Effect of Xiaoyu Zhixue Tablet (消瘀止血片) on the expression of platelet membrane glycoprotein I b/IX/V complex in patients with chronic renal failure

ABSTRACT Objective： To investigate the effect of Xiaoyu Zhixue Tablet （消瘀止血片, XYZXT） on the expression of platelet membrane glycoprotein （GP） Ⅰ b/Ⅸ/Ⅴ complex and GP Ⅰ b α in patients with chronic renal failure （CRF） in early metaphase. Methods： Fifty-one patients with CRF in early metaphase （treated group） were treated with XYZXT, 3 months as the course of treatment for 2 courses. The previous therapies remained unchanged. Flow cytometry was used to assess the expression of platelet GP Ⅰb/Ⅸ/Ⅴ complex and GP Ⅰb α in patients with CRF, and turbidity method was used to determine the platelet maximum aggregation rate （MAR）, meanwhile the renal function was measured. The final data were compared with those before the treatment, and with those in the normal control group （31 healthy subjects）. Results： Compared with the normal control group, expressions of GP Ⅰ b/Ⅸ/Ⅴ complex and GPⅠb α, and platelet MAR in CRF patients were significantly lower （P=0.007,P=0.001,P=0.009） before the treatment; after the treatment with XYZXT, the above indexes in CRF patients were remarkably increased （P=0.033,P=0.026, P=0.045）, but still lower than those in the normal control group, however, it was not statistically significant. Conclusion： （1） The expression of GP Ⅰ b/Ⅸ/Ⅴ complex in CRF patients of early metaphase was decreased, which lead to platelet aggregation dysfunction. This might be one of the reasons for the hemorrhagic trend in CRF. （2） XYZXT was able to upgrade expressions of GP Ⅰb/Ⅸ/Ⅴ complex and GPⅠb α in CRF patients, improve platelet function and clown-regulate platelet activation in patients with CRF.     

A study of platelet organelles and membrane glycoprotein in patients with Binswanger''s disease

OBJECTIVE To discuss the possible role of platelets in Binswanger's disease by studying the changes of organelles and membrane glycoprotein in platelets.

METHODS The organelles (dense bodies, alpha granules, and mitochondria) within platelets were measured with transmission electron microscopy in 25 patients with Binswanger's disease and matched controls, while alpha granule membrane glycoprotein CD62 and lysosomal integral membrane glycoprotein CD63 on platelet membrane were analyzed by flow cytometry.

RESULTS The percentage of CD62-positive platelets was 3.6% +/- 2.1% and 5.7% +/- 2.4% in controls and in patients, respectively (P < 0.01). The percentage of CD63 expression platelets was 3.1% +/- 2.2% and 3.2% +/- 2.3% in controls and patients, respectively (P > 0.05). When compared with controls, platelets of patients contained fewer alpha granules (P < 0.01), and had no changes in dense bodies and mitochondria (P > 0.05). CD62 levels were different among patients with regarding to the degree of white matter low attenuation.

CONCLUSIONS There is selective degranuation of platelets in patients with Binswanger's disease and the abnormalities of platelet secretion may play a role in the pathophysiology of this illness.

     

Clinical Observation on Shu Xin Yi Mai Capsules for Prevention of Recurrent Stricture after Coronary Artery Introducing Treatment

Shu Xin Yi Mai Capsules (舒心益脉胶囊) combined with western medicine was used in the routinetreatment of 22 cases who successfully received coronary artery introducing therapy (Chinese-westernmedicine group),and the results was compared with the 26 cases treated routinely with simple westernmedicine in the control group (western medicine group).It was found that both the recurrence rate of anginapectoris and the incidence rate of recurrent stricture in the Chinese-western medicine group were significantlylower than that in the control group (both P<0.05).There was no significant difference between the twogroups in expression of platelet activating molecules CD62P (a-granular membrane protein),CD63(lysosome intact membrane protein) and CD41 (glucoprotein IIb) before the treatment,but with a significantdifference after the treatment (P<0.05).     

