Revisão sistemática sobre resolução de problema e mediação de conflito pela terapia cognitivo-comportamental / Systematic review on problem solving and conflict mediation by cognitive-behavioral therapy

RESUMO Objetivo: Na prática clínica, é importante diferenciar problema e conflito, porque os passos sugeridos na técnica de resolução de problemas costumam não ser suficientes para auxiliar o cliente a lidar com conflitos. Esta revisão sistemática teve como objetivos: investigar como a terapia cognitivo-comportamental (TCC) pode auxiliar na resolução de problemas e na mediação de conflito; sugerir uma estratégia que favoreça a melhor capacidade de mediar conflitos (QPD). Métodos: Foi realizada uma busca nas bases de dados: PubMed, PsycINFO, Web of Science (ISI) e Scopus. O método prisma foi utilizado, e foram selecionados para leitura na íntegra artigos experimentais. Resultados: Trezentos e sessenta e quatro ensaios clínicos aplicaram a resolução de problemas, apontando a eficácia dessa técnica juntamente com outras estratégias/intervenções da TCC. Livros-guias de TCC: não diferenciam problema e conflito; descrevem detalhadamente passos para resolução de problemas, focando na perspectiva do cliente, no momento presente e no uso da razão lógica; não abordam a mediação de conflitos pela TCC. Sugerimos uma estratégia que pode ajudar na mediação de conflitos: auxiliando na coleta/organização de informações; melhorando a comunicação - empática e assertiva; favorecendo escolhas com o intuito de causar o menor dano possível a todas as partes envolvidas no conflito. Conclusões: Para treinar terapeutas para aplicarem a resolução de problemas, há descrição detalhada dos passos a serem seguidos. Entretanto, para capacitar os terapeutas para mediarem conflitos, práticas clínicas que têm sido frequentemente descritas/utilizadas nas terapias cognitivas contextuais podem ser necessárias: aceitação psicológica, mindfulness , entender valores individuais, vivenciar/considerar a emoção em tomadas de decisão, ativar a compaixão/autocompaixão.

ABSTRACT Objective: It is important to differentiate between problem and conflict in clinical practice, because the steps suggested in the problem-solving technique are usually not enough to help patients deal with conflicts. This systematic review aimed to: investigate how cognitive-behavioral therapy (CBT) can help in problem solving and conflict mediation; suggest a strategy that can improve conflict mediate skills (QPD). Methods: A search was performed in the following databases: PubMed, PsycINFO, Web of science (ISI) and Scopus. Prisma flow diagram was used and experimental articles were selected for full reading. Results: Three hundred and sixty four clinical trials applied problem solving, showing the effectiveness of this technique with other CBT strategies/interventions. CBT guide books: do not differentiate between problem and conflict; describe in detail problem solving steps, focusing on the customer's perspective, the present moment and the use of logical reason; do not explore conflict mediation in the CBT. We suggest a strategy that can help in the mediation of conflicts: assisting in the collection/organization of information; improving communication - empathic and assertive; favoring choices that can cause the least possible harm to all parties in the conflict. Conclusions: There is detailed description of the steps to train therapists to apply problem solving. However, to improve therapeutic skills to mediate conflicts, clinical practices that have been frequently described/used in the contextual cognitive behavioral therapies may be necessary: psychological acceptance, mindfulness, understanding personal values, experiencing/considering emotion in decision making, activating compassion/self-compassion.

Novel insights into histone lysine methyltransferases in cancer therapy:From epigenetic regulation to selective drugs / 药物分析学报

The reversible and precise temporal and spatial regulation of histone lysine methyltransferases(KMTs)is essential for epigenome homeostasis.The dysregulation of KMTs is associated with tumor initiation,metastasis,chemoresistance,invasiveness,and the immune microenvironment.Therapeutically,their promising effects are being evaluated in diversified preclinical and clinical trials,demonstrating encouraging outcomes in multiple malignancies.In this review,we have updated recent understandings of KMTs'functions and the development of their targeted inhibitors.First,we provide an updated overview of the regulatory roles of several KMT activities in oncogenesis,tumor suppression,and im-mune regulation.In addition,we summarize the current targeting strategies in different cancer types and multiple ongoing clinical trials of combination therapies with KMT inhibitors.In summary,we endeavor to depict the regulation of KMT-mediated epigenetic landscape and provide potential epigenetic targets in the treatment of cancers.

