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The connotation of theory of"toxin"in TCM is rich,and"toxin"is closely related to the occurrence and development of chronic liver disease.Treatment from"toxin"is an important treatment for chronic liver disease.In this article,by summarizing the ancient and modern literature to explain the theory of"toxin",and combined with clinical experience,it concluded that"toxin"has the pathogenic characteristics of strong bias,lingering nature,complex and changeable in chronic liver disease.The authors put forward the view that"toxin leads to disease occurrence and accelerates disease progression",and explored the idea of treating chronic liver disease from"toxin",including tracing the source of toxins,clarifying the nature of toxins,identifying changes of toxins,strengthening the body and eliminating toxins,in order to provide ideas for the clinical treatment of chronic liver disease.
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The clinical manifestations of colorectal polyps are consistent with the characteristics of dampness, stickiness and heaviness. The TCM constitutions in the prone population are mostly related to dampness. The pathological changes of intestinal flora imbalance, intestinal micro inflammation, neuroendocrine immune network and abnormal aquaporin in colorectal polyps are consistent with the research results of modern mechanism of dampness pathogen. This article believed that the TCM pathogenesis of colorectal polyps caused by damp pathogen is the accumulation of spleen deficiency and dampness caused by improper diet, poor emotion and other factors, and the interweaving of various diseases and pathogens to form tangible foreign bodies. According to the pathogenic characteristics of damp pathogen and the pathogenic factors of colorectal polyps, the influence of damp pathogen on the pathogenesis of colorectal polyps was discussed, in order to provide an effective TCM theoretical basis for the diagnosis and treatment of colorectal polyps in clinic.
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The wind, phlegm, and blood stasis are important pathogenic factors of cough variant asthma in children, and they are also the pathological products in the occurrence and development of this disease. They have typical pathogenic characteristics. The main pathogenesis characteristics of cough caused by wind, phlegm and blood stasis are as follows that external wind attacks the lungs and induces internal wind, phlegm and dampness accumulates in the lungs, and the lungs fail to declare and descend, and blood stasis obstructs the collaterals and stagnation of Qi. The wind, phlegm, and blood stasis have their own pathogenic characteristics, and their cough-causing also have their own pathogenic characteristics and clinical characteristics. Based on the characteristics of wind, phlegm, and blood stasis, the application of medicine based on the differentiation of symptoms and signs can effectively prevent and treat this disease, and provide theoretical basis and treatment ideas for the treatment of cough variant asthma in children with Chinese medicine.
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This study aims to investigate the etiology, pathogenic properties and pathogenic characteristics of corona virus disease-2019 (COVID-19) in traditional Chinese medicine(TCM), so as to provide ideas for clinical treatment based on syndrome differentiation. Efforts were made to retrive relevant literature concerning clinical studies, theoretical discussions and TCM diagnosis and treatment schemes issued by the state and various provinces, municipalities, autonomous regions and municipalities directly under the central government in relation to TCM from China Knowledge Network(CNKI) and Wanfang Database, and to analyze and summarize the etiology, pathology, theoretical viewpoints, clinical symptoms and signs, syndrome differentiation and medication rules. Currently, the common understanding of the etiology of COVID-19 in the field of TCM is the infection of "pestilential pathogen". However, there is a dispute over cold and heat or mixed understanding of cold and heat in terms of pathogenic attributes. The pathogenic factors are different from each other in dampness, toxin, dryness, fire (heat), wind, filth, depression, etc. There are various understandings on the pathogenesis including dampness, cold, heat, toxin, stasis, phlegm, stagnation, knot, dryness, filth, deficiency, blocking, collapse and asthma, etc. The etiology and pathogenesis are often mixed up. Integration of cold and heat, dryness and dampness, and other contradictory pathogens or pathogenesis is widely seen, which lacks the logicality of theoretical systems, and does not in line with the thinking characteristics of TCM on the etiology, pathogenesis, and syndrome differentiation of exogenous diseases. The main idea of medication in treatment is to diffuse the lung, clear away heat, eliminate dampness, resolve phlegm and repel foulness with aromatics. Maxing Shigantang is used as the core prescription. Chosen warm acrid drugs are mainly the ones with the effect of fragrance, removing dampness, resolving phlegm, and invigorating spleen. They are not the ones with the effects of warming yang and dissipating cold, but the combination of cold and heat, suggesting the complexity of etiology and pathogenesis. COVID-19 is categorized as plaque in TCM, and its etiology is "pestilential pathogen". This pestilential pathogen possesses not only the basic properties of toxin and filth, but also the characteristics of dampness, heat and wind. Throughout the course of the disease, phlegm, stasis, stagnation and other secondary pathogenic factors also occur. The evolution of pathogenesis is characterized by depression, blocking, and deficiency. There are more evidences that the pestilential pathogen of COVID-19 belongs to heat property no matter in the aspects of clinical manifestation, transmission law (syndrome differentiation at different stages), or in compatibility of medication.
