High Joule heat as a risk factor for post-endoscopic submucosal dissection electrocoagulation syndrome:A multicenter prospective study

BACKGROUND Thermal damage may lead to inflammation of the peeled mucosal surface during endoscopic submucosal dissection(ESD).AIM To determine the effect of Joule heat on the onset of post-ESD electrocoagulation syndrome(PECS).METHODS In this prospective study,PECS was characterized by in-hospital fever(white blood cell count:≥10000μ/L or body temperature≥37.5°C)and abdominal pain(visual analog scale score≥30 mm during hospitalization or increased by≥20 mm from baseline at admission).High Joule heat was defined as 15390 J.Between April 2020 and April 2024,209 patients underwent colorectal ESD;those with intraoperative perforation or penetration were excluded.The remaining 202 patients were divided into the PECS and non-PECS groups.RESULTS PECS occurred in 30(14.9%)patients.Multivariate analysis revealed high Joule heat as an independent factor associated with PECS(odds ratio=7.96;95%confidence interval:2.91-21.8,P<0.01).The procedure time and presence of lesions in the right colon were not associated with PECS.CONCLUSION Accumulated thermal damage on the peeled mucosal surface should be considered during PECS onset.This thermal damage is likely a major component of the mechanism underlying PECS.

High total Joule heat increases the risk of post-endoscopic submucosal dissection electrocoagulation syndrome after colorectal endoscopic submucosal dissection

BACKGROUND We hypothesized that thermal damage accumulation during endoscopic submucosal dissection(ESD)causes the pathogenesis of post-ESD electrocoagulation syndrome(PECS).AIM To determine the association between Joule heat and the onset of PECS.METHODS We performed a retrospective cohort study in patients who underwent colorectal ESD from May 2013 to March 2021 in Japan.We developed a novel device that measures swift coagulation time with a sensor adjacent to the electrosurgical coagulation unit foot switch,which enabled us to calculate total Joule heat.PECS was defined as localized abdominal pain(visual analogue scale≥30 mm during hospitalization or increased by≥20 mm from the baseline)and fever(temperature≥37.5 degrees or white blood cell count≥10000μ/L).Patients exposed to more or less than the median Joule heat value were assigned to the high and low Joule heat groups,respectively.Statistical analyses included Mann-Whitney U and chisquare tests and logistic regression and receiver operating characteristic curve(ROC)analyses.RESULTS We evaluated 151 patients.The PECS incidence was 10.6%(16/151 cases),and all patients were followed conservatively and discharged without severe complications.In multivariate analysis,high Joule heat was an independent PECS risk factor.The area under the ROC curve showing the correlation between PECS and total Joule heat was high[0.788(95%confidence interval:0.666-0.909)].CONCLUSION Joule heat accumulation in the gastrointestinal wall is involved in the onset of PECS.ESD-related thermal damage to the peeled mucosal surface is probably a major component of the mechanism underlying PECS.

Effect of the Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia

Objective: To investigate the effect of Chinese medicine prescription-Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia and its influence on the immune function. Methods: A total of 48 Wistar rats were randomly divided into the normal control group, the damp-heat syndrome model group, the Haoqinqingdan decoction group (high, medium and low dose group) and the ribavirin group. The body temperature and weight of rats in each group were recorded after modeling. After treatment for 6 d, the concentration of T lymphocyte subgroup (CD3+ CD4+ , CD3+ CD8+ ) was determined by flow cytometry. The OD value of IFN毭/IL-4 was detected by double-antibody sandwich ELISA method, and its concentration was acquired through conversion. Results: After modeling, the temperature and weight of rats in each modeling group showed the increasing trend ( P<0.01). From the second day of treatment, there was significant difference in the body mass between groups, and the rat weight of the control group was higher than in the modeling group ( P<0.05 or 0.01). With the advances of treatment, only the temperature in the medium and high dose Haoqinqingdan decoction groups declined significantly ( P<0.05). After treatment, the CD4+ /CD8+ ratio of the damp-heat syndrome model group decreased more significantly compared with the control group. Elevated CD3+ CD8+ percentages and declined CD4+ /CD8+ ratios can be observed in the low dose group and ribavirin group ( P<0.05). Moreover, the CD3+ CD4+ percentage of ribavirin group was lower than in the control group ( P<0.05). After treatment, the IFN-毭 and IFN-毭/ IL-4 levels in the peripheral blood of rats in the dampheat syndrome group were obviously higher than in the control group ( P<0.05). Conclusions: Compared with ribavirin, the high dose Haoqinqingdan decoction can improve the ratio of T lymphocyte subgroup and Th1/Th2 cell balance more effectively.

Structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome differentiated by traditional Chinese medicine

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of subhealthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the“GHRS diagnostic scale”,collected their oropharyngeal swabs,and sequenced the 16 SrDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,Metagenome Seq analysis,and linear discriminant analysis effect size(LEf Se)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundancebased coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while betadistances did not exhibit any significant intergroup differences.There were 9 differently distributed nonpredominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in Metagenome Seq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

Effect of gastrointestinal heat retention syndrome on gut microbiota in children with upper respiratory tract infection and lung-heat syndrome

Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in children.The study will explore the effect of GHRS on the structure and function of gut microbiota in children with URTI lung-heat syndrome.Methods:Participants were divided into both groups using the self-developed URTI scale and the“GHRS Diagnostic Scale$Pediatric Part”:GHRS-positive children(LS group)and GHRS-negative children(L group).General information,clinical symptoms,and stool were collected.We used 16S rRNA amplicon sequencing technology to determine the gene sequence of the V3eV4 region in feces and measure the gut microbiota of the both groups at the genus level.Results:A total of 23 children were included in the both groups.There were 12 cases in the LS group and 11 cases in the L group.There was no statistical difference between the both groups in age,gender,height,weight,and body mass index.The effective sequences shared by the both groups accounted for 85.66%of the total.In the gut microbiota,there was no difference in the a diversity and the b diversity between the both groups.Compared with the L group,the LS group had a significant increase in the relative abundance of the Ruminococcus gnavus group,Prevotella-9,Staphylococcus,and Actinomyces(P<.05).The functions of the both groups of microbiota primarily concentrate on metabolism,genetic information processing,and environmental information processing.The relative abundance of signaling molecules and interactions in the LS group were higher than that in the L group(P<.05).The redundancy analysis(RDA)showed that the URTI score had the greatest impact on the distribution of microbiota.Conclusion:GHRS may affect the development of URTI lung-heat syndrome by changing the relative abundances of gut microbiota.

Heat stroke induced cerebellar dysfunction:A “forgotten syndrome”

We report a case of heat stroke induced acute cerebellar dysfunction, a rare neurological disease characterized by gross cerebellar dysfunction with no acute radiographic changes, in a 61 years old ship captain presenting with slurred speech and gait ataxia. A systematic review of the literature on heat stroke induced cerebellar dysfunction was performed, with a focus on investigations, treatment and outcomes. After review of the literature and detailed patient investigation it was concluded that this patient suffered heat stroke at a temperature less than that quoted in the literature.

Role of mast cell-mi R-490-5p in irritable bowel syndrome

AIM To determine the functional role of mi R-490-5p in mast cell proliferation and apoptosis,and in the mast cell tryptase/PAR-2 signal pathway.METHODS The 3rd generation of lentivirus vector systems containing enhanced green fluorescent protein(EGFP)(Ruisai Inc.,Shanghai,China),which acts as a reporter gene was used to construct the mmu-mi R-490-5p lentivirus expression vector p EGFP-antagomi R-490-5p,and the lentivirus vector p EGFP-negative was used as a negative control.The stably transfected mast cell line p815 was then constructed.GFP positive cells were successfully transfected cells.We determined the expression of mi R-490-5p in p815 mast cells before and after transfection using quantitative real-time PCR(q RT-PCR).In addition,after transduction with the lentivirus vectors,the role of mi R-490-5p in mast cell proliferation and apoptosis was investigated using the CCK-8 assay and flow cytometry,respectively.The m RNA levels of tryptase and PAR-2 were detected by q RT-PCR and the protein levels were detected by Western blot.RESULTS The inhibition of mi R-490-5p expression promoted apoptosis and inhibited proliferation of p815 mast cells.The m RNA levels of tryptase and PAR-2 were significantly increased after transfection comparedwith the control group,tryptase(P=0.721,normal vs null;P=0.001,si RNA vs normal;P=0.002,si RNA vs null)and PAR-2(P=0.027,si RNA vs null;P=0.353,normal vs null;P=0.105,si RNA vs normal).The protein levels of tryptase and PAR2 were slightly higher in the si RNA group than those in the control group,but the difference was not statistically significant(P>0.05).CONCLUSION mi R-490-5p plays a vital role in the pathogenesis of irritable bowel syndrome by affecting mast cell proliferation and apoptosis;with down-regulation of mi R-490-5p,the m RNA level of mast cell tryptase and PAR-2 increased,and the protein level increased,but the difference was not statistically significant.

