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It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine， from crossover to integration to innovation， and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification， while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine， both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine， and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”， which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model， and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice， it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine， i.e.， “Western medicine as the basis and treating with Chinese medicine； Chinese medicine as the basis and treating with Western medicine”. On the one hand， Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine， and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand， the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice， so as to locate the target and adjust the body state in a gradual and orderly manner， and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other， combine organically， give full play to their respective strengths， and form an internal law， so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.
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ABSTRACT Introduction: The main clinical feature of chronic nonspecific low back pain (CNLBP) is lower back pain, and suspension sports therapy has a specific effect in this case. Objective: To investigate the changes of flexion-relaxation phenomenon in patients with lower back pain after core control training of suspension exercise therapy (SET). Methods: 84 subjects who met the inclusion and exclusion criteria of chronic low back pain in this experiment were randomly divided into an experimental group and a control group. The experimental group was treated with suspension training. The control group only received acupuncture. We then determined the muscle fascia tension and core stability of the lower lumbar region. Results: The visual analog scale (VAS) and Oswestry dysfunction index (ODI) evaluations of the two groups of patients were different. Conclusion: Suspended core stabilization training has a significant long-term effect in reducing lower back pain and improving waist function in patients with chronic nonspecific low back pain. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução: A característica clínica principal da dor lombar crônica não especifica (CNLBP) é dor na região lombar. A terapia esportiva por suspensão tem um efeito específico neste caso. Objetivo: Investigar as mudanças do fenômeno flexão- relaxamento em pacientes com dor lombar após treinamento de controle core com terapia de exercícios de suspensão (SET). Métodos: 84 indivíduos que preencheram os critérios de inclusão e exclusão para dor lombar crônica neste experimento foram aleatoriamente divididos em um grupo experimental e um grupo de controle. O grupo experimental foi tratado com treinamento de suspensão. O grupo de controle recebeu apenas acupuntura. Determinamos então a tensão da fáscia muscular e a estabilidade core da região lombar. Resultados: Avaliações da escala visual analógica (EVA) e do índice de incapacidade Owestry (ODI) dos dois grupos de pacientes tiveram resultados diferentes. Conclusão: O treinamento de estabilização do core por suspensão tem efeito de longo prazo considerável na redução de dor lombar e a recuperação da função da cintura em pacientes com dor lombar não especifica crônica. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.
Resumen Introducción: La característica clínica principal del dolor lumbar crónico inespecífico (CNLBP) es dolor en la región lumbar. La terapia deportiva en suspensión tiene un efecto específico en este caso. Objetivo: Investigar los cambios del fenómeno flexión-relajamiento en pacientes con dolor lumbar tras el entrenamiento de control de core con terapia de ejercicios en suspensión (SET). Métodos: Se dividió aleatoriamente los 84 individuos que rellenaron los criterios de inclusión y exclusión para dolor lumbar crónico en este experimento en un grupo experimental y un grupo de control. El grupo experimental fue tratado con entrenamiento en suspensión. El grupo de control recibió apenas acupuntura. Determinamos, entonces, la tensión de la fascia muscular y la estabilidad core de la región lumbar. Resultados: Evaluaciones de escala visual analógica (EVA) y del índice de discapacidad Owestry (ODI) de los dos grupos tuvieron resultados diferentes. Conclusión: El entrenamiento de estabilización del core por suspensión tiene efecto de largo plazo considerable en la reducción de dolor lumbar y la recuperación de la función de la cintura en pacientes con dolor lumbar inespecífico crónico. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.
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Objective@#To learn the prevalence and drug resistance of nontuberculous mycobacteria ( NTM ) in Zhejiang Province, so as to provide evidence for NTM prevention and control.@*Methods@#A total of 2 878 clinical mycobacterium isolates in Zhejiang Province were collected from the drug resistance surveillance in 2008-2009, 2013-2014 and 2018-2019, PNB/TCH growth tests were used to preliminarily identify the NTM in these mycobacterium-positive isolates. 16SrRNA, rpoB, ITS and hsp65 gene sequencing analysis were used to confirm strains initially identified as NTM. Proportional method was applied to detect drug susceptibility of NTM isolates.@*Results @# Finally, 135 strains were confirmed as NTM and the isolation rate was 4.69%. The isolation rates of NTM in 2008-2009, 2013-2014 and 2018-2019 were 1.85%, 4.56% and 7.84%, respectively, with an increasing trend ( P<0.05 ). Thirteen species were identified and the top two species were M. intracellulare ( 82, 60.74% ) and M. kansassi ( 18, 13.33% ). The NTM isolates showed the highest drug resistance rate to isoniazid ( 97.78% ), followed by p-aminosalicylic acid ( 94.87% ) and streptomycin ( 94.81% ).@*Conclusions@#The isolation rates of NTM showed an upward trend in the drug resistance surveillance in 2008-2019,2013-2014 and 2018-2019 in Zhejiang Province. M. intracellulare and M. kansassi were the main strains isolated. The NTM isolates showed high resistance against both first and second-line antituberculosis drugs.