Effect of Xiaoyu Zhixue Tablet (消瘀止血片) on Expression of Platelet Membrane Glycoproteins in Patients with Hemorrhagic Thrombopathy

Objective: To observe the effect of Xiaoyu Zhixue tablet (消瘀止血片,XYZXT) on the expression of platelet membrane glycoproteins in patients with hemorrhagic thrombopathy, and to explore its possible mechanism. Methods: The total of 148 patients with hemorrhagic thrornbopathy were randomly divided into two groups, the traditional Chinese medicicne (TCM) group (n=98) treated with XYZXT and the Western medicine (WM) group (n = 50) treated with adrenosin, vitamins C, K and P, both for 6 months.The therapeutic effect and the recovery rate of platelet aggregation in the two groups were observed. And platelet membrane glycoprotein (GP) Ⅰ b/Ⅸ, GP Ⅱ b/Ⅲ a complexes, GP Ⅰ b, GP Ⅱ b, GPⅢ a and P-selectin were analyzed by flow cytometry in both groups before and after treatment and also in 34 normal healthy subjects. Results: The total effective rate of hemostasis was 89.8% in TCM group and 54.0% in the WM group (X2 =45.83, P＜0.01), and the recovery rate of platelet aggregation was 72.4% and 4.0% respectively (X2 = 62.06, P＜0.01). The fluorescence intensity of GP Ⅰ b/Ⅸ, GP Ⅱ b/Ⅲ a complexes, GP Ⅰ b, GP Ⅲ a and P-selectin were lower in both groups before treatment than those in the healthy subjects. Expression of above-mentioned marks was elevated in TCM group after 6 months' therapy, which was insignificantly different as compared with the healthy subjects (P＞0.05) and higher than those in the WM group (P＜0.05).Conclusion: One of the mechanisms in treating hemorrhagic thrombopathy with XYZXT is that it could regulate the expression of GP Ⅰ b/Ⅸ, GP Ⅱ b/Ⅲ a complexes, GP Ⅰ b, GPⅢ a and P-selectin at the level of receptor protein.     

Effects of ixeris sonchifolia on platelet function and hemorrheology of type 2 diabetes mellitus patients

Objective: To observe the effects of Ixeris sonchifolia Hance (ISH) on platelet function and hemorrheology in type 2 diabetes mellitus (DM) patients. Methods: Thirtythree type 2 DM patients were treated with 20 ml ISH per day, intravenously dripping for 15 days; 31 patients in the red sage treated group were treated with composite red sage injection intravenous dripping for 15 days, and their changes of platelet membrane glycoprotein Ⅱb/Ⅲa compound (GPⅡb/Ⅲa), granular membrane protein140 (GMP140), platelet aggregation rate (PAgR) and hemorrheology were observed. Results: After treatment with ISH, the GPⅡb/Ⅲa compound positive rate of 33 type 2 DM patients were lowered (P<0.05), GMP140 showed lowering trend, PAgR obviously reduced, and compared with before treatment it showed significant difference; comparison between the two groups after treatment,it showed significant difference (P<0.05, P<0.01). At the same time, the various parameters of hemorrheology displayed significant improvement. There was no adverse effect during the course of treatment. Conclusion: ISH could improve platelet function and abnormal hemorrheology of type 2 DM patients, which is vital for the treatment of DM and their vascular lesion.     

Expression of Platelet Membrane Glycoprotein Ib/Ⅸ/Ⅴ Complex,a Receptor of Thrombin,in Patients with Hemorrhagic Thrombopathy

To investigate the role of platelet membrane glycoprotein (GP) Ib/Ⅸ/Ⅴ complex and its subunit GP Ibα in patients with hemorrhagic thrombopathy (HT), the expressions of GP Ib/Ⅸ/Ⅴ complex and GP Ibα,defined as mean fluorescence intensity (MFI), were assessed by flow cytometry. The maximum aggregation of platelet was determined by turbidity method. These indicators were compared among 68 HT patients with the presenting complaint of hemorrhage, 33 well-controlled HT patients and 32 normal healthy subjects. The results showed that the MFI of GP Ib/Ⅸ /Ⅴ complex and GP Ibα was markedly lower in HT patients with current hemorrhage than that in the healthy subjects, with difference being statistically significant (P<0.05). There was no significant difference in the expressions of GP Ib/ Ⅸ/ Ⅴ complex and GP Ibα between well-controlled HT patients and normal healthy subjects (P>0.05). It was concluded that the expression of GP Ib/Ⅸ /Ⅴ complex, the receptor of thrombin and von Willebrand factor, was down-regulated in HT patients with current hemorrhage, which might result in the dysfunction of platelet aggregation and recurrence of HT.     

