prednisone) or control group(71 cases bathing with placebo plus oral prednisone).Bathing(40 ℃,30 min) of the upper and lower limbs was carried out once daily for 12 consecutive weeks.The primary outcome measure was MRSS;secondary outcomes were Raynaud's phenomenon(RP) score,quality of life(QOL),physician visual analogue scale(VAS),patient VAS,percent predicted diffusing capacity for carbon monoxide(DLCO),percent predicted forced vital capacity(FVC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP) level and overall treatment effect.Results:The final analysis included 135 patients(control group,68 cases;TSD group,67 cases).Primary and secondary outcome measures after 2 weeks of treatment showed no improvement(versus baseline) in both groups,with no differences between groups.At 12 weeks,QOL,physician VAS,patient VAS,ESR and CRP were improved in both groups,but MRSS and RP score were improved only in the TSD group(all P0.05).MRSS,RP score,QOL,physician VAS,patient VAS,ESR and CRP differed significantly between groups(all P0.05).Meanwhile,the overall treatment effect was significantly higher in the TSD group than in the control group(P0.05).Adverse events in the two groups were similar(P0.05).Conclusions:Bathing with TSD plus oral prednisone achieves better outcomes than oral prednisone alone in patients with dcS Sc and is not associated with serious adverse events.     

Comparative study of graft flow between on-pump and off-pump coronary bypass surgery for patients with multivessel coronary artery disease

Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and compared with 100 cases of CCABG by means of Medi-Stim Butterfly Flowmeter measurement intraoperatively. Results： The mean number of the distal anastomosis was 3.78＋ 1.11 in CCABG group, and 3.83 ＋ 0.93 in OPCAB group. The index of completeness of revascularization in CCABG group was 1.01 ＋ 0.08, and 1.10＋ 0.09 in OPCAB group. The flow of grafts was satisfied in all patients. The PI values were all under 5. There was no significant difference in the mean graft flow and PI value between two groups. Conclusion： OPCAB can provide the same grafts flow and similar completeness of revascularization when compared with CCABG which indicates the similar anastomosis quality of grafts in OPCAB and CCABG groups.     

The clinical research of esophagus radiographic locating method of atrial septal puncture-including the clinical analyses of 486 cases

Objective To devise the safety and validity of clinical application of esophagus radiographic locating method of transseptal puncture. Methods Four hundreds and eighty-six patients who were undergone transseptal puncture were randomized into two groups. Esophagus radiographic locating method of tansseptal puncture was applied in the study group(n=243) and modified-Ross locating method was used in the control group(n=243). After successful location, transseptal puncture was made. Then observe the success rate and complication incidences of the 2 groups. Results Left atria impression in the study group was clearly seen. 120 cases in control group could not shown clearly the left atria silhouette. The success rate of locating transseptal puncture in the study group and control group were 100% and 50.6 % respectively(P<0.001). The success rate of transeptal puncture in the study group and control group was 99.6% and 45.7% respectively (P<0.001). There were no puncture complication in study group and pericardial tamponade occurred in 1 case in control group. Conclusion The esophagus radiographic locating method of transeptal puncture is accurate, safe and simple to perform. According to the radiographic result, to perform thetranseptal puncture can achieve high success rate with few complications.     

Effects of Minimally Invasive Puncture and Drainage of Intracranial Hematoma on the Blood-brain Barrier in Patients with Cerebral Hemorrhage

The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentra-tion were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was signifi-cantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive sur-gery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the per-meability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.     

