Scientific connotation of “treating different diseases with the same method” from the perspective of metabolic–immune dysregulation in inflammation-mediated carcinogenesis of digestive organs

Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system. In the chronic inflammation microenvironment, the metabolic activity of tissue cells undergoes extensive changes, which interfere with the normal function of immune cells. Dysregulation of cell metabolism and immune function has been identified as a key factor contributing to inflammation-mediated carcinogenesis within the major digestive organs, such as the stomach, liver, and colorectum. This metabolic–immune imbalance also corresponds to traditional Chinese medicine (TCM) theories of “yin-yang disharmony” and “disharmony between Ying-nutrients and Wei-defense.” The metabolic–immune imbalance has also been regarded as the key factor supporting “treatment of different diseases with the same method,” in which the same approach is adopted in the treatment of different conditions. In the TCM treatment process, it is necessary to first identify TCM patterns and then apply the corresponding TCM to correct the dysregulated metabolic and immune function, thereby blocking the progression from inflammation to malignancy. Our study findings deepen the TCM understanding of metabolic–immune dysregulation and the relationship between metabolic–immune dysregulation, pattern identification, and treatment method. They also provide new insights for the treatment of inflammation-mediated carcinogenesis in major digestive organs and help us further explore the scientific connotation of the TCM strategy of “treating different diseases with the same method.     

miR-146a-5p regulates autophagy and NLRP3 inflammasome activation in epithelial barrier damage in the in vitro cell model of ulcerative colitis through the RNF8/Notch1/mTORC1 pathway

Ulcerative colitis (UC) is a chronic inflammatory disease affecting the colon that can be influenced by microRNAs (miRNAs). This study aims to investigate the impact of miR-146a-5p on lipopolysaccharide (LPS)-induced Caco-2/HT-29 cell autophagy and NLRP3 inflammasome activation and the underlying mechanism, with the aim of identifying potential therapeutic targets. We used LPS to establish Caco-2/HT-29 cell models and measured cell viability by CCK-8. The levels of miR-146a-5p, RNF8, markers of NLRP3 inflammasome activation and autophagy, proteins involved in the Notch1/mTORC1 pathway, and inflammatory factors were assessed by RT-qPCR, Western blot, and ELISA. Intestinal epithelial barrier function was evaluated by measuring transepithelial electrical resistance. Autophagic flux was measured using tandem fluorescent-labeled LC3. miR-146a-5p was highly-expressed in LPS-induced Caco-2/HT-29 cells, and autophagy flux was blocked at the autolysosomal stage after LPS induction. Inhibition of miR-146a-5p suppressed NLRP3 inflammasome activation, reduced intestinal epithelial barrier damage, and facilitated autophagy inhibition in LPS-induced Caco-2/HT-29 cells. The autophagy inhibitor NH4Cl partially nullified the inhibitory effects of miR-146a-5p inhibition on NLRP3 inflammation activation. miR-146a-5p targeted RNF8, and silencing RNF8 partly abrogated the action of miR-146a-5p inhibition on promoting autophagy and inhibiting NLRP3 inflammasome activation. miR-146a-5p inhibition suppressed the Notch1/mTORC1 pathway activation by upregulating RNF8. Inhibition of the Notch1/mTORC1 pathway partially nullified the function of silencing RNF8 on inhibiting autophagy and bolstering NLRP3 inflammasome activation. In conclusion, miR-146a-5p inhibition may be a potential therapeutic approach for UC, as it facilitates autophagy of LPS-stimulated Caco-2/HT-29 cells, inhibits NLRP3 inflammasome activation, and reduces intestinal epithelial barrier damage by upregulating RNF8 and suppressing the Notch1/mTORC1 pathway.     

