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We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.
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BACKGROUND@#Occurrence at a younger age has been demonstrated to be associated with a distinct biology in non-small cell lung cancer. However, genomics and clinical characteristics among younger patients with lung adenocarcinoma remain to be determined. Here we studied the potentially targetable genetic alterations by next-generation sequencing (NGS) assay in young Chinese patients with lung adenocarcinoma.@*METHODS@#Eighty-nine surgically resected lung adenocarcinoma tissue samples from patients aged less than 45 years were collected with informed consent from all patients. Targeted NGS assays were used to identify actionable genetic alterations in the cancer tissues. Additionally, the genomic and clinical pathologic characteristics of 95 patients with lung adenocarcinoma who received NGS testing over the same period were analyzed retrospectively.@*RESULTS@#The frequencies of targetable genetic alterations in 184 patients with lung adenocarcinoma were analyzed by defined age categories, which unveiled a distinctive molecular profile in the younger group, aged less than 45 years. Notably, higher frequency of anaplastic lymphoma kinase (ALK) and human epidermal growth factor receptor 2 (HER2) genetic alterations were associated with young age. However, a reverse trend was observed for kirsten rat sarcoma viral oncogene (KRAS), serine/threonine kinase 11 (STK11) and epidermal growth factor receptor (EGFR) exon 20 mutations, which were more frequently identified in the older group, aged more than 45 years. Furthermore, concurrent EGFR/tumor protein p53 (TP53) mutations were much more prevalent in the younger patients (81.6% vs 44.9%), which might have a poor response to treatment with EGFR-tyrosine kinase inhibitor (EGFR-TKI).@*CONCLUSIONS@#NGS assay revealed a distinctive genetic profile in younger patients with adenocarcinoma. High frequency of concurrent EGFR/TP53 mutations was found in the younger patients, which especially warranted personalized treatment in this population.
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Objective Next generation sequencing (NGS) was used for identifying the potential gene mutations in advanced gastric cancer(AGC) tissue in order to instruct the targeted drug use for AGC patients. Methods A total of 31 AGC patients from the Affiliated Hospital of Qingdao University between August 10, 2016 and April 23, 2017 were enrolled, and the tissues of gastric cancer were collected. 7 708 exons of 508 tumor related genes and 78 introns of 19 frequently rearranged genes were assessed for base substitutions, indels, copy number alterations, and gene fusions detection. The average median sequencing depth was 470×. Results Somatic mutations were detected in all the patients, of which 9.7 % (3/31) patients could select targeted drugs approved by National Comprehensive Cancer Network (NCCN) guideline according to the identified genetic alterations (human epidermal growth factor receptor 2 gene amplification / mutation). Other targetable genetic alterations were detected in 13 (41.9 %) AGC patients, including mTOR inhibitors, PARP inhibitors, FGFR inhibitors and other targeted drugs of mutations genes. Conclusion The detection of targeted genes based on NGS might help to identify available targeted drugs and to personalize targeted therapy for AGC patients.