VAGINAL HYSTERECTOMY FOR PATIENTS WITH MODERATELY ENLARGED UTERUS OF BENIGN LESIONS

Objective To evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. Methods One hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group Ⅰ contained 60 patients with uterine enlargement to a weight of 200 to 750 g, and group Ⅱ contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The perioperative data in both groups were analyzed. Results In group Ⅰ, 59 cases underwent transvaginal hysterectomy successfully, except 1 case converted to abdominal operation and the uterine morcellation was performed in 21 women. In group Ⅱ, all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group Ⅰ was significantly heavier than that of group Ⅱ (280.18± 100.40 g vs 146.48 ± 35.19 g). The mean operating time was significantly longer for group Ⅰ than that for group Ⅱ(83.93± 26.26 minutes vs 35.22±20.55 minutes). There were no significant differences in blood loss and complications between group Ⅰ and group Ⅱ. There was no injury of urinary bladder or rectum, and no vaginal vault infection. Conclusions Vaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases, in order to reduce the uterine volume, uterine morcellation should be used to shorten operative time, reduce the bleeding, and lower the postoperative complications.     

Clinical Observation on the Treatment of Atrial Fibrillation with Amiodarone Combined with Shenmai Injection (参麦注射液)

Objective: To observe the therapeutic efficacy and safety of amiodarone combined with Shenmai Injection (参麦注射液) on atrial fibrillation. Methods: A total of 351 patients with atrial fibrillation caused by cardiovascular diseases and idiopathic atrial fibrillation were assigned to amiodarone group (control group, 128 cases) and amiodarone combined with Shenmai Injection group (treatment group, 223 cases). The patients in the control group received intravenous injection of 150 mg amiodarone in 10 min, followed by intravenous drip infusion at 1 mg /min and 6 h later at 0.5 mg /min until 48 h or cardioversion. The patients in the treatment group received the same treatment of amiodarone, while in addition, they received an injection of Shenmai Injection of 100 mL simultaneously. Blood pressure, ventricular rate, and cardioversion were observed. Results: The total efficiency rate was 98% (control group) and 99% (treatment group) (P0.05). The mean ventricular rate decreased 23% and 31% in the control group and the treatment group, respectively (P0.05). The mean cardioversion time of the two groups was 570±211 min and 351±123 min, respectively (P0.05). Only mild side effects were observed in both groups. Conclusion: Compared with amiodarone, amiodarone combined with Shenmai Injection takes effect more quickly with low side effects on the treatment of atrial fibrillation.     

Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer's Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.     

Minimally invasive puncture and drainage or patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases

Background: The treatment of hypertensive spontaneous intracranial hemorrhage(ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage(MIPD) could provide improved patient outcome compared with decompressive craniectomy(DC).Methods: Eligible, consecutive patients with ICH(≥30 ml, in basal ganglia, within 24 hours of ictus) were nonrandomly assigned to receive MIPD(group A) or to undergo DC(group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale(GOS, scores range from 1 to 5, score 1 indicating death, ≥4 indicating functional independence, with lower scores indicating greater disability). Results: A total of 198 patients met the per protocol analysis(84 cases in group A and 114 cases in group B), including 9 cases lost during follow-up(2 cases in group A and 7 cases in group B). For these 9 patients, their last observed data were used as their final results for intention-to-treat analysis. The mean age of all patients was 57.1 years(range of 31-95 years), and 114 patients were male. The initial Glasgow Coma Scale(GCS) score was 8.1±3.4, and the National Institutes of Health Stroke Scale(NIHSS) score was 20.8±5.3. The mean hematoma volume(HV) was 56.7±23.0 ml(range of 30-144 ml), and there was extended intraventricular hemorrhage(IVH) in 134 patients(67.7%). There were no significant intergroup differences in the above baseline data, except group A had a higher mean age(59.4±14.5years) than the mean age of group B(55.3±11.1 years, P=0.025). The total cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%, respectively, and there were no significant differences between groups A and B(30 days: 27.4% vs. 36.0%, P=0.203; 1 year: 36.1% vs. 48.2%, P=0.112, respectively). However, the mortality for patients ≤60 years, NIHSS<15 or HV≤60 ml was significantly lower in group A than that in group B(all P<0.05). The total     

Clinical observation on the effect of dexamethasone and chinese herbal decoction for purgation in severe acute pancreatitis patients

