Routine Symptomatic Treatment Research Articles

Effect of electroacupuncture of "Biao-Ben" acupoints on renal function and hemorheology and eNOS level in patients with early diabetic nephropathy

To observe the effect of electroacupuncture (EA) of "Biao-Ben acupoints" (Biao indicates pathogenic factors of disease; Ben refers to body constitution) on renal function, hemorheology and endothelial nitric oxide synthase (eNOS) level in patients with early diabetic kidney disease (DKD), so as to explore its mechanism underlying relieving early DKD. A total of 120 patients with early DKD were selected and randomized into 3 groups: medication, conventional acupoints, and "Biao-Ben"acupoints groups by stratified randomization method, with 40 cases in each group. Patients of the me-dication group were treated by routine symptomatic supportive treatment (gleziquantel tablets or subcutaneous injection of insulin \[for hyperglycemia\], candesartan tablet \[hypertension\], simvastatin tablets \[hyperlipidemia\], etc.).Based on the medication group, patients of the conventional acupoint group were treated by EA of bilateral Feishu (BL13), Weiwanxiashu (EX-B3), Weishu (BL21), Shenshu (BL23), Sanyinjiao (SP6), Taixi (KI3) (main acupoints), etc., and those of the Biao-Ben acupoint group treated by EA of main acupoints Zhongwan (CV12), Fenglong (ST40), Xuehai (SP10) and Taichong (LR3) (Biao acupoints), and Guanyuan (CV4) and Zusanli (ST36) (Ben acupoints). The EA treatment was conducted one daily, 5 days a week for 8 weeks. The urine microprotein level in 24 h was detected using an automatic specific protein analyzer, followed by calcula-ting the urine albumin excretion rate (UAER). The serum creatinine (Scr), urea nitrogen (BUN) and cystatin (CysC) contents were detected by using an automatic biochemical analyzer, and the whole blood low-cut viscosity (ηbL), whole blood mid-cut viscosity (ηbM), whole blood high-cut viscosity (ηbH), plasma viscosity (ηp) and fibrinogen (FIB) levels were detected using an automatic hemorheology tester, and the serum eNOS and nitric oxide (NO) levels assayed using enzyme linked immunosorbent assay. The total clinical effective rates were compared and the adverse reactions of the treatment were recorded. Compared with the values before the treatment in each group, the levels of UAER, Scr, BUN, CysC, ηbL, ηbM, ηbH, ηp and FIB were all significantly decreased (P<0.01), while serum eNOS and NO levels significantly increased in the three groups after the treatment (P<0.01). Compared with the medication group, the levels of UAER, Scr, BUN, CysC, ηbL, ηbM, ηbH, ηp and FIB were notably lower (P<0.01, P<0.05), and serum eNOS and NO contents obviously higher in both the conventional acupoint and "Biao-Ben" acupoint groups (P<0.01). Comparison between the two EA groups showed that the levels of UAER, BUN, ηbL, ηbM, ηbH and ηp were lower (P<0.05), whereas the serum eNOS and NO contents were considerably higher (P<0.05) in the "Biao-Ben" acupoint group than in the conventional acupoint group. After the treatment, the total clinical effective rate of the "Biao-Ben" acupoint group was 89.74%(35/39), being significantly higher than those of both the conventional acupoint group (71.05%, 27/38,P<0.05) and medication group (64.10%, 25/39, P<0.05). EA of "Biao-Ben" acupoints can improve renal function and reduce microcirculation disorders in patients with early DKD, which may be related to its function in up-regulating the levels of serum eNOS and NO.

Effect of bronchofiberscopic lavage with budesonide suspension on refractory mycoplasma pneumoniae pneumonia.