Early local intracoronary platelet activation after drug-eluting stent placement

Background Early local platelet activation after coronary intervention identifies patients at increased risk of acute stent thrombosis （AST）. However, early changes in platelet activation in coronary circulation following drug-eluting stent （DES） implantation have never been reported. Methods In a prospective study of 26 consecutive elective stable angina patients, platelet activation was analyzed by measuring soluble glycoprotein V （sGPV） and P-selectin （CD62P） before and after implantation of either DES or bare metal stent （BMS）. All patients were pretreated with clopidogrel （300 mg loading dose） and aspirin （75 mg orally） the day before the procedure. Blood samples were drawn from the coronary ostium and 10 - 20 mm distal to the lesion site. Results Consistent with the lower baseline clinical risk, the levels of CD62P and sGPV were within normal reference range, both in the coronary ostium and distal to the lesion before percutaneous coronary intervention （PCI） procedure. The levels of CD62P and sGPV did not change significantly （CD62P： （31.1 ± 9.86） ng/ml vs （29.5 ± 9.02） ng/ml, P=0.319 and sGPV： （52.4 ± 13.5） ng/ml vs （51.8 ± 11.7） ng/ml, P=0.674, respectively） after stent implantation when compared with baseline. Changes in these platelet activation markers did not differ between stent types. Conclusions Intracoronary local platelet activation does not occur in stable angina patients before and immediately followina DES implantation when dual anti-Dlatelet is administered.     

Effects of salivae miltiorrhizae liguspyragine hydrochloride and glucose injection (参芎葡萄糖注射液) on the levels of main platelet thrombin receptors in chronic haemodialysis patients

Objective:To investigate the effects of Salvia Miltiorrhiza Liguspyragine Hydrochloride and Glucose Injection(参芎葡萄糖注射液,SLGI) on the expression of platelet membrane receptors proteinase-activated receptor-1(PAR1) and proteinase-activated receptor-4(PAR4) in end-stage renal disease(ESRD) patients on chronic haemodialysis(HD).Methods:Eighty-six ESRD patients on HD(treated group) were treated with SLGI,7 days as one therapeutic course,for two successive courses.The previous therapies were unchanged.Flow cytometry was used to assess the expression of platelet PAR1 and PAR4 in the patients,and turbidity method was used to determine the platelet maximum aggregation rate(MAR).Meanwhile,renal function was measured.The final data were compared with those before treatment and with those in the normal control group(54 healthy subjects).Results:Compared with the normal control group,the expressions of PAR1 and PAR4 and platelet MAR in ESRD patients on HD was significantly higher before treatment(P=0.001,P=0.006, and P=0.008);after treatment with SLGI,the above indices in patients were remarkably decreased(P=0.036 and P=0.046),except PAR4(P=0.067),but still higher than those in the normal control group,however,it was not statistically significant.Conclusions:(1) The overexpression of PAR1 and PAR4 might lead to increased platelet aggregation and this could be one of the reasons for the thrombotic events in ESRD patients on HD.(2) SLGI was able to down-regulate the expression of PAR1 in ESRD patients on HD,improve platelet function,and regulate platelet activation.     

2型糖尿病患者血小板膜糖蛋白PAC-1、CD62P的表达及与糖尿病肾病的相关性研究

Three hundred and thirty eight patients with type 2 diabetes mellitus( DM) admitted from January 2006 to June 2009 and 50 healthy subjects (control group) were enrolled in the study. Platelet glycoprotein PAC-1 and CD62P levels were measured in both groups. Compared with control group, plasma PAC-1 and CD62P levels of DM patients increased significantly (P ＜0.01). Patients were divided into three groups according to their urinary albumin excretion rate ( UAER) . PAC-1 and CD62P levels in macroalbuminuria group (UAER≥200μg/min) were significantly higher than those in normoalbuminuria group( UAER <20μg/min) and microalbuminuria group (20μg/min≤UAER ＜ 200μg/min) (both P＜ 0.05). The results indicate that plasma levels of PAC-1 and CD62P, which reflect platelet activation, are the independent risk factors for diabetic nephropathy.     

