Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services ...Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.展开更多
Background:The prevalence,morbidity and mortality of chronic obstructive pulmonary disease(COPD)is very high,so it has become a public health problem.The early stage of COPD has been paid much attention before it deve...Background:The prevalence,morbidity and mortality of chronic obstructive pulmonary disease(COPD)is very high,so it has become a public health problem.The early stage of COPD has been paid much attention before it develops severely.As well,traditional Chinese medicine has some advantages in relieving symptoms and reducing the incidence of COPD exacerbations.Methods:A practical randomized controlled trial will be designed to test the clinical effects of traditional Chinese medicine treatment according to syndrome differentiation.A total of 80 patients with mild/moderate COPD will participate in this study,40 in the treatment group and 40 in the control group.On the basis of the lifestyle intervention,traditional Chinese medicine formula granules for treatment group and the placebo simulation of traditional Chinese medicine granules for control group.The exacerbation and the improvement of pulmonary function will be used as the primary outcome measures.The improvement of clinical symptoms and signs,the quality of life and Dyspnea will be used as the secondary outcomes measures.Conclusion:We assume that the COPD patients will be benefit from therapy with Traditional Chinese medicine treatment.展开更多
OBJECTIVE:The theory of lung being connected with large intestine,which is a major topic in Traditional Chinese Medicine(TCM),has guided clinical practice for thousands of years in China.METHODS:In this study,we analy...OBJECTIVE:The theory of lung being connected with large intestine,which is a major topic in Traditional Chinese Medicine(TCM),has guided clinical practice for thousands of years in China.METHODS:In this study,we analyzed the history,main contents,clinical application,and material basis of the theory,to attempt to improve the potential clinical significance of "lung being connected with large intestine" in China.RESULTS:The lung being connected with large intestine was first described in "Huang Di Nei Jing",and formed one of the basic theories of TCM.For thousands of years,the majority of TCM practitioners explored this theory continuously,leading to its development and use as an important theory in the guidance of TCM clinics In the last decade,researchers in the field of integrated TCM and Western medicine have studied clinical applications and biomedical mechanisms with experimental methods to explore the implications of the theory.CONCLUSION:With the further development of science and technology,research concerning the theory of lung being connected with large intestine will be greatly stimulated and contribute to the modernization of TCM.展开更多
OBJECTIVE: To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate progno...OBJECTIVE: To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate prognostic factors. METHODS: We selected 98 inpatients with middle-late stage NSCLC diagnosed from March 2009 to March 2011 and randomly divided them into two groups, with 49 cases in each group, and the clinical data were analyzed retrospectively.The control group was treated by the combined methods of Western Medicine, including chemotherapy, supportive treatment and symptomatic treatment. The observation group was treated by injection and prescriptions of Chinese medicine based on Traditional Chinese Medicine syndrome differentiation and by the same combined methods of western treatment used in the control group. After treatment, the survival rates of the patients were compared by the stage of cancer and evaluation of 24 prognostic factors analyzed by a Cox regressionmodel, and the clinical data were statistically analyzed. RESULTS: The survival rates of all patients were over 90.0% at 1 and 3 months after treatment with no significant differences between the two groups (P>0.05); In the observation group the survival rates at 6 months and 1 year were 93.4% and 42.8%, respectively, being superior to 85.6% and 18.3% in the control group (P<0.05). The median survival time in the observation group was superior to the control group (P<0.05); The effects of 24 prognostic factors were significantly better in the observation group than in the control group (P<0.05). CONCLUSION: Integrated Chinese-western therapy can significantly improve the survival rate in patients with middle-late stage NSCLC and improve prognostic factors compared with western therapy alone.展开更多
Background Successful lung transplantation has been limited by the scarcity of donors. Brain death （BD） donors are major source of lung transplantation. Whereas BD process induces acute lung injury and aggravates lu...Background Successful lung transplantation has been limited by the scarcity of donors. Brain death （BD） donors are major source of lung transplantation. Whereas BD process induces acute lung injury and aggravates lung ischemia reperfusion injury. Carbon monoxide （CO） inhalation at 50-500 parts per million （ppm） can ameliorate lung injury in several models. We examined in rats whether CO inhalation in BD donor would show favorable effects on lung grafts. Methods Rats were randomly divided into 4 groups. In sham group, donor rats received insertion of a balloon catheter into the cranial cavity, but the balloon was not inflated. In BD-only group, donor rats were ventilated with 40% oxygen after BD confirmation. In BD＋CO250 and BD＋CO500 groups, donor rats inhaled, after BD confirmation, 250 ppm or 500 ppm CO for 120 minutes prior to lung procurement, and orthotopic lung transplantation was performed. The rats were sacrificed 120 minutes after the lung transplantation