Objectives:To investigate the clinical efficacy of budesonide suspension through bronchofiberscopic lavage in the treatment of refractory mycoplasma pneumoniae pneumonia.(RMPP)Methods:A total of 108 children with refractory mycoplasma pneumoniae pneumonia from June 2018 to October 2020 were randomly divided into two groups: the study group and the control group, with 54 cases in each group. Children in the control group were treated with anti-infective, antitussive, antipyretic routine symptomatic treatment and nebulization of budesonide suspension, while children in the study group were treated with bronchofiberscopic lavage with Budesonide suspension along with standard treatment as in control group. The clinical efficacy, changes in blood gas analysis indexes, levels of inflammatory mediators, time for improvement of clinical symptoms and the incidence of adverse reactions were compared between the two groups.Results:The efficacy of treatment in the study group was 85.19%, which was higher than 66.67% in the control group (P<0.05). The antipyretic time, antitussive time, lung rales disappearance time and length of hospital stay in the study group were shorter than those in the control group (P<0.05). Moreover, the levels of arterial oxygen partial pressure (PaO2) in the study group were higher than those in the control group, while the levels of partial pressure of carbon dioxide (PaCO2) and arterial oxygen saturation (SaO2) in the study group were lower than those in the control group (P<0.05). The levels of inflammatory mediators interleukin-6 (IL-6), interleukin-4 (IL-4), and interferon-γ (IFN-γ) in the study group were lower than those in the control group (P<0.05), and no significant difference was found in the comparison of the incidence of adverse reactions between the two groups (P>0.05).Conclusions:Budesonide suspension combined with bronchofiberscopic lavage with Budesonide suspension is a safe treatment regimen that can significantly improve the clinical outcome in children with RMPP. With such a combined treatment regimen, the clinical symptoms of children can be ameliorated, the ventilation function can be enhanced, and the level of inflammatory mediators will be reduced.

Effect of Nephritis Rehabilitation Tablets combined with tacrolimus in treatment of idiopathic membranous nephropathy.

BACKGROUNDIdiopathic membranous nephropathy (IMN) has a high incidence in the middle-aged and elderly population, and poses a great threat to the physical and mental health and quality of life of patients. Nephritis Rehabilitation Tablets have many potential effects, such as clearing residual toxins, tumefying the kidney and spleen, replenishing qi, and nourishing yin, and have played an important role in the treatment of a variety of kidney diseases.AIMTo investigate the efficacy and safety of Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN.METHODSEighty-four patients with IMN recruited from January 2017 to September 2020 were randomly divided into a study group (n = 42) and a control group (n = 42). On the basis of routine symptomatic treatment, both groups were treated with tacrolimus, and the study group was additionally treated with Nephritis Rehabilitation Tablets. Both groups were treated for 12 wk. The therapeutic effect, the levels of renal function indexes [serum creatinine (Scr), serum albumin, and 24-h urinary protein], urinary immunoglobulin (IgG4), membrane attack complex (C5b-9), and the incidence of adverse reactions were measured before and after 12 wk of treatment.RESULTSThe total effective rate in the study group was significantly higher than that of the control group. Before treatment, there was no significant difference in Scr, serum albumin, or 24 h urinary protein between the two groups. After 12 wk of treatment, the levels of Scr and 24-h urinary protein in both groups were significantly lower and serum albumin was significantly higher than those before treatment (P < 0.05), and the levels of Scr and 24-h urinary protein were significantly lower (P = 0.003 and 0.000, respectively), and the level of serum albumin was significantly higher (P = 0.00) in the study group than in the control group. Before treatment, there was no significant difference in urinary IgG4 and C5b-9 levels between the study group and the control group (P = 0.336 and 0.438, respectively). After 12 wk of treatment, the levels of urinary IgG4 and C5b-9 in the two groups were lower than those before treatment, and the levels of urinary IgG4 and C5b-9 in the study group were significantly lower than those in the control group (P = 0.000). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.710).CONCLUSIONBased on routine intervention, Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN can effectively improve the renal function of patients and downregulate the expression of urinary IgG4 and C5b-9. In addition, they can improve the overall therapeutic effect while not increasing the risk of adverse reactions.

Use of Artificial Intelligence to Triage Patients with Flu-Like Symptoms Using Imaging in Non-COVID-19 Hospitals during COVID-19 Pandemic: An Ongoing 8-Month Experience.

