Traditional Chinese medicine nursing protocols for COVID-19

In order to facilitate nurses to understand the key points of COVID‑19’s common syndromes,master the key points of nursing with syndrome differentiation,use the advantages of traditional Chinese medicine(TCM)nursing characteristics,standardize TCM nursing behavior,and improve the TCM nursing effect,through the search of relevant information,combined with the clinical practice experience of more than 1 month of front‑line anti‑epidemic nursing staff,the TCM nursing protocols for COVID‑19(draft)were formed.After four rounds of expert consultation and discussion,and 15 times of collation and revision,the final version of TCM nursing protocols for COVID‑19 was formed.The TCM nursing protocols for COVID‑19 include the following five parts:key points of common syndromes,nursing for common symptoms/syndromes,TCM special nursing,healthy guidance,and difficulties in nursing;it is scientific and practical,and can provide clinical guidance for nursing of patients with COVID‑19.

Mechanism of traditional Chinese medicine in the treatment of allergic rhinitis

Objective To review the major progress in mechanism of traditional Chinese medicine （TCM） in the treatment of allergic rhinitis （AR）. Methods Contents about the treatment mechanism of TCM in the therapy of AR in this article were obtained from 22 original articles and reviews published in Chinese- and English-language journals. All of the references were searched by use of Pubmed （1997-2012）. Results AR is one of the most common and most serious public health problems in children and young people. Many AR patients were worried about the possible adverse effects of synthetic drugs they were taking. Thus, they seek complementary and alternative therapy, such as TCM. TCM emphasized on the importance of holistic convalescence, not just the disease itself. The favorable safety profile of TCM makes well-acceptance by the general population. In the recent decade, more and more studies of TCM for AR are developed. These studies indicated that the treatment of allergic disorders with TCM therapy including herbal medicines and acupuncture are of safety and efficacy. The mechanism of TCM in the treatment of AR has been discussed. It has been reported that a number of the herbs in the Chinese herbal formulae used in the treatment possess anti-allergic, anti-inflammatory or immune modulation activity. Such function include the inhibition of the release or the activity of mast cell mediators （such as histamine）, inhibition the induction of inflammation reaction by chemical agents, and down regulation of serum （immunoglobulin E） IgE levels or the activity of lymphocyte and/or macrophage. Conclusions TCM are frequently used concurrently to improve the clinical efficacy. This review is focuses on the description of the actions mechanism of Chinese medicine＇s approach relevant to the treatment of AR.

Lesion discrimination with breath-hold hepatic diffusionweighted imaging:A meta-analysis

AIM:To investigate the diagnostic capability of breathhold diffusion-weighted imaging(DWI) for differentiation between malignant and benign hepatic lesions.METHODS:A total of 614 malignant liver lesions(132 hepatocellular carcinomas,468 metastases and 14 intrahepatic cholangiocarcinomas) and 291 benign liver lesions(102 hemangiomas,158 cysts,24 focal nodular hyperplasia,1 angiomyolipoma and 6 hepatic adenomas) were included from seven studies(eight sets of data).RESULTS:The pooled sensitivity and specificity of breath-hold DWI were 0.93 [95% confidence interval(CI):0.91-0.95] and 0.87(95%CI:0.83-0.91),respectively.The positive likelihood ratio and negative likelihood ratio were 7.28(95%CI:4.51-11.76) and 0.09(95%CI:0.05-0.17),respectively.The P value for χ2 heterogeneity for all pooled estimates was < 0.05.From the fitted summary receiver operating characteristic curve,the area under the curve and Q * index were 0.96 and 0.91,respectively.Publication bias was not present(t = 0.49,P = 0.64).The meta-regression analysis indicated that evaluated covariates including magnetic resonance imaging modality,echo time,mean age,maximum b factor,and number of b factors were not sources of heterogeneity(all P > 0.05).CONCLUSION:Breath-hold DWI is useful for differentiating between malignant and benign hepatic lesions.The diffusion characteristics of benign lesions that mimic malignant ones have rarely been investigated.

Improvement of Quality of Life with Shenfu Injection (参附注射液) in Non Small Cell Lung Cancer Patients Treated with Gemcitabine plus Cisplatin Regimen