by exsanguination, and their blood and lung graft samples were obtained. A total of 8 rats fulfilling the criteria were included in each group. Results The inhalation decreased the severity of lung injury in grafts from BD donors checked by histological examination. CO pretreatment reversed the aggravation of PaO2/FiO2 in recipients from BD donors. The CO inhalation down-regulated pro-inflammatory cytokines （TNF-α, IL-6） along with the increase of anti-inflammatory cytokine （IL-10） in recipient serum, and inhibited the activity of myeloperoxidase in grafts tissue. The inhalation significantly decreased cell apoptosis in lung grafts, inhibiting mRNA and protein expression of intercellular adhesion molecule-1 （ICAM-1） and caspase-3 in lung grafts. Further, the inhalation activated phosphorylation of p38 expression and inhibited phosphorylation of anti-extracellular signal-regulated kinase （ERK） expression in lung grafts. The effects of CO at 500 ppm were greater than those at 250 ppm. Conclusions CO exerts potent protective effects on lung grafts from BD donor, exhibiting anti-inflammatory and anti-apoptosis functions by modulating the mitogen-activated protein kinase （MAPK） signal transduction.展开更多
OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and ...OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and meta-analysis. METHODS： The literatures concerning randomized controlled trials （RCTs） and quasi-RCTs comparing TCM treatment plus Western Medicine （WM） treat- ment with TCM alone, orTCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed （1990-December 2010）, in Eng- lish and using Chinese National Knowledge Infra- structure （CNKI, 1990-December 2010）, Chinese Bio- medical Database （1990-December 2010）, Wang- fang Database （1990-December 2010）, and Weipu （VlP） Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allo-cation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration＇s Revman 5.0 software. RESULTS： Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial （Jadad score=4）. In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [0R=3.82, 95%C/（2.45, 5.95）], and the effective rate between TCM treatment and placebo also had significant difference [0R=4.31, 95%C/（2.35, 7.91）]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity （FVC）, P=O.01, quali- ty of life, P〈O.O01 ]. CONCLUSION： The experience in TCM-WM treat- ment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treat- ment might be more efficient in effective rate, qual- ity of life, and FVC than WM treatment alone. But for forced expiratory volume in one second （FEVl） and FEV1/FVC, no matter TCM-WM treatment com- pared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials includ- ed, more RCTs of high quality in large scale are re- quired.展开更多
Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not be...Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been de- scribed in English language-based medical literature. Pri- mary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted ingood clinical outcome in our patient. At 18 months follow- up, no signs of avascular necrosis of the femoral head or infection were observed.展开更多
文摘Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.
文摘Background:The prevalence,morbidity and mortality of chronic obstructive pulmonary disease(COPD)is very high,so it has become a public health problem.The early stage of COPD has been paid much attention before it develops severely.As well,traditional Chinese medicine has some advantages in relieving symptoms and reducing the incidence of COPD exacerbations.Methods:A practical randomized controlled trial will be designed to test the clinical effects of traditional Chinese medicine treatment according to syndrome differentiation.A total of 80 patients with mild/moderate COPD will participate in this study,40 in the treatment group and 40 in the control group.On the basis of the lifestyle intervention,traditional Chinese medicine formula granules for treatment group and the placebo simulation of traditional Chinese medicine granules for control group.The exacerbation and the improvement of pulmonary function will be used as the primary outcome measures.The improvement of clinical symptoms and signs,the quality of life and Dyspnea will be used as the secondary outcomes measures.Conclusion:We assume that the COPD patients will be benefit from therapy with Traditional Chinese medicine treatment.
基金Supported by The National Basic Research Program of China(973 Program)(2009CB522707)the Distinguished Young Scholars Project from the Education Department of Hubei Province(Q20101081)the Science Fund for Distinguished Young Scholars of Wuhan City(D201050231081)
文摘OBJECTIVE:The theory of lung being connected with large intestine,which is a major topic in Traditional Chinese Medicine(TCM),has guided clinical practice for thousands of years in China.METHODS:In this study,we analyzed the history,main contents,clinical application,and material basis of the theory,to attempt to improve the potential clinical significance of "lung being connected with large intestine" in China.RESULTS:The lung being connected with large intestine was first described in "Huang Di Nei Jing",and formed one of the basic theories of TCM.For thousands of years,the majority of TCM practitioners explored this theory continuously,leading to its development and use as an important theory in the guidance of TCM clinics In the last decade,researchers in the field of integrated TCM and Western medicine have studied clinical applications and biomedical mechanisms with experimental methods to explore the implications of the theory.CONCLUSION:With the further development of science and technology,research concerning the theory of lung being connected with large intestine will be greatly stimulated and contribute to the modernization of TCM.