Background Evaluation of suspected coronavirus disease-2019 (COVID-19) patient is a diagnostic dilemma as it commonly presents like influenza in early stages. Studies and guidelines have emerged both for and against the use of imaging as a frontline tool to investigate such patients. Reverse transcriptase-polymerase chain reaction (RT-PCR) is suggested as the backbone of diagnosis. We designed and tested a diagnostic algorithm using artificial intelligence (AI) to determine the role of imaging in the evaluation of patients with acute flu-like presentation. Materials and Methods Overall, 3,235 consecutive patients with flu-like presentation were evaluated over a period of 240 days. All patients underwent plain radiographs of chest with computer-aided detection for COVID-19 (CAD4COVID) AI analysis. Based on the threshold scores, they were divided into two groups: group A (score < 50) and group B (score > 50). Group A patients were discharged and put on routine symptomatic treatment and follow-up with RT-PCR, while group B patients underwent high-resolution computed tomography (HRCT) followed by COVID-19 AI analysis and RT-PCR test. These were then triaged into COVID-19 and non-COVID-19 subgroups based on COVID-19 similarity scores by AI, and lung severity scores were also determined. Results Group A had 2,209 (68.3%) patients with CAD4COVID score of <50 while 1,026 (31.7%) patients comprised group B. Also, 825 (25.5%) patients were COVID-19 positive with COVID-19 similarity threshold of >0.85 on AI. RT-PCR was positive in 415 and false-negative in 115 patients while 12 patients died before the test could be done. The sensitivity and specificity of CAD4COVID AI analysis on plain radiographs for detection of any lung abnormality combined with HRCT AI analysis was 97.9% and 99% using the above algorithm. Conclusion Combined use of chest radiographs and plain HRCT with AI-based analysis is useful and an accurate frontline tool to triage patients with acute flu-like symptoms in non-COVID-19 health care facilities.

Efficacy and Safety of Tripterygium Glycoside in the Treatment of Diabetic Nephropathy: A Systematic Review and Meta-Analysis Based on the Duration of Medication.

AimThe aim of this study was to assess the clinical efficacy and safety of Tripterygium-derived glycosides (TG) after 3-month and 6-month of treatments of diabetic nephropathy (DN) and to resolve the conflict between medicine guidance and clinical practice for TG application.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials involving TG application in treating DN. We extensively searched PubMed, Cochrane Library, CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Trial Registry, and WHO International Clinical Trial Registration Platform till November 2020, along with grey literature for diabetes and all other relevant publications to gather eligible studies. Based on the preset inclusion and exclusion criteria, document screening, quality assessment of methodology, and data extraction was conducted by two researchers independently. The methodological quality was assessed by the Cochrane risk test from the Cochrane Handbook 5.2, and then analyses were performed by Review Manager 5.3 (Rev Man 5.3). The quality of output evidence was classified by GRADE.ResultsThirty-one eligible studies (2764 patients) were included for this meta-analysis. Our study results showed a comparable significant decrease in the 24 h-UTP and blood creatinine levels in DN patients from both 3-month and 6-month TG treatment groups, compared with the routine symptomatic treatment alone. To the contrary of the findings from the included studies, our results showed that the occurrence of serious adverse reaction events was significantly higher in the TG treated group with 6 months of treatment duration compared to that of 3 months of the treatment course. However, the total AR ratio was slightly varied while increasing the percent of severe adverse events. GRADE assessment indicated that the quality of evidence investigating TG-induced adverse reactions was moderate and that for 24 h-UTP and blood creatinine indicators were considerably low.ConclusionCombinatorial treatment regimen including TG can significantly decrease the pathological indicators for DN progression, while it can also simultaneously predispose the patient to a higher risk for developing severe adverse events, as the medicine guidance indicates. Notably, even in 3-month of course duration smaller percent of severe adverse events can get to a fatal high percent and is likely to increase proportionally as the TG treatment continues. This suggests that TG-mediated DN treatment duration should be optimized to even less than 3 continuous months to avoid adverse event onset-associated further medical complications in DN patients. In clinical practice, serious attention should be paid to these severe side-effects even in a course normally considered safe, and importantly more high-quality studies are urgently warranted to obtain detailed insights into the balance between the efficacy and safety profiles of TG application in treating DN.

