Antiviral Properties of Traditional Chinese Medicine against Coronavirus: Research Clues for Coronavirus Disease-2019

The objective of this study was to provide research clues for the prevention and treatment of coronavirus disease?2019 (COVID?19) and coronavirus (CoV) infection using Traditional Chinese Medicine (TCM). A review on research and clinical trials that using TCM extracts and active ingredients against CoV was performed, and a table of TCM agents and their effects on CoV were summarized. Relevant analysis was performed and visual expression of the data included summarizing the types of TCM and treatment methods for COVID?19. TCM fighting against CoV is mainly used in the lung and heart channels, and its medicinal properties are mainly cold and mild, while its taste is mainly bitter and sweet. The majority of research focused on treatments that clear away heat and toxic materials and those that strengthen body resistance and tonify deficiencies. TCM has unique advantages to fight against CoV. The development of new anti?CoV therapy using TCM is of great significance for the prevention and treatment of COVID?19 pneumonia and various viral infectious diseases.     

Effect of Acupoints on Acupuncture-Moxibustion and its Therapeutic Mechanism

The clinical efficacy of acupuncture-moxibustion(AM) mainly depends on acupoints, but the relationship between the acupoints and AM remains unclear. Improving clinical efficacy and clarifying the mechanisms of AM is critical. We found that the specificity and sensitivity of acupoints, the skill of operation, and reasonable amount of stimulation can significantly improve the efficacy of AM. In addition, some studies have shown that Neural-Endocrine-Immune network and metabolites are involved in this process, clarifying the therapeutic mechanism of acupoints. Therefore, how to effectively use acupoints to improve the clinical efficacy of AM is one of the key issues in need of an urgent solution. In summary, this article reviewed the Chinese and English databases on the clinical efficacy and underlying mechanisms of acupoints to clarify the relationship between acupoints and AM efficacy and ultimately improve clinical efficacy through effective and rational use of acupoints.     

高龄直肠癌患者腹会阴联合切除术后会阴切口并发症发生的相关危险因素

探讨高龄直肠癌患者腹会阴联合切除术(APR)后会阴切口并发症发生的相关危险因素。方法采用回顾性病例对照研究的方法,分析中国医学科学院肿瘤医院结直肠外科2007年1月至2018年9月行APR的72例高龄(≥80岁)直肠癌患者的临床病理资料。采用单因素和多因素分析确定影响高龄直肠癌患者APR后会阴切口并发症发生的危险因素。结果72例患者中,男47例,女25例,年龄为(81.8±1.8)岁。术后会阴切口并发症发生率为23.6%(17/72),其中切口感染5例,切口脂肪液化4例,切口延迟愈合8例。所有患者均顺利出院,无围手术期死亡病例。单因素分析显示,术前血清白蛋白<35 g/L、术中置入氟尿嘧啶缓释剂/洛铂冲洗液、盆底修复、糖尿病和冠心病与高龄患者APR术后会阴切口并发症的发生均有关(均P<0.05)。多因素分析显示,未行盆底修复(OR=0.17,95%CI为0.04~0.82;P=0.027)和糖尿病(OR=4.32,95%CI为1.05~17.81;P=0.043)为高龄直肠癌患者APR后会阴切口发生的独立危险因素。结论行APR的高龄直肠癌患者应尽可能保留盆底腹膜,并予以关闭。围手术期血糖监测也是预防会阴切口并发症发生的有力保障。     

基于临床医案分析新安六大医家温补学术思想及辨治特色

新安医学是中医学的重要组成部分,作为地域性综合性流派,其历史悠久,特色鲜明,名医辈出。本文基于六大新安医家的临床医案集,即汪机《石山医案》、孙一奎《孙文垣医案》、郑重光《素圃医案》、程杏轩《杏轩医案》、叶天士《临证指南医案》、吴楚《吴氏医验录》浅析其各自温补学术思想及辨治特色。汪机基于“营卫一气学说”认为营兼气血,温补脾胃当培元益气,倡“参芪”可气血阴阳俱补,尤重其补阴血之功;孙一奎强调元气当生生不息,治法上将汪机参芪同用与薛己温补下元法结合,在用药上重视对三焦元气的保护和治疗;郑重光针对时医专事苦寒伐真阳之弊,喜以附桂姜类取效,多用温阳益火之剂,以四逆汤见长;程杏轩汇多家之学,既重视温补下元精气又重视脾胃气血,强调补养阳气,尤重肾中之阳;叶天士以上中下损为经,伤阴伤阳为纬,形成“甘药培中,上下兼顾”的特色理虚大法,并首提“通补胃阳”,强调当善用补益胃气、温补胃阳之法;吴楚以活用参芪桂附著称,常合用益气温阳之品,健脾与温肾同治。     