Objective:To investigate the effect of dexamethasone(Dx) combined with modified Dachengqi Decoction(大承气汤,DCQD),a Chinese herbal decoction for purgation,on patients with severe acute pancreatitis(SAP) accompanied with systematic inflammatory response syndrome(SIRS).Methods:A total of 81 patients diagnosed as SAP were randomly assigned to a control group or treatment group according to a random number table generated from an SPSS software.The patients in the control group(38 cases) received standard treatment and Chinese herbal decoction for purgation;those in the treatment group(43 cases) received additional 1 mg/(kg·d) dexamethasone(Dx) treatment for three days based on the above treatment.The mortality rate,acute respiratory distress syndrome(ARDS),renal failure,hemorrhage,sepsis,pancreatic pseudocyst, pancreatic abscess,operability,and days of hospitalization were compared between the two groups.Results: Three patients in the control group and eight patients in the treatment group dropped out from the study with a drop-out rate of 7.8%and 18.6%,respectively,and no statistics difference was shown between the two groups (P>0.05).Dx treatment significantly reduced ARDS rate and shortened the length of hospitalization compared to those in the control group(7/35,20.0%versus 15/35,42.9%,P=0.0394;32.5±13.2 days versus 40.2±17.5 days,P=0.0344).Other parameters including the mortality rate were not significant different between the two groups.Conclusion:Dx combined with DCQD could decrease the risk of developing ARDS in SAP patients with SIRS and shorten their length of hospitalization.     

Seventy-two Cases of Antidiabetic-Induced Hepatopathy Treated by Huatan Yigan Decoction

In order to observe the therapeutic effects of Huatan Yigan Decoction (化痰益肝汤 Decoction for resolvingphlegm and replenishing the liver) on antidiabetic-induced hepatopathy,129 cases were divided into twogroups,72 cases in the treatment group were administrated with Huatan Yigan Decoction and 57 cases inthe control group with the liver-protecting drugs.Their liver function,plasma prothrombin time (PT),bloodurea nitrogen and symptoms of the patients before and after treatment were observed during the threetherapeutic courses.Results:The total effective rate and cured rate of the treatment group manifested anobvious difference in comparison with those of the control group (P<0.05 or P<0.01).Even though the liverfunction,blood urea nitrogen (BUN) and symptoms in both groups were improved markedly,theseindicators in the treatment group were improved more markedly than those in control group (P<0.01).Noadverse effect was found during the treatment.Conclusion:Huatan Yigan Decoction shows a repair actionon hepatic injury.     

Tartrate-resistant acid phosphatase 5b is a potential biomarker for rheumatoid arthritis: a pilot study in Han Chinese

Background Bone damage around the joints is one of the major pathophysiological mechanisms that leads to rheumatoid arthritis （RA） chronic disability.Serum tartrate-resistant acid phosphatase 5b （TRACP-5b） is secreted by osteoclasts,its activity can be used as a clinically relevant bone resorption marker.The aim of this study was to test whether the measurement of serum levels of TRACP-5b in patients with RA would correlate with measures of disease activity and with responses to therapy.Methods Fifty-six patients were randomly assigned to receive recombinant human cytotoxic tlymphocyte-associated antigen-4 immunoglobulin （RhCTLA4-lg）,infliximab or methotrexate （MTX）.The clinical and serologic indicators of RA activity were evaluated at baseline and at 24 weeks.Serum TRACP-5b was measured by Enzyme-linked Immunosorbent Assay （ELISA） at 0,12 and 24 weeks.Hand X-rays were obtained at baseline.Results At baseline,the levels of TRACP-5b correlated with the severity of X-ray damage,disease duration （r=0.332,P=0.012）,and tender joint count （r=0.408,P=0.002）.The 24 weeks values of TRACP-5b for RhCTLA4-lg group and infliximab group differed significantly from the baseline values in each group （P 〈0.05; P 〈0.05）,whereas only the value for RhCTLA4-lg group differed significantly from the 24 weeks value for the MTX group （P 〈0.01）.Considering the two biologics-treated groups together,the TRACP-5b levels at 24 weeks differed significantly from the baseline values only in those patients who reached an ACR70 level （P 〈0.05）.Conclusions Measurement of serum TRACP-5b in RA patients reflects clinical and radiological measures of disease activity,treatment with certain biologics,and degree of response to therapy.TRACP-5b should be investigated further as a potential biomarker to predict response to therapy,including slowing of radiographic progression.     