Treatment of Stage 3 COVID-19 With Transcutaneous Auricular Vagus Nerve Stimulation Drastically Reduces Interleukin-6 Blood Levels: A Report on Two Cases

Treatment of Stage 3 COVID-19 With Transcutaneous Auricular Vagus Nerve Stimulation Drastically Reduces Interleukin-6 Blood Levels: A Report on Two Cases

Corneal Recovery Following Rabbit Peripheral Blood Mononuclear Cell–Amniotic Membrane Transplantation with Antivascular Endothelial Growth Factor in Limbal Stem Cell Deficiency Rabbits

Background: Limbal stem cell deficiency (LSCD) is a refractory ocular surface disorder characterized by progressive corneal epithelial degeneration, conjunctivalization, and neovascularization, potentially leading to blindness. There are currently no effective therapeutic options for patients experiencing routine symptomatic treatment failure. Transplantation of amniotic membrane (AM) with adherent stem cells (but not bare AM transplantation alone) has shown promise in preclinical studies for ocular surface restoration. A major limitation, however, is finding a reliable stem cell source. Stem cells can be isolated from the peripheral blood mononuclear cell (PBMC) population, and these PBMC-derived stem cells have numerous advantages over allogeneic and other autologous stem cell types for therapeutic application, including relative ease of acquisition, nonimmunogenicity, and the absence of ethical issues associated with embryonic stem cells. Experiment: We examined the efficacy of autologous PBMC-AM sheet cultures combined with postoperative antiangiogenesis treatment for corneal restoration in LSCD model rabbits. Rabbit PBMCs (rPBMCs) were isolated, labeled with EdU for in vivo tracing, and then cultured on AMs in conditioned medium before transplantation. Rabbits were transplanted with bare AMs (group 1), rPBMC-AM sheets (group 2), or rPBMC-AM sheets plus postoperative treatment with the vascular endothelial growth factor antagonist bevacizumab (group 3). Corneal opacity and neovascularization were monitored by slit-lamp imaging for 8 weeks and corneas were examined histologically at 1 and 2 months. Results: Corneal opacity decreased in all three groups over 8 weeks, but was significantly lower in group 2 and even lower in group 3. Corneal neovascularization was significantly higher in group 1 throughout the observation period, and significantly lower in group 3 than group 1 and 2 by 8 weeks post-transplant. At 4 weeks, the corneal surface completed epithelialization (although thinner than normal) in group 3 but still patchy in groups 1 and 2. By 8 weeks, the epithelium in group 3 was complete and smooth, resembling a normal epithelium. Integrin β1 as a progenitor marker was also generally higher in groups 2 and 3. Conclusions: Autologous rPBMC-AM sheets with post-transplant topical bevacizumab can effectively facilitate corneal epithelium recovery in a LSCD model, suggesting clinical utility for LSCD-related ocular surface diseases. Impact statement Limbal stem cell deficiency (LSCD) increases corneal opacity and vascularization, resulting in severe visual impairment or even blindness. Traditional surgical limbal transplant is currently the main treatment option for LSCD, but carries the risks of rejection and immunosuppressant side effects. Autologous stem cell-based therapy is a promising alternative approach, but a reliable stem cell source is a major limitation. We report that transplantation of autologous rabbit peripheral blood mononuclear cell-amniotic membrane sheets plus antivascular endothelial growth factor restored avascular transparent cornea in a rabbit LSCD model. These results demonstrate a potentially effective approach for ocular surface reconstruction in bilateral LSCD.

Effectiveness of Atorvastatin in the Treatment of Asymptomatic Heart Failure After Myocardial Infarction: A Clinical Study.

