Diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia and acute exacerbation of chronic obstructive pulmonary disease in Gansu Province:A case report

BACKGROUND In December 2019,the first patient with 2019-novel coronavirus(2019-nCoV)was reported in Wuhan,China,and the disease spread rapidly across the country and surrounding countries within 2 mo.As of February 29,2020,a total of 91 confirmed cases had been reported in Gansu Province.This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.CASE SUMMARY The patient,a 94-year-old female,lived in Maiji District of Tianshui,Gansu Province,China.On January 30,2020,she was admitted to the Fourth People’s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia.She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3,2020 for treatment.Upon initial examination,her body temperature was 36.7°C,pulse was 80,breathing was 20,and blood pressure was 130/80 mmHg.She was conscious with normal development and normal nutrition.The pharynx was not red,and bilateral tonsils were not red and swollen.The lungs sounded slightly coarse with no dry or wet rales.The first symptoms were cough and fatigue on 2 February.The patient was hospitalized for 12 d.After active treatment,she was discharged on February 14 with a good prognosis.CONCLUSION A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection,and population clustering is a high risk factor for transmission.Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms.Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome.Nucleic acid testing is extremely important and needs to be repeated several times.Laboratory and auxiliary examination indicators during the first week of admission are extremely important.It is feasible to carry out dynamic and continuous index monitoring,which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.

Current Status of Traditional Chinese and Western Medicine Treatment of Diabetic Peripheral Vascular Disease

Diabetic peripheral vascular disease(PVD)is one of the common chronic complications of diabetes.The main clinical manifestations of PVD are numbness and coldness of the limbs,resting pain,intermittent claudication,and other symptoms.The combined treatment involving Chinese and Western medicine for PVD has various clinical methods and definite curative effects.It is worthy of in-depth clinical research and application.

Traditional Chinese combined with western therapy in treatment of upper extremity edema after breast cancer surgery: A meta-analysis

Objective:To evaluate clinical efficacy by traditional Chinese combined with western therapy to treat upper extremity edema after breast cancer surgery.The clinical efficacy was described by the effective rate and the change of peripheral diameter of the affected limb.Methods:National Knowledge Internet(CNKI),Wan Fang Digital Journals(Wan Fang),VIP Chinese periodical service platform(VIP),Chinese biomedical literature service system(CBM),PubMed and EMBASE were searched on computer.And clinical randomized controlled trials(RCT)of the treatment of upper extremity edema after breast cancer surgery with integration of Chinese and western treatment were selected.The time was from January 2011 to May 2020.Upper extremity edema after breast cancer surgery was the first key word and the second was traditional Chinese combined with western therapy.Note Express was used to screen and extract literature.Bias risks of all the literature included in the study were evaluated and analyzed by RevMan5.3 software.Results:10 randomized controlled clinical tests,644 patients in conformity to the inclusion criteria,9 for the observation of curative effectiveness,5 of changes in limb circumference.322 cases were included in the observation group and the same number of cases in the control group,all of which were in Chinese.The results expressed that the curative effect in the observation group was 91.1%,and it was higher than the curative effect in the control group treated by single western treatment obviously,and it was only 68.9%[95%CI(1.22,1.44),Z=6.55,P<0.00001].The peripheral diameter shrinking degree of the affected limb in the observation group was also clearly higher than that in the control group which was healed by simple western treatment[95%CI(-0.98,-0.64),Z=9.40,P<0.00001].Conclusion:Traditional Chinese combined with western therapy treating upper extremity edema after the surgery of breast cancer had a notable clinical effect,which treated the disease and effectively lessened the peripheral diameter of the affected limb.The method was worthy of clinical application.However,owing to the low quality of the included documents,further discussion and learning were still needed.

Bi-doped carbon quantum dots functionalized liposomes with fluorescence visualization imaging for tumor diagnosis and treatment

Liposomes are one of the significant classes of antitumor nanomaterials and the most successful nanomedicine drugs in clinical translation. However, it is difficult to accurately reveal liposome delivery modes and drug release rates at different p H values to assess the biodistribution and drug delivery pathways in vivo. Here, we established a strategy to integrate Bi-doped carbon quantum dots(CQDs)with liposomes to produce fluorescence visualization and therapeutic effects, namely lipo/Bi-doped CQDs.Lipo/Bi-doped CQDs show good water solubility and physicochemical properties, which can be used for in vitro labeling of colon cancer(CT26) cells and in vivo imaging localization tracking tumors for monitoring. Simultaneously, thanks to the excellent p H sensitivity and ion doping characteristic of Bi-doped CQDs, lipo/Bi-doped CQDs can be used to reveal the drug release rate of liposomes at different p H values and exhibit potential effects in vivo antitumor therapy.