2型糖尿病患者血小板膜糖蛋白PAC-1、CD62P的表达及与糖尿病肾病的相关性研究

Three hundred and thirty eight patients with type 2 diabetes mellitus( DM) admitted from January 2006 to June 2009 and 50 healthy subjects (control group) were enrolled in the study. Platelet glycoprotein PAC-1 and CD62P levels were measured in both groups. Compared with control group, plasma PAC-1 and CD62P levels of DM patients increased significantly (P ＜0.01). Patients were divided into three groups according to their urinary albumin excretion rate ( UAER) . PAC-1 and CD62P levels in macroalbuminuria group (UAER≥200μg/min) were significantly higher than those in normoalbuminuria group( UAER <20μg/min) and microalbuminuria group (20μg/min≤UAER ＜ 200μg/min) (both P＜ 0.05). The results indicate that plasma levels of PAC-1 and CD62P, which reflect platelet activation, are the independent risk factors for diabetic nephropathy.     

Expression of Platelet Membrane Glycoprotein Ib/Ⅸ/Ⅴ Complex,a Receptor of Thrombin,in Patients with Hemorrhagic Thrombopathy

To investigate the role of platelet membrane glycoprotein （GP） Ib/Ⅸ/Ⅴ complex and its subunit GP Ibα in patients with hemorrhagic thrombopathy （HT）, the expressions of GP Ib/Ⅸ/Ⅴ complex and GP Ibα,defined as mean fluorescence intensity （MFI）, were assessed by flow cytometry. The maximum aggregation of platelet was determined by turbidity method. These indicators were compared among 68 HT patients with the presenting complaint of hemorrhage, 33 well-controlled HT patients and 32 normal healthy subjects. The results showed that the MFI of GP Ib/Ⅸ /Ⅴ complex and GP Ibα was markedly lower in HT patients with current hemorrhage than that in the healthy subjects, with difference being statistically significant （P〈0.05）. There was no significant difference in the expressions of GP Ib/ Ⅸ/ Ⅴ complex and GP Ibα between well-controlled HT patients and normal healthy subjects （P〉0.05）. It was concluded that the expression of GP Ib/Ⅸ /Ⅴ complex, the receptor of thrombin and von Willebrand factor, was down-regulated in HT patients with current hemorrhage, which might result in the dysfunction of platelet aggregation and recurrence of HT.     

Relation of Blood Arsenic Concentration with Effect and Safety of Arsenic-Containing Qinghuang Powder (青黄散) in Patients with Myelodysplastic Syndrome

Objective: To investigate the relation of blood arsenic concentration(BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder(青黄散, QHP) in patients with myelodysplastic syndrome(MDS). Methods: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluorescence spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. Results: After 2 courses of treatment, the total effective rate was 89.6%(146/163), with 31.3%(51/163) of hematological improvement and 58.3%(95/163) of stable disease. The hemoglobin increased from 73.48±19.30 g/L to 80.39±26.56 g/L(P0.05), the absolute neutrophil count increased from 0.81±0.48×10~9/L to 1.08±0.62×10~9/L(P0.05), and no significant changes were observed in platelet counts(P0.05). Among 46 patients previously depended on blood transfusion, 28.3%(13/46) completely got rid of blood transfusion and 21.7%(10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17±18.04 μg/L(P0.05), 3 months with 33.56±15.28 μg/L(P0.05), and 6 months with 36.78±11.92 μg/L(P0.05), respectively, as compared with those before treatment(4.08±2.11 μg/L). There were no significant differences of BACs among the patients treated for 1, 3 and 6 months(P0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases(8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions(22.39±10.38 vs. 37.89±11.84, μg/L, P0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment(40.41±11.69 vs. 23.84±12.03, μg/L, P0.05). Conclusion: QHP was effective and safe in the treatment of patients with MDS and the effect was associated with BACs of patients.     