Silent heart failure after myocardial infarction has not been effectively treated. Atorvastatin has certain efficacy in the treatment of heart failure. Our clinical study aimed to investigate the effectiveness of atorvastatin in patients with asymptomatic heart failure after myocardial infarction. A total of 162 patients with asymptomatic heart failure after myocardial infarction in our hospital from August 2018 to August 2019 were randomly divided into the observation group (81 cases were treated with atorvastatin on the basis of routine therapy) and the control group (81 cases were treated with routine symptomatic treatment). The clinical curative effect, the level of related inflammatory cytokines, cardiac function index, and vascular endothelial function were compared between the two groups. Before intervention, there was no significant difference in tumor necrosis factor (TNFα), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasma N-terminal B-type natriuretic peptide (NT-ProBNP), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT), asymmetric dimethyarginine (ADMA), activity of nitric oxide synthase (NOS), nitric oxide (NO) and flow-mediated dilation (FMD) between the two groups. After intervention, TNFα, hs-CRP, IL-6, NT-ProBNP, LVEF, LVEDD, LVESD, LVPWT, ADMA, NOS, NO, and FMD were improved in both groups. The clinical curative effect, TNFα, hs-CRP, IL-6, NT-ProBNP, LVEF, LVEDD, LVESD, LVPWT, ADMA, NOS, NO, and FMD in the observation group showed significantly greater results than those in the control group (P < 0.05). Atorvastatin exerted a great effect in treating asymptomatic heart failure after myocardial infarction, which can evidently reduce the level of related inflammatory cytokines, improve cardiac function, and regulate vascular endothelial function. Hence, atorvastatin is considered a valid and alternative approach in clinical practice.

Influence of acupuncture combined with rehabilitation therapy on limb motor function and serum cAMP and cGMP in patients with hemiplegia of cerebral ischemic stroke

To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke. A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the yang aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the yin aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment (FMA) and the score of Chinese stroke scale (CSS) were recorded, the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups. After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment (P<0.01) and CSS score decreased as compared with that before treatment (P<0.01). After treatment, FMA score in the observation group was higher than that in the control group (P<0.01) and CSS score was lower than the control group (P<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment (P<0.01) and that of cGMP decreased as compared with that before treatment (P<0.01). After treatment, the level of cAMP in the observation group was higher than that in the control group (P<0.01) and that of cGMP was lower than the control group (P<0.01). The total effective rate was 93.3% (42/45) in the observation group, better than 73.3% (33/45) in the control group (P<0.01). The balance acupuncture therapy combined with exercise re-learning rehabilitation effectively improves the motor function of the affected limb, relieves injury and regulate the levels of serum cAMP and cGMP in the patients with hemiplegia of ischemic stroke.

Clinical efficacy of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis

Objective To observe clinical effect of Huxiang-Yangwei powder combined with conventional western medicine on gastric motility and gastrointestinal hormones in patients with chronic atrophic gastritis. Methods A total of 100 patients with chronic atrophic gastritis according to the inclusion criteria were randomly divided into the observation group and the control group, with 50 cases in each group. The control group was given routine symptomatic treatment. Based on the treatment of control group, the observation group was given Huxiang-Yangwei powder therapy. After 1 month, the gastroscope score, pathological tissue score, gastric motility index (gastric motility rhythm, gastroelectric rhythm and gastric antrum motility), and the improvement of plasma gastrointestinal hormone (MTL, GAS, SS) were compared. Results The total effective rate of the observation group was 92.0% (42/50), and the total effective rate of the control group was 78.0% (39/50), with statistically significant (Z=-2.978, P=0.003). After treatment, the under gastroscope score (0.59 ± 0.06 vs. 1.23 ± 0.17, t=4.877) and the pathological organization score (0.65 ± 0.08 vs. 1.33 ± 0.19, t=5.096) of the observation group were significantly lower than those of the control group (P<0.05). After treatment, the gastric motility rhythm (76.15% ± 8.77% vs. 62.35% ± 7.31%, t=5.301), gastroelectric rhythm (81.02% ± 9.23% vs. 73.02% ± 8.43%, t=5.286), gastric antral motility (0.012 ± 0.002 Ω vs. 0.008 ± 0.001 Ω, t=4.160) of the observation group were significantly higher than those of the control group (P<0.05). After treatment, the plasma MTL (246.73 ± 31.82 pg/ml vs. 203.86 ± 27.91 pg/ml, t=5.832), GAS (49.55 ± 6.25 pg/ml vs. 35.81 ± 4.63 pg/ml, t=5.126), SS (17.35 ± 2.76 pg/ml vs. 15.01 ± 2.60 pg/ml, t=4.970) of the observation group were significantly higher than those of the control group (P<0.05). Conclusions The application of Huxiang-Yangwei powder in the treatment of chronic atrophic gastritis patients can repair gastric mucosa, regulate gastrointestinal hormone levels and increase gastric motility. Key words: Gastritis, atrophic; Huxiang-Yangwei powder; Gastric emptying; Prokinetic drugs (TCD); Motilin; Plastering therapy

