Doctor Song Fuyin's Experience in Treating Hashimoto's Thyroiditis Based on Qi,Blood Essence and Spirit Syndrome Differentiation Stage Classification

The paper systematically summarizes the experience of Director Song Fuyin in treating Hashimoto's thyroiditis which is a typical emotional disease that causes obvious changes in organ morphology and endocrine and body fluid metabolism.It belongs to the category of psychosomatic diseases,and is the embodiment of a series of pathogenesis processes of qi disease,blood disease,essence disease and deformation in TCM theory.The whole course of the disease is dominated by the dialectical relationship of mutual influence,mutual control,mutual root and mutual use among the deity disease,qi disease,blood disease,essence and spiritual disease.Therefore,the treatment emphasizes the dialectical relationship based on qi,blood,essence and spirit.At the beginning,the treatment focuses on regulating qi and clearing heat and eliminating phlegm;at the middle stage,the treatment focuses on replenishing essence and promoting yang and eliminating wind and calming the deity;at the late stage,the treatment focuses on replenishing qi and eliminating phlegm and promoting collages.Flexible use of calming the spirits,regulating qi,dispersing essence,eliminating phlegm,promoting blood and other methods of stage classification treatment,can be targeted,improve the cure rate of the disease.This article aims to clarify the experience of Director Song Fuyin in treating Hashimoto's thyroiditis based on syndrome differentiation of qi,blood essence and spirit.

Stage Ⅳ non-small cell lung cancer with multiple metastases to the small intestine leading to intussusception: A case report

BACKGROUND Gastrointestinal tract metastasis from lung cancer is rare and compared to small cell lung cancer(SCLC),non-SCLC(NSCLC)is even less likely to metastasize in this manner.Additionally,small intestinal tumors can also present with diverse complications,some of which require urgent intervention.CASE SUMMARY In this report,we detail a unique case of stage IV lung cancer,where the presence of small intestine tumors led to intussusception.Subsequent to a small intestine resection,pathology confirmed that all three tumors within the small intestine were metastases from adenocarcinoma of the lung.The postoperative follow-up period extended beyond 14 mo.CONCLUSION In patients with stage IV NSCLC,local tumor control can be achieved with various treatments.However,if small intestinal metastasis occurs,surgical intervention remains necessary,as it may improve survival.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Perceptions and factors influencing exercise interventions in elderly patients with debilitating spinal surgery and healthcare professionals:A qualitative study

BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.

Regulatory factors of Nrf2 in age-related macular degeneration pathogenesis

Age-related macular degeneration(AMD)is a complicated disease that causes irreversible visual impairment.Increasing evidences pointed retinal pigment epithelia(RPE)cells as the decisive cell involved in the progress of AMD,and the function of anti-oxidant capacity of PRE plays a fundamental physiological role.Nuclear factor erythroid 2 related factor 2(Nrf2)is a significant transcription factor in the cellular anti-oxidant system as it regulates the expression of multiple anti-oxidative genes.Its functions of protecting RPE cells against oxidative stress(OS)and ensuing physiological changes,including inflammation,mitochondrial damage and autophagy dysregulation,have already been elucidated.Understanding the roles of upstream regulators of Nrf2 could provide further insight to the OS-mediated AMD pathogenesis.For the first time,this review summarized the reported upstream regulators of Nrf2 in AMD pathogenesis,including proteins and miRNAs,and their underlying molecular mechanisms,which may help to find potential targets via regulating the Nrf2 pathway in the future research and further discuss the existing Nrf2 regulators proved to be beneficial in preventing AMD.

