Examples for Clinical Use of Ma Zi Ren Wan

Ma Zi Ren Wan (麻子仁丸), originally recorded in Treatise on Febrile Diseases (伤寒论), is composed of Ma Zi Ren (麻子仁Fructus Cannabis), Bai Shao (白芍Radix Paeoniae Alba), Zhi Shi (枳实Fructus Aurantii Immaturus), Da Huang (大黄Radix etRhizoma Rhei), Hou Po (厚朴cortex Magnoliae Officinalis) and Xing Ren (杏仁Semen Armeniacae Amarum). Good therapeutic results have been achieved by using Ma ZiRen Wan in treatment of febrile disease at the restoring stage, chronic consumptive diseases, hemorrhoid, disorders in women after delivery, chronic kidney disease, senile constipation, pulmonary heart disease, diabetes, coronary heart disease and hypertension. Some illustrative cases are introduced below. ……

CLINICAL USE OF BIOLOGICAL HEMOSTATIC GLUE IN NEUROSURGERY

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The clinical use of interventional chemotherapy and intravesical instillation for preventing recurrence of superficial bladder cancer

Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but

CLINICAL USE OF HOMOGRAFT STORED BY VITRIFICATION

Using 20% DMSO and 6% propylene glycol in Kreb' Ringer phosphate solution as cryopotective agent for homograft vitrification storage, the viability of stored bomograft (79.2%) was higher than that of slow cooling storage (59.7%). About 540000 cm2 of vitrified homograft were used to cover the wounds after excision of burn eschar in 135 pateints with major burns. The take-rate was over 94%. The cryopreservation of skin by vitrification can improve the viability and quality of skin and save time and cost.

Clinical Observation and Safety Evaluation of Zhuang Medicine Xiaoyan Zhiyang Formula for Dermatosis

[Objectives]To observe the clinical efficacy and safety of Zhuang Medicine Xiaoyan Zhiyang Formula by retrospective analysis of clinical use.[Methods]A total of 225 cases were collected,including 117 males and 108 females,115 cases of contact dermatitis and 110 cases of acute eczema.Zhuang Medicine Xiaoyan Zhiyang Formula was administered to 225 patients with contact dermatitis and acute eczema and the clinical efficacy was evaluated.[Results]After one week of treatment,among 225 patients with contact dermatitis and acute eczema,76 cases were cured(33.78%),133 cases showed marked response(59.11%),16 cases(7.11%)were improved,0 case was ineffective,and the overall response rate was 92.89%.After one week of Zhuang Medicine Xiaoyan Zhiyang Formula treatment,the symptoms of itching,pain and swelling were significantly improved in all patients,and the rash was partially crusted without new symptom,and there were no complications and adverse reactions.[Conclusions]Zhuang Medicine Xiaoyan Zhiyang Formula therapy has a remarkable effect in the treatment of contact dermatitis and acute eczema.

Controversies regarding transplantation of mesenchymal stem cells

Mesenchymal stem cells(MSCs)have tantalized regenerative medicine with their therapeutic potential,yet a cloud of controversies looms over their clinical tran-splantation.This comprehensive review navigates the intricate landscape of MSC controversies,drawing upon 15 years of clinical experience and research.We delve into the fundamental properties of MSCs,exploring their unique immuno-modulatory capabilities and surface markers.The heart of our inquiry lies in the controversial applications of MSC transplantation,including the perennial debate between autologous and allogeneic sources,concerns about efficacy,and lingering safety apprehensions.Moreover,we unravel the enigmatic mechanisms surro-unding MSC transplantation,such as homing,integration,and the delicate balance between differentiation and paracrine effects.We also assess the current status of clinical trials and the ever-evolving regulatory landscape.As we peer into the future,we examine emerging trends,envisioning personalized medicine and innovative delivery methods.Our review provides a balanced and informed perspective on the controversies,offering readers a clear understanding of the complexities,challenges,and potential solutions in MSC transplantation.