Objective： To observe the effect of Shenfu injection （参附注射液, SFI） in treating non small cell lung cancer （NSCLC） patients on quality of life with gemcitabine （GEM） plus cisplatin （GP） regimen. Methods： Thirty-four patients were ready to receive GP regimen chemotherapy for treating NSCLC disease, according to lot-drawing, they were divided into SFI pre-treatment group （18 cases） and SFI post-treatment group （ 16 cases）. SFI pre-treatment group： During the first treatment course, chemotherapy was begun with SFI 60 ml, intravenous dripping on the 3rd day, once daily, consecutively for 10 days; on the 1st day, GP regimen （GEM 1250 mg/m^2 , intravenous dripping, on the 1st and 8th day; cisplatin 70 mg/m^2 on the 2nd day; 21 days as one cycle） was carried out; in the second treatment course GP regimen was merely given to serve as the self-control. SFI post-treatment group： the medicament sequence order was reversed from that of pre-treatment group. Using dual international quality of life （QOL） scores, the effect of SFI on the patients＂ QOL was observed through randomized self pre- and post- crossover control. Results： The QOL in the 34 patients after being treated by SFI in combination with GP chemotherapy regimen in one group, and GP chemotherapy regimen alone in the other, was improved in different degrees, with significant difference （P〈0.01）; comparision of SFI combined with GP chemotherapy regimen with GP chemotherapy alone showed that QOL in patients was significantly different （P〈0.01）. Conclusion： SFI could improve QOL in patients with NSCLC who were treated with GP regimen.

3.0 T proton magnetic resonance spectroscopy of the liver: Quantification of choline

AIM: To investigate the normal hepatic magnetic resonance spectroscopy findings choline/lipid2 (Cho/Lip2) associated with age and body mass index (BMI).METHODS: A total of 58 single-voxel proton spectra of the liver were acquired at 3.0 T using the eightchannel phased array abdominal coil as the receiver coil. Consecutive stacks of breath-hold spectra were acquired using the point resolved spectroscopy technique at a short echo time of 30 ms and a repetition time of 1500 ms. The spectra were processed with the SAGE software package. Areas and heights for metabolite resonance were obtained. Student's t test for unpaired data was used for comparisons of shimming, Cho/Lip2, and lipid content. RESULTS: There were significant negative correlations between the Cho/Lip2 peak height ratios and BMI (r=-0.615) and age (r=-0.398) (all P<0.01). Compared with the high-BMI group, the low-BMI group was younger (39.1±13.0 years vs 47.6±8.5 years, t=-2.954,P=0.005); had better water suppression (93.4%±1.4% vs 85.6%±11.6%, t=2.741, P=0.014); had higher Cho/Lip2 peak heights ratio (0.2±0.14 vs 0.05±0.04,t=6.033,P<0.000); and had lower lipid content (0.03±0.08 vs 0.29±0.31, t=-3.309, P=0.004). Compared with the older group, the younger group had better shimming effects (17.1±3.6 Hz vs 22.0±6.8 Hz, t=-2.919, P=0.008); higher Cho/Lip2 peak heights ratios (0.03±0.05vs 0.09±0.12,t=2.4, P=0.020); and lower lipid content (0.05±0.11 vs 0.23±0.32,t=-2.337,P=0.031). Compared with the lowcholine peak group, the high-choline peak group had lower lipid content (0.005±0.002 vs 0.13±0.23, t=-3.796,P<0.000); lower BMI (19.6±2.4vs 23.9±3.0, t=-4.410, P<0.000); and younger age (34.7±10.0 years vs 43.2±12.5 years, t=-2.088, P=0.041). CONCLUSION: Lipid accumulation could result from the increased fat in the body depending on age and BMI. Lipid can mask the resonance signal of choline.

Meta analysis of application of acupuncture combined with drug anesthesia in anorectal surgery

Objective:To evaluate the effectiveness and safety of acupuncture combined drug anesthesia and simple drug anesthesia in anorectal surgery.Methods:The randomized controlled trials of acupuncture combined with drug anesthesia was evaluated using Cochrane systematic review method.The search scope was China National Knowledge Internet,wanfang database,China Biomedical Literature,Pubmed and Embase.The deadline was December 31,2018.The randomized controlled trials of acupuncture combined with anesthesia that met the inclusion criteria were selected.In terms of trial quality evaluation,Cochrane risk bias was used for evaluation.Finally,RevMan 5.2 software was used for statistical analysis.Results:This study finally included 15 articles,a total of 1321 patients.The heterogeneity of significant rate was good,and the combined effect amount OR was 3.55(95%CI[2.06,6.12]).The combined effect quantitative test(Z=4.57,P<0.00001)showed that there was a statistical significance,indicating that acupuncture combined drug anesthesia was better than simple anesthesia in anorectal surgery.The heterogeneity of adverse reactions was good,and the combined effect test(Z=8.88,P<0.00001)showed that there was a statistical significance,indicating that the adverse reaction rate of acupuncture combined with drug anesthesia was lower than that of simple drug anesthesia in the anorectal surgery.Conclusion:Compared with simple drug anesthesia,acupuncture combined with drug anesthesia can improve the anesthesia effect and reduce the occurrence of adverse reactions in anorectal surgery.

CT guided ^125iodine seed implantation for portal vein tumor thrombus in primary hepatocellular carcinoma

Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT. Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case. Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.