Spatiotemporal Dynamics of the Molecular Expression Pattern and Intercellular Interactions in the Glial Scar Response to Spinal Cord Injury / 神经科学通报·英文版

Nerve regeneration in adult mammalian spinal cord is poor because of the lack of intrinsic regeneration of neurons and extrinsic factors - the glial scar is triggered by injury and inhibits or promotes regeneration. Recent technological advances in spatial transcriptomics (ST) provide a unique opportunity to decipher most genes systematically throughout scar formation, which remains poorly understood. Here, we first constructed the tissue-wide gene expression patterns of mouse spinal cords over the course of scar formation using ST after spinal cord injury from 32 samples. Locally, we profiled gene expression gradients from the leading edge to the core of the scar areas to further understand the scar microenvironment, such as neurotransmitter disorders, activation of the pro-inflammatory response, neurotoxic saturated lipids, angiogenesis, obstructed axon extension, and extracellular structure re-organization. In addition, we described 21 cell transcriptional states during scar formation and delineated the origins, functional diversity, and possible trajectories of subpopulations of fibroblasts, glia, and immune cells. Specifically, we found some regulators in special cell types, such as Thbs1 and Col1a2 in macrophages, CD36 and Postn in fibroblasts, Plxnb2 and Nxpe3 in microglia, Clu in astrocytes, and CD74 in oligodendrocytes. Furthermore, salvianolic acid B, a blood-brain barrier permeation and CD36 inhibitor, was administered after surgery and found to remedy fibrosis. Subsequently, we described the extent of the scar boundary and profiled the bidirectional ligand-receptor interactions at the neighboring cluster boundary, contributing to maintain scar architecture during gliosis and fibrosis, and found that GPR37L1_PSAP, and GPR37_PSAP were the most significant gene-pairs among microglia, fibroblasts, and astrocytes. Last, we quantified the fraction of scar-resident cells and proposed four possible phases of scar formation: macrophage infiltration, proliferation and differentiation of scar-resident cells, scar emergence, and scar stationary. Together, these profiles delineated the spatial heterogeneity of the scar, confirmed the previous concepts about scar architecture, provided some new clues for scar formation, and served as a valuable resource for the treatment of central nervous system injury.

The Pathology of Primary Familial Brain Calcification: Implications for Treatment / 神经科学通报·英文版

Primary familial brain calcification (PFBC) is an inherited neurodegenerative disorder mainly characterized by progressive calcium deposition bilaterally in the brain, accompanied by various symptoms, such as dystonia, ataxia, parkinsonism, dementia, depression, headaches, and epilepsy. Currently, the etiology of PFBC is largely unknown, and no specific prevention or treatment is available. During the past 10 years, six causative genes (SLC20A2, PDGFRB, PDGFB, XPR1, MYORG, and JAM2) have been identified in PFBC. In this review, considering mechanistic studies of these genes at the cellular level and in animals, we summarize the pathogenesis and potential preventive and therapeutic strategies for PFBC patients. Our systematic analysis suggests a classification for PFBC genetic etiology based on several characteristics, provides a summary of the known composition of brain calcification, and identifies some potential therapeutic targets for PFBC.