Clinical Application Analysis of Andrographolide Total Ester Sulfonate Injection,a Traditional Chinese Medicine Licensed in China

Andrographolide total ester sulfonate（ATES） injection is one of the products of traditional Chinese medicine（TCM） currently used against viral infection in China.ATES injection was approved for manufacturing and marketing in January 2002.It is indicated for acute respiratory infections,tonsillitis,chronic obstructive pulmonary disease,influenza,foot and mouth disease,bronchiolitis,herpangina,mumps,infectious mononucleosis and psychosis.However,its usage also carries risk.We investigated the use of ATES at the Wuhan Union Hospital from January 2014 to December 2014 and evaluated its real-world clinical application using the hospital centralized monitoring method.A total of 848 cases were enrolled in this study.In these cases,it was mainly used for postoperative anti-inflammation and treating upper respiratory infection,pneumonia and bronchitis.Among them,39.86% were contraindicated.Irregular medication of adults and children accounted for 1.91% and 23.38%,respectively.Improper choice of solvent accounted for 3.18%.The choice of intravenous drip versus aerosol inhalation was reasonable.A case of adverse events（AEs） was observed in the monitoring period,and the incidence of adverse drug reaction（ADR） of ATES injection was 0.12%.ATES injection in our hospital is relatively safe with a low incidence of adverse reactions.The study assesses the clinical usage and adverse reactions of ATES injection,and provides suggestions for rational use in clinical practice.

Clinical application of Aconitum carmichaelii Debx. (Fu Zi in Chinese) by traditional Chinese medicine physicians–A cross-sectional questionnaire survey in Beijing

Objective:To investigate clinical application of aconite root(Aconitum carmichaelii Debx.;hereinafter“aconite”)by traditional Chinese medicine(TCM)physicians in TCM hospitals in Beijing and explore the specific use of aconite and the effect of different doses on decoction time.Methods:This was a cross-sectional study using two-stage sampling.Questionnaires were administered among TCM physicians from TCM hospitals in Beijing between September 2020 and August 2021.The questionnaire mainly included general demographics,clinical backgrounds of TCM physicians,and clinical application of aconite.The data analyses were performed using SPSS 20.0.Results:A total of 387 questionnaires were collected,of which 385 were valid.Of the 385 participating TCM physicians,331(85.97%)used aconite in clinical practice.The top three medical diagnoses treated with aconite were heart failure,diarrhea without cause,and chronic gastritis.The TCM pattern treated most frequently with a high dose of aconite was spleen-kidney yang deficiency,and the TCM pattern treated most frequently with a low dose was spleen yang deficiency,while spleen-kidney yang deficiency was treated most frequently with a common dose of aconite.The top three common formulas were Sini decoction,Mahuang Xixin Fuzi decoction,and Zhenwu decoction.Hei Shun Pian was the most common herbal pieces of aconite.The highest frequency of the maximum dose of aconite was 15 g,that of the minimum dose was 3 g,and that of the common dose was 10 g.There was a certain correlation between decoction time and the dose of aconite.Most TCM physicians advised their patients to take medicine twice a day.Conclusion:In this study,we refined and quantified the use of aconite and enriched the exploration of the clinical application of aconite besides its provisions in the Pharmacopoeia of the People's Republic of China.

Antimicrobial Profile of Lactic Acid Bacteria Isolated from Vegetables and Indigenous Fermented Foods of India against Clinical Pathogens Using Microdilution Method

In dairy and food industries lactic acid bacteria （LAB） have been used in form of starter culture that plays vital role in fermentation; as flavouring and texturizing or as preservative agents. There is increasing evidence that lactobacilli which inhabit the gastrointestinal tract develop antimicrobial activities and participate in the host＇s defence system[1]. During fermentation, most of the LAB produces a number of different compounds like organic acids, hydrogen peroxide, diacetyl, acetaldehyde, carbon dioxide, polysaccharides, and proteinaceous compounds called bacteriocins or bacteriocinogenic peptides.

