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A real-world study of the differences in Traditional Chinese medicine diagnosis and treatment rules for coronavirus disease 2019 between Northern and Southern China

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Journal of Traditional Chinese medicine 2024年第4期44卷 822-829页

作者： SU Rui SU Youzhu WANG Shuo FAN Jie LIU Qingquan LIU Mifeng department of infectious diseases Capital Medical University Beijing Hospital of Traditional Chinese Medicine

OBJECTIVE: To explore the differences in Traditional Chinese medicine(TCM) diagnosis and treatment rules for coronavirus disease 2019(COVID-19) between Northern and Southern China based on the real-world data from 982 COVID-19 patients. METHODS: All consecutive cases of COVID-19 admitted to the TCM department of designated COVID-19 hospitals in eight provinces and cities were retrospectively analyzed. Patients were divided into a Northern and a Southern group according to the location of the admitting hospital. The symptoms, syndrome elements, syndrome distribution and herbal treatments were analyzed. The core prescriptions were extracted using the multiscale backbone-based network comparison algorithm(msbNC). RESULTS: The distribution of syndrome elements showed that dampness was common in Northern and Southern China, wind and heat were more often present in the South, while fire toxin and spleen deficiency were more often encountered in the North. The distribution of syndromes showed that the South was dominated by heat dampness accumulating in the lung(55.69%), while the North was dominated by dampness-toxin stagnating in the lung(44.90%).The results of core prescription mining showed that dispelling dampness, dispersing wind, clearing heat and strengthening spleen were the common treatment methods in Northern and Southern China. For mild cases, Jinyinhua(Flos Lonicerae) and Lianqiao(Fructus Forsythiae Suspensae) were often used in the South to clear heat and relieve exterior symptoms, while Chaihu(Radix Bupleuri Chinensis) and Huangqin(Radix Scutellariae Baicalensis) were often used in the North to relieve muscles by expelling heat. For moderate cases, Chaihu(Radix Bupleuri Chinensis), Qinghao(Herba Artemisiae Annuae), and Shigao(Gypsum Fibrosum) were often used to clear heat of Tri-jiao Channel and stomach in the South, while Fuling(Poria), Chenpi(Pericarpium Citri Reticulatae), and Dangshen(Radix Codonopsis) were often used to invigorate spleen and remove damp

关键词： COVID-19 North-South difference core prescription medicine, Chinese traditional retrospective studies syndrome

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High-throughput sequencing analysis of differential microRNA expression in the process of blocking the progression of chronic atrophic gastritis to gastric cancer by Xianglian Huazhuo formula(香连化浊方)

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Journal of Traditional Chinese medicine 2024年第4期44卷 703-712页

作者： GUO Yuxi LI Ze CHENG Nan JIA Xuemei WANG Jie MA Hongyu ZHAO Runyuan LI Bolin XUE Yucong CAI Yanru YANG Qian department of spleen and stomach diseases First Affiliated Hospital of Hebei University of Traditional Chinese Medicine department of Traditional Chinese medicine Hebei General Hospital department of Gastroenterology the First Affiliated Hospital of Guangzhou University of Chinese Medicine College of Integrative medicine Hebei University of Chinese Medicine

OBJECTIVE: To explore the mechanism of Xianglian Huazhuo formula( 香连化浊方, XLHZ) blocking the development of chronic atrophic gastritis(CAG) to gastric cancer(GC) through bioinformatics analysis and in vitro. METHODS: Pathological morphology of gastric mucosa of rats were observed. High-throughput sequencing was used to analyze the miRNA expression profile of gastric mucosa. The miRanda, miRDB and miRWalk databases were used to predict the differential target genes. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis were performed for differential target genes. Real-time quantitative reverse transcription polymerase chain reaction(qRTPCR) was used to verify the differentially expressed miRNAs and target genes. Western blot, EdU, wound healing and flow cytometry were used to observe the effect of XLHZ on epithelial-mesenchymal transition(EMT) markers, proliferation, migration, apoptosis and cell cycle of CAG cells in vitro. RESULTS: A total of five differentially expressed miRNAs and four differential target genes were screened in this study. GO analysis showed that the target genes were enriched in regulation of neuron development, regulation of transcription factor activity and regulation of RNA polymerase. KEGG pathways database differences in gene enrichment of target genes in the Wnt signaling pathway, Phospholipase D signaling pathway and mitogen-activated protein kinase signaling pathway. qRTPCR confirmed that miRNAs and its target genes were consistent with the screening results. In vitro, our study revealed that XLHZ could increase the expression of Ecadherin, decrease the expression of transforming growth factor β1, vimentin and β-catenin, inhibite the proliferation and migration of CAG cells, cause cell cycle arrest at G0/G1 and G2/M phase, induce the apoptosis of CAG cells, and prevent the progression of CAG to GC. CONCLUSION: This study provided a new idea for the mechanism of blocking the progression of CAG to GC b