Estrategias terapéuticas actuales en el tratamiento del cáncer de ovario

Introducción: El cáncer de ovario es uno de los tumores más frecuentes y letales entre las mujeres. Esto se debe a su detección en estados tardíos y al desarrollo de quimiorresistencia a la terapia estándar. El desarrollo de terapias dirigidas contra las propiedades distintivas de las células cancerosas y sus características habilitadoras ha surgido como una alternativa promisoria para el tratamiento de estos tumores. Objetivo: Describir las actuales estrategias terapéuticas dirigidas contra las distintas capacidades de las células tumorales en el tratamiento del cáncer de ovario. Método: Se realizó una búsqueda en las bases de datos ScienceDirect, Redalyc, Latindex, ResearchGate, PubMed, Elsevier, ClinicalTrials.gov, SpringerLink, LARVOL´s CLIN, Registro Público Cubano de Ensayos Clínicos, entre enero y abril de 2023. Se seleccionaron 50 artículos referentes al cáncer de ovario y las alternativas para su tratamiento. Desarrollo: Se mencionaron los diversos factores que influyen en la elección de terapias contra el cáncer de ovario. Se describieron las actuales dianas terapéuticas utilizadas en el tratamiento de esta neoplasia, así como el empleo de múltiples fármacos aprobados y en fases de estudio, y las combinaciones sinérgicas de los mismos. Consideraciones finales: Actualmente existen disímiles opciones de tratamiento del cáncer de ovario. A pesar de que la eficacia clínica de los agentes dirigidos todavía está restringida a subtipos moleculares específicos y ningún ensayo ilustra un beneficio en la supervivencia general, son notorios los resultados alcanzados en el desarrollo de fármacos específicamente dirigidos contra la inestabilidad del genoma y angiogénesis sostenida.

Introduction: Ovarian cancer is one of the most common and lethal tumor in women. This happens as a result of late-stage cancer detention and an increased chemoresistance to standard therapy. The current development in therapies to kill the cancer cells and its spread tendencies has emerged as a key alternative to treat tumors. Objective: To describe the current therapeutic strategies lead to confront different capabilities of tumor cells found in the ovarian cancer treatment. Method: A search of literuture was carried out in the following databases ScienceDirect, Redalyc, Latindex, ResearchGate, PubMed, Elsevier, ClinicalTrials.gov, SpringerLink, LARVOL's CLIN, Cuban Public Registry of Clinical Trials, from January to April 2023. A total of 50 text concerning ovarian cancer subject and alternative for treatment were selected. Development: The driving factors that promoted the use of ovarian cancer therapies were pointed out. The current therapeutic targets used in the treatment of this neoplasia were described, as well as the use of multiple approved drugs or in process of approval, including the synergistic drug combinations. Final considerations: There are a lot of options currently being implemented in ovarian cancer treatment. Despite clinical efficacy of targeted therapy, it´s presented still restricted to specific molecular subtypes and none of the assays illustrated survival benefit in general; the results obtained in the process of drugs development specifically targeting genome instability and sustained angiogenesis have been remarkable.

Introdução: O câncer de ovário é um dos tumores mais frequentes e letais entre as mulheres. Isso se deve à sua detecção em estágios tardios e ao desenvolvimento de quimiorresistência à terapia padrão. O desenvolvimento de terapias direcionadas contra as propriedades distintas das células cancerígenas e suas características facilitadoras surgiu como uma alternativa promissora para o tratamento desses tumores. Objetivo: Descrever as atuais estratégias terapêuticas dirigidas contra as diferentes capacidades das células tumorais no tratamento do câncer de ovário. Método: Foi realizada uma busca nas bases de dados ScienceDirect, Redalyc, Latindex, ResearchGate, PubMed, Elsevier, ClinicalTrials.gov, SpringerLink, LARVOL's CLIN, Registro Público Cubano de Ensaios Clínicos, entre janeiro e abril de 2023. 50 artigos referentes ao câncer de ovário e as alternativas para o seu tratamento. Desenvolvimento: Foram mencionados os vários fatores que influenciam a escolha das terapias contra o câncer de ovário. Foram descritos os atuais alvos terapêuticos utilizados no tratamento desta neoplasia, bem como o uso de múltiplas drogas aprovadas e em fase de estudo, e suas combinações sinérgicas. Considerações finais: Atualmente existem opções de tratamento dissimilares para o câncer de ovário. Apesar de a eficácia clínica dos agentes direcionados ainda estar restrita a subtipos moleculares específicos e nenhum ensaio mostrar benefício na sobrevida global, são notáveis os resultados alcançados no desenvolvimento de fármacos direcionados especificamente contra a instabilidade do genoma e a angiogênese sustentada.