Adipose-derived mesenchymal stem cells accelerate nerve regeneration and functional recovery in a rat model of recurrent laryngeal nerve injury

Medialization thyroplasty or injection laryngoplasty for unilateral vocal fold paralysis cannot restore mobility of the vocal fold. Recent studies have shown that transplantation of mesenchymal stem cells is effective in the repair of nerve injuries. This study investigated wheth- er adipose-derived stem celt transplantation could repair recurrent laryngeal nerve injury. Rat models of recurrent laryngeal nerve injury were established by crushing with micro forceps. Adipose-derived mesenchymal stem cells （ADSCs; 8 ×105） or differentiated Schwann-like adipose-derived mesenchymal stem cells （dADSCs; 8×105） or extracellular matrix were injected at the site of injury. At 2, 4 and 6 weeks post-surgery, a higher density of myelinated nerve fiber, thicker myelin sheath, improved vocal fold movement, better recovery of nerve conduction capacity and reduced thyroarytenoid muscle atrophy were found in ADSCs and dADSCs groups compared with the extracellu- lar matrix group. The effects were more pronounced in the ADSCs group than in the dADSCs group. These experimental results indicated that ADSCs transplantation could be an early interventional strategy to promote regeneration after recurrent laryngeal nerve injury.

Application of lesser trochanteric reduction fixator in the treatment of unstable intertrochanteric fractures

BACKGROUND Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.AIM To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.METHODS We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer.Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails,and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.RESULTS The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator,which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.CONCLUSION We fully realize the significance of trochanteric reduction and fixation,namely,reconstruction of structures under pressure,in the treatment of intertrochanteric fractures.As long as the general condition of patients is favorable and they are willing to undergo surgery,fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.

Genetic Cell Therapy in Anti-Aging Regenerative Cosmetology

As post-WWII baby boomer approaching age 80, Anti-Aging Regenerative Cosmetology (AARC) has been developed and patented for beautifying and strengthening the human body using live cells;to enhance the appearance and function of various bodily parts to provide health and aestheticism of human being throughout life. It is a combined cosmetic and preventive medicine to intervene with and to correct the undesirable phenotypic expression of aging. The intrinsic properties of myoblasts and foreskin fibroblasts in development and regeneration are harnessed to formulate a genetic cell therapy program which is safe and efficacious as previously been tested in FDA Phase III clinical trials. Myoblasts are selected for strength development and foreskin fibroblasts for tenacity and smooth-to-the-touch. Both cell types are highly mitotic and non-carcinogenic. In additional to providing large quantities of nuclei as regenerative gene medicine, and of mitochondria as energy generators, myoblasts secret tumor necrosis factor alpha (TNF-α) for skin whitening and melanoma prevention. Myoblasts, because of their small size, spindle shape, and resilience, grow readily on collagen and laminin within wrinkles of skin surfaces, thus enhancing the color, luster, and texture of the skin “plated” with them. Alternatively, they can be injected subcutaneously as cell filler to reduce wrinkles. Intramuscular injection of myoblasts can augment the size, shape, consistency, tone, and strength of muscle groups, improving the lines, contours, and vitality to sculpt a youthful appearance. By improving cell genetics and organ functions, the program holds promise to sustain the human subject in good health and appearance, with a good quality of life and life prolongation.

Dry needling at myofascial trigger points mitigates chronic post-stroke shoulder spasticity

Post-stroke spasticity is associated with restriction in the range of motion of the shoulder.Reducing muscular dystrophy may help relieve muscular dysfunction in patients with post-stroke shoulder spasticity.Dry needle therapy is a method of needling the trigger points using a syringe needle without the use of a drug.Dry needle therapy is commonly used for pain at the shoulder,neck,waist,and back.In this case study,a 62-year-old male patient affected with cerebral hemorrhage of the right frontal lobe had received rehabilitative treatment for 12 years.However,he still experienced shoulder spasticity.The patient received daily dry needling at the trigger points of infraspinatus,teres minor,posterior deltoid,and pectoralis major on 9 days.After the first and ninth treatment,the Modified Ashworth Scale and the passive range of motion of the shoulder was used to assess the effect of the treatment.The spasticity and range of motion of the shoulder showed obvious improvement.These results indicate that dry needling at the myofascial trigger points can effectively treat chronic poststroke shoulder spasticity.