A new way to analyze the traditional Chinese medicine syndrome:heat toxin syndrome in cerebral infarction

Objective:To establish a diagnostic system for heat toxin syndrome of acute cerebral infarction.Based on this toxin syndrome diagnostic system,the general principles of heat toxin development will be uncovered,and the critical turning point at which the heat toxin syndrome occurs will also be explored.Methods:In this study,a total of 271 hypertension patients with cerebral infarction within 72 h were recruited from the Affiliated Dongfang Hospital of the Beijing University of Chinese Medicine,the Affiliated Dongzhimen Hospital of Beijing University of Chinese Medicine,the Affiliated Renmin Hospital of Peking University,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,the Affiliated Hospital of Hebei University of Traditional Chinese Medicine and China Meitan General Hospital from August,2008,to December,2009.The patients’Chinese medical information was recorded on days 1,3,5,7,and 14 during their hospitalizations.The medical records were recorded according to traditional Chinese medicine(TCM)theory and included the serum marker levels at the beginning and at the end of the trial.The time line was also analyzed.Results:The level of Hs-CRP,PAG,NSE,OX-LDL,and MMP-9 were abnormal and,were higher in CI patients compared to hypertension patients.In the study of the heat toxin diagnosis system,according to the entropy clustering results,30 combinations of the medical information can be sorted into the traditional syndromes,but 13 combinations cannot be sorted.To obtain more precise symptoms related to the heat toxins,a logistic regression equation was set up with the variables from the unsorted medical information;the dependent variables were fever and BP fluctuation.Weighted variables were obtained.MLP analysis demonstrated that the diagnosis model was stable and precise.The accuracy reached 83.82%.The ROC test showed that seven points of the diagnosis system was the best cutting point,with a sensitivity of 0.857 and a specificity of 0.955.Progressing stroke was related to heat toxin syndrome.When the turning point appeared,the combination of symptoms,such as coma,aphasia,gummy eyes,and halitosis,predicted the deterioration or recovery of CI.The heat toxin syndrome existed in every subtype of CI;however,the observed heat toxin levels were highest in PACI and lowest in LACI.Meanwhile,blood and sputum stasis syndromes transformed into heat toxicity were one source of heat toxin syndrome.Conclusion:Heat toxin syndrome,as well as qi/blood/sputum stasis,co-existed in the CI patients,and the transformation frequently appeared during the process.Three to five days after the onset of CI was the turning point,at which time several combinations of medical indicators make it possible to predict the development of CI.

Effects of Lycii Fructus and Salviae Miltiorrhizae on the Syndrome of Deficiency with Blood Stasis in RCS(rdy-/-, p-/-) Rats with Retinitis Pigmentosa: An Intervention Study

Objective To investigate the effects of Lycii Fructus(LF,Gou Qi Zi,枸杞子)and Salviae Miltiorrhizae Radix Ex Rhizoma(SM,Dan Shen,丹参)on the syndrome of deficiency with blood stasis in the RCS(rdy-/-,p-/-)rats with retinitis pigmentosa(RP).Methods A total of 32 RCS(rdy-/-,p-/-)rats were divided into 4 groups(equal amounts of female and male rats in each group):model group treated with 0.9%normal saline,LF group treated with LF formula granules,SM group treated with SM formula granules,and LF and SM(L·S)group treated with LF and SM formula granules.Eight RCS(rdy+/+,p+/+)rats(4 males and 4 females)were treated with 0.9%normal saline to serve as blank group.The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate and fibrinogen content in plasma,and the content of cAMP and cGMP in retinal homogenate were detected.The retina was evaluated by hematoxylin-eosin staining.Results The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate,and fibrinogen content in the plasma of L·S group significantly differed from those of model group(P<0.01),but were similar to those of blank group.The contents of cAMP and cGMP in the retinal homogenate of L·S group significantly differed from those in model group(P<0.01)but were similar to those in blank group(P>0.05).Conclusions LF and SM can effectively treat retinitis pigmentosa by ameliorating the syndrome of deficiency with blood stasis.