Effect of volatile oil of amomum on expressions of platelet activating factor and mastocarcinoma-related peptide in the gastric membrane of chronic gastritis patients with helicobacter-pylori infection

Objective： To observe the effect of volatile oil of amomum （VOA） on the expressions of mastocarcinoma-related peptide （PS2） and platelet activating factor （PAF） in helicobacter pylori- associated gastritis （HPG） and to analyze its potential mechanism. Methods： Eighty patients with HPG were randomly assigned to two groups, 42 patients in the treated group treated with 0.5 mL VOA, thrice per day; and the 38 patients in the control group receiving Western tertiary medicinal treatment. Gastroscopic picture and helicobacter pylori （HP） infection （by quick urease and Warthin- Starry stain） of the gastro-membrane, expressions of PS2 and PAF （by immunohistochemical assay and Western blotting） as well as the contents of aminohexose and phospholipid （by Neuhaus method） in the gastric membrane of all patients were detected before treatment and 4 weeks after treatment. The clinical efficacy in the two groups was compared. Results： The total effective rate in the treated group was 88.1%, which was significantly higher than that in the control group （78.9%, P〈0.05）. After treatment, in the treated group, gastric membranous contents of aminohexose and phospholipid was increased, expression of PS2 elevated but that of PAF lowered, all showing significant difference as compared with those in the control group （P〈0.01）. In the control group, the expressions of PS2 and PAF changed insignificantly. The radical eliminating rate of HP in the treated group and the control group was insignificantly different between them （76.1% vs. 65.8%, P 〉 0.05）. Conclusion： The mechanism of VOA for anti-gastritis might be related with its action in increasing the expression of PS2 and decreasing the expression of PAF, and thus regulating the hydrophobicity of the gastric membrane.     

Changes in immunological function after treatment with transarterial chemoembolization plus radiofrequency ablation in hepatocellular carcinoma patients

Background Different strategies for hepatocellular carcinoma （HCC） may have distinct effects on the immune system.The aim of this research was to investigate changes in the immunological function after transcatheter arterial chemoembolization （TACE） plus radiofrequency ablation （RFA） in HCC patients.Methods A total of 51 consecutive HCC treatment-naive patients was enrolled in this study and 20 healthy subjects served as controls.The therapeutic strategy was selected according to the tumor stage and general conditions.TACE was performed in 25 cases,TACE plus RFA in 17 and RFA in nine.All the patients underwent routine examinations and peripheral blood was harvested for the detection of lymphocyte subset by flow cytometry 1 day before,and 2 and 4 weeks after the treatment.The serum levels of alpha-fetoprotein （AFP）,ALT and AST were also measured before and 4 weeks after treatment for the evaluation of therapeutic efficacy and liver function impairment.Results When compared with healthy controls,the CD4/CD8 ratio and the number of B cells and natural killer （NK） cells were significantly decreased in HCC patients before treatment （P 〈0.05）.When compared with before treatment,the CD4＋ cells and CD4/CD8 ratio decreased but CD8＋ cells increased in the TACE group （P 〈0.05）; the CD4/CD8 ratio and NK cells decreased but CD8＋ cells increased in the TACE-RFA group （P 〈0.05）; the CD3＋ cells,CD4＋ cells,CD4/CD8 ratio and NK cells increased in the RFA group （P 〈0.05）.Significant differences in the CD3＋ cells,CD8＋ cells,CD4/CD8 ratio and NK cells were observed among groups （P 〈0.05）.Moreover,the AFP level decreased and transaminase level increased in all groups （P 〈0.05）.Differences of pre and post treatment between groups were statistically significant （P =0.016,0.025,0.018 respectively）.Conclusions Immunity was compromised in HCC patients; TACE and TACE plus RFA lowered immunologic function to a certain extent.RFA improved it accompanied by a protective effect on liver function.     