Curative Effects of Warming Needle Moxibustion Combined with Manipulation Massage on Cervical Spondylotic Vertebral Arteriopathy and Its Influence on the Cerebral Blood Flow Parameters and Cervical Vertebral Function

OBJECTIVE: To explore the curative effects of warming needle moxibustion combined with manipulation massage on cervical spondylotic vertebral arteriopathy and its influence on the cerebral blood flow and cervical vertebra function. METHODS: A total of 84 patients with cervical spondylotic vertebral arteriopathy admitted to our hospital from February 2016 to June 2017 were selected, and all patients were divided into an observation group (n=42) and a control group (n=42) according to the random number table method. The patients in the control group were given conventional western treatment, and the patients in the observation group were treated with warming needle moxibustion combined with manipulation massage on the basis of the control group. After 4 weeks of treatment, the changes of main clinical symptoms (vertigo, headache, neck and shoulder pain, tinnitus), cervical function (clinical symptoms, clinical examination, daily life action) and cerebral blood flow parameters (average blood flow velocity of left vertebral artery, right vertebral artery and basilar artery) of the 2 groups were observed, and the clinical efficacy of the 2 groups were statistically analyzed. RESULTS: The scores of vertigo, headache, neck and shoulder pain and tinnitus in the 2 groups were all significantly lower than before treatment (P < 0.05), and the clinical symptom scores in the observation group were significantly lower after treatment (P < 0.05);After treatment, the scores of clinical symptoms, clinical examination and daily life action in the 2 groups were significantly higher than those before treatment (P < 0.05), and the increase of cervical vertebral function score in the observation group was better than that in the control group (P < 0.05);The mean blood flow velocity of the left vertebral artery, right vertebral artery and the basilar artery in the 2 groups after treatment were significantly higher than before treatment (P < 0.05), and the increase of the above cerebral blood flow parameters in the observation group were higher than the control group (P < 0.05). The total effective rate was 92.9% in the observation group and 76.2% in the control group after treatment, and the difference between the 2 groups was statistically significant (P < 0.05). CONCLUSION: Warming needle moxibustion combined with manipulation massage can quickly relieve the clinical symptoms of patients with cervical spondylotic vertebral arteriopathy, improve the cervical function and cerebral blood flow parameters, increase the vertebrobasilar artery blood flow, and promote the recovery of the disease.

Plasma Concentration of the Novel Peptide Apelin is Regularly Changed in Patients With Heart Failure

Objectives Apelin, the novel endogenous ligand for the G-protein-coupled receptor APJ, has been observed in many animals and humans studies. It is concluded that it has inotropic effects, hypotension and diuretic properties. The change of apelin in relation to heart failure is still controversial. Our goal was to observe the change of apelin-12 in patients with heart failure （HF）. Methods From 2005 to 2006, 81 consecutive patients （46 male and 35 female, mean age 68.5±12.1 years） with heart failure resulting from variable etiologies and 15 healthy controls were included in this study. Plasma concentration of apelin-12 was measured through ELISA on admission. All patients received conventional therapy and recorded detailed the clinical conditions. Results （1） Plasma concentration of apelin of the controls is lower than the ones of heart failure patients. （2） Plasma concentration of apelin is increased in the early stage and decreased in the advanced period. （3） Apelin is related with variable indexes in the Pearson＇s association analysis. Apelin is also changed with the atrium and ventricular＇s diameter. Conclusions Plasma concentration of apelin is increased in early stage and decreased in advanced period. The apelin-APJ system might be important in the pathophysiological process of heart failure. And it might be valuable in diagnosis and therapeutic implications in heart failure.