Deep acupuncture of Lianquan (CV23) and Yifeng (TE17) in combination with conventional acupuncture of other acupoints is superior to swallowing rehabilitation training in improving post-stroke dysphagia in apoplexy patients

To observe the therapeutic effect of acupuncture therapy in the treatment of dysphagia in apoplexy patients. A total of 104 patients with post-stroke dysphagia were randomized into a control (conventional swallowing rehabilitation training) group and an acupuncture group (n＝ 52 cases in each one). In the control group, the conventional swallowing rehabilitation training was conducted, twice daily, 6 times a week for 4 weeks. In the acupuncture group, deep needling of main acupoints Lianquan (CV23) and Yifeng (TE17), and conventional acupuncture of adjuvant acupoints as Fengchi (GB20) and Fengfu (GV16), Wangu (GB12), Lieque (LU7), Jinjin (EX-HN12), Yuye (EX-HN13), etc. as well as electroacupuncture stimulation (15－20 Hz, 5 mA, and duration of 30 min) of ipsilateral CV23-GV16, TE17-GB20, and bilateral Neidaying acupoints were conducted. The acupuncture treatment was given once daily, 6 times a week for consecutive 4 weeks. In addition, patients of the two groups also received routine symptomatic treatment with drugs for anti-platelet aggregation, nourishing cranial nerve, lowering blood pressure, controlling blood glucose, improving cerebral circulation, etc. Before and after the treatment, the standard swallowing assessment (SSA, 18－46 points) and Kubota water swallowing test (WST, 1－5 grades) were conducted to evaluate the patient's swallowing function. The comprehensive therapeutic effect was assessed in accordance with the SSA and Kubota WST, and adverse reactions were recorded. After the treatment, the SSA score was considerably reduced in the two groups relevant to their own pre-treatment (both P<0.05), and was significantly lower in the acupuncture group than in the control group (P<0.05). The Kubota WST grade was evidently increased in the number of patients with grade Ⅰ (P<0.05) and reduced in the numbers of patients with grade Ⅲ－Ⅴ in both groups relevant to their own pre-treatment, and was more patients with grade Ⅰ in the acupuncture group than in the control group (P<0.05). Outcomes of the comprehensive therapeutic effect indicated that of the two 52 cases in the control and acupuncture groups, 8 (15.38%) and 19 (36.53%) were cured, 7 (13.46%) and 15 (28.45%) had marked improvement, 17 (32.69%) and 12 (23.08%) were effective, and 20 (38.46%) and 6 (11.54%) failed in the treatment, with the effective rate being 61.54% and 88.46%, respectively. The total effective rate of the acupuncture group was significantly higher than that of the control group (P<0.05). The adverse reactions such as regional hematoma (in 3 cases) and pain (in 2 cases) in the acupuncture group, and choking-coughing in the control group were seen, being 9.62% and 11.54% in the incidence rate, respectively. Deep needling of main acupoints Lianquan (CV23) and Yifeng (TE 17) in combination with conventional acupuncture of other acupoints is effective in improving local glossopharyngeal function in apoplexy patients with dysphagia, which is obviously superior to conventional swallowing rehabilitation training in the therapeutic effect and is applicable in clinical practice.

Effect of baicalin on renal function in patients with diabetic nephropathy and its therapeutic mechanism.