Clinical Study on Application of Xinrun Tongluo Method Based on the Theory of Collateral Diseases in Treating Androgenic Baldness of Blood Heat Wind Dryness Syndrome

[Objectives]To explore the intervention effect of the representative formula of Xinrun Tongluo method,Liangxue Xiaofeng Powder,on the incidence of androgenic alopecia in the syndrome of blood heat and wind dryness.[Methods]A total of 72 patients with androgenic alopecia in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine from October,2022 to June,2023 were randomly divided into a control group(36 cases,treated with Western medicine)and a treatment group(36 cases,treated with Chinese herbal formula+Western medicine).The short-term and long-term efficacy of the two groups of patients was compared.[Results]The hair microscopic signs and short-term and long-term efficacy of the treatment group were significantly better than those of the control group before and after treatment,with a statistically significant difference(P<0.05).[Conclusions]The representative formula of Xinrun Tongluo method is Liangxue Xiaofeng Powder,which has better clinical efficacy as an auxiliary Western medicine in the treatment of androgenic alopecia patients with blood heat and wind dryness syndrome,and is worthy of further promotion and application in clinical practice.

Association between gastrointestinal heat retention syndrome and respiratory tract infections in children:A prospective cohort study

Objective:To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections(RRTIs)in children.Methods:A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital.Children without respiratory tract infections(RTIs)were consecutively recruited according to the selection criteria.A semi-structured questionnaire was used to record traditional Chinese medicine(TCM)symptoms and demographic and physiological characteristics.Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity.The participants were followed up for 12 months.Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months.Episodes of pneumonia and RTIs were recorded in detail.Results:A total of 420 children were included.Of participants,370(88.10%)were followed up for 12 months.The mean number of RTI episodes per participant was 5.37(95%CI:5.14 to 5.60).In total,186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the nongastrointestinal heat retention syndrome group completed the 12-month follow-up period.The baseline of both groups was comparable.The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27(95%CI:1.01 to 1.59)times that in children without gastrointestinal heat retention syndrome.Logistic regression analysis revealed that abnormally increased appetite with frequent hunger,foul breath,dry stools,and dark red or purple fingerprints were positively correlated with the incidence of pneumonia.Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI.Conclusions:Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children.Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.

Exploring the association between gastrointestinal heat retention syndrome and adult chronic eczema: A caseecontrol study

Objective:To investigate the association between gastrointestinal heat retention syndrome(GHRS)and adult chronic eczema.Methods:This caseecontrol study compared GHRS/GHRS accompanied by damp-heat syndrome(GHRSDHS)and other patient characteristics between subjects with(cases)and without chronic eczema(controls)to identify potential factors associated with this condition.Semi-structured questionnaires were used to collect data via face-to-face interviews.Participants were recruited from Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine.A logistic regression analysis was performed on the collected data,and odds ratios(ORs)were calculated.Results:A total of 168 cases and 172 controls were recruited.Among the cases of adult chronic eczema,there were 79 subjects with GHRS and 68 with GHRS-DHS.Sex(P=.02,OR=0.54,95%confidence interval[CI]:0.32-0.91),GHRS(P=.04,OR=1.90,95%CI:1.02-3.51),GHRS-DHS(P<.001,OR=4.89,95%CI:2.36-10.15),high sweet food consumption(P=.04,OR=2.03,95%CI:1.03-3.97),and mental stress(P=.01,OR=2.37,95%CI:1.26-4.47)were each found to be associated with chronic eczema.Furthermore,GHRS had a weak positive correlation with eczema EASI severity as measured by the eczema area and severity index(EASI)(P=003).Conclusion:GHRS/GHRS-DHS may be associated with adult chronic eczema.In the future,prospective cohort studies with larger samples should be conducted to investigate the cause and effect association between GHRS and adult chronic eczema.