Improving Colonoscopy Polyp Detection Rate Using Semi-Supervised Learning

Colorectal cancer is one of the biggest health threats to humans and takes thousands of lives every year.Colonoscopy is the gold standard in clinical practice to inspect the intestinal wall,detect polyps and remove polypsin early stages,preventing polyps from becoming malignant and forming colorectal cancer instances.In recentyears,computer-aided polyp detection systems have been widely used in colonoscopies to improve the qualityof colonoscopy examination and increase the polyp detection rate.Currently,the most efficient computer-aidedsystems are built with machine learning methods.However,developing such a computer-aided detection systemrequires experienced doctors to label a large number of image data from colonoscopy videos,which is extremelytime-consuming,laborious and expensive.One possible solution is to adopt a semi-supervised learning,which canbuild a detection system on a dataset where part of its data is not necessary to be labeled.In this paper,on thebasis of state-of-the-art object detection method and semi-supervised learning technique,we design and implementa semi-supervised colonoscopy polyp detection system containing four main steps:running standard supervisedtraining with all labeled data;running inference on unlabeled data to obtain pseudo labels;applying a set ofstrong augmentation to both unlabeled data and pseudo label;combining labeled data,and unlabeled data withits pseudo labels to retrain the detector.The semi-supervised learning system is evaluated both on public datasetand our original private dataset and proves its effectiveness.Also,the inference speed of the semi-supervisedlearning system can meet the requirement of real-time operation.

Chondrogenic medium in combination with a c-Jun N-terminal kinase inhibitor mediates engineered cartilage regeneration by regulating matrix metabolism and cell proliferation

Cartilage tissue engineering is a promising strategy for repairing cartilage defects.However,achieving satisfactory cartilage regeneration in vitro and maintaining its stability in vivo remains a challenge.The key to achieving this goal is establishing an efficient cartilage regeneration culture system to retain sufficient active cells with physiological functions,generate abundant cartilage extracellular matrix(ECM)and maintain a low level of cartilage ECM degradation.The current chondrogenic medium(CM)can effectively promote cartilage ECM production;however,it has a negative effect on cell proliferation.Meanwhile,the specific c-Jun N-terminal kinase pathway inhibitor SP600125 promotes chondrocyte proliferation but inhibits ECM synthesis.Here,we aimed to construct a three-dimensional cartilage regeneration model using a polyglycolic acid/polylactic acid scaffold in combination with chondrocytes to investigate the effect of different culture modes with CM and SP600125 on in vitro cartilage regeneration and their long-term outcomes in vivo systematically.Our results demonstrate that the long-term combination of CM and SP600125 made up for each other and maximized their respective advantages to obtain optimal cartilage regeneration in vitro.Moreover,the long-term combination achieved stable cartilage regeneration after implantation in vivo with a relatively low initial cell-seeding concentration.Therefore,the long-term combination of CM and SP600125 enhanced in vitro and in vivo cartilage regeneration stability with fewer initial seeding cells and thus optimized the cartilage regeneration culture system.

Public knowledge of heart attack symptoms in Beijing residents

Background Definitive treatment for heart attack is early reperfusion with either angioplasty or thrombolytic therapy, and the benefit is strictly time-dependent. Patient outcomes are improved with either therapy when initiated as soon as possible. Recognition of heart attack symptoms is logically tied to taking action to receive prompt emergency care. Inadequate knowledge of heart attack symptoms may prolong delay. The purpose of this study was to document knowledge about heart attack symptoms in Beijing residents and to identify the characteristics associated with increased knowledge of heart attack. Methods A structured survey was conducted in 18 communities in Beijing from March 1 through June 10 in 2006. Addresses and participants were selected randomly following a stratification. The survey was designed to collect knowledge of heart attack symptoms from sampled adults in each community. Results A total of 4627 respondents completed the questionnaires correctly, and 50.29% of them were female. Totally 64.15% of the respondents reported chest pain or discomfort （common symptoms） as a symptom of heart attack; 75.38% reported at least one of the following eight symptoms as a symptom of heart attack： back pain, shortness of breath, arm pain or numbness, nausea or vomiting, neck, jaw or shoulder pain, epigastric pain, sweating, weakness （less common symptoms）; 20.36% correctly reported four or more heart attack symptoms, only 7.4% knew all the correct heart attack symptoms, and 28.94% knew about reperfusion therapy for heart attack; 31.7% reported to call 120 or 999 while having a heart attack themselves; however 89.6% reported to call 120 or 999 when someone else is suffering from a heart attack. Very old persons and those with health insurance coverage, high education level, high household income, longer living in Beijing and previous experience with heart disease had greater knowledge of heart attack symptoms. Conclusions Public knowledge of common heart attack symptoms as well as less common heart attack symptoms is deficient in Beijing residents. But their knowledge of calling emergency medical services when someone is having a heart attack is relatively adequate. Public health efforts are needed to increase the recognition of the major heart attack symptoms in both the general public and groups at high risk for an acute cardiac event, especially in socioeconomically disadvantaged subgroups, including persons with low education level, low household income, and no health insurance coverage.

