Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

BACKGROUND Stroke is a common and frequently occurring disease of the nervous system and one of the three major diseases leading to human death.The incidence and mortality of stroke in China increase with age.Overall,70%of patients with stroke have serious disability,which results in heavy burden to their families and the society.AIM To analyze the effects of Qixue Shuangbu decoction and acupuncture combined with Western medicine on immune indexes and digestive tract function in patients with acute severe stroke.METHODS A total of 68 patients with acute severe stroke admitted to Lanzhou Second People’s Hospital between March 2018 and September 2021 were selected and divided into the control and observation groups according to a random number table method.The control group was administered routine Western medicine treatment,such as dehydration,lowering intracranial pressure,anticoagulation,improving cerebral blood circulation and cerebral nerve protection according to the“Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China.”The observation group was administered Qixue Shuangbu decoction via nasal feeding tube on the basis of the routine Western medicine treatment with simultaneous acupuncture.The two groups were compared.RESULTS The acute physiology and chronic health evaluation II,organ dysfunction syndrome score,National Institutes of Health Stroke Scale,and traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with those measured before treatment,and the complements C3 and C4,and immunoglobulins(Ig)M and G were significantly increased compared with those observed before treatment(P<0.05).After treatment,the scores of the observation group were lower than those of the control group,and the complement and Ig levels were higher than those of the control group(P<0.05).The levels of diamine oxidase(DAO),Dlactic acid(D-LA),and calcitonin gene-related peptide(CGRP)in the two groups were significantly higher than those before treatment,while the levels of lipopolysaccharide,ubiquitin carboxyl-terminal hydrolase 1(UCH-L1),tumor necrosis factor-α(TNF-α),interleukin(IL)-2,and IL-8 were significantly lower than those before treatment(P<0.05).After treatment,DAO,D-LA,and CGRP were higher in the observation group than in the control group,while lipopolysaccharide,UCH-L1,TNF-α,IL-2,and IL-8 were lower than in the control group(P<0.05).The hospitalization time of individuals in the observation group was shorter than that of the control group(P<0.05).CONCLUSION Qixue Shuangbu decoction and acupuncture combined with Western medicine for the treatment of acute severe stroke can regulate intestinal flora,reduce inflammation,improve intestinal mucosal barrier function and immune function related indicators,and promote recovery.

Severe liver injury by heat stroke: analysis of 10 cases

Objective: To analyse the clinical features and prognosisof liver injury caused by heat stroke.Methods: The clinical data of 10 patients with severe liverinjury caused by heat stroke were analysed retrospective-ly.Results: In 4 patients the level of ALT was over 1000 U/L, in 3 patients ranged from 300 to 1000 U/L, and in 3patients 50-300 U/L. The level of TBIL in 2 patientswas over 400 μmol/L and in 5 varied from 20 to 75μmol/L. Two patients showed jaundice and petechia on

Definition,prediction,prevention and management of patients with severe ischemic stroke and large infarction

Severe ischemic stroke carries a high rate of disability and death.The severity of stroke is often assessed by the degree of neurological deficits or the extent of brain infarct,defined as severe stroke and large infarction,respectively.Critically severe stroke is a life-threatening condition that requires neurocritical care or neurosurgical intervention,which includes stroke with malignant brain edema,a leading cause of death during the acute phase,and stroke with severe complications of other vital systems.Early prediction of high-risk patients with critically severe stroke would inform early prevention and treatment to interrupt the malignant course to fatal status.Selected patients with severe stroke could benefit from intravenous thrombolysis and endovascular treatment in improving functional outcome.There is insufficient evidence to inform dual antiplatelet therapy and the timing of anticoagulation initiation after severe stroke.Decompressive hemicraniectomy(DHC)<48 h improves survival in patients aged<60 years with large hemispheric infarction.Studies are ongoing to provide evidence to inform more precise prediction of malignant brain edema,optimal indications for acute reperfusion therapies and neurosurgery,and the individualized management of complications and secondary prevention.We present an evidence-based review for severe ischemic stroke,with the aims of proposing operational definitions,emphasizing the importance of early prediction and prevention of the evolution to critically severe status,summarizing specialized treatment for severe stroke,and proposing directions for future research.