Study on the relationship between syndrome characteristics degree and inflammatory factor and negative emotional scale in"double heart disease"patients with Qi stagnation blood stasis and heart gallbladder heat stagnation

Objective:To Discuss the correlation between Hypersensitivity C-reactive Protein(Hs-CRP),Total Cholesterol(TC),Triglyceride(TG),negative emotion scale and TCM syndrome scores in“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation.Method:Fifty-two patients in Western Medicine Diagnosis of Double Heart Disease,in TCM syndrome identified as Qi stagnation blood stasis Heart gallbladder heat stagnation syndrome,detects it Hs-CRP,TC,TG levels by ELISA,use TCM Syndromes Scale to evaluate TCM Syndrome,use the Pittsburgh Sleep Quality Index(PSQI)and Self-rating symptom scale(SCL-90)to assess anxiety and sleep levels,analyze the correlation between TCM syndrome scores and Hs-CRP,TC,TG level,PSQI index,SCL-90 index.Result:There was a significant positive correlation between Hs-CRP,TG level and TCM Syndrome scores(P<0.05);TC level was postively correlated with TCM Syndrome scores,but there was no statistical significance(P>0.05);There was a significant positive correlation between PSQI index,SCL-90 index and TCM Syndrome scores(P<0.05).Conclusion:In“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation,there have characteristic syndrome changes in terms of inflammatory factor level,blood lipid level and negative emotion score;Which the above indexes can reflect the severity of TCM syndromes to a certain extent and provide the basis for the effective intervention treatment of TCM.

miR-103-3p regulates the differentiation of bone marrow mesenchymal stem cells in myelodysplastic syndrome

The pathogenesis of myelodysplastic syndrome(MDS)may be related to the abnormal expression of microRNAs(miRNAs),which could influence the differentiation capacity of mesenchymal stem cells(MSCs)towards adipogenic and osteogenic lineages.In this study,exosomes from bone marrow plasma were successfully extracted and identified.Assessment of miR-103-3p expression in exosomes isolated from BM in 34 MDS patients and 10 controls revealed its 0.52-fold downregulation in patients with MDS compared with controls(NOR)and was downregulated 0.55-fold in MDS-MSCs compared with NOR-MSCs.Transfection of MDS-MSCs with the miR-103-3p mimic improved osteogenic differentiation and decreased adipogenic differentiation in vitro,while inhibition of miR-103-3p showed the opposite results in NOR-MSCs.Thus,the expression of miR-103-3p decreases in MDS BM plasma and MDS-MSCs,significantly impacting MDS-MSCs differentiation.The miR-103-3p mimics may boost MDS-MSCs osteogenic differentiation while weakening lipid differentiation,thereby providing possible target for the treatment of MDS pathogenesis.

Creutzfeldt-Jakob disease presenting as Korsakoff syndrome caused by E196A mutation in PRNP gene:A case report

BACKGROUND Prion diseases are a group of degenerative nerve diseases that are caused by infectious prion proteins or gene mutations.In humans,prion diseases result from mutations in the prion protein gene(PRNP).Only a limited number of cases involving a specific PRNP mutation at codon 196(E196A)have been reported.The coexistence of Korsakoff syndrome in patients with Creutzfeldt-Jakob disease(CJD)caused by E196A mutation has not been documented in the existing literature.CASE SUMMARY A 61-year-old Chinese man initially presented with Korsakoff syndrome,followed by rapid-onset dementia,visual hallucinations,akinetic mutism,myoclonus,and hyperthermia.The patient had no significant personal or familial medical history.Magnetic resonance imaging of the brain revealed extensive hyperintense signals in the cortex,while positron emission tomography/computed tomography showed a diffuse reduction in cerebral cortex metabolism.Routine biochemical and microorganism testing of the cerebrospinal fluid(CSF)yielded normal results.Tests for thyroid function,human immunodeficiency virus,syphilis,vitamin B1 and B12 levels,and autoimmune rheumatic disorders were normal.Blood and CSF tests for autoimmune encephalitis and autoantibody-associated paraneoplastic syndrome yielded negative results.A test for 14-3-3 protein in the CSF yielded negative results.Whole-genome sequencing revealed a diseasecausing mutation in PRNP.The patient succumbed to the illness 11 months after the initial symptom onset.CONCLUSION Korsakoff syndrome,typically associated with alcohol intoxication,also manifests in CJD patients.Individuals with CJD along with PRNP E196A mutation may present with Korsakoff syndrome.

Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B(CHB)Patients with Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome

Objective:This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common traditional Chinese medicine(TCM)Syndromes—damp heat syndrome and liver depression and spleen deficiency syndrome.Methods:According to the diagnostic criteria of Western medicine,TCM and screening exclusion criteria,65 cases of CHB with damp heat syndrome and 28 cases of CHB with liver depression and spleen deficiency syndrome were finally included in the study.All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing.16S rDNA of gut microbiota was sequenced using Illumina hiseq 2,500 high-throughput sequencing platform.Based on the optimized sequence,Operational Taxonomic Units(OTU)clustering analysis and taxonomic annotation were carried out.Results:The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients.Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales,Alphaproteobacteria and Lachnospira were higher in the damp heat syndrome.LDA Effect Size(LEfSe)analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusion:The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.