Comprehensive analysis of the relationship between competitive endogenous RNA (ceRNA) networks and tumor infiltrating-cells in hepatocellular carcinoma

BackgroundThe innovation of immune checkpoint blockade (ICB) represents a promising shift in the treatment of advanced hepatocellular carcinoma (HCC). However, response to ICB has varied largely due to the high tumor heterogeneity and complex tumor microenvironment (TME). The competitive endogenous RNA (ceRNA) network also plays an important role in tumor occurrence and progression, but its relation with tumor-infiltrating immune cells (TICs) remains largely unexplored in HCC. The overriding objective of our study was thus to construct a prognosis-related risk model and to further evaluate the relationship between ceRNA networks and TICs.MethodsDifferentially expressed gene (DEG) analysis was performed to identify the differentially expressed RNAs. Lasso and multivariable Cox regression analyses were used to construct risk models, which were assessed by the area under the receiver operating characteristic curve (AUC of ROC) and Kaplan-Meier (K-M) curves. Then, a single-sample gene set enrichment analysis (ssGSEA) algorithm was adopted to dissect the TICs in HCC samples. Nomograms were constructed and calibration curves were used to verify the discrimination and accuracy of the nomograms. Finally, integration analysis was performed to validate the correlation of ceRNA and TICs.ResultsIn the study, 7 differentially expressed RNAs [5 messenger RNA s (mRNAs) and 2 micro RNAs (miRNAs)] were incorporated to construct a ceRNA risk model. The AUC of the 1-, 3-, and 5-year overall survival (OS) were 0.784, 0.685, and 0.691 respectively. Likewise, 7 types TICs were in the TICs signature model and the AUC of the 1-, 3-, and 5-year OS were 0.706, 0.731, and 0.721 respectively. The integration analysis showed that 7 pairs of mRNA-TICs and 1 pair of miRNA-TICs had a close relation (all correlation coefficients >0.2, P<0.001).ConclusionsThrough constructing two risk models based on ceRNA network and TICs, we identified the hub RNAs and key TICs in the progression and prognosis of HCC, and further explored the relationship between ceRNA and TME. Importantly, targeting these hub RNAs may facilitate the remodeling of the TME and be a potential therapeutic alternative to enhancing the response to ICB, thus improving the prognosis of HCC patients.     

Severe lumbar spinal stenosis combined with Guillain-Barré syndrome: A case report

BACKGROUNDGuillain-Barré syndrome (GBS) is a rare disorder that typically presents with ascending weakness, pain, paraesthesias, and numbness, which mimic the findings in lumbar spinal stenosis. Here, we report a case of severe lumbar spinal stenosis combined with GBS.CASE SUMMARYA 70-year-old man with a history of lumbar spinal stenosis presented to our emergency department with severe lower back pain and lower extremity numbness. Magnetic resonance imaging confirmed the diagnosis of severe lumbar spinal stenosis. However, his symptoms did not improve postoperatively and he developed dysphagia and upper extremity numbness. An electromyogram was performed. Based on his symptoms, physical examination, and electromyogram, he was diagnosed with GBS. After 5 d of intravenous immunoglobulin (0.4 g/kg/d for 5 d) therapy, he gained 4/5 of strength in his upper and lower extremities and denied paraesthesias. He had regained 5/5 of strength in his extremities when he was discharged and had no symptoms during follow-up.CONCLUSIONGBS should be considered in the differential diagnosis of spinal disorder, even though magnetic resonance imaging shows severe lumbar spinal stenosis. This case highlights the importance of a careful diagnosis when a patient has a history of a disease and comes to the hospital with the same or similar symptoms.     

Metabolic Profile for Prediction of Ischemic Stroke in Chinese Hypertensive Population

Background

Stroke burden is extremely high in Chinese hypertensive population. Novel biomarkers for cardiovascular diseases can be detected by metabolomic profiling of human fluids. We aim to find a panel of distinctive plasma metabolites for predicting incident ischemic stroke in hypertensive patients.

鼓膜大穿孔耳内镜下鼓膜成形术的临床报告

目的探讨对鼓膜大穿孔病例应用耳内镜下单纯鼓膜成形术的疗效。方法选取2015年9月-2018年1月收治的鼓膜大穿孔患者43例(46耳),耳内镜下采取耳屏软骨-软骨膜进行鼓膜成形术,对鼓膜愈合及听力情况进行评价。结果 43耳鼓膜愈合,3耳未愈合,愈合率93.5%,听力改善患者满意,1例出现迟发性面瘫,药物治疗后恢复,其余均无并发症出现。结论耳内镜下应用耳屏软骨-软骨膜修补鼓膜大穿孔操作相对简单,能抵近观察,手术成功率高,比显微镜下手术更具优势,利于年轻医师上手,值得临床推广。