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Objective To study the protective effect of warming kidney and subsiding yang traditional Chinese medicine (TCM) method on lung tissues of rats with acute respiratory distress syndrome (ARDS) associated with sepsis. Methods Eighty healthy male Wistar rats were divided into normal control group, model group and low, medium and high dose Fusuheji groups by random number table, 16 rats in each group. The acute lung injury (ALI) model was established by injecting lipopolysaccharide (LPS) 3 mg/kg into a rat caudal vein within 5 minutes, and the normal control group was given the same volume of normal saline. Then the low, medium and high dose TCM groups were given low, medium and high dose Fusuheji TCM mixture (the ingredients of the mixture: radix aconite lateralis preparata 30 g, oysters 30 g, ginger 15 g, ephedra 15 g, licorice 10 g) 2.625, 7.875, 10.500 g/kg intragastric administration respectively. Equal volume of saline was given to the normal control group and model group by gavage. At 24 and 48 hours after respective administration, 8 rats were taken from each group to observe the pathological changes of lung tissues and score the lung injury. The rates of survival of rats were calculated after the experiment in various groups. Results After administration for 48 hours, the survival rate of rats in model group was obviously lower than that of the normal control group [18.7% (3/16) vs. 100.0% (16/16)], the low, middle and high dose Fusuheji groups' survival rates were all significantly higher than the rate of ALI model group [50.0% (8/16), 75.0% (12/16), 93.7%(15/16) vs. 18.7% (3/16), all P < 0.05]. There were no pathological changes in the lung tissues of rats in the normal control group, large amounts of exudates and hemorrhages were present in the lung tissues of ALI model group, and the inflammatory, exudative and hemorrhagic changes of lung tissues in the high, middle and low dose Fusuheji groups were obviously improved. After administration for 24 hours and 48 hours, the lung injury scores in the ALI model group were higher than those in control group (after administration for 24 hours: 7.83±0.60 vs. 2.89±4.23; after administration for 48 hours: 7.33±0.88 vs. 3.00±0.28), the scores of lung injury of any Fusuheji drug group were significantly lower than those of ALI model group, and the degrees of decrease were more marked in high dose Fusuheji group than those in low and middle dose Fusuheji groups (after administration for 24 hours: 3.37±0.32 vs. 6.00±0.44, 4.63±0.50; after administration for 48 hours: 3.25±0.25 vs. 5.25±0.25, 3.50±0.50). Conclusion The warming kidney and subsiding yang TCM method can improve the lung tissue injury in ARDS associated with sepsis in rats, promote the damaged lung tissue to recover, and ultimately the prognosis of ARDS rats is getting better.
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Objective To study the protective effect of warming kidney and subsiding yang traditional Chinese medicine (TCM) method on lung tissues of rats with acute respiratory distress syndrome (ARDS) associated with sepsis. Methods Eighty healthy male Wistar rats were divided into normal control group, model group and low, medium and high dose Fusuheji groups by random number table, 16 rats in each group. The acute lung injury (ALI) model was established by injecting lipopolysaccharide (LPS) 3 mg/kg into a rat caudal vein within 5 minutes, and the normal control group was given the same volume of normal saline. Then the low, medium and high dose TCM groups were given low, medium and high dose Fusuheji TCM mixture (the ingredients of the mixture: radix aconite lateralis preparata 30 g, oysters 30 g, ginger 15 g, ephedra 15 g, licorice 10 g) 2.625, 7.875, 10.500 g/kg intragastric administration respectively. Equal volume of saline was given to the normal control group and model group by gavage. At 24 and 48 hours after respective administration, 8 rats were taken from each group to observe the pathological changes of lung tissues and score the lung injury. The rates of survival of rats were calculated after the experiment in various groups. Results After administration for 48 hours, the survival rate of rats in model group was obviously lower than that of the normal control group [18.7% (3/16) vs. 100.0% (16/16)], the low, middle and high dose Fusuheji groups' survival rates were all significantly higher than the rate of ALI model group [50.0% (8/16), 75.0% (12/16), 93.7%(15/16) vs. 18.7% (3/16), all P < 0.05]. There were no pathological changes in the lung tissues of rats in the normal control group, large amounts of exudates and hemorrhages were present in the lung tissues of ALI model group, and the inflammatory, exudative and hemorrhagic changes of lung tissues in the high, middle and low dose Fusuheji groups were obviously improved. After administration for 24 hours and 48 hours, the lung injury scores in the ALI model group were higher than those in control group (after administration for 24 hours: 7.83±0.60 vs. 2.89±4.23; after administration for 48 hours: 7.33±0.88 vs. 3.00±0.28), the scores of lung injury of any Fusuheji drug group were significantly lower than those of ALI model group, and the degrees of decrease were more marked in high dose Fusuheji group than those in low and middle dose Fusuheji groups (after administration for 24 hours: 3.37±0.32 vs. 6.00±0.44, 4.63±0.50; after administration for 48 hours: 3.25±0.25 vs. 5.25±0.25, 3.50±0.50). Conclusion The warming kidney and subsiding yang TCM method can improve the lung tissue injury in ARDS associated with sepsis in rats, promote the damaged lung tissue to recover, and ultimately the prognosis of ARDS rats is getting better.