关键词： Xianglian Huazhuo formula gastritis, atrophic high-throughput nucleotide sequencing microRNAs stomach neoplasms

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Dengue hemorrhagic fever with rectus sheath hematoma:A case report

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Asian Pacific Journal of Tropical medicine 2024年第3期17卷 136-138页

作者： Boudhayan Bhattacharjee Hardik Patel Rucha Karad Vasireddy Teja Agnibho Mondal Soumendra Nath Haldar Bibhuti Saha department of Infectious diseases and Advanced Microbiology School of Tropical MedicineKolkataIndia

Rationale:Acute pain is a medical emergency that requires prompt abdominal evaluation and ***,a mosquito-borne arboviral infection,can lead to complications such as acute abdominal *** concerns:A 72-year-old hypertensive female presented with high-grade intermittent fever with chills and rigors for four *** was diagnosed with dengue fever(NS1Ag-reactive)the day before admission.A contrast-enhanced computed tomography of the abdomen showed a hematoma along the rectus sheath which was managed conservatively as per surgical ***:Dengue hemorrhagic fever with rectus sheath ***:Blood transfusion and fluid ***:Ten days after discharge,the patient reproted no pain in the right iliac fossa and the size of the hematoma was significantly ***:Although it is rarely seen as a cause of acute abdomen,complaints of adnominal pain should never be ignored in critical or convalescent phase of dengue *** investigations should be promptly conducted as hematoma is often difficult to be diagnosed *** in diagnosis of rectus sheath hematoma can be fatal.

关键词： Dengue fever Rectus sheath hematoma Surgical emergency Acute appendicitis

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Impact of short-term ambient air pollution exposure on the risk of severe COVID-19

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Journal of Environmental Sciences 2024年第1期135卷 610-618页

作者： Baihuan Feng Jiangshan Lian Fei Yu Dan Zhang Weizhen Chen QiWang Yifei Shen Guoliang Xie Ruonan Wang Yun Teng Bin Lou Shufa Zheng Yida Yang Yu Chen department of Laboratory medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310000China Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province Hangzhou 310000China Institute of Laboratory medicine Zhejiang UniversityHangzhou 310000China department of Infectious diseases The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310000China State Key Laboratory for Diagnosis and Treatment of Infectious diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious Diseasesthe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310000China

Ecological studies suggested a link between air pollution and severe COVID-19 outcomes,while studies accounting for individual-level characteristics are *** the present study,we aimed to investigate the impact of short-term ambient air pollution exposure on disease severity among a cohort of 569 laboratory confirmed COVID-19 patients admitted to designated hospitals in Zhejiang province,China,from January 17 to March 3,2020,and elucidate the possible biological processes involved using *** with mild cases,severe cases had higher proportion of medical conditions as well as unfavorable results in most of the laboratory tests,and manifested higher air pollution exposure *** exposure to air pollutants was associated with increased risk of severe COVID-19 with odds ratio(OR)of 1.89(95%confidence interval(CI):1.01,3.53),2.35(95%CI:1.20,4.61),2.87(95%CI:1.68,4.91),and 2.01(95%CI:1.10,3.69)for PM_(2.5),PM_(10),NO_(2)and CO,*** for NO_(2)remained significant in two-pollutant models after adjusting for other *** analysis showed 884 differentially expressed genes which mainly were enriched in virus clearance related biological processes between patients with high and low NO_(2)exposure levels,indicating that compromised immune response might be a potential underlying mechanistic *** findings highlight the impact of shortterm air pollution exposure,particularly for NO_(2),on COVID-19 severity,and emphasize the significance in mitigating the COVID-19 burden of commitments to improve air quality.

关键词： Air pollution COVID-19 Severity Transcriptomics Immune response

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Hypertension and NAFLD risk:Insights from the NHANES 2017-2018 and Mendelian randomization analyses

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Chinese Medical Journal 2024年第4期137卷 457-464页

作者： Mengqin Yuan Jian He Xue Hu Lichao Yao Ping Chen Zheng Wang Pingji Liu Zhiyu Xiong Yingan Jiang Lanjuan Li department of Infectious diseases Renmin Hospital of Wuhan UniversityWuhanHubei 430000China department of Gastroenterology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510010China State Key Laboratory for Diagnosis and Treatment of Infectious diseases National Clinical Research Centre for Infectious DiseasesCollaborative Innovation Centre for Diagnosis and Treatment of Infectious DiseasesDepartment of Infectious DiseasesThe First Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiang 310000China

