Combination treatment of inflammatory bowel disease:Present status and future perspectives

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical gastroenterologist.It seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the treatment.In daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical agents.These combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment applied.Therefore,a part of these patients are going to surgery.In recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe cases.In our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very few.As mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal manifestations.The appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research shortly.In this editorial,we attempt to summarize the existing data regarding the already applied combination therapies and to humbly formulate thoughts and suggestions for the future application of the combination treatment of biological agents in a well-defined category of patients.We suggest that the application of biomarkers and artificial intelligence could help in establishing new forms of treatment using the available modern drugs in patients with IBD resistant to treatment.

The application of the “Treatment in Accordance with Three Categories of Etiologic Factors” theory in the prevention and treatment of epidemic diseases in traditional Chinese medicine since the Ming and Qing Dynasties

“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.

Cannabis Indoor Growing Conditions, Management Practices, and Post-Harvest Treatment: A Review

Cannabis has attracted a new wave of research attention as an herbal medicine. To deliver compliant, uniform, and safe cannabis medicine, growers should optimize growing environments on a site-specific basis. Considering that environmental factors are interconnected, changes in a factor prompts adjustment of other factors. This paper reviews existing work that considers indoor growing conditions (light, temperature, CO2 concentration, humidity, growing media, and nutrient supply), management practices (irrigation, fertilization, pruning & training, and harvest timing), and post-harvest treatment (drying and storage) for cannabis indoor production.

COMMENTS ON ACUPUNCTURE TREATMENT OF DISEASES ACCORDING TO SEASONAL CONDITIONS IN 《THE INTERNAL CLASSIC》

In the present paper, the author gives some comments on acupuncture treatment of diseases from 1) selecting acupoints based on seasonal conditions; 2) performing reinforcing or reducing needling manipulations in accordance with the waxing and wanning of the moon; 3) conducting acupuncture treatment in accordance with the time and the state of disease; and 4) performing acupuncture treatment based on the prosperity or decline of the meridian-qi, which are described in medical book The Yellow Emperor’s Internal

Treatment of Helicobacter pylori infection in atrophic gastritis

Helicobacter pylori(Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmission of infection. There is no ideal treatment for Hp. Hp infection is not cured by a single antibiotic, and sometimes, a combined treatment with three or more antibiotics is ineffective. Atrophic gastritis(AG) is a chronic disease whose main features are atrophy and/or intestinal metaplasia of the gastric glands, which arise from long-standing Hp infection. AG is reportedly linked to an increased risk for gastric cancer, particularly when extensive intestinal metaplasia is present. Active or past Hp infection may be detected by conventional methods in about two-thirds of AG patients. By immunoblotting of sera against Hp whole-cell protein lysates, a previous exposure to Hp infection is detected in all AG patients. According to guidelines, AG patients with Hp positivity should receive eradication treatment. The goals of treatment are as follows:(1) Cure of infection, resolution of inflammation and normalization of gastric functions;(2) possible reversal of atrophic and metaplastic changes of the gastric mucosa; and(3) prevention of gastric cancer. An ideal antibiotic regimen for Hp should achieve eradication rates of approximately 90%, and complex multidrug regimens are required to reach this goal. Amongst the factors associated with treatment failure are high bacterial load, high gastric acidity, Hp strain, smoking, low compliance, overweight, and increasing antibiotic resistance. AG, when involving the corporal mucosa, is linked to reduced gastric acid secretion. At a non-acidic intra-gastric p H, the efficacy of the common treatment regimens combining proton pump inhibitors with one or more antibiotics may not be the same as that observed in patients with Hp gastritis in an acid-producing stomach. Although the efficacy of these therapeutic regimens has been thoroughly tested in subjects with Hp infection, there is a paucity of evidence in the subgroupof patients with AG. Bismuth-based therapy may be an attractive treatment in the specific setting of AG, and specific studies on the efficacy of bismuth-based therapies are needed in patients with AG.

Photoacoustic treatment mitigates cognitive dysfunction in a model of sleep-wake rhythm disturbance

