What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,oc...What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,occurred with an accelerated episode of cough,productive sputum and a dropping down to 86%in SatO₂due to a cold weather.A diagnosis of pulmonary encephalopathy(PE)was made on the basis of the subsequent agitation and delirium,and the sedatives,such as quatiepine and haloperidol,had to be given for her mental excitation respectively,but she still pulled out indwelling needle herself and refused to any infusion therapy.As an alternative,a vaporized therapy integrated with tea herb drinking had to be applied to relieving her agitation,being designed as the vaporization of the inhaled oxygenation by means of high-flow oxygenation device(HFOD),with an ampoule of ambroxol mixed into the inhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles when being infected.We thought that a better efficacy would be achieved for hypercapnic encephalopathy due to AECOPD if we concentrate on a good ventilation of small airway through the vaporized therapy.展开更多
Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(S...Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(SFHT)and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019(COVID-19).Methods:This case-control study was conducted at shelter hospitals and quarantine hotels in China.A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31,2022,while 2190 uninfected individuals served as healthy controls.Structured questionnaires were used to collect data on demographics,underlying diseases,vaccination status,and use of SFHT.Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score.Subsequently,a conditional logistic regression model was used for data analysis.Results:Overall,7538 eligible subjects were recruited,with an average age of[45.54±16.94]years.The age of COVID-19 patients was significantly higher than that of uninfected individuals([48.25±17.48]years vs[38.92±13.41]years;t=22.437,P<0.001).A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio.The use of SFHT(odds ratio=0.753,95%confidence interval:0.692,0.820)was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.Conclusion:Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection.This is a useful study in the larger picture of COVID-19 management,but data from large-sample multi-center,randomized clinical trial are warranted to confirm the finding.展开更多
Objective: To study the effect and mechanism of mexican tea herb and pilular adina herb (abbreviated to MP) on concrescence of gastric mucosa in experimental gastric ulcer rats by observing the changes of epidermal...Objective: To study the effect and mechanism of mexican tea herb and pilular adina herb (abbreviated to MP) on concrescence of gastric mucosa in experimental gastric ulcer rats by observing the changes of epidermal growth factor (EGF), nitrogen monoxidum (NO) and expression of epidermal growth factor receptor (EGFR). Methods: The rat ulcer model was established by 100% glacial acetic injection into the subserosa. The ulcer index (UI) was measured by sliding caliper. The levels of NO and EGF in tissue and serum were measured by the nitrate reductase method and enzyme-linked immunosorbent assay, respectively. The expression of EGFR in the mucosa around the ulcer was detected by the immunohistochemical assay and microimage analysis system. Results: (1) Compared with the model group, UI of MP groups (10, 15 and 20 mg·kg^-1·d^-1) and ranitidine group was lower (P〈0.05 or P〈0.01), the levels of NO and EGF in the tissue and serum were higher (P〈0.05), the thickness of regenerated mucous membrane increased, and the width loss of lamina muscularis mucosa decreased (all P〈0.05). (2) The expression of EGFR is weakly positive in gastric mucosa cells in the normal group, mainly in the cytoplasm and cytomembrane. In the model group, the expression of EGFR was mainly in epithelial cells in cervical part and basilar part of gastric gland around the ulcer margin, and the number of cells with EGFR weakly positive expression was more than that in the normal group. Compared with that in the normal and model groups, the number of cells with EGFR positive in MP groups and ranitidine group increased (all P〈0.05), with weakly positive expression. Conclusion: MP can protect gastric mucosa, cure gastric ulcer, restrain the secretion of gastric acid, and boost multiplication, differentiation, migration and repair of the endothelial cell by promoting the secretion of NO and EGF, and increasing the expression of EGFR of gastric mucosa epithelial cells.展开更多
文摘What methods would you choose apart from increasing sedatives for agitation in an advanced patient with hypercapnic encephalopathy due to AECOPD?This is a 94-year-old female who suffered from COPD for over 30 years,occurred with an accelerated episode of cough,productive sputum and a dropping down to 86%in SatO₂due to a cold weather.A diagnosis of pulmonary encephalopathy(PE)was made on the basis of the subsequent agitation and delirium,and the sedatives,such as quatiepine and haloperidol,had to be given for her mental excitation respectively,but she still pulled out indwelling needle herself and refused to any infusion therapy.As an alternative,a vaporized therapy integrated with tea herb drinking had to be applied to relieving her agitation,being designed as the vaporization of the inhaled oxygenation by means of high-flow oxygenation device(HFOD),with an ampoule of ambroxol mixed into the inhaler and simultaneous drinking of TCM tea herb for reducing sputum,helping dissolve the mucoid bolts inside her terminal bronchioles when being infected.We thought that a better efficacy would be achieved for hypercapnic encephalopathy due to AECOPD if we concentrate on a good ventilation of small airway through the vaporized therapy.