Background:Hypertension and non-alcoholic fatty liver disease(NAFLD)share several pathophysiologic risk factors,and the exact relationship between the two remains *** study aims to provide evidence concerning the relationship between hypertension and NAFLD by analyzing data from the National Health and Nutrition Examination Survey(NHANES)2017-2018 and Mendelian randomization(MR)***:Weighted multivariable-adjusted logistic regression was applied to assess the relationship between hypertension and NAFLD risk by using data from the NHANES ***,a two-sample MR study was performed using the genome-wide association study(GWAS)summary statistics to identify the causal association between hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),and *** primary inverse variance weighted(IVW)and other supplementary MR approaches were conducted to verify the causal association between hypertension and *** analyses were adopted to confirm the robustness of the ***:A total of 3144 participants were enrolled for our observational study in *** multivariable-adjusted logistic regression analysis suggested that hypertension was positively related to NAFLD risk(odds ratio[OR]=1.677;95%confidence interval[CI],1.159-2.423).SBP≥130 mmHg and DBP≥80 mmHg were also significantly positively correlated with ***,hypertension was independently connected with liver steatosis(β=7.836[95%CI,2.334-13.338]).The results of MR analysis also supported a causal association between hypertension(OR=7.203[95%CI,2.297-22.587])and *** results were observed for the causal exploration between SBP(OR=1.024[95%CI,1.003-1.046]),DBP(OR=1.047[95%CI,1.005-1.090]),and *** sensitive analysis further confirmed the robustness and reliability of these findings(all P>0.05).Conclusion:Hypertension was associated with an increased risk of NAFLD.

关键词： Hypertension Non-alcoholic fatty liver disease National Health and Nutrition Examination Survey Mendelian randomization analysis Causality

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Trauma to the solid abdominal organs:The missed dark box of colonoscopy

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World Journal of Gastroenterology 2024年第7期30卷 624-630页

作者： Mohamed H Emara Usama Mazid Yasmine A Elshaer Mahmoud A Elkerdawy Dilaver Farooq Malik Aya M Mahros department of Hepatology Gastroenterologyand Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt department of medicine Alyousif HospitalAlkhobar 31952Saudi Arabia

Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient *** is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used,the sedatives used,but to the procedure related as well including bleeding and *** to the extra-luminal abdominal organs during colonoscopy are uncommon,however,serious complications related to the procedure have been reported infrequently in the *** threatening injuries to the spleen,liver,pancreas,mesentery,and urinary bladder have been reported as early as in *** injuries should not be overlooked by clinicians and *** increasing abdominal pain,abdominal distension,and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ *** and hepatic injury following colonoscopy are usually serious and may be life *** conservative management may help,yet they usually need interventional radiology or surgical *** pancreatitis following colonoscopy is usually mild and is mostly managed *** mechanism of abdominal organ injuries during colonoscopy is not fully understood,however many risk factors have been identified,which can be classified as-organ related,procedure related,and local abdominal *** colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these *** lateral position,avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.

关键词： Colonoscopy Pancreatitis Trauma Complications Adhesions

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Role of endoscopic-ultrasound-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1981-1985页

作者： Smit S Deliwala Emad Qayed department of medicine Division of Digestive DiseasesEmory University School of MedicineAtlantaGA 30303United States

In this editorial,we discuss the article by Peng et al in the recent issue of the World Journal of Gastrointestinal Surgery,focusing on the evolving role of endoscopicultrasound-guided biliary drainage(EUS-BD)with electrocautery lumen apposing metal stent(LAMS)for distal malignant biliary *** endoscopy has rapidly advanced in decompression techniques,with growing evidence of its safety and efficacy surpassing percutaneous and surgical *** endoscopic retrograde cholangiopancreatography(ERCP)has been the gold standard for biliary decompression,its failure rate approaches 10.0%,prompting the exploration of alternatives like *** random-effects meta-analysis demonstrated high technical and clinical success of over 90.0% and an adverse event rate of 17.5%,mainly in the form of stent *** based on stent size were not reported but the majority used 6 mm and 8 mm *** the body of literature continues to demonstrate the effectiveness of this technique,the challenges of stent dysfunction need to be addressed in future *** strategy that has shown promise is placement of double-pigtail stents,only 18% received the prophylactic intervention in this *** expect this to improve with time as the technique continues to be refined and *** results above establish EUS-BD with LAMS as a reliable alternative after failed ERCP and considering EUS to ERCP upfront in the same session is an effective *** the promising results,studies must explore the role of EUS-BD as first-line therapy for biliary decompression.