Effect of Yisui Shengxue Granule (益髓生血颗粒) on the Oxidative Damage of Erythrocytes from Patients with Hemoglobin H Disease

<正>Objective:To investigate the effect of Yisui Shengxue Granule(益髓生血颗粒,YSSXG),a complex Chinese medicine,on the oxidative damage of erythrocytes from patients with hemoglobin H(HbH) disease. Methods:Twenty-two patients with HbH disease and 22 healthy volunteers were observed.YSSXG was given to patients with HbH disease for 3 months.Before and after the 3-month treatment,blood parameters[hemoglobin (Hb),red blood cells(RBCs),and reticulocyte percent(Ret)]were examined;inclusion bodies in erythrocytes were observed by transmission electron microscopy(TEM);activities of antioxidant defense enzymes [superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),and catalase(Cat)]and erythrocyte membrane malondialdehyde(MDA) concentrations were determined.Results:In patients with HbH disease,measured values of RBC and Hb obtained from the first to the third months after treatment with YSSXG were significantly higher than before treatment(P0.01).Measured values of Ret from the second to the third months after treatment were significantly lower than before treatment(P0.05 and P0.01,respectively).Prior to treatment with YSSXG,TEM images of RBCs showed the presence of numerous inclusion bodies.After treatment with YSSXG,the amount and volume of inclusion bodies decreased.Treatment with YSSXG also led to a significant increase in SOD activity(P0.01),a decrease in Cat activity(P0.01),and no significant differences in GSHPx activity(P0.05) or MDA concentration(P0.05).However,compared with the healthy counterparts,SOD, GSH-Px,and Cat activities presented at high levels(P0.01) both before and after treatment.Conclusions: YSSXG could improve the degree of hemolysis and anemia in patients with HbH disease.The mechanism may be related to its antioxidative effects,which could elevate the activity of total SOD in erythrocytes and efficiently inhibit the oxidative precipitation ofβ-globin chains.     

Effects of Xuezhikang Capsule(血脂康胶囊) on Blood Lipids,Platelet Activation and Coagulation-Fibrinolysis Activity in Patients with Hyperlipidemia

Objective: To investigate the effects of Xuezhikang capsule (XZK, 血脂康胶囊) on blood lipids level, platelet activation and coagulation-fibrinolysis activity in patients with hyerlipidemia. Methods:Seventy-six patients of hyperlipidemia were randomly divided into two groups, the XZK group (n = 38) treated with XZK 600mg, taken two times per day and the Simvastatin (SIM) group (n = 38) treated with SIM 20mg per day, with the treatment lasting 8 weeks for both groups. Levels of fasting serum lipids, including total cholesterol (TC), triglyceride (TG), high and low density l ipoprotein cholesterol (HDL-C and LDL-C),plasma GMP-140, fibrinogen (FIB), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAl-) and prothrombin time (PT) were all measured before and 8 weeks after treatment. Data were compared before and after treatment and also compared with those measured in 20 healthy subjects of control. Results: Before treantment the levels of TC, TG and LDL-C were obviously higher and HDL-C level was significantly lower in hyperlipidemia patients than those in healthy subjects ( P＜0.05 or P＜0.01). After 4-8 weeks of XZK treatment, the levels of TC, TG, LDL-C and FIB and activities of GMP-140 and PAl-1 were obviously lowered (P＜0.05 or P＜0.01). But in the SIM group there was no obvious change in FIB (P＞0.05), instead it showed obvious increase of HDL-C and decrease of TC and LDL-C after treatment ( P＜0.05 or P＜0.01). Conclusion: XZK could inhibit platelet activity and improve coagulation-fibrinolysis function, besides its lipids lowering effect.     