Sleep-wake rhythm disturbances,which are characterized by abnormal sleep timing or duration,are associated with cognitive dysfunction.Photoacoustic treatments including light and sound stimulation have been found to be effective in modulating sleep patterns and improving cognitive behavior in abnormal sleep-wake pattern experiments.In this study,we examined whether light and sound interventions could reduce sleep-wake pattern disturbances and memory deficits in a sleep rhythm disturbance model.We established a model of sleep rhythm disturbance in C57 BL/6 J mice via a sleep deprivation method involving manual cage tapping,cage jostling,and nest disturbance.We used a Mini Mitter radio transmitter device to monitor motor activity in the mice and fear conditioning tests to assess cognitive function.Our results indicated that an intervention in which the mice were exposed to blue light(40-Hz flickering frequency)for 1 hour during their subjective daytime significantly improved the 24-hour-acrophase shift and reduced the degree of memory deficit induced by sleep deprivation.However,interventions in which the mice were exposed to a 40-Hz blue light at offset time or subjective night time points,as well as 2 Hz-blue light at 3 intervention time points(subjective day time,subjective night time,and offset time points),had no positive effects on circadian rhythm shift or memory deficits.Additionally,a 2000-Hz sound intervention during subjective day time attenuated the24-hour-acrophase shift and memory decline,while 440-Hz and 4000-Hz sounds had no effect on circadian rhythms.Overall,these results demonstrate that photoacoustic treatment effectively corrected abnormal sleep-wake patterns and cognitive dysfunction associated with sleep-deprivation-induced disturbances in sleep-wake rhythm.All animal experiments were approved by the Experimental Animal Ethics Committee of Drum Tower Hospital Affiliated to the Medical College of Nanjing University,China(approval No.20171102)on November20,2017.

Evaluation of copper removal efficiency using water treatment sludge

Large quantities of sludge are produced during water treatment processes. Recently, sludge has been treated as waste and disposed of in landfills, which increases the environmental burdens and the operational cost. Therefore, sludge reuse has become a significant environmental issue. In this study, adsorption of copper ions (Cu^2+) onto calcined sludge was investigated under various operational conditions (with varying temperature, Cu^2+ initial concentration, pH, and sludge dosage). The prepared sludge material was characterized with transmission electron microscopy (TEM), X-ray diffraction (XRD), dynamic light scattering (DLS), and Brunauer-Emmett-Teller (BET) surface area. The sorption capacity of sludge was directly proportional to the initial Cu^2+ concentration and inversely proportional to the sludge dosage. The optimum operational pH and solution temperature were 6.6 and 80℃, respectively. The experimental results followed a Langmuir isotherm and pseudo-first-order adsorption kinetics. Thermodynamic parameters such as activation energy, change in free energy, enthalpy, and entropy were calculated. Thermodynamic analyses indicated that the sorption of copper ions onto the calcined sludge was driven by a physical adsorption process. The prepared sludge was proven to be an excellent adsorbent material for the removal of Cu^2+ from an aqueous solution under optimum conditions.

Optimization of reaction conditions for the electroleaching of manganese from low-grade pyrolusite

In the present study, a response surface methodology was used to optimize the electroleaching of Mn from low-grade pyrolusite. Ferrous sulfate heptahydrate was used in this reaction as a reducing agent in sulfuric acid solutions. The effect of six process variables, including the mass ratio of ferrous sulfate heptahydrate to pyrolusite, mass ratio of sulfuric acid to pyrolusite, liquid-to-solid ratio, current density, leaching temperature, and leaching time, as well as their binary interactions, were modeled. The results revealed that the order of these factors with respect to their effects on the leaching efficiency were mass ratio of ferrous sulfate heptahydrate to pyrolusite 〉 leaching time 〉 mass ratio of sulfuric acid to pyrolusite 〉 liquid-to-solid ratio 〉 leaching temperature 〉 current density. The optimum conditions were as follows： 1.10：1 mass ratio of ferrous sulfate heptahydrate to pyrolusite, 0.9：1 mass ratio of sulfuric acid to pyrolusite, liquid-to-solid ratio of 0.7：1, current density of 947 A/m^2, leaching time of 180 min, and leaching temperature of 73°C. Under these conditions, the predicted leaching efficiency for Mn was 94.1%; the obtained experimental result was 95.7%, which confirmed the validity of the model.

Households’Willingness-to-Pay for Wastewater Treatment in Traditional Agro-Food Processing Villages,Nhue-Day River Basin,Vietnam:Case Study in Hanoi City

Despite the number of studies focusing on the financial analysis of production activities, conducting on technical solutions, and improving water quality, no study has been conducted on the application of economic instruments that apply to water quality management in craft villages, and several studies of WTP also. This study aimed to estimate the households’ willingness-to-pay for wastewater treatment in selected traditional agro-food processing villages in Nhue-Day River Basin, Vietnam. A pilot Choice Experiment (CE) technique in Choice Modelling (CM) approach was applied for this study with 267 selected agro-food processing households by using the conditional logit (CL) and random parameter logit (RPL) models. The results showed that total annual environmental fee for wastewater treatment from agro-food processing households is estimated as 1089 million VND (equal to US$47,868 per year) for the total of 902 agro-food processing households in three research sites in Nhue-Day River Basin. This estimated budget for wastewater treatment accounted for 55.85% of total annual operation and maintenance costs only. In addition, the technology is improved to enable 90% of treated wastewater. Overall, the results of this study suggest the new wastewater treatment plant construction and improved wastewater collection system by increasing the investment in order to improve the water quality in Nhue-Day River Basin that brings about the reducing environmental degradation, biodiversity loss and human health risks.