Metabolomics in the development and progression of rheumatoid arthritis: A systematic review

ObjectiveA systematic review and analysis of data from several rheumatoid arthritis metabolomics studies attempts to determine which metabolites can be used as potential biomarkers for the diagnosis of rheumatoid arthritis and to explore the pathogenesis of rheumatoid arthritis.MethodsWe searched all the subject-related documents published by EMBASE, PubMed, Web of Science, and Cochrane Library from the database to the September 2019 publication. Two researchers independently screened the literature and extracted the data. QUADOMICS tool was used to assess the quality of studies included in this systematic review.ResultsA total of 10 studies met the inclusion criteria of systematic review, including 502 patients with rheumatoid arthritis and 373 healthy people. Among them, the biological samples utilised for metabolomic analysis include: serum (n = 8), urine (n = 1) and synovial fluid (n = 1). Some metabolites play an important role in rheumatoid arthritis: glucose, lactic acid, citric acid, leucine, methionine, isoleucine, valine, phenylalanine, threonine, serine, proline, glutamate, histidine, alanine, cholesterol, glycerol, and ribose.ConclusionsMetabolomics provides important new opportunities for further research in rheumatoid arthritis and is expected to elucidate the pathogenesis of rheumatoid arthritis that has not been fully understood before.     

大剂量甲钴胺对糖尿病周围神经病变疗效与安全性的meta分析

目的 系统评价大剂量甲钴胺治疗糖尿病周围神经病变的疗效和安全性,为临床合理用药及超说明书用药政策评估提供参考。方法 通过检索Cochrane图书馆、PubMed、Embase、万方、中国知网（CNKI）、中国生物医学文献服务系统（Sinomed）数据库,收集大剂量甲钴胺（试验组）对比常规剂量甲钴胺（对照组）治疗糖尿病周围神经病变的随机对照试验,检索时间截至2018年5月。提取相关资料并评价研究的方法学质量,使用RevMan 5.3软件进行meta分析。结果 共纳入10项随机对照试验,共计747例患者。Meta分析结果显示,试验组患者在腓神经运动神经传导速度[MD=1.61,95%CI（0.26,2.96）,P=0.02],腓神经感觉神经传导速度[MD=2.73,95%CI（2.07,3.39）,P<0.001],治疗总有效率方面显著优于对照组[RR=1.16,95%CI（1.09,1.23）,P<0.001]。亚组分析显示,大剂量甲钴胺1日1次给药或1日2次给药,试验组治疗总有效率均显著高于对照组（P<0.001）。试验组患者的不良反应发生率略高于对照组,差异无统计学意义。结论 大剂量甲钴胺在治疗糖尿病周围神经病变方面与常规剂量甲钴胺相比,临床疗效更优,安全性相当。     

清开灵与利巴韦林治疗小儿呼吸道合胞病毒肺炎的比较：单盲、随机、平行对照试验

目的:比较清开灵与利巴韦林对呼吸道合胞病毒肺炎患儿治疗效果的差异。方法:选择2005-02/2006-04在北京儿童医院分中心治疗的小儿呼吸道合胞病毒肺炎97例,患儿法定监护人知情同意。采用单盲、随机、平行对照试验的原则,按区组随机化方法分为2组,清开灵注射液组49例,利巴韦林组48例。①清开灵注射液组:清开灵注射液静脉滴注加口服中成药。②利巴韦林组:利巴韦林注射液静脉滴注加口服复方愈创木酚磺酸钾口服液。两组疗程均为10d,比较两组患儿的疗效。结果:清开灵注射液组脱落3例,利巴韦林组脱落1例,进入结果分析清开灵注射液组46例,利巴韦林组47例。①清开灵注射液组发热患儿体温恢复正常时间比利巴韦林组短[(2.72±1.86)d,(6.29±2.41)d(P<0.01)]。②清开灵注射液组患儿咳嗽、痰壅、气促症状积分改善方面优于利巴韦林组(P<0.05～0.01)。③清开灵注射液组的呼吸道合胞病毒转阴时间明显优于利巴韦林组。④咳嗽、痰壅、病毒转阴时间、气促均进入Logistic模型,其中前两个症状的回归系数绝对值较大。结论:清开灵注射液治疗小儿呼吸道合胞病毒肺炎在退热、止咳平喘、呼吸道合胞病毒转阴时间等方面均具有明显优势,咳嗽、痰壅这两个症状更能反映清开灵注射液的疗效优于利巴韦林。     