Clinical and histopathologic features of biofilm-associated chronic rhinosinusitis with nasal polyps in Chinese patients

Background Biofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis （CRS）. However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps （CRSwNP）. Methods A total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy （SEM）. Their demographic and clinical features were recorded. Results Thirteen （68.4%） out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery （ESS） history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP. Conclusion Our study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.

Frontolateral Approach Applied to Sellar Region Lesions： A Retrospective Study in 79 Patients

Background： Various surgical approaches for the removal of sellar region lesions have previously been described. This study aimed to evaluate the reliability and safety of the frontolateral approach （FLA） to remove sellar region lesions. Methods： We presented a retrospective study of 79 patients with sellar region lesions who were admitted and operated by the FLA approach from August 2011 to August 2015 in Department of Neurosurgery of Beijing Tian Tan Hospital. We classified FLA into three types, compared the FLA types to the areas of lesion invasion, and analyzed operation bleeding volume, gross total resection （GTR） rate, visual outcome, and mortality. Results： Seventy-nine patients were followed up from 2.9 to 50.3 months with a mean follow-up of 20.5 months. There were 42 cases of meningiomas, 25 cases of craniopharyngiomas, and 12 cases of pituitary adenomas. The mean follow-up Karnofsky Performance Scale was 90.4. GTR was achieved in 75 patients （94.9%）. Two patients （2.5%） had tumor recurrence. No patients died perioperatively or during short-term follow-up. Three patients （3.8%） with craniopharyngioma died 10, 12, and 23 months, respectively, after surgery. The operative bleeding volume of this study was no more than that of the other approaches in the sellar region （P = 0.783）. In this study, 35 patients （44.3%） had visual improvement after surgery, 38 patients （48.1%） remained unchanged, and three patients＇ visual outcome （3.8%） worsened. Conclusions： FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions.