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[Objective] In order to provide a basis for treatment,the article discussed the meaning of Nourishing Spleen Theory and its relationship with clinical liver disease.[Methods]Reviewing the ancient Chinese literature,the paper discussed the Nourishing Spleen Theory from the origin and practice of ancient physicians.By studying the physiological and symptoms,the author discussed the relationship between the liver and traditional spleen,and found the principles of nourishing spleen for treating liver diseases.[Results] Originated in (Huangdi Neijing),the Nourishing Spleen Theory is known as superior,and has a long history.The liver of modern medicine is one of the important contents of traditional Chinese "spleen".There is full theoretical and practical basis in treatment of liver disease by nourishing spleen.And the treatment including replenishing qi,promoting digestion,draining water,activating blood.[Conclusion] Nourishing spleen is an important method for the treatment of liver disease,and it is expected to achieve a good effect in clinic.
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ObjectiveTo investigate the molecular mechanism in the pathogenesis of mild chronic hepatitis B from the perspective of microRNA (miRNA) regulation. MethodsA total of 16 patients who visited the outpatient service of Chengdu Hospital of Infectious Diseases from July 2013 to February 2014 were enrolled and divided into mild chronic hepatitis B group and normal group. The Agilent Human miRNA 8×60 k microarray chips were used to detect the expression profile of miRNA in plasma and obtain the profile of miRNAs expressed differentially between the two groups. The miRNA bioinformatics analysis software was used to predict target genes, and GO functional enrichment analysis and pathway analysis were performed for these target genes. An analysis of variance was used for comparison between multiple groups, and the t-test was used for comparison between two groups. ResultsA total of 54 miRNAs were differentially expressed between the two groups (all P＜0.05), and among them, 30 were upregulated, and 24 were downregulated. The functions of these miRNAs included cell proliferation, positive/negative transcription regulation, positive/negative regulation of biosynthesis, protein localization, the Wnt receptor signaling pathway, positive/negative regulation of gene expression, the enzyme-linked receptor protein signaling pathway, and phosphorylation of protein amino acids. Pathway analysis revealed that miRNAs were mainly involved in the Wnt signaling pathway, Notch signal transduction pathway, Hedgehog signaling pathway, p53 signaling pathway, and B cell receptor signaling pathways, etc. ConclusionThe pathogenesis of mild chronic hepatitis B is regulated by specific miRNAs and involves various life processes and pathways.
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Objective To observe the clinical efficacy and adverse reactions of docetaxel and carboplatin 21 day regimen (TC)as second -or third -line in treatment of patients with advanced triple -negative breast cancer (ATNBC).Methods 37 ATNBC patients with anthracyclines resistance were given docetaxel 70mg/m2 ,the first day of intravenous drip,carboplatin AUC =5,through intravenous drip on the first day,21 days for a course of treatment, until disease progression or not tolerated or most received six cycles of chemotherapy.Results 147 cycles of chemo-therapy were completed in 37 patients,and the median chemotherapy cycle was 4 cycles.The efficacy and adverse reactions could be evaluated in all patients.Among them,complete remission (CR)in 0 patient,partial remission (PR)in 12 patients (32.43%),stable (SD)in 11 patients (29.73%),and progression (PD)in 14 patients (41.18%).The effective rate(CR +PR)was 32.43%.The disease control rate (CR +PR +SD)was 62.15%,median TTP was 3.9 months (95%CI:4 -8months),and median OS was 10 months.Until the end of follow -up,there were 3 patients with no progress.The main adverse reactions were hematological toxicity (51.53%)and gastrointestinal reaction (56.76%).Conclusion TC regimen is effective and safe in the treatment of patients with ATNBC.