Alleviation of Cancerous Pain by External Compress with Xiaozheng Zhitong Paste(消癥止痛方)

<正>Objective:To observe the clinical effectiveness of a topical application of Xiaozheng Zhitong Paste(消癥止痛方,XZP)in alleviating the cancerous pain of patients with middle/late stage cancer.Methods:By adopting a random number table,124 patients enrolled were randomized into the treatment group(64 patients) and the control group(60 patients).In addition to the basic therapy[including the three-ladder(3L)analgesia] used in both groups,topical application of XZP was given to patients in the treatment group for pain alleviation. The analgesic efficacy was recorded in terms of pain intensity,analgesia initiating time and sustaining time, and the optimal analgesic effect revealing time.Meanwhile,the quality of life(QOL)and adverse reactions that occurred in patients were recorded as well.Results:The total effective rate in the treatment group was 84.38%(54/64),and in the control group it was 88.33%(53/60),showing no significant difference between them(P0.05),but the analgesia initiating time and the optimal analgesia effect revealing time in the treatment group were significantly shorter(both P0.01).Moreover,XZP was better in improving patients' QOL,showing more significant improvements in the treatment group than those in the control group in aspects of mental condition,walking capacity,working capacity,social acceptability,sleep and joy of living(P0.05 or P0.01). Lower incidence of adverse reactions,such as nausea,vomiting,mouth dryness,dizziness,etc.,especially constipation,was noted in the treatment group(P0.05 or P0.01).Conclusion:Applying an external compress of XZP showed a synergistic action with 3L analgesia for shortening the initiating time and the optimal effect revealing time,and could evidently enhance patients' QOL with fewer adverse reactions.     

Clinical Observation of Shuanghuang Shengbai Granule(双黄升白颗粒) on Prevention and Treatment of Myelosuppression Caused by Chemotherapy in Cancer Patients

Objective: To study the efficacy and safety of Shuanghuang Shengbai Granule(双黄升白颗粒, SSG), a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods: A total of 330 patients were randomly assigned to the treatment group(220 cases, analysed 209 cases) and the control group(110 cases, analysed 102 cases) with a 2:1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results: At the 7th day of chemotherapy, the white blood cells(WBCs) level in the treatment group was significantly higher than that in the control group(P0.05). After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group(P0.05). The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group(84.2% vs. 72.5%, P0.05). The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3~+ and CD4~+ cells were significantly increased in the treatment group after treatment(P0.05). The discrepancy of CD3~+ and CD4~+ cell activity before and after treatment in both groups were significantly different(P0.05). No obvious adverse event occurred in both groups. Conclusion: SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.     

Effect of Shexiang Tongxin Dropping Pills(麝香通心滴丸) on the Immediate Blood Flow of Patients with Coronary Slow Flow

Objective: To observe the immediate effect and safety of Shexiang Tongxin dropping pills(麝香通心滴丸, STDP) on patients with coronary slow flow(CSF), and furthermore, to explore new evidence for the use of Chinese medicine in treating ischemic chest pain. Methods: Coronary angiography(CAG) with corrected thrombolysis in myocardial infarction(TIMI) frame count(CTFC) was applied(collected at 30 frames/s). The treatment group included 22 CSF patients, while the control group included 22 individuals with normal coronary?ow. CSF patients were given 4 STDP through sublingual administration, and CAG was performed 5 min after the medication. The immediate blood ?ow frame count, blood pressure, and heart rate of patients before and after the use of STDP were compared. The liver and kidney functions of patients were examined before and after treatments. Results: There was a signi?cant difference in CTFC between groups(P0.05). The average CTFC values of the vessels with slow blood ?ow in CSF patients were, respectively, 49.98±10.01 and 40.42±11.33 before and after the treatment with STDP, a 19.13% improvement. The CTFC values(frame/s) measured before and after treatment at the left anterior descending coronary artery, left circumflex artery, and right coronary artery were, respectively, 48.00±13.32 and 41.80±15.38, 59.00±4.69 and 50.00±9.04, and 51.90±8.40 and40.09±10.46, giving 12.92%, 15.25%, and 22.76% improvements, respectively. The CTFC values of vessels with slow ?ow before treatment were signi?cantly decreased after treatment(P0.05). There were no apparent changes in the heart rate, blood pressure, or liver or kidney function of CSF patients after treatment with STDP(all P0.05). Conclusions: The immediate effect of STDP in treating CSF patients was apparent. This medication could signi?cantly improve coronary ?ow without affecting blood pressure or heart rate. Our ?ndings support the potential of Chinese medicine to treat ischemic chest pain.