Necrotizing fasciitis of cryptoglandular infection treated with multiple incisions and thread-dragging therapy:A case report

BACKGROUND Necrotizing fasciitis is a fulminant necrotizing soft tissue disease with a high fatality rate.It always starts with impact on the deep fascia rapidly and might result in secondary necrosis of the subcutaneous tissue,fascia,and muscle.Thus,timely and multiple surgical operations are needed for the treatment.Meanwhile,the damage of skin and soft tissue caused by multiple surgical operations may require dermatoplasty and other treatments as a consequence.CASE SUMMARY Here,we report a case of 50-year-old male patient who was admitted to our hospital with symptoms of necrotizing fasciitis caused by cryptoglandular infection in the perianal and perineal region.The symptoms of necrotizing fasciitis,also known as the cardinal features,include hyperpyrexia,excruciatingly painful lesions,demonstration gas in the tissue,an obnoxious foul odor and uroschesis.The results of postoperative pathology met the diagnosis.Based on the premise of complete debridement,multiple incisions combined with thread-dragging therapy(a traditional Chinese medicine therapy)and intensive supportive therapies including comprising antibiotics,nutrition and fluids were given.The outcome of the treatment was satisfactory.The patient recovered quickly and achieved ideal anal function and morphology.CONCLUSION Timely and effective debridement and multiple incisions combined with thread-dragging therapy are an integrated treatment for necrotizing fasciitis.

Can the management of depression in type 2 diabetes be democratized?

Both type 2 diabetes and depression are common and are projected to increase.There is increasing evidence for a bidirectional relationship between the two.Diabetes is a risk factor for depression;contrariwise,individuals with depression are at greater risk of developing diabetes.They are a burden for both the individual and the society.Co-existent depression worsens diabetic control because of obesity,insulin resistance and the adverse metabolic effects of anti-diabetes medicines.In addition,compliance to lifestyle measures required for diabetes is also compromised such as following a specific diet,taking proper medications on time,getting metabolic parameters assessed and maintaining a sleep cycle.Depression occurs in many grades;mild depression is more common in diabetes than frank or full-blown depression leading to suicide.Unfortunately,there are not enough trained and accessible mental health professionals such as psychologists or psychiatrists to deal with the increasing burden of depression in diabetes.Therefore,alternate models for management of mild to moderate depression are required.There is evidence that a team-approach by employing health care assistants can lower the risk of cardiac risk factors.INtegrating DEPrEssioN and Diabetes treatmENT study was carried out to determine whether the team-approach using non-health care professionals could be effective in managing mild to moderate depression and to study its effects on metabolic parameters among subjects with type 2 diabetes mellitus.The international study,carried out in four independent centers in India assessed the impact of a trained but not qualified non-psychiatrist in coordinating and forming a fulcrum between the patient,the family and the consultant endocrinologist/diabetologist.The interventions were fine-tuned to be culturally appropriate by qualitative interviews before they began.It was shown that the outcomes of both depression and diabetes could be improved by the employment of a clinical care coordinator.It is possible to scale up the studies to wider geographical areas and health-care organizations.

Preparation of NIR-II-excited Drug-loaded Liposomes and Their Antitumor Activity and in Vitro Imaging Studies

In recent years,with the rapid development of nano-technology,the combination of diagnosis and treatment by nanotechnologyhas brought new hope for mankind to overcome cancer.The Near-infrared two-region(NIR-II)imaging technology hasdeveloped rapidly in recent years because of its non-invasive nature,strong tissue penetration and overall imaging of small animals.In this study,a novel nano-drug delivery system(DOX-IR1061 cationic liposomes)was prepared,loaded with doxorubicin(DOX)as a chemotherapeutic drug and NIR-II-excited fluorescent probe IR1061 as an imaging agent,and the uptake ability of tumor cellswas enhanced by octadecylamine.DOX-IR1061 cationic liposomes have good NIR-II imaging ability,clear imaging and obvioussignal.Cell uptake indicated that palamine could enhance the uptake efficiency of cationic liposomes by tumor cells,while in vitroanti-tumor experiments revealed that the enhancement of uptake efficiency would enhance the anti-tumor effect of DOX.Therefore,DOX-IR1061 cationic liposomes we prepared have the potential to realize both tumor imaging and therapy,and to realize theintegration of rapid diagnosis and treatment,and provide new ideas for cancer cure and the development of the field of diagnosis andtreatment integration.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

Oral Administration and External Application of Chinese Drugs Combined with Micro-invasive Operation for the Treatment of Varicose Ulcers in the Lower Extremities

Objective:To evaluate the clinical therapeutic effects of oral administration and external application of Chinese drugs combined with micro-invasive surgery for the treatment of varicose ulcers in the lower extremities(ecthyma).Methods:A total of 152 patients(163 limbs) suffering from varicose ulcers on the lower limbs were assigned to two groups according to the patients' willingness.The 102 cases(109 limbs) in the treatment group underwent the method of endovenous microwave closure of communicating vei...