A predictive score for retinopathy of prematurity by using clinical risk factors and serum insulin-like growth factor-1 levels

AIM：To detect the impact of insulin-like growth factor-1（IGF-1）and other risk factors for the early prediction of retinopathy of prematurity（ROP）and to establish a scoring system for ROP prediction by using clinical criteria and serum IGF-1 levels.METHODS：The study was conducted with 127 preterm infants.IGF-1 levels in the 1st day of life,1st,2nd,3rd and4th week of life was analyzed.The score was established after logistic regression analysis,considering the impact of each variable on the occurrences of any stage ROP.A validation cohort containing 107 preterm infants was included in the study and the predictive ability of ROP score was calculated.RESULTS：Birth weights（BW）,gestational weeks（GW）and the prevalence of breast milk consumption were lower,respiratory distress syndrome（RDS）,bronchopulmonarydysplasia（BPD）and necrotizing enterocolitis（NEC）were more frequent,the duration of mechanical ventilation and oxygen supplementation was longer in patients with ROP（P〈0.05）.Initial serum IGF-1 levels tended to be lower in newborns who developed ROP.Logistic regression analysis revealed that low BW（〈1250 g）,presence of intraventricular hemorrhage（IVH）and formula feeding increased the risk of ROP.Afterwards,the scoring system was validated on 107 infants.The negative predictive values of a score less than 4 were 84.3%,74.7%and 79.8%while positive predictive values were 76.3%,65.5%and71.6%respectively.CONCLUSION：In addition to BW〈1250 g and IVH,formula consumption was detected as a risk factor for the development of ROP.Breastfeeding is important for prevention of ROP in preterm infants.

带量采购前后不同静脉留置针的临床使用情况及费用比较

目的通过对比带量采购前后不同静脉留置针的临床使用情况及整体费用,为优化临床决策、完善医用耗材带量采购提供参考。方法通过关键知情人访谈收集带量采购前后不同静脉留置针产品的临床使用情况,基于文献回顾及关键知情人访谈等构建模型对静脉留置针的整体费用进行分析。结果对来自南京和临沂的16家医院的27位临床护士进行了访谈。与带量采购前使用X品牌留置针相比,带量采购后使用中标品牌留置针的平均留置时间由3.7 d降为2.1 d,单个患者留置针平均用量由2.0个上升为3.5个。穿刺平均耗时增加,首次穿刺成功率降低,导管堵塞、脱管、发红、皮下血肿、液体渗漏、静脉炎等并发症发生率上升,留置针穿刺及耗材费用、并发症治疗、产品破损及护士人工费等上升。以100例使用静脉留置针的住院患者为1个研究单位,总费用从7765.4元上升到9338.7元,增加了1573.3元。结论带量采购后,静脉留置针的质量及临床使用出现一定的问题。尽管中标产品单价下降,但整体费用控制效果不如预期,甚至不降反增。建议逐步建立针对医疗耗材带量采购的质量和整体费用评价标准,加强对医用耗材带量采购事前、事中、事后的质量评估与临床使用监测,更全面地分析费用并进行决策。

Preparation and Drug-release Behavior of β-TCP Ceramics Drug Carrier in vitro

β-TCP ceramics drug carrier was first prepared and characterized. SEM showed that β-TCP carrier was in porous amorphous structure with diameters around 10 μm. The physical properties including apparent porosity, volume-weight, tensile strength and the permeability were measured and the results indicated those properties fit the clinical usage of β-TCP drug carrier. Furthermore, drug release experiment in vitro showed that the carrier could prolong drug release in simulated body fluid which provides basis for the clinical use of β-TCP ceramics as drug carrier.

Stem Cells: A Promising Therapeutic Target for COVID-19

A large variety of therapeutic products have been developed as vaccines or treatments of COVID-19 infection. Meanwhile SARS-CoV-2 continues to mutate and spread. The severe COVID-19 patients have limited treatment options. Therefore, mesenchymal stem cells (MSCs) are proposed as another therapeutic target. They are known for their regenerative and immunomodulatory properties. They showed potent efficacy and safety abilities for the treatment of critical COVID-19 patients and intriguing benefits in reducing lungs damage, mortality, and cytokine storm in several clinical studies. Another promising treatment option is the use of dental pulp stem cells (DPSCs) to combat SARS-CoV-2, despite the fact that detailed therapeutic strategies and mechanisms are still lacking. In this review we shed light on the immune response against COVID-19 infection and the relevant knowledge considering the role of MSCs in innate and adaptive immune responses to better understand the immune-physiological mechanisms of MSCs treatment. Lastly, we summarize the latest progress in clinical and research studies suggesting potential MSCs/DPSCs as therapeutic targets in battling COVID-19.