文摘OBJECTIVE: To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate prognostic factors. METHODS: We selected 98 inpatients with middle-late stage NSCLC diagnosed from March 2009 to March 2011 and randomly divided them into two groups, with 49 cases in each group, and the clinical data were analyzed retrospectively.The control group was treated by the combined methods of Western Medicine, including chemotherapy, supportive treatment and symptomatic treatment. The observation group was treated by injection and prescriptions of Chinese medicine based on Traditional Chinese Medicine syndrome differentiation and by the same combined methods of western treatment used in the control group. After treatment, the survival rates of the patients were compared by the stage of cancer and evaluation of 24 prognostic factors analyzed by a Cox regressionmodel, and the clinical data were statistically analyzed. RESULTS: The survival rates of all patients were over 90.0% at 1 and 3 months after treatment with no significant differences between the two groups (P>0.05); In the observation group the survival rates at 6 months and 1 year were 93.4% and 42.8%, respectively, being superior to 85.6% and 18.3% in the control group (P<0.05). The median survival time in the observation group was superior to the control group (P<0.05); The effects of 24 prognostic factors were significantly better in the observation group than in the control group (P<0.05). CONCLUSION: Integrated Chinese-western therapy can significantly improve the survival rate in patients with middle-late stage NSCLC and improve prognostic factors compared with western therapy alone.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30571784）.Acknowledgements： The authors are grateful to JIN Di and GUO Yue-ping for their support and technical assistance, and professor Tsutomu Kobayashi for reviewing the manuscript.
文摘Background Successful lung transplantation has been limited by the scarcity of donors. Brain death （BD） donors are major source of lung transplantation. Whereas BD process induces acute lung injury and aggravates lung ischemia reperfusion injury. Carbon monoxide （CO） inhalation at 50-500 parts per million （ppm） can ameliorate lung injury in several models. We examined in rats whether CO inhalation in BD donor would show favorable effects on lung grafts. Methods Rats were randomly divided into 4 groups. In sham group, donor rats received insertion of a balloon catheter into the cranial cavity, but the balloon was not inflated. In BD-only group, donor rats were ventilated with 40% oxygen after BD confirmation. In BD＋CO250 and BD＋CO500 groups, donor rats inhaled, after BD confirmation, 250 ppm or 500 ppm CO for 120 minutes prior to lung procurement, and orthotopic lung transplantation was performed. The rats were sacrificed 120 minutes after the lung transplantation by exsanguination, and their blood and lung graft samples were obtained. A total of 8 rats fulfilling the criteria were included in each group. Results The inhalation decreased the severity of lung injury in grafts from BD donors checked by histological examination. CO pretreatment reversed the aggravation of PaO2/FiO2 in recipients from BD donors. The CO inhalation down-regulated pro-inflammatory cytokines （TNF-α, IL-6） along with the increase of anti-inflammatory cytokine （IL-10） in recipient serum, and inhibited the activity of myeloperoxidase in grafts tissue. The inhalation significantly decreased cell apoptosis in lung grafts, inhibiting mRNA and protein expression of intercellular adhesion molecule-1 （ICAM-1） and caspase-3 in lung grafts. Further, the inhalation activated phosphorylation of p38 expression and inhibited phosphorylation of anti-extracellular signal-regulated kinase （ERK） expression in lung grafts. The effects of CO at 500 ppm were greater than those at 250 ppm. Conclusions CO exerts potent protective effects on lung grafts from BD donor, exhibiting anti-inflammatory and anti-apoptosis functions by modulating the mitogen-activated protein kinase （MAPK） signal transduction.
基金Supported by Program for Changjiang Scholars and Innovative Research Team in University, Ministry of Education ofChina (NO. IRT0977)
文摘OBJECTIVE： To evaluate the efficacy of Jianpi thera- py in Traditional Chinese Medicine （TCM） for treat- ment of chronic obstructive pulmonary disease （COPD） in stable phase by performing a systematic review and meta-analysis. METHODS： The literatures concerning randomized controlled trials （RCTs） and quasi-RCTs comparing TCM treatment plus Western Medicine （WM） treat- ment with TCM alone, orTCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed （1990-December 2010）, in Eng- lish and using Chinese National Knowledge Infra- structure （CNKI, 1990-December 2010）, Chinese Bio- medical Database （1990-December 2010）, Wang- fang Database （1990-December 2010）, and Weipu （VlP） Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allo-cation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration＇s Revman 5.0 software. RESULTS： Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial （Jadad score=4）. In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [0R=3.82, 95%C/（2.45, 5.95）], and the effective rate between TCM treatment and placebo also had significant difference [0R=4.31, 95%C/（2.35, 7.91）]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity （FVC）, P=O.01, quali- ty of life, P〈O.O01 ]. CONCLUSION： The experience in TCM-WM treat- ment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treat- ment might be more efficient in effective rate, qual- ity of life, and FVC than WM treatment alone. But for forced expiratory volume in one second （FEVl） and FEV1/FVC, no matter TCM-WM treatment com- pared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials includ- ed, more RCTs of high quality in large scale are re- quired.
文摘Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been de- scribed in English language-based medical literature. Pri- mary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted ingood clinical outcome in our patient. At 18 months follow- up, no signs of avascular necrosis of the femoral head or infection were observed.