基金supported by the fund of COVID-19 Prevention and Treatment from Administration of Traditional Chinese Medicine (No. XGYJKY2022-09 and No. 2022ZYLCYJ05-10)the Threeyear Action Plan for Promoting Clinical Skills and Innovation Ability of Municipal Hospitals (No. SHDC2022CRS039)+2 种基金the Shanghai Natural Science Foundation (No.23ZR1464000 and No.23ZR1463900)Medical Innovation Research Special Project of the Shanghai ‘‘Science and Technology Innovation Action Plan”(No.21Y11922500 and No.21Y11922400)the Talent Fund of Longhua Hospital (No. LH001.007)
文摘Objective:Omicron,a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant,is responsible for numerous infections in China.This study investigates the association between the use of Seven-Flavor Herb Tea(SFHT)and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019(COVID-19).Methods:This case-control study was conducted at shelter hospitals and quarantine hotels in China.A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31,2022,while 2190 uninfected individuals served as healthy controls.Structured questionnaires were used to collect data on demographics,underlying diseases,vaccination status,and use of SFHT.Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score.Subsequently,a conditional logistic regression model was used for data analysis.Results:Overall,7538 eligible subjects were recruited,with an average age of[45.54±16.94]years.The age of COVID-19 patients was significantly higher than that of uninfected individuals([48.25±17.48]years vs[38.92±13.41]years;t=22.437,P<0.001).A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio.The use of SFHT(odds ratio=0.753,95%confidence interval:0.692,0.820)was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.Conclusion:Our findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection.This is a useful study in the larger picture of COVID-19 management,but data from large-sample multi-center,randomized clinical trial are warranted to confirm the finding.
文摘Objective: To study the effect and mechanism of mexican tea herb and pilular adina herb (abbreviated to MP) on concrescence of gastric mucosa in experimental gastric ulcer rats by observing the changes of epidermal growth factor (EGF), nitrogen monoxidum (NO) and expression of epidermal growth factor receptor (EGFR). Methods: The rat ulcer model was established by 100% glacial acetic injection into the subserosa. The ulcer index (UI) was measured by sliding caliper. The levels of NO and EGF in tissue and serum were measured by the nitrate reductase method and enzyme-linked immunosorbent assay, respectively. The expression of EGFR in the mucosa around the ulcer was detected by the immunohistochemical assay and microimage analysis system. Results: (1) Compared with the model group, UI of MP groups (10, 15 and 20 mg·kg^-1·d^-1) and ranitidine group was lower (P〈0.05 or P〈0.01), the levels of NO and EGF in the tissue and serum were higher (P〈0.05), the thickness of regenerated mucous membrane increased, and the width loss of lamina muscularis mucosa decreased (all P〈0.05). (2) The expression of EGFR is weakly positive in gastric mucosa cells in the normal group, mainly in the cytoplasm and cytomembrane. In the model group, the expression of EGFR was mainly in epithelial cells in cervical part and basilar part of gastric gland around the ulcer margin, and the number of cells with EGFR weakly positive expression was more than that in the normal group. Compared with that in the normal and model groups, the number of cells with EGFR positive in MP groups and ranitidine group increased (all P〈0.05), with weakly positive expression. Conclusion: MP can protect gastric mucosa, cure gastric ulcer, restrain the secretion of gastric acid, and boost multiplication, differentiation, migration and repair of the endothelial cell by promoting the secretion of NO and EGF, and increasing the expression of EGFR of gastric mucosa epithelial cells.