Effect of different process conditions on the physicochemical and antimicrobial properties of plasma-activated water

The physicochemical properties of plasma-activated water(PAW)generated under different process conditions were investigated,and their changes under different storage conditions were also studied.The results showed that increasing the processing time and power,and decreasing generated water volume,could cause an increase in the redox potential,conductivity,and temperature of PAW,and a decrease in its pH.A slower dissipation of the reactive oxygen and nitrogen species in PAW was found on storage at 4℃in a sealed conical flask than on storage at room temperature.The inactivation ability of plasma-activated lactic acid(LA)to Listeria monocytogenes(L.monocytogenes)and Pseudomonas aeruginosa(P.aeruginosa)was higher than that of PAW or LA alone under the same experimental conditions.The results of this study may provide theoretical information for the application of PAW as a potential antimicrobial agent in the future.

Developing a Novel Approach for Sludge Treatment Using Microwaves Technology

The purpose of this research is to find a method that can improve the cost and efficiency of sludge treatment. Currently, large amounts of sludge are produced every day, but sludge treatment is neither efficient nor profitable. To improve the sludge treatment process, we proposed the method of using microwave technology to treat sludge. We hypothesized that using microwave technology, we can reduce the volume of the sludge up to 90%, and can save more energy and time comparing to the traditional methods that we are currently using to treat the sludge. To prove our hypothesis, we designed an experiment to compare the solid-liquid boundary height and the solid-liquid mass ratio of the sludge treated by the conventional method and the microwave technology. Prime temperature and time found for dewatering sludge are 70 Celsius degrees and five minutes. The results were rather surprising, as microwave heating demonstrated no significant advantage over conventional heating. The solid-liquid boundary height of sludge heated by conventional and by microwave methods are 22.34 mL and 22.56 mL;the solid-liquid mass ratio of sludge using conventional heating and microwave heating at 70 Celsius degrees are 14.28% and 14.55% (by separation with filter press), or 9.82% and 9.89% (by centrifugation). In conclusion, the difference is negligible.

Determination on Microclimatic Conditions at Vines upon Development on Gray Mold (<i>Botrytis cinerea</i>)

One of the most important plant diseases in viticulture is gray mold caused by Botrytis cinerea Pers. Fr., the anamorph of an ascomycete fungus (Botryotinia fuckeliana Whetzel). Locality Smilica, Kavadarci, Republic of North Macedonia, was the place where experimental fields with white varieties Smedervka and Zilavka were continuously observed. Working hypothesis was to follow development of the disease after increasing glucose over 11% until the time of the grape harvest, and microclimate was monitored at the same time. In both white varieties Smederevka and Zilavka on the control variants weren’t used botricide treatments to distinguish between the variants that were conventionally treated against B. cinerea. The aim of the research was to determine how microclimatic conditions affect the development of B. cinerea and consequently to create forecasting model for gray mold. The forecasting model for B. cinerea is based on relationship between temperature and humidity in the vines’ canopies. The aim of the research is to prevent development of B. cinerea and consequently reduce the number of chemical treatments.

Enriched Oxygen BAC Method in Advanced Treatment of Textile Dyeing-printing & Alkali-peeling Wastewater

A novel Pressurized Enriched Oxygen Biological Activated Carbon （PRBAC） method in treating secondary effluent of textile dying-printing & alkali peeling wastewater was configured. The PRBAC reactor simply increased reactor pressure to create an enriched dissolved oxygen （DO） environment to stimulate the bioactivities of microbes on GAC surface for removing refractory organic matter. Rapid Small-Scaled Column Test （RSSCT） was carried out to evaluate the adsorption characteristics of target stream constituents, and over 80% COD components were poorly adsorbable while about 82.5% color inducing matter and 85% UV 254 surrogated matter were readily adsorbable. Compared with performances of normal BAC reactor under conventional DO condition, PRBAC achieved 20%, 10% and 50% more removal in COD, color and NH3-N abatement.

Surface Cleaning or Activation?Control of Surface Condition Prior to Thermo-Chemical Heat Treatment

Actual heat treatment processes must face increasing specifications with reference to process quality, safety and results in terms of reproducibility and repeatability. They can be met only if the parts’ surface condition is controlled during manufacturing and, especially, prior to the treatment. An electrochemical method for the detection of a steel part’s surface condition is presented, together with results, consequences, and mechanisms concerning surface pre-treatment before the thermochemical process. A steel surface’s activity or passivity can be detected electrochenucalry, independently from the chemical background. The selected method was the recording of potential vs. time curves at small constant currents, using a miniaturized electrochemical cell, a (nearly) non-destructive electrolyte and a potentio-galvanostatic setup. The method enables to distinguish types of surface contamination which do not interfere with the thermochemical process, from passive layers which do and must be removed. Whereas some types of passive layers can be removed using conventional cleaning processes and agents, others are so stable that their effects can only be overcome by applying an additional activation pre-treatment, e.g. oxynitriding.