Surgical versus conservative treatment for acute type A aortic intramural hematoma: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare the outcomes following emergency surgery or conservative treatment for patients with acute type A aortic intramural hematoma (IMH). Methods    Clinical data of consecutive patients diagnosed with acute type A aortic IMH in our hospital from September 2014 to December 2018 were retrospectively analyzed. The patients who met our surgical indications received surgery (an operation group) and other patients received strict conservative treatment (a conservative treatment group). Results    Finally 127 patients were enrolled, including 112 males and 15 females with an average age of 53.6±13.0 years. Of 127 patients, 85 (66.9%) patients accepted emergency surgery and 42 (33.1%) patients accepted strict conservative treatment. There was no difference between the two groups in early mortality or complications (P>0.05). The 5-year survival rate was 90.4% in the operation group and 74.3% in the conservative treatment group (P=0.010). A maximum aortic diameter in the ascending aorta and aortic arch≥45 mm and maximum thickness of IMH in the same section≥8 mm were risk factors for IMH-related death in patients undergoing conservative treatment (P<0.001). Conclusion    The mortality associated with emergency surgery for patients with acute type A aortic IMH is satisfactory. In clinical centers with well-established surgical techniques and postoperative management, emergency surgical treatment may provide a better outcome than conservative treatment for patients with acute type A aortic IMH.

Therapeutic strategies for chronic wound infection / 中华创伤杂志(英文版)

Chronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.

Research progress in tumor microenvironment and therapeutic strategies of head and neck squamous cell carcinoma / 国际生物医学工程杂志

Head and neck squamous cell carcinoma of the head and neck is a very aggressive cancer with a poor prognosis in the late stages. Studies have revealed that head and neck squamous cell carcinoma is highly heterogeneous and immunosuppressive. The tumor microenvironment plays a key role in the development of head and neck squamous cell carcinoma, facilitating its evolution and resistance to treatment, thus adversely affecting patient prognosis. A comprehensive understanding of the tumor microenvironment could lead to new therapeutic interventions for head and neck squamous cell carcinoma. In this review, recent research findings on the tumor microenvironment and therapeutic strategies targeting the tumor microenvironment were reviewed, leading to the development of novel combination therapies to address head and neck squamous cell carcinoma and the tumor microenvironment, with the aim of gaining a deeper understanding of the disease and developing more accurate treatment plans for head and neck squamous cell carcinoma.

Neutralizing monoclonal antibodies present new prospects to treat SARS-CoV-2 infections / 医学前沿

The coronavirus disease 2019 (COVID-19) has caused global public health and economic crises. Thus, new therapeutic strategies and effective vaccines are urgently needed to cope with this severe pandemic. The development of a broadly neutralizing antibody against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the attractive treatment strategies for COVID-19. Currently, the receptor-binding domain (RBD) of the spike (S) protein is the main target of neutralizing antibodies when SARS-CoV-2 enters human cells through an interaction between the S protein and the angiotensin-converting enzyme 2 expressed on various human cells. A single monoclonal antibody (mAb) treatment is prone to selective pressure due to increased possibility of targeted epitope mutation, leading to viral escape. In addition, the antibody-dependent enhancement effect is a potential risk of enhancing the viral infection. These risks can be reduced using multiple mAbs that target nonoverlapping epitopes. Thus, a cocktail therapy combining two or more antibodies that recognize different regions of the viral surface may be the most effective therapeutic strategy.