Effect of Longbishu Capsule (癃闭舒胶囊) plus Doxazosin on Benign Prostatic Hyperplasia: A Randomized Controlled Trial

Objective:To investigate the effect of Longbishu Capsule(癃闭舒胶囊,LBS),doxazosin,and combination therapy on benign prostatic hyperplasia(BPH).Methods:A randomized,double-blind,multi-center parallel trial was conducted involving 360 patients in hospitals in Beijing(108 cases),Heilongjiang(90 cases),Sichuan(90 cases),Shanghai(72 cases),China.They were randomly assigned with central randomization method to group A(LBS placebo plus doxazosin),group B(LBS plus doxazosin)or group C(LBS plus doxazosin placebo),120 cases for each group.The international prostate symptom score,maximum urinary flow rate,postvoid residual urine volume and prostate volume were measured for evaluating the efficacy of the three treatments.Results:At baseline,there was no significant difference in the measured variables among the three groups.After 12-month treatment,the three groups showed significant improvements in IPSS and maximum urinary flow rate from baseline(P0.01).Although postvoid residual urine volume was not significantly different from the baseline in group A(P0.05),it significantly decreased in group B and C(P0.05).The incidence of adverse events were similar among the three groups.Conclusions:The treatment of LBS alone or LBS plus doxazosin was able to significantly improve IPSS in patients with BPH.The treatments may reduce the increase in prostate volume and postvoid residual urine volume as well.     

Effectiveness and Safety Evaluation of Qixiong Zhongzi Decoction (芪芎种子汤) in Idiopathic Asthenozoospermia Treatment: A Randomized Controlled Trial

Objective: To evaluate the clinical effectiveness and safety of the Chinese medicine(CM) Qixiong Zhongzi Decoction(芪芎种子汤, QZD) in the treatment of patients with idiopathic asthenozoospermia. Methods: A total number of 66 patients with idiopathic asthenozoospermia were included and randomly divided into treatment and control groups by SAS-generated code from January 2015 to August 2016, 33 patients in each group. Patients in the treatment group were administered with 150 m L of QZD twice a day, whereas those in the control group were given 1 g of levocarnitine oral liquid twice a day. The two groups received the indicated medication for 12 weeks and were then followed up for 4 weeks. The primary outcome was sperm motility, and the secondary therapeutic indices were sperm volume, density, pregnancy probability, and CM syndrome score. The comparison between groups was carried out at 4, 8 and 12 weeks, respectively. The safety was determined before and after treatment. Results:(1) Drop-off: 5 cases(7.58%) were lost after treatment(2 from the treatment group and 3 from the control group).(2) Primary outcomes: after 8-and 12-week treatment, the progressive sperms in the two groups were significantly higher than the baseline(all P0.05); however, the treatment group showed greater improvement compared with the control group at 12-week treatment(22.7%±9.0% vs. 14.1%±8.8%, P0.05). The increasement of non-progressive grade sperms at both groups was observed at 8-and 12-week treatment with statistical difference(all P0.05), however, the treatment group showed remarkable improvement compared with the control group at 12-week treatment(38.7%±14.1% vs. 26.2%±15.4%, P0.05).(3) Secondary outcomes: no significant statistical differences were found in semen volume and density(4, 8, and 12-week treatment) and pregnancy probability of patients' wives(12-week treatment) between two groups(all P0.05), however, the CM syndrome score of the treatment group significantly declined compared with baseline level at each time points(all P0.05).(4) Safety: no obvious side reactions were found during the treatment in both groups. Conclusions: QZD could improve the progressive and non-progressive grade sperm in the treatment of idiopathic asthenozoospermia. It is safe with no obvious side effects.     