Contrast-Enhanced Mammogram: A New Game-Changer in Breast Imaging. Indications with Case-Based Experience

Mammograms are the mainstay of diagnostic breast imaging and cancer screening. Despite advances in technology such as Full Field Digital Mammography (FFDM) and Digital Breast Tomosynthesis (DBT), these imaging techniques are purely structural, and are unable to overcome shortcomings in mammography posed by dense breast parenchyma. Magnetic Resonance Imaging (MRI) is the most sensitive modality in breast imaging, due to its functional aspects in addition to structural imaging with this modality. The use of MRI is however constrained by cost and availability. The utilization of intravenous contrast with mammograms introduces a functional element to imaging. This greatly improves the sensitivity of the examination, approaching sensitivity levels of Magnetic Resonance Imaging (MRI) in the detection of primary breast cancer. With increased sensitivity afforded by assessment of tumor neo-vascularity, as well as its low cost, low energy imaging that is more readily available than MRI, Contrast-Enhanced Mammography (CEM) if more readily available than MRI, this imaging modality is a potential game-changer in breast imaging. In this article, we share our experience in the use of CEM, for indications previously reserved for MRI, with the literature review of these indications. In resonance with prior studies, we echo the ease of performing and reporting of CEM as well as greater patient comfort as the distinct advantages of CEM. In spite of slightly higher radiation dose and some risks related to contrast media, functional results at a significantly lower cost may change how we practice breast imaging in the future using CEM.

Could We Use Clinical Benefit to Evaluate the Effects of Chinese Medicine on the Treatment of Cancer?

The patients, who cannot endure the chemotherapy anymore, or internal disease or present drug resistance, normally use CM for improving their physical conditions and inhibiting tumor. CM has got excellent reputation because of the effects. Nonetheless, few clinical articles of CM to treat cancer are published on major international journals up to now.

Efficacy and safety of Firebird sirolimus-eluting stent in treatment of complex coronary lesions in Chinese patients： one-year clinical and eight-month angiographic outcomes from the FIREMAN registry

Background Off-label application of drug-eluting stents （DES） during percutaneous coronary intervention （PCI） was not uncommon in daily practice, however DES in treating Chinese patients with complex lesion subset was under-investigated. The primary objective of the FIREMAN registry was to evaluate the long term efficacy and safety of the Firebird sirolimus-eluting stent （SES） in treating patients with complex coronary lesions. Here we report the mid-term of one-year clinical outcomes and eight-month angiographic follow-up results of FIREMAN registry.Methods The FIREMAN registry was a prospective multi-center registry, which included 1029 consecutive patients undergoing PCI with Firebird SES implantation between September 2006 and July 2007 in 45 centers in China. The clinical follow-up was designed to be performed at 1, 6, 12, 18, 24, 30 and 36 months post index procedure, and non-mandatory angiographic follow-up at 8 months was planned. One hundred percent site monitoring was conducted.Results Long lesions （59.2%）, multi-vessel disease （50.4%）, and small vessel disease （31.6%） were mostly found in angiography. Major adverse cardiac events （MACE） occurred in 51 （5.1%） patients at 1 year clinical follow-up,including cardiac mortality in 6 （0.6%）, non-fatal myocardial infarction in 11 （1.1%）, and target lesion revascularization in 36 （3.5%） of the patients. Definite and probable stent thrombosis （ST） by Academic Research Consortium （ARC） definition occurred in 12 （1.36%） patients at one-year clinical follow-up. The 8-month binary restenosis rate was 5.7% in-segment and 4.3% in-stent, respectively. Late lumen loss was （0.21±0.40） mm in-segment and （0.23±0.36） mm in-stent, respectively. Furthermore, Cox regression analysis revealed that diabetes, small vessel diameter, and chronic total occlusion were independent predictors of ST.Conclusions The results showed that the Firebird SES was effective and safe in treating Chinese patients with complex coronary lesions and occurrence of ST rate at one-year clinical follow-up was acceptable, however further long-term follow-up was still necessary. （NCT00552656）