Clinical Observation of Dingchuan Decoction(定喘汤)Combined with Omazumab in Treating Acute Attack of Bronchial Asthma(Heat Asthma Syndrome)

Objective:To explore the therapeutic effect of Dingchuan Decoction combined with omazumab on acute attack of bronchial asthma.Methods:From January 2020 to November 2021,90 patients with acute asthma were treated in our hospital,which belonged to heat asthma syndrome according to TCM syndrome differentiation in our hospital.They were divided into control group and observation group with 45 cases in each group.The control group was treated with omazumab,while the observation group was treated with omazumab combined with Dingchuan Decoction.The changes of lung function,exhaled nitric oxide(FeNO),blood gas indexes and hematological indexes were observed before and after treatment,and the adverse reactions and asthma recurrence within 3 months were observed.At the same time,animal experiments were carried out to verify the curative effect of Dingchuan.Results:After treatment,the total effective rate,FeNO,pulmonary function,partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),interleukin-6(IL-6),interleukin-5(IL-5),immunoglobulin E(IgE)and asthma recurrence in 3 months in the observation group were better than those in the control group;There was no significant difference in pulse oxygen saturation(SaO_(2))and the incidence of adverse reactions between the two groups.Animal experiments show that Dingchuan Decoction can effectively improve lung inflammation.Conclusion:The combination of Dingchua Decoction and omazumab has a good curative effect in the treatment of acute attack of bronchial asthma,which can effectively improve the lung function and blood gas index of patients,reduce the levels of inflammatory factors and IgE,and has no obvious increase in adverse reactions,and effectively control the recurrence of asthma within 3 months.It can be used as an auxiliary maintenance treatment for patients with mild and moderate acute attack and clinical remission of asthma,thus reducing the utilization rate of hormones and having high application value.

热射病致吉兰-巴雷综合征三例并文献复习

目的 报道3例热射病致吉兰-巴雷综合征并进行文献复习,总结热射病致吉兰-巴雷综合征的临床特征。方法与结果 共3例患者均为南昌大学第二附属医院2022年8月诊断与治疗病例,临床主要表现为热射病意识障碍恢复后四肢无力、构音障碍,体格检查腱反射消失,肌电图提示广泛性周围神经损害,以轴索损害为主,运动神经受累为著,其中例1和例2存在脑脊液蛋白细胞分离现象,临床诊断为热射病致吉兰-巴雷综合征,予免疫治疗后肌力较前好转,但1年余随访时仍遗留明显神经功能障碍。结论 热射病致吉兰-巴雷综合征病情危重,多发生于热射病3周内,免疫治疗后肌力不同程度改善,但仍遗留严重神经功能缺损,预后较差。

王阶从“虚-痰-瘀-热-滞”论治冠状动脉狭窄经验

冠状动脉粥样硬化斑块导致冠状动脉狭窄是冠心病发病的关键和病理基础。目前,冠心病的常规治疗措施包括药物治疗和血运重建,在一定程度上能改善症状,但仍有发生不良心血管事件的风险。全国名中医王阶教授临证经验丰富,在中医辨治冠心病及用药方面独具特色。王教授提出,冠心病的核心病机是“痰瘀滞虚”,四大证候要素紧密结合,互相转化,贯穿于冠心病发生、发展的全过程。王教授认为,冠状动脉狭窄与“虚、痰、瘀、热、滞”病机密切相关,其中“虚”为内在致病之本,“血瘀、痰浊”是主要病理因素,“热毒内蕴”是重要病机,“气滞”是加重病情、干扰疾病转归的重要因素。王教授临证时强调治病求本,病机结合病理,脏腑辨证和病证结合,方证相应指导处方用药,药性结合药理,灵活配伍。治疗上,以益气补肾、活血化痰、清热解毒之法立法组方,擅用经方加减化裁,守机用之,遵旨变通;或合方治疗,兼顾病情;善用对药配伍,强化药效,颇具特色。现将王阶教授在冠状动脉狭窄治疗方面的临床经验总结如下,并附医案一则,以飨同道。