Anti-apoptosis Effect of Decoy Receptor 3 in Cholangiocarcinoma Cell Line TFK-1

Background： Decoy receptor 3 （DcR3） is a protein with anti-apoptotic effect that belongs to the tumor necrosis factor receptor superfamily. DcR3 is highly expressed in a variety of malignant tumors including cholangiocarcinoma and its expression was found to be related to the clinical stage, the invasion, and tile metastasis of the tumor. This in vitro study aimed to investigate the effect ofdownregulated expression of DcR3 on cell viability, cell apoptosis, and cell cycle in cholangiocarcinoma cell line TFK-1. Methods： Three different cell lines were cultured： human cholangiocarcinoma TFK-I, human biliary epithelial carcinoma HuCCT-1, and human cholangiocarcinoma RBE. The cholangiocarcinoma cell line with the highest expression of DcR3 was selected for further investigation. The expression of DcR3 was silenced/knocked down by transfection with DcR3-siRNA in the selected cell line. Various biological phenotype parameters such as cell viability, apoptosis, and cell cycle were observed. Results： The mRNA and protein levels of DcR3 were measured in the three cell lines, and TFK-1 was selected. After the treatment with DcR3-siRNA for 48 h, DcR3 mRNA and protein expression in the treatment group were 38.45% （P 〈 0.01 ） and 48.03% （P 〈 0.05） of that of＇the control, respectively. It was found that the cell viability decreased to 61.87% of the control group （P 〈 0.01 ） after the downregulation of DcR3 in cholangiocarcinoma cell line TFK- 1 by transfection with DcR3-siRNA, while tile percentage ofapoptotic cells was 2.98 times as compared with the control group （P 〈 0.05）. Compared with the control group the ratio of G0/G1 increased, and the ratio of G2/M dccreased in the treatment group. However, the differences were not statistically significant. Conclusions： The effect of DcR3 on the growth and apoptosis ofcholangiocarcinoma has been demonstrated. DcR3 is not only a predictive marker for malignant tumor but it is also likely to be a potential target for cancer gene therapy. Further studies should focus on exploring the binding ligand of DcR3, the signaling pathway involved, and the molecular mechanism for the regulation of DcR3 expression in cholangiocarcinoma.

Efficacy and safety of Liangxue Jiedu decoction for the treatment of progressive psoriasis vulgaris: a multicenter, randomized, controlled study

OBJECTIVE: To determine the clinical efficacy and safety of Liangxue Jiedu decoction(LJD) for the treatment of progressive psoriasis vulgaris and to provide the basis for the development of a standardized treatment protocol for psoriasis vulgaris.METHODS: In this multicenter, randomized, controlled study, patients with blood-heat type psoriasis were randomly assigned to receive either Chinese herbal medicine(LJD;treatment group) or Western Medicine(cetirizine hydrochloride, vitamin C, and vitamin B complex;control group). Psoriasis Area and Severity Index(PASI) scores were calculated in addition to the number of patients who achieved ≥ 50% or ≥ 75% improvement in PASI score from baseline. The change in symptoms of Chinese medicine(color of rash, burning sensation,itchiness, severity of irritation, and anger) was evaluated and safety was assessed as adverse events and laboratory analysis. t test, independent sample non-parametric test and χ2 test were used to analyze the results.RESULTS: A total of 238 participants were included in the study [treatment group, n = 122(PP analysis117);control group, n = 116(PP analysis 104)]. LJD treatment was associated with a significant improvement in skin lesions and symptoms com-pared with Western Medicine treatment. At the end of the 8-week treatment period, 23.77%(PP analysis 24.79%) of patients in the treatment group had achieved PASI75 and 57.38%(PP analysis 58.97%)had achieved PASI50;the corresponding figures in the control group were 9.48%(9.62%) and 25.00%(25.00%), respectively. The between-group differences were statistically significant(P < 0.05).CONCLUSION: Treatment of psoriasis vulgaris of the blood-heat type using LJD was associated with significantly better outcomes compared with those achieved using standard Western Medicine.

Bilateral nontuberculous mycobacterial keratitis after laser in situ keratomileusis

Laser in situ keratomileusis （LASIK） is currently the most popular keratorefractive procedure performed worldwide with generally excellent outcomes. However, infectious keratitis after LASIK is a devastating, vision-threatening complication. The common pathogens were bacteria and fungi. Nontuberculous mycobacterium （NTM） accounted for a substantial proportion of these pathogens. Most NTM infections （86% of cases） were involved in unilateral cornea. In this study, we report six patients with bilateral NTM keratitis following LASIK.

Is it really the ＂dark side＂ of herbal medicine？

Aristolochic acids （AAs）, previously rarely mentioned compounds, have been brought into the public eye several times since the beginning of this century; and currently, they have drawn even greater attention due to their association with liver cancer, as was recently reported by Ng et al.（Ng et al., 2017）. The authors sequenced the whole exomes of 98patients with hepatocellular carcinomas （HCC） from Taiwan and reported that 78%of the cases carried the AAs mutational signature, A：T〉T：A transversion.