The present study observed the effect of baicalin on blood glucose and renal function in patients with diabetic nephropathy and explored its mechanism of action. A total of 95 patients diagnosed with diabetic nephropathy by clinical and laboratory examinations were selected and randomly divided into a control and treatment group. The control group included 45 patients who were treated with routine symptomatic treatment. The remaining 50 patients in the treatment group received baicalin, in addition to routine symptomatic treatment. The treatment course was 6 months. Following this, the changes of indicators such as fasting plasma glucose (FPG), glycosylated hemoglobin (HBA1c), aldose reductase (AR) activity, 24-h urinary microalbumin, urinary β2-microglobulin (β2-MG) and urinary albumin excretion rate (UAER) were compared before and after treatment; at the same time, the variations of indexes, including superoxide dismutase (SOD), glutathione peroxidase (GSH-px), nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) were detected. Compared with those in the control group, baicalin had little effect on the treatment group's FPG and HBA1c, but it clearly reduced the AR activity and the difference was significant (P<0.05). Baicalin visibly decreased the 24-h urinary microalbumin, urinary β2-MG and UAER (P<0.05) and had notable effect on improving renal function. Following treatment, compared with those in the control group, baicalin distinctly increased the levels of SOD and GSH-px (P<0.05) and decreased the content of NF-κB and VEGF (P<0.05), however, its impact on the expression of TGF-β1 was not statistically significant (P>0.05). The results showed that baicalin may improve the renal function in patients with diabetic nephropathy and delay the progression of diabetic nephropathy through various ways, including anti-inflammation and anti-oxidation.

Systematic review of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease

To evaluate the inflammatory factors, the pulmonary function, the efficiency and the safety of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The randomized controlled trials (RCTs) on Chuankezhi injection for treating AECOPD were collected from 7 databases (PubMed, CNKI, et al) between inception to November 2016. Two reviewers independently screened literature and extracted the data according to the inclusion and exclusion criteria, and assessed methodological quality of included studies according to the criteria from Cochrane Reviewer's Handbook 5.3. Then, Meta-analysis was conducted by using RevMan 5.3 software. A total of 13 RCTs involving 1 016 patients were included. Meta-analysis results indicated that Chuankezhi group was superior to the control group in the clinical effectiveness [RR=1.15, 95% CI(1.06, 1.23), P=0.000 3], improved pulmonary functions including forced expiratory volume in one second (FEV1) [MD=0.21, 95% CI (0.15, 0.27), P<0.000 01], forced vital capacity (FVC) [MD=0.36, 95% CI（0.15, 0.56）, P=0.000 6], the first seconds breathing volume percentage of forced vital capacity (FEV1/FVC) [MD=6.85, 95% CI（4.68, 9.02）, P<0.000 01] and decreased the level of inflammatory factors including interleukin-6 (IL-6) [MD=-6.35, 95% CI (-8.23, -4.47), P<0.000 01], IL-8 [MD = -2.00, 95% CI ( -3.13, 0.87), P=0.000 5], tumor necrosis factor-α (TNF-α) [ MD=-2.79, 95% CI (-4.61,-0.97), P=0.003]. Besides, there were no frequently happened or serious adverse reactions observed in Chuankezhi group. The results showed that Chuankezhi injection could improve the efficiency and the pulmonary function, reduce inflammation for AECOPD with a high safety on the basis of routine symptomatic treatment. However, due to limited quantity and quality of the included studies, the conclusion above should be further verified by conducting more high quality RCTs.

The clinical efficacy of nicergoline combined with donepezil hydrochloride in the treatment of mild vascular de-mentia and its influence on cognitive function

Objective To investigate the clinical efficacy of nicergoline combined with donepezil hydrochloride in the treatment of mild vascular dementia and its influence on cognitive function. Methods 66 patients with mild vascular dementia from neurology were divided into two groups by random numbers,33 cases in each group.On the based of the routine symptomatic treatment,the control group were given nicergoline,the observation group were treated with nicergoline combined with aricept.Four weeks was a course,both groups were continuously treated for 3 courses. Results The MMSE scores of the observation group after treatment was(36.7±5.7)points,which was significantly increased compared with before treatment(t=10.137,P<0.05)and the control group(t=11.236,P<0.05);The ADL score was(35.8±16.2)points,which was significantly lower compared with before treatment(t=10.825,P<0. 05)and the control group(t=11.415,P<0.05);The total effective rate of the observation group was 78.9%,which was higher than 54.5%of the control group(χ2=9.24,P<0.05). Conclusion Nicergoline combined with donepezil hydrochloride in the treatment of mild vascular dementia can significantly improve cognitive function scores,and it is a significant effect,safe and reliable method. Key words: Nicergoline; Donepezil Hydrochloride; Dementia,Vascular; Cognitive