不同Barthel指数分级肠癌病人的护理需求调查

[目的]了解不同Barthel指数分级肠癌病人的护理需求情况,为实施按需施护提供参考依据。[方法]采用自行设计的护理需求调查问卷对不同Barthel指数分级住院肠癌病人进行护理需求调查,了解不同Barthel指数分级肠癌病人的主要护理需求。[结果]不同Barthel指数分级住院肠癌病人护理需求前5项中皆对“护士的护理技术过硬”需求较高;但Bathel指数I级肠癌病人对疾病康复知识及良好睡眠与休息需求较高,Bathel指数Ⅱ级肠癌病人需要护士协助其完成日常生活及缓解肿瘤相关症状,Bathel指数Ⅲ级肠癌病人更注重于满足疼痛控制、精神安宁的需求。[结论]护理人员在确保治疗质量的情况下,可根据不同Barthel指数分级肠癌病人护理需求实施按需施护。     

4种手术方法治疗藏毛窦的疗效比较

目的比较4种手术方法治疗藏毛窦的临床治疗效果。方法回顾性分析2008年1月至2013年3月期间江苏省中医院肛肠科收治的43例骶尾部藏毛窦患者的临床资料,均接受手术治疗,其中藏毛窦切除＋切口开放术4例（切口开放组）、藏毛窦切除＋切口直接缝合术7例（直接缝合组）、藏毛窦切除＋切口袋形缝合术19例（袋形缝合组）、藏毛窦菱形切除＋Limberg皮瓣转移术13例（皮瓣转移组）。结果①4组患者的一般临床资料比较,差异无统计学意义（P〉0．05）,具有可比性。②切口开放组、直接缝合组、袋形缝合组和皮瓣转移组的住院时间分别为（16．70±8．69）d、（16．43±10．68）d、（15．84±11．29）d和（14．69±4．01）d,术后平均愈合时间分别为（64．75±6．50）d、（34．57±19．15）d、（35．16±15．49）d和（17．92±4．29）d。4组住院时间比较差异无统计学意义（P〉0．05）。切口愈合时间皮瓣转移组明显短于其他3组（P〈0．05）,直接缝合组和袋形缝合组均明显短于切口开放组（P〈0．05）,直接缝合组与袋形缝合组间差异无统计学意义（P〉0．05）。③4组的并发症：直接缝合组有2例患者切口部分裂开,2例患者因切口感染行部分拆开;皮瓣转移组1例患者术后切口渗血行部分拆开引流,1例患者出现张力性水泡;其余2组没有发生并发症。切口愈合后随访半年均无复发。结论从本组有限的数据初步得出,藏毛窦术后的闭合方式根据切口张力大小而定,张力小者可行直接缝合,张力大者可行袋形缝合;病变范围广或术后复发的患者可行菱形切除＋Limberg皮瓣转移。     

人Survivin蛋白的表达?纯化及初步应用

目的:克隆、表达肿瘤特异性凋亡抑制因子(Survivin),并对其在人肝癌诊断中的意义进行研究。方法:从人白血病细胞系HL60提取总RNA,用RT-PCR方法扩增出Survivin基因片段。将Survivin基因片段插入载体pMD-18T中,测序正确后亚克隆到原核表达载体pGEX-2TK中。IPTG诱导重组质粒pGEX-2TK-Survivin在大肠杆菌BL21中表达N端融合GST的目的蛋白,采用GST蛋白纯化系统进行纯化,经SDS-PAGE分析后,将所得产物用Thrombin裂解后进行Westernblot鉴定。将获得的目的蛋白包板,用ELISA法初步检测了肝癌患者血清中抗Survivin蛋白的表达。结果:克隆了人Survivin基因、表达出相对分子质量约为16.2ku的蛋白并进行了肝癌患者血清的检测应用。结论:成功克隆、表达和纯化了Survivin基因和融合蛋白,为进一步探讨以Survivin为基础的肿瘤诊断和治疗奠定了实验基础。     

气的医学层次哲学性认识的唯物观

从医学层次哲学性认识的唯物观对气和气的具体形态进行了区分,并阐述了气的物质性和多样性.物质性指它的客观实在性,是与人密切相联系的各种事物或现象的总和;多样性是指各种具体物质形态都具有各自特殊的质的规定性.在假定两个基本概念"象"、"象集"的基础上,结合中西医的认识,分别从宏观、微观、生理(正常)、病理(异常)诸角度将气的具体形态作了初步阐述,并指出寻找气的不同侧面或层次的具体形态,特别是其在微观层次上相应的存在形式,将有助于把中医辨证推向微观化.