因地制宜发展新质生产力的必要性、科学性及着力点

因地制宜发展新质生产力是习近平总书记就如何发展新质生产力提出的新要求,为各地发展新质生产力提供了基本遵循、指明了方法路径。因地制宜发展新质生产力重要且迫切,体现在其为实现高质量发展提供强劲推动力、为推进中国式现代化注入新鲜活力、为培育国际竞争新优势把握新机遇、为完善现代化产业体系提供坚实支撑、为贯彻落实新发展理念指明前进方向。因地制宜是习近平总书记始终强调并亲自践行的方法论,是坚持实事求是的重要方法、是立足中国国情的现实选择、是统筹发展全局的前提条件、是避免产能过剩的关键举措。因此,因地制宜发展新质生产力应立足本地资源禀赋和优势条件,以整合科技创新资源,研发通用底层技术;释放数据要素潜能,推进区域协同创新;坚持全面深化改革,打通束缚发展堵点;调整优化金融供给,减轻企业融资压力;完善招才引智体系,锻造人才中坚力量为着力点,加快培育各具特色的新质生产力。

新时代李冰文化的精神内涵分析及其传承价值探讨

李冰于公元前256年主持修建都江堰,是中国古代科学治水的典型象征。李冰文化是中华优秀传统文化的一部分。目前关于李冰文化精神内涵的表述众说纷纭。研究认为李冰文化的精神内涵是以李冰为代表的都江堰历代治水先贤以及广大人民群众在都江堰的建设管理发展过程中、治水实践中所形成和体现的执政理念、科学思想、优秀品德及与之相关的民族情感,也是都江堰巨大作用、历史地位、独特价值的反映。本着客观、便于接受和推广的原则,提出李冰文化的精神内涵具体表述为“治水兴邦,师法自然,求实创新,人水和谐”。同时,结合国家政策以及新时代经济、文化发展需要,对李冰文化的传承发展提出建议。

老年慢性病共病病人治疗负担现状和影响因素分析

目的:了解老年慢性病共病病人治疗负担现状及其影响因素。方法:采用方便抽样方法,对北京某三级甲等医院老年慢性病共病住院病人进行问卷调查。采用二元Logistic回归分析老年慢性病共病病人治疗负担的影响因素。结果:共收回有效问卷102份。其中58.8%老年人有低度治疗负担,39.2%有中、高度治疗负担。家庭人均月收入、患慢性病数量、心理健康状况是老年慢性病共病病人治疗负担的影响因素(P<0.05)。结论:应加强对老年慢性病共病病人的关注,重视共病管理的动态变化性,以减轻老年慢性病共病病人治疗负担。

周学文等11位国医大师论治消化性溃疡的撷萃

消化性溃疡在中医药的治疗下疗效显著。因其症状与病机的复杂多样,在临床上的治法也各不相同。文章通过研究各位国医大师的宝贵经验和学术理论,认为此病虽病位在胃腑,但根据五脏一体关理论认为其成因与肝之疏泄调达,脾之转化运化功能都密切相关。临证可将其分为:肝气犯胃、脾胃虚弱、毒热内蕴等证型,治以疏肝和胃、益气健脾、清热解毒等法。突出各位国医大师在辨证论治、选方用药、预防调摄等方面的见解,以期能够为指导临床治疗提供借鉴意义与理论指导。

李飞针灸治疗面瘫经验举隅

总结李飞教授治疗面瘫的学术思想及诊疗经验。李飞提出诊治面瘫时应遵循“初病审因,次探病机,再明病证,辨证论治”,以祛风通络、疏调筋经为基本治疗原则。临床治疗时,以“重视解剖,依症施治”为基本方针,贯通中西理论,结合表情肌解剖结构,动态化判断神经、肌肉恢复情况,依据症状选取相应经验组穴。重视整合理论,总结理法辨证、分期辨证、症状辨证之“辨证三重”法则,调经、调筋、调神之“治疗三调”理论,值得临床借鉴。

基于“随其所得而攻之”探讨脾胃湿热证防治内涵及临床实践

脾胃湿热证是中医临床辨治较为棘手的脾胃复合证型之一。基于“随其所得而攻之”理论内涵,认为脾胃湿热证需从“攻无形邪气所据”(祛湿温阳)、“攻治所合之腑”(苦寒直折胃腑湿热)、“随五脏欲恶而攻”(制定脾胃所喜的生活调摄方案)、“随五脏所喜用药”(随脾胃所喜用药)、“各量轻重,从宜施治”(把握细节,辨证施治)5个方面进行综合辨治,并附临证案例一则,为脾胃湿热证防治提供参考。