Clinical characteristics of 528 patients with pyogenic liver abscess / 中华传染病杂志

Objective:To analyze and summarize the clinical features of pyogenic liver abscess (PLA) patients treated in 10 years, so as to provide evidence to improve current diagnosis and corresponding treatment strategies of PLA.Methods:The clinical symptoms, signs, laboratory and imaging findings, etiology and different treatments as well as corresponding efficacy and prognosis of PLA patients treated in Xiangya Hospital of Central South University during January 2010 to December 2019 were retrospectively analyzed.The chi-square was used to evaluate the differences of the categorical variables.Results:A total of 528 PLA cases were included in this study.Diabetes mellitus (46.8%, 247/528), biliary tract diseases (34.7%, 183/528) and previous hepatobiliary surgery history (19.7%, 104/528) were three most common risk factors leading to PLA. Fever (80.9%, 427/528), loss of appetite (53.6%, 283/528) and abdominal pain (51.9%, 274/528) were most common clinical manifestations. The accuracies of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were 95.5%(472/494), 97.0%(384/396), and 96.8%(92/95), respectively. The positive rate of pus culture (70.9%, 168/237) was higher than that of blood culture (20.0%, 42/210), and the difference was statistically significant ( χ2=115.746, P<0.01). The top three most common bacteria were Klebsiella pneumoniae (122 strains), Escherichia coli (29 strains) and Enterococcus faecium (10 strains). The drug resistance rate of Klebsiella pneumoniae to ampicillin was as high as 97.4%(112/115). The treatment programs included 200 cases of sole antibiotic treatments. Based on the antibiotic treatment, imaging guided percutaneous puncture therapy was the most commonly used treatment (45.6%, 241/528), included imaging guided percutaneous puncture and drainage (29.0%, 153/528) and imaging guided percutaneous catheterization (16.7%, 88/528). The surgical treatments included surgical catheter drainage (5.5%, 29/528) and surgical hepatectomy(11.0%, 58/528). The total number of cured cases was 495, and the cure rate was 93.8%. Conclusions:The common clinical manifestations of PLA are fever, loss of appetite, abdominal pain. Ultrasound is a routine and effective method to detect liver abscess. Klebsiella pneumoniae is the most common pathogen. Imaging guided percutaneous puncture is the most common treatment.

Potenciales estrategias terapéuticas basadas en péptidos para mitigar la infección por SARS-CoV-2 / Potential Peptide-Based Therapeutic Strategies to Mitigate SARS-COV-2 Infection

Resumen La nueva pandemia por SARS-CoV-2 ha incentivado la búsqueda de alternativas terapéuticas que reduzcan los índices de mortalidad. Dentro de estas, el uso de péptidos se destaca por su facilidad de síntesis, fácil producción a gran escala, especificidad en la respuesta inmunológica, versatilidad en la dosificación, alta pureza, economía, entre otros. Esto ofrece una excelente opción al enfoque tradicional, con lo que se resta la evaluación de su eficacia, eficiencia y seguridad a nivel clínico.

Abstract The new pandemic by SARS-CoV-2 has encouraged the search for therapeutic alternatives that reduce mortality rates; within these, the use of peptides stands out for its ease of synthesis; easy production on a large scale, specificity in the immune response, versatility in dosage, high purity, economy, among others; offering an excellent option to the traditional approach, failing to evaluate its effectiveness, efficiency and safety at clinical level.

Research progress on roles of gut microbiota in cardiovascular disease and treatment / 中国临床药理学与治疗学

Cardiovascular disease (CVD), a chronic disease endangering human health, remains the highest morbidity and mortality globally. The human gut is inhabited by communities of bacteria and viruses, along with their genome, are collectively known as the gut microbiota. Recent reserch suggests that gut microbiota affects various metabolic pathways in the host by producing and releasing important metabolites such as trimethylamine oxide, bile acids and short chain fatty acids, and play an important role in pathologies of CVD, such as atherosclerosis, hypertension, myocardial infarction, heart failure and dyslipidemia. Individual treatment based on gut microbiota, including diet intervention, fecal microbiota transplantation and small molecule antimicrobial enzyme therapeutics, may provide a potential novel strategy for therapeutics.