A Clinical Study on Global TCM Therapy in Treating Senile Advanced Non-small Cell Lung Cancer

Objective： To assess the clinical efficacy of global traditional Chinese medicine （TCM） therapy in treating senile advanced non-small cell lung cancer （NSCLC）, with the aim of seeking a standardized, rational and economical way to treat advanced NSCLC in old patients. Methods： A retrospective analysis and comparison was carried out in 86 patients with senile advanced NSCLC, 44 treated by global TCM （TCM group） and 42 by chemotherapy （control group） through dynamical observation on related indexes including tumor size, quality of life and the survival time, as well as on the fee for medical service at various time points in the course of the treatment. Results： The changes of tumor size, score of clinical main symptoms and behavior condition （by ZPS scoring）, as well as survival rates in the two groups at corresponding time points, were not different significantly （P〉0.05）. The mean survival time in the TCM group was 13.20 ± 1.52 months and that in the chemotherapy group was 13.45 ±1.94 months, showing insignificant difference between them. However, the median survival time in the TCM group （12 months） was actually longer than that in the chemotherapy group （9 months, P〈0.05）. The mean daily expense and the mean expense （RMB yuan） for each patient in the TCM group were significantly lower than that in the control group, which was 180.73 ±93.21 vs 825.84 ±329.63 for the mean daily expense and 34 077.21 ±14 638.04 vs 58 516.59 ±45 429.76 for the mean expense for each patient （both P〈0.01）. Conclusion： Treatment of senile advanced NSCLC with TCM alone has its apparent superiority in stabilizing tumor focus, improving clinical symptoms, elevating quality of life and prolonging the survival time. TCM is also less expensive, making it a good alternative therapeutic approach for this specific group of people.

Electroacupuncture in Treating Depression:A Randomized Controlled Study

Objective: To observe the clinical efficacy of electroacupuncture in treating depression. Methods: By a randomized controlled study method, sixty patients with depression were randomized into an electroacupuncture group and a medication group, 30 in each. The electroacupuncture group was treated with electroacupuncture, and the medication group was orally administrated Paroxetine tablets. They were evaluated by using Hamilton Depression Scale (HAMD) before and after treatments and the safety was also assessed. Results: The total effective rate was 83.3% in the electroacupuncture group versus 60.0% in the medication group, and the difference was statistically significant (P<0.05). The electroacupuncture group was superior to the medication group in comparing the improvement of HAMD scores after treatment (P<0.05). Conclusion: Electroacupuncture is an effective approach in treating depression.

The Proteomic Research of the Cure of Experimental Diabetes Deafness by Granules of Eliminating Phlegm and Removing Blood Stasis

Objective: Observing the expression changes of serum proteome in model rats after intervention of the Granules of Eliminating Phlegm and Removing Blood Stasis (豁痰祛瘀颗粒 also known as GEPRB), screening out and identifying the differentially expressed proteins by mass spectrometry and bioinformatics analysis, discussing the molecular mechanism of control the Diabetes deafness by GEPRB. Methods: By use of proteomics technology, the serum protein serum proteome of the control group, model control group, Duxil and each observation group were observed for 2-DE gel pattern matching, and the difference in the relative content of 2 times was chosen for the differentially expressed proteins. Identification of differentially expressed proteins by MALDI-TOF MS/MS, the authors further analysis the phosphorylation, subcellular localization, interaction, direct regulation, and transmembrane of the differences proteins by the way of bioinformatics analysis. Sixty SPF level SD rats elected in diabetic rats model group (abbreviated as DM group) were be randomly divided into 5 groups based on random number sheet, namely model control group, positive drug control group (Du-ke-xi group) and Mai-tong-fang high, medium and low dose group respectively. In addition, set of normal control group. 10 rats in each group. Results: By Coomassie brilliant blue staining, identified 51 differential protein spots dug from 2-D gel by mass spectrometry, successfully identified 13 non-redundant proteins. Most of the identified proteins were secreted protein and belong to different protein families. There were about 12 proteins have the transmembrane region from the authors’ result, ten of them were plasma membrane proteins. Conclusion: It’s suggesting that 13 differential proteins is most likely the protein response to GEPRB in vivo, these proteins may play key role for the treatment of GEPRB to Diabetes deafness. The two highly differentially expressed proteins Apolipoprotein E (apoE) and C3 may be a potential drug target of GEPRB.

Clinical Study on Electroacupuncture for Perimenopausal Insomnia

Objective： To observe the clinical efficacy of electroacupuncture in treating perimenopausal insomnia. Methods： Seventy eligible subjects were randomized into two groups, 38 subjects in the treatment group were intervened by electroacupuncture, 30 min each session; 32 subjects in the control group were intervened by Alprazolam, 0.4 mg each time before sleep. Athens insomnia scale （AIS） was adopted to evaluate sleep quality. Results： The therapeutic efficacy in the treatment group was significantly better than that in the control group （P〈0.05）. Conclusion： Electroacupuncture efficacy in treating perimenopausal can produce a content therapeutic nsomnia.