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ABSTRACT Objective: The aim was to characterize blood glucose fluctuations in patients with fulminant type 1 diabetes (FT1DM) at the stable stage using continuous blood glucose monitoring systems (CGMSs). Subjects and methods: Ten patients with FT1DM and 20 patients with classic type 1 diabetes mellitus (T1DM) (the control group) were monitored using CGMSs for 72 hours. Results: The CGMS data showed that the mean blood glucose (MBG), the standard deviation of the blood glucose (SDBG), the mean amplitude glycemic excursions (MAGE), the blood glucose areas and the percentages of blood glucose levels below 13.9 mmol/L were similar between the two groups. However, the percentage of blood glucose levels below 3.9 mmol/L was significantly higher in the FT1DM group compared to the T1DM group (p < 0.05). The minimum (Min) blood glucose level in the FT1DM group was significantly lower than that of the T1DM group (p < 0.05). Patients with FT1DM had severe dysfunction of the islet beta cells and alpha cells compared to patients with T1DM, as indicated by lower C-peptide values and higher glucagon/C-peptide values. Conclusion: In conclusion, patients with FT1DM at the stable stage were more prone to hypoglycemic episodes as recorded by CGMSs, and they had a greater association with severe dysfunction of both the beta and alpha islet cells compared to patients with T1DM.
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Humans , Male , Female , Adult , Middle Aged , Blood Glucose/analysis , Diabetes Mellitus, Type 1/blood , Reference Values , Blood Glucose/metabolism , C-Peptide/blood , Glucagon/blood , Blood Glucose Self-Monitoring/methods , Case-Control Studies , Retrospective Studies , Statistics, Nonparametric , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Insulin/bloodABSTRACT
Objective To investigate the inhibitory effect of favipiravir (T-705) on canine distemper virus (CDV) replication in Vero cells and DH82 cells.Methods The growth curves of CDV-11 strains from canine and CDV-3 strains from mink in Vero cells and DH82 cells were determined with indirect immunofluorescence assay and 50％ endpoint titration.The viability of Vero and DH82 cells was determined using the Cell Counting Kit-8.CDV inhibition at different concentrations of T-705 at different time points was measured .Results Cytotoxicity data showed that there was a moderate decline of viability in Vero cells after T-705 treatment, but no apparent cytotoxicity in DH 82 cells.T-705 significantly inhibited the replication of CDV-3 and CDV-11 in both Vero cells and DH82 cells in the test range of 2.441-1250 μg/ml. T-705 exhibited effective and stable antiviral activity when given at different time points post virus challenge .Conclusion Our results demonstrate that T-705 has effective antiviral activity and may be a promising anti-CDV drug candidate .
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In order to investigate the relationship between gut microbiota and type 2 diabetic erectile dysfunction (T2DED),we analyzed the characteristics of gut microbiota in the Sprague-Dawley (SD) rats with T2DED.Thirty-five SD rats were randomly divided into two groups:control group (n=15)with normal diet,and experimental group (n=20) with construction of T2D model.Faecal and serum samples were collected at 2nd and 8th week after establishment of T2D model,respectively.Faecal samples were used for analysis of gut microbiota,and serum samples for detection of trimethylamine N-oxide (TMAO),lipopolysaccharide (LPS),and inflammatory factors like interleukin-1 (IL-1),IL-2,IL-10,and monocyte chemoattractantprotein-1 (MCP-1).The main compositions of gut microbiota were Bacteroidetes,Proteobacteria and Firmicutes at the phylum level,and Oscillospira,Allobaculum,Bacteroides,Ruminococcus,SMB53,Prevotella,Coprococcus,Sutterella and Blautia at the genus level with relatively higher abundance in all SD rats.The relative abundance of Enterococcus,Corynebacterium,Aerococcus,Facklamia (opportunistic pathogens in most case) increased,and that ofAllobaculum,Bifidobacterium,Eubacterium,Anaerotruncus (beneficial bacteria) decreased in T2DED group as compared with that at 2nd week after establishment of T2D model (T2D2 group).The serum contents of TMAO,LPS,IL-1,IL-2,IL-10 and MCP-1 in T2DED group were significantly higher than those in control group.The gut microbiota of T2DED rats was inhibited.The gut microbiota of T2DED rats had changed,as the relative abundance of beneficial bacterium was decreased while that of opportunistic pathogens was increased.The variations of gut microbiota might lead to inflammation and prompt the emergence of erectile dysfunction in the rats with T2D.TMAO might play an important role in the formation of T2DED.