Diagnostic and therapeutic strategies of lung cancer patients during the outbreak of 2019 novel coronavirus disease (COVID-19) / 中华肿瘤杂志

With the increasing number of cases and widening geographical spread, the 2019 novel coronavirus disease (COVID-19) has been classified as one of the class B infectious diseases but prevented and controlled as class A infectious disease by the National Health Commission of China. The diagnosis and treatment of lung cancer patients have been challenged greatly because of extraordinary public health measures since the lung cancer patients are a high-risk population during the COVID-19 outbreak period. Strict protection for lung cancer patients is needed to avoid infection. Lung cancer patients are difficult to differentiate from patients with COVID-19 in terms of clinical symptoms, which will bring great trouble to the clinical work and physical and mental health of lung cancer patients. This review will demonstrate how to applicate appropriate and individual management for lung cancer patients to protect them from COVID-19.

Current status and prospect of treatment for severe community acquired pneumonia / 中华危重病急救医学

Severe community acquired pneumonia (SCAP) has raised substantial concern due to high morbidity and mortality. SCAP is usually associated with multiple organ dysfunction syndrome (MODS) and sepsis. It is suggested that organ function and coagulation/fibrinolysis improvement, organ injury reduction and organ repair facilitation are highly required besides microbiology detection and optimization of antibiotics strategy on treatment of SCAP. Neutralization antibody, steroid, immunmodulatory therapy, and Chinese medicine etc. contribute to organ function improvement from different perspective. The unique profile of multiple target and personalized therapy of Chinese medicine may become a promising new option for SCAP and MODS. The combination of Western and Chinese Medicine shed new light on SCAP treatment.

Progress of therapeutic strategies for glucose metabolic disorders in sepsis / 中华危重病急救医学

Glucose metabolic disorder is a common issue in sepsis and it leads to an increase in mortality. However, the therapeutic methods of the glucose metabolic disorders in sepsis patients need to be improved. Studying the mechanism of glucose metabolism disorder, and adjusting the existing treatment measures are especially significant in curing the sepsis. This review summarizes recent animal experiments and clinical studies about glucose change after septic complications, focusing on the treatment of three disorders including hyperglycemia, hypoglycemia, and blood glucose variability. They definitely provide new ideas for the control of blood glucose in sepsis patients.

Research on the strategy of eradication of HIV latent reservoirs / 中国比较医学杂志

HIV latent reservoirs are the latent cells and tissues of HIV under the pressure of immune responses and antiviral therapy. Although HIV infection is effectively controlled by the advent of highly active antiretroviral therapy (HAART) and the viral load in the plasma is suppressed to a low level which are undetectable by most clinical measures, HAART is not able to completely eradicate the virus in the reservoirs. The viral rebound occurs when antiviral therapy is ceased. Therefore, the eradication of HIV reservoirs is a major challenge for the therapy of AIDS. In this paper, we will focus on the strategies of eradication of AIDS latent reservoirs.

Efficacy of the All-in-One Therapeutic Strategy for Severe Traumatic Brain Injury: Preliminary Outcome and Limitation / 대한신경손상학회지

OBJECTIVE: Despite recent advances in medicine, no significant improvement has been achieved in therapeutic outcomes for severe traumatic brain injury (TBI). In the treatment of severe multiple traumas, accurate judgment and prompt action corresponding to rapid pathophysiological changes are required. Therefore, we developed the “All-in-One” therapeutic strategy for severe TBI. In this report, we present the therapeutic concept and discuss its efficacy and limitations. METHODS: From April 2007 to December 2015, 439 patients diagnosed as having traumatic intracranial injuries were treated at our institution. Among them, 158 patients were treated surgically. The “All-in-One” therapeutic strategy was adopted to enforce all selectable treatments for these patients at the initial stages. The outline of this strategy is as follows: first, prompt trepanation surgery in the emergency room (ER); second, extensive decompression craniotomy (DC) in the operating room (OR); and finally, combined mild hypothermia and moderate barbiturate (H-B) therapy for 3 to 5 days. We performed these approaches on a regular basis rather than stepwise rule. If necessary, internal ecompression surgery and external ventricular drainage were performed in cases in which intracranial pressure could not be controlled. RESULTS: Trepanation surgery in the ER was performed in 97 cases; among these cases, 46 had hematoma removal surgery and also underwent DC in the OR. Craniotomy was not enforced unless the consciousness level and pupil findings did not improve after previous treatments. H-B therapy was administered in 56 cases. Internal decompression surgery, including evacuation of traumatic intracerebral hematoma, was additionally performed in 12 cases. Three months after injury, the Glasgow Outcome Scale (GOS) score yielded the following results: good recovery in 25 cases (16%), mild disability in 28 (18%), severe disability in 33 (21%), persistent vegetative state in 9 (6%), and death in 63 (40%). Furthermore, 27 (36%) of the 76 most severe patients who had an abnormal response of bilateral eye pupils were life-saving. Because many cases of a GOS score of ≤5 are included in this study, this result must be satisfactory. CONCLUSION: This therapeutic strategy without any lose in the appropriate treatment timing can improve the outcomes of the most severe TBI cases. We think that the breakthrough in the treatment of severe TBI will depend on the shift in the treatment policy.