Clinical Observation on Treatment of Tourette Syndrome by Integrative Medicine

Objective:To explore the clinical efficacy of integrative Chinese and Western medicine in treating Tourette syndrome(TS).Methods:Ninety children with TS were randomized into two groups by randomizing digital table method:the 60 patients in the treated group were treated by Ningdong Granule(宁动颗粒,NDG) plus haloperidol,and the 30 in the control group treated by haloperidol alone.The course for both groups was 6 months.Conditions of the patients were estimated before and after treatment with Yale Global Tic ...

Thinking and Strategy on the Diagnosis and Treatment of Functional Gastrointestinal Disorders with Integrative Medicine

The functional gastrointestinal disorders (FGIDs) are a group of diseases mainly manifested as gastrointestinal functional disorders,including 45 kinds of different diseases,such as functional dyspepsia(FD), irritable bowel syndrome (IBS),functional

Surface-enhanced Raman scattering technology based on TiO_(2)/Nb_(2)C coated microfluidic chip for monitoring glioma cells invasion in real time

Glioma is a malignant primary brain tumor that is extremely harmful to human beings.Therefore,studying the invasiveness of glioma cells is of great significance for the diagnosis and treatment of glioma.In this work,TiO_(2)/Nb_(2)C was prepared as a SERS substrate and combined with microfluidic chip to construct an invasion model capable of monitoring glioma invasion in real time.Both experimental data and density function theory(DFT)calculations showed that the significant SERS-enhancing effect of TiO_(2)/Nb_(2)C on methylene blue(MB)originated from the chemical magnification(CM)mechanism when MB was used as the adsorbed molecule.Based on this,we achieved a highly sensitive and targeted detection of vascular endothelial growth factor(VEGF),a biomarker for glioma with a low detection limit of 3.7 pg/m L,then quantified the invasive process in real time by detecting VEGF.Meanwhile,the depletion of reactive oxygen species(ROS)by TiO_(2)/Nb_(2)C can inhibit the invasion of glioma cells.For the first time,the invasion model combines SERS technology with microfluidic technology,while monitoring the cell invasion process in real time,the invasion process can be quantified by detecting the VEGF secreted by glioma cells during the invasion process,realizing the integration of diagnosis and treatment,and establish a new model for the biomedical analysis,clinical diagnosis and treatment of glioma.

Shenyi Capsule(参一胶囊) plus Chemotherapy versus Chemotherapy for Non-Small Cell Lung Cancer:A Systematic Review of Overlapping Meta-Analyses

Objective:To assist decision-makers interpret and choose among conflicting meta-analyses,as well as to offer treatment recommendations based on current best evidence by performing a systematic review of overlapping meta-analyses regarding Shenyi Capsule(参一胶囊,SC) plus chemotherapy versus chemotherapy of non-small cell lung cancer(NSCLC).Methods:A literature search was conducted to select systematic reviews comparing SC plus chemotherapy with chemotherapy for NSCLC.Meta-analyses only composed of randomized controlled trials(RCTs) met the inclusion criteria.Two authors individually estimated the quality of meta-analysis and extracted data.The Jadad decision algorithm was applied to guarantee which meta-analysis provided the best original evidence.Results:A total of 5 meta-analyses were included.All the studies composed of RCTs or quasi-RCTs and were regarded as level-Ⅱ evidence.The scores of the Assessment of Multiple Systematic Reviews ranged from 3 to 6(median 4).A high-quality meta-analysis with more RCTs was chosen,which suggested that SC plus chemotherapy could increase incidence of short-term efficacy,improve the quality of life and survival rate in comparison to chemotherapy.However,there was no statistically significant difference between SC plus chemotherapy and chemotherapy regarding chemotherapy-induced side effect,such as liver and kidney function obstacle,leukopenia,hemoglobin decrement and gastrointestinal adverse reaction.Conclusions:Based on the best available evidence,treatment effect of SC plus chemotherapy was better than chemotherapy and did not increase side effects.Therefore,SC plus chemotherapy may be superior to chemotherapy for treating NSCLC.However,due to some limitations,SC plus chemotherapy should be cautiously considered,and further high-quality meta-analyses are needed.