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Sphingosine-1-phosphate (S1 P) is a kind of bioactive messenger which is catalyzed by sphingosine kinases (SphK) and mediates various biological behaviors through binding to sphingosine-1-phosphate receptors(S1PR).Researches demonstrate that the aberration of SphK,S1P and S1PR is closely related to the occurrence and development of cancers,such as leukemia,breast cancer,colorectal cancer and lymphoma.The interaction between S1PR1 and signal transducer and activator of transcription 3 (STAT3) is shown to take part in the pathogenesis of malignant tumors as well.Therefore,they are considered to have the potential tumor-treatment value.
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<p><b>OBJECTIVE</b>To investigate the patients' characteristics and efficacy of prognosis evaluation by International Prognosis Scoring System (IPSS) and Revised International Prognosis Scoring System (IPSS-R) in patients with myelodysplastic syndrome (MDS).</p><p><b>METHODS</b>Prognostic value of IPSS and IPSS-R was evaluated on clinical data from 159 MDS patients, according to WHO classification.</p><p><b>RESULTS</b>With a median age of 44 years (range:15-80 years), MDS patients had the frequency of 38.56% with abnormal karyotype, including the most common abnormality +8 (20/153, 12.6%). 34 of 142 patients transformed into leukemia. Age and the level of β2 micro-globulin were the prognostic factors by multivariate analysis and IPSS-R had a better prognostic significance. The differences in cumulative survival between IPSS subgroups were significant (P<0.05) except that between low- and intermediate I-risk group (P>0.05). There were statistical differences for IPSS-R low risk group vs high or very high risk group, and intermediate risk group vs high or very high risk group (P<0.05). IPSS-R enables IPSS subgroups re-stratification and split IPSS intermediate I-risk group into two subgroups with different prognosis.</p><p><b>CONCLUSION</b>There were significant differences in age of onset, distribution of prognosis scoring system subgroups and abnormal karyotype compared with those in Europe and America. The proportion of higher risk (worse than good karyotype) in IPSS-R was higher than that in Europe and America. Age and the level of β2 micro-globulin were prognostic factors. Both IPSS and IPSS-R were applicable in Chinese MDS patients and the latter performed better. Applying IPSS-R to re-stratify IPSS subgroups helps evaluate prognosis more accurately and improve treatment outcomes.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Young Adult , Asian People , Karyotype , Karyotyping , Leukemia , Multivariate Analysis , Myelodysplastic Syndromes , Prognosis , RiskABSTRACT
<p><b>OBJECTIVE</b>To report a Chinese Charcot-Marie-Tooth disease type 2 (CMT2) family.</p><p><b>METHODS</b>All the members in the family were studied clinically,and 6 patients were studied electrophysiologically. Sural nerve biopsy was performed in the proband. PMP22 gene duplications were detected by highly polymorphic short tandem repeat. Point mutation analysis of PMP22, MPZ and NEFL gene was screened by PCR-SSCP combined with DNA direct sequencing. A genome-wide screening was carried out to the family.</p><p><b>RESULT</b>Except 2 who had weakness and atrophy in both proximal and distal muscles of the lower limbs, all patients presented muscle wasting and a predominating weakness of distal parts of the lower limbs, and mild to moderate sensory impairments. In 6 patients who were subjected to elctrophysiological examinations, median-nerve conduction velocity (NCV) of the median nerve was normal. Electromyograms (EMGs) revealed signs of denervation with large motor unit potentials, fibrillation potentials and positive sharp waves. Sural nerve biopsy of the proband confirmed the presence of axonal neuropathy with an important loss of large myelinating fibers and a large number of clusters with mostly thinly myelinated axons. PMP22, MPZ and NEFL gene mutations were not found. The results of genome-wide screening revealed a linkage of CMT2 to a locus at chromosome 12q24.</p><p><b>CONCLUSION</b>The results are consistent with the diagnosis of CMT2. This family represents a rare genetic type of CMT2 which can be designated as CMT2L.</p>