Advances in sepsis induced immunosuppression and immunomodulation therapy / 中华危重病急救医学

Immunosuppression plays a vital role in the pathophysiological mechanism of sepsis, and it is the main cause of death in patients with sepsis during the later phase. Sepsis induced immunosuppression is gradually recognized. Its underlying mechanisms involve immune cell apoptosis, autophagy, cell metabolism reprogramming, endotoxin tolerance, central nervous system regulation, and epigenetic regulation. New approaches that target the host immune response and reconstruct the immune balance are the keys to improve the prognosis of patients with sepsis. With the help of immune status monitor, novel immunomodulatory agents, such as thymosin α1, γ- interferon (IFN-γ), interleukin-7 (IL-7), granulocyte-macrophage colony stimulating factor (GM-CSF) and anti-programmed death receptor 1 (PD-1) antibody, are expected to become a new strategy for the treatment of sepsis in future.

Valor de la vena digital para el diagnóstico tradicional y pronóstico de las diarreas en una lactante / Value of the digital vein for the traditional diagnosis and prognosis of diarrheas in an infant

Se presenta el caso clínico de una lactante de 8 meses de edad, de procedencia rural, quien ingresa en el Hospital Docente Infantil Norte de Santiago de Cuba por presentar fiebre, vómitos y diarreas. Se le realizó examen físico y observación de la vena digital, cuyo resultado desde el punto de vista de la medicina tradicional fue diarrea por frío-humedad, para lo cual se orientó una estrategia terapéutica que favoreció la mejoría del cuadro diarreico y emético, sin el empleo de medicamentos

The case report of an 8 months infant is presented. She had rural origin and is admitted to the Northern Teaching Children Hospital in Santiago de Cuba due to fever, vomits and diarrheas. Physical examination and observation of the digital vein was carried out whose result from the traditional medicine point of view was diarrhea due to cold-humidity, for which a therapeutic strategy was guided that favored the improvement of the diarrheal and emetic pattern, without using medication

Role of ADAM8 in tumor metastasis / 中国药理学通报

Tumor metastasis is one of the important biological characteristics of malignant tumor,which is closely related with the prognosis of the cancer patients.High expression of ADAM8 in varieties of tumors was revealed in many recent studies,and such aberrant expression played a crucial role in regulating of tumor metastasis.Studies showed that overexpression of ADAM8 attenuated the intercellular adhesion effect,promoted tumor angiogenesis,and enhanced the degradation of ECM as well as the releasing of cytokines.Therefore,suppression of ADAM8 may lead to inhibition of tumor metastasis,which makes ADAM8 a particular attractive target as it can be used as a prognostic indicator and a potential therapeutic target of malignant tumor.A review about the relations between ADAM8 protein′s abnormal expression and tumor occurrence was discussed in this paper,also include discussion about the mechanisms of ADAM8 protein′s disorder-induced tumor formation,as well as therapeutic strategies based on ADAM8-targeted,which may provide references for follow-up research and clinical treatment.