Clinical curative effect observation of Juan-tong decoction hot compressing on Shoulder hand syndrome after stroke

Objective: To observe the clinical effect of Juan-tong decoction hot compressing on Shoulder hand syndrome after stroke. Methods: Sixty selected cases were randomly divided into treatment group of 30 patients and control group of 30 patients．The cases in control group were treated with routine symptomatic treatment，and the ones in treatment group were treated with Juan-tong decoction hot compressing on the basis of above treatment．At last the curative effects were observed． Results: In treatment group 17 cases were recovered，10 cases effective，3 cases ineffective． The total effective rate was 90.00% . In control group 10 cases were recovered,12 cases effective，and 8 cases ineffective．The total effective rate was 73.33%.There was significant difference between the two groups. Conclusion: Juan-tong decoction hot compressing combined with routine symptomatic treatment has better effect on Shoulder hand syndrome after stroke compared to onlyroutine symptomatic treatment．

The clinical effectiveness of oseltamivir in mild cases of pandemic influenza A H1N1 2009 infection

Oseltamivir is widely used for the treatment of influenza infection, but data on its effectiveness in treating infections with pandemic influenza A H1N1 2009 are scarce. Therefore, we compared the effectiveness of oseltamivir and routine symptomatic treatment in pandemic influenza A H1N1 2009 infection. Between August and October 2009, among laboratory confirmed influenza cases who were aged over 15 y with no underlying disease, 90 patients with oseltamivir treatment and 72 patients with symptomatic treatment were evaluated by telephone interviews to compare clinical outcomes. No patient was hospitalized. The primary end-point was the duration of illness. We also assessed the time to attain a sense of well-being and the time to return to normal activity. There was no statistically significant difference in the duration of illness between the oseltamivir-treated group and the symptomatic treatment group (mean duration after the start of treatment, 6.50 ± 3.75 days vs 7.04 ± 3.75 days). There was also no statistically significant difference between the 2 groups in the time to a sense of well-being (1.70 ± 1.57 days vs 2.00 ± 2.12 days) and to return to normal activity (7.13 ± 2.61 days vs 7.58 ± 2.71 days). The complication rate was very low (only 2 cases of mild pneumonia in oseltamivir recipients) and no significant difference was found between the 2 groups (p = 0.50). Oral oseltamivir treatment does not significantly reduce the duration of illness or influenza-related complications in mild pandemic influenza A H1N1 2009 virus infection in previously healthy adults.

Benefits of urea-molasses block supplementation and symptomatic and tactical anthelmintic treatments of communally grazed indigenous goats in the Bulwer area, KwaZulu-Natal Province, South Africa

This study was carried out with the cooperation of farmers owning communally grazed indigenous goats in southwestern KwaZulu-Natal Province, South Africa, where farmers had identified poor reproductive performance in their herds as one of their major problems. The aim was to quantify the effects of 3 interventions and the interaction between these interventions on goat productivity and gastrointestinal nematode infection. The interventions were: urea-molasses block supplementation during the dry winter seasons of 2004 and 2005, tactical anthelmintic treatment with ivermectin (400 microg/kg) during the wet summer period (on 3 January 2005) and symptomatic treatment with ivermectin (400 microg/kg) of all goats judged anaemic throughout the entire study period. The FAMACHA system was used as a gauge of anaemia. It was noted that goats considered anaemic tended to remain so throughout the study period. The tactical anthelmintic treatment was effective as it markedly reduced (P = 0.066) the summer peak in faecal egg counts and is therefore recommended. By contrast, while the urea-molasses block supplementation appeared to reduce the faecal egg counts immediately following the 2004 supplementation (P < 0.05), this did not hold true in 2005. Interestingly, in the tactically treated anaemic goats, the improvement in the number of kids suckled per doe year-on-year tended to be greater than in the non-anaemic goats. It is considered that the routine symptomatic treatment of anaemic goats may have been a key factor. More detailed investigations into the routine symptomatic treatment of anaemic goats are therefore recommended.