关键词： Endoscopic-ultrasound Malignant biliary obstruction Lumen apposing metal stent Choledochoduodenostomy Hepaticogastrostomy

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History of chronic gastritis:How our perceptions have changed

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World Journal of Gastroenterology 2024年第13期30卷 1851-1858页

作者： Dmitry Bordin Maria Livzan department of Pancreatic Biliary and Upper GI Tract DiseasesA.S.Loginov Moscow Clinical Scientific CenterMoscow 111123Russia department of Propaedeutic of Internal diseases and Gastroenterology Russian University of MedicineMoscow 127006Russia department of Outpatient Therapy and Family medicine Tver State Medical UniversityTver 170100Russia department of Internal medicine and Gastroenterology Omsk State Medical UniversityOmsk 644099Russia

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular *** classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a ***,this attitude to the patient suffering from CG was far from *** present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

关键词： Chronic gastritis Intestinal metaplasia Dysplasia Gastric cancer Helicobacter pylori

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A retrospective analysis of carbapenem-resistant Acinetobacter baumannii infections in critically ill patients:Experience at a tertiary-care teaching hospital ICU

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Journal of Intensive medicine 2024年第2期4卷 181-186页

作者： Leyla Ferlicolak Neriman Defne Altintas Fugen Yoruk department of Internal medicine Division of Intensive Care Unit Ankara University Faculty of MedicineAnkaraTurkey department of Infectious diseases and Clinical Microbiology Ankara University Faculty of MedicineAnkaraTurkey

Background Acinetobacter baumannii is a clinically significant pathogen with a high incidence of multidrug resistance that is associated with life-threatening nosocomial ***,we aimed to provide an insight into the clinical characteristics and outcomes of a unique group of *** infections in which the isolates were resistant to carbapenems and most other antibiotic groups in a tertiary-care intensive care unit(ICU).Methods We performed a retrospective observational study in which records of patients hospitalized in the ICU between June 1,2021 and June 1,2023 were *** checked the clinical,laboratory,and microbiological records of all adult patients who had carbapenem-resistant ***(CRAB)*** antibiotic treatments and definitive antibiotic treatments after culture positivity and susceptibility test results were recorded.C-reactive protein(CRP)and procalcitonin levels and leukocyte counts were *** of ICU stay and 30-day mortality were defined as the outcome *** During the study period,57 patients were diagnosed with CRAB *** respiratory tract was the leading infection site(80.7%).In non-survivors,bloodstream infections(21.9%vs.4.0%P=0.05)and colistin-resistant(col-R)CRAB infections(43.8%vs.24.0%,P=0.12)were more common than in survivors,but these parameters were not statistically *** length of ICU stay was not different between survivors and ***,the rate of col-R among CRAB clinical isolates was 35.1%.The 30-day mortality in all patients with CRAB infection was 56.1%.Mortality in col-R CRAB and colistin-susceptible(col-S)CRAB infections was 70.0%and 48.6%,respectively(P=0.12).Prior carbapenem use was 56.1%.Prior colistin use before col-R and col-S CRAB infections was not significant(35.0%vs.27.0%,P=0.53).Conclusions Our study provides real-world data on highly resistant *** infections and shares the characteristics of infections with such resistant stra

关键词： Mortality Colistin-resi stant Gram-negative bacteria MDR Intensive care unit

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RNA modifications in the progression of liver diseases: from fatty liver to cancer

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Science China Life Sciences 2024年

作者： Simiao Li Wajahat Z Mehal Xinshou Ouyang Yale University School of medicine Section of Digestive diseases department of Internal medicine

Non-alcoholic fatty liver disease (NAFLD) has emerged as a prominent global health concern associated with high risk of metabolic syndrome, and has impacted a substantial segment of the population. The disease spectrum ranges from simple fatty liver to non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis and hepatocellular carcinoma (HCC) and is increasingly becoming a prevalent indication for liver transplantation. The existing therapeutic options for NAFLD, NASH, and HCC are limited, underscoring the urgent need for innovative treatment strategies. Insights into gene expression, particularly RNA modifications such as N6methyladenosine (m6A), hold promising avenues for interventions. These modifications play integral roles in RNA metabolism and cellular functions, encompassing the entire NAFLD-NASH-HCC progression. This review will encompass recent insights on diverse RNA modifications, including m6A, pseudouridine (Ψ), N1-methyladenosine (m1A), and 5-methylcytidine (m5C) across various RNA species. It will uncover their significance in crucial aspects such as steatosis, inflammation, fibrosis, and tumorigenesis. Furthermore, prospective research directions and therapeutic implications will be explored, advancing our comprehensive understanding of the intricate interconnected nature of these pathological conditions.

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