Treatment of middle/late stage primary hepatic carcinoma by Chinese medicine comprehensive therapy: A prospective randomized controlled study

<正>Objective:To observe the efficacy of Chinese medicine comprehensive therapeutic project in treating the middle/late stage primary hepatic carcinoma(PHC).Methods:With prospective randomized controlled design, 97 patients with PHC were assigned to the test group(49 cases) treated with Chinese medicine comprehensive therapy using Oleum fructus bruceas intervention combining oral intake of Ganji Decoction(肝积方) and external application of Ailitong(癌理通),and the control group(48 cases) treated with chemotherapeutic agents combining iodized oil chemo-embolization and analgesics.The immediate and long-term efficacy,adverse reaction,pain-relieving initial time(PRIT) and pain-relieving sustained time(PRST) of the treatment,as well as the change in patients' quality of life(QOL) were observed.Results:The difference between the two groups in illness control rate was statistically insignificant(P0.05),but the adverse reaction occurence rate in the test group was lesser than that in the control group(P0.05).PRIT was insignificantly different in the two groups(P0.05),but the PRST was significantly superior in the test group than that in the control group(10.37±2.18 h vs 7.78±1.95 h,P0.01).After treatment,the increased Karnofsky scores in the test group indicated that the patients' somatic activity,symptoms and QOL were improved significantly,which were significantly superior to those in the control group(P0.05).The survival rate in the two groups was similar at the 3rd month after treatment,but the test group did show superiority in terms of half- and 1-year survival rate(65.9%vs 42.5%and 38.6%vs 18.1%,respectively,P0.05).The median survival time in the test group was 8.9 months and that in the control group was 5.3 months.Conclusion:Chinese medicine comprehensive therapy is an effective treatment for the middle/late stage patients of PHC,and it could extend the PRST,improve the patients' QOL and long-term survival with less adverse reaction.     

Xinfeng Capsule(新风胶囊)for the Treatment of Rheumatoid Arthritis Patients with Decreased Pulmonary Function—A Randomized Controlled Clinical Trial

Objective:To determine the effectiveness and safety of Xinfeng Capsules(新风胶囊,XFC) for the treatment of rheumatoid arthritis(RA) patients with decreased pulmonary function.Methods:This was a randomized controlled clinical trial of 80 RA patients.Participants were assigned to the trial group(40 cases) and the control group(40 cases) by block randomization.The trial group was treated with XFC,three pills each time three times daily for 2 months.The control group was treated with tripterygium glycoside(TPT),two pills each time three times daily for 2 months.Both groups were followed up after 2 months.The clinical effects,changes in joint and pulmonary function,and quality of life before and after treatment were observed;safety indices were also evaluated.Results:Pain,swelling,tenderness,and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline(P0.01).Compared with before treatment,hand grip strength increased significantly after treatment in the trial group(P=0.0000);pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity(FEV_1/FVC),50%of the expiratory flow of forced vital capacity(FEF_(50)),carbon monoxide diffusing capacity(DLco) were increased(P0.01 or P0.05);measures of quality of life such as role-physical,body pain,vitality and mental health were also improved after treatment in the trial group(all P0.05).Joint swelling in the trial group decreased compared with the control group(P=0.0043),while hand grip strength was increased after treatment(P=0.0000).The increase in FEF_(50),DLco,and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group(P0.05 or P0.01).Conclusions:XFC not only relieved joint pain in RA patients,but also significantly improved the ventilation and diffusion function of the lungs.Therefore,XFC could improve the whole body function and enhance the quality of life of RA patients.     

Effectiveness and Safety of Double-balloon Catheter versus Intra-amniotic Injection of Ethacridine Lactate for Termination of Second Trimester Pregnancy in Patients with Liver Dysfunction

Severe liver dysfunction in pregnancy(SLDP) is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively(P=0.639). The induction-to-delivery interval was similar between Cook group and EL group(38.1±21.5 vs. 41.3±17.4, P=0.543). The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.     

Chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly

Background Legionella is an important community-acquired pneumonia pathogen.Although the elderly are especially susceptible to Legionella,few studies have looked at comparative radiographic features of Legionella pneumonia in this population.The aim of this study was to explore the chest radiographic characteristics of community-acquired Legionella pneumonia in the elderly.Methods Serial chest radiographs obtained in 34 patients hospitalized with serologically proven Legionella pneumonia were retrospectively reviewed.Chest x-ray features of an aged group of ≥65 years were assessed and compared with a non-aged group of ＜65 years old with regard to initial patterns and distributions of pulmonary abnormalities,accompanying signs,and progression.Results The most common initial presentation was a patchy alveolar infiltrate involving a single lobe,most often the lower lobe.There was no middle or lingular lobe involvement in the aged group patients,but bilateral pleural effusion was significantly more common in this group.In the aged group patients,radiographic progression following adequate therapy,despite a clinical response,was more often noted and the radiographs were less likely to have returned to the premorbid state at discharge,but the differences were not significant between the two groups.Conclusion The discrepancy between imaging findings and clinical symptoms seems more prominent in community-acquired Legionella pneumonia in the elderly.     

Effects of Huang Qi Wu Wu Decoction on Plasma Proteins in 70 Cases of Chronic Pulmonary Heart Disease

Simple immune agar diffusion test was used to assay the contents of 12 plasma proteins in 70 cases ofchronic pulmonary heart disease treated by Huang Qi Wu Wu Decoction(黄芪五物汤),with theother 70 cases who were not given Huang Qi Wu Wu Decoction as the control group.The totalclinical effective rate in the treatment group was 90.0%,while that in the control group was 75.7%,with a statistically significant difference between the two groups(P<0.05).In the treatment group,thelevels of prealbumin,transferrin and fibronectin elevated obviously after treatment,and the contentsof C-reactive protein,ceruloplasmin,haptoglobin,α_1-antitrypsin and oh-acid glycoprotein decreasedmarkedly(P<0.01).In the control group,only the levels of ceruloplasmin and C-reactive proteindecreased significantly(P<0.05).It is shown that Huang Qi Wu Wu Decoction may enhance thetherapeutic effects for pulmonary heart disease,regulate the metabolism of plasma proteins,andimprove the life quality of the patients.     

非X线经验性ERCP与超声引导下ERCP在治疗妊娠期胆胰疾病中的疗效对比分析

BACKGROUND The aim of this study was to compare ultrasound-guided endoscopic retrograde cholangiopancreatography with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients. METHODS The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively. Endoscopic retrograde cholangiopancreatography was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B). Data on the following variables were compared between the two groups: surgical success rate, rate of complete stone removal, time to resolution of clinical manifestations and laboratory indicators, length of hospital stay, complications, outcome and differences in efficacy of endoscopic retrograde cholangiopancreatography during different stages of pregnancy. RESULTS In group A, the rates of surgical success and complete removal of stones were 69.44% and 60%, respectively; the corresponding values were 90.63% and 88.89% in Group B (P < 0.05).Postoperatively, clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups(P > 0.05). Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in Group B (8.64 ± 1.83 vs. 14.57 ± 3.74, 14.29 ± 4.64 vs. 20.00 ± 5.40, P < 0.01). The hospital stay was shorter in Group B (16.28 ± 7.25 vs. 28.00 ± 6.83, P < 0.001). The complication rate was 13.89% in Group A and 3.13% in Group B (P < 0.05). There were no differences between the two groups in the procedure’s efficacy during different stages of pregnancy. CONCLUSIONS In the treatment of acute pancreaticobiliary disease during pregnancy, ultrasound-guided endoscopic retrograde cholangiopancreatography is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners. Its more widespread use is recommended.