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Objective:To provide data support for the prevention and control of dengue fever in Henan Province by analyzing the molecular epidemiological and etiological characteristics of dengue fever outbreaks in Puyang in 2019.Methods:Blood samples were collected from all suspected cases of dengue fever. The antigen, antibody and nucleic acid of dengue virus (DENV) were detected. The E gene was amplified by viral nucleic acid extraction and sequenced. Phylogenetic tree was constructed to trace the source of infection. Results:A total of 61 local cases of dengue fever were reported, and no deaths were reported. Among them, 4 cases (72.13%) were positive for DENV NS1 antigen; 16(26.23%) cases were positive for specific IgM; 38(62.30%) cases were positive for specific IgG; 34 cases (54.10%) were positive for dengue nucleic acid testing. Ten dengue virus strains were isolated, all of which were dengue virus type 1(DENV-1). Sequence analysis of E gene suggested it belonged to the same clade as Henan201903 strain imported from Cambodia to Zhumadian, Henan in 2019, with the highest homology. Conclusions:The dengue fever epidemic in Henan Province was caused by DENV-1, which might be improted from Cambodia, Singapore, Myanmar and other Southeast Asian countries. Therefore, the surveillance of DENV in people returning from Southeast Asia should be strengthened.
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Objective@#To analysis pathogenic conditions and pathogenic characteristics of organic fluorosis caused by applying of anti-fingerprint coating material on touch screen glass of the mobile phone.@*Methods@#To collect clinical data and analyze the causes and pathogenic characteristics of poisoning through surveying occupational health, detecting occupational hazards in the workplace, collecting clinical data and diagnosing of occupational diseases. 6 employees in workshop 1 of packaging were as the organic fluorine exdposed group, and 16 employees in other workshops were as the non-exposed group.@*Results@#Organic fluorine chemicals (perfluoro-1, 3-dimethylcyclohexane, hexadecafluoroheptane, perfluoro-hexane, perfluoromethy lopentane, perfluoro-2-methyl-2-pentene, etc.) can be volatilized by spraying and baking of anti-fingerprint nano-coating material on touch screen. The relative percentage of volatile components in air is 85.65%. Four cases of acute poisoning were caused by organic fluorosis deposited in a dustless air conditioning workshop with poor ventilation.The clinical manifestations of the patients were acute bronchitis, pulmonary edema and/or myocarditis. The average concentration of urine fluorine in the organic fluorine exposed group was 13.7± 4.4 mmol/mol creatinine, which was 4-5 times higher than that of other non-organic fluorine exposed groups. The difference of urine fluorine level between the organic fluorine exposed group and non exposed group was statistically significant (P<0.01) . The main indicators were abnormal for the blood oxygen saturation of finger pulse under suction air, leukocytes, neutrophils, monocytes, hypersensitivec-reactive protein, procalcitonin, l-lactate dehydrogenase, forebrain diuretic natriuretic peptide, hypersensitive troponin T in the four cases. One case was myocardial ischemia, four cases had bilateral lung symmetrically exudative lesions, one case was accompanied by a small amount of pleural pericardial effusion.@*Conclusion@#Acute organofluorine poisoning can caused by the applying of the fingerprint nano-coating material on touch screen of the mobile phone. Attention should be paid to occupational poisoning caused by the applying of the small molecular perfluoroalkanes (olefins) in new industries, new processes and new materials.
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Objective@#To understand the epidemiological and pathogenic characteristics of hospitalized severe acute respiratory infections (SARI) in Shanghai, China.@*Methods@#From 2015 to 2017, one Tertiary hospital and one Secondary hospital were chosen as the surveillance sites. Two respiratory tract specimens per case were collected from SARI cases aged 15 years and older. One specimen was tested for 22 respiratory pathogens by RT-PCR, and the other specimen was cultured for 6 respiratory bacteria.@*Results@#A total of 287 SARI cases were enrolled for sampling and lab testing. 70.73% of the cases were aged 60 years and older, with 41.46% (119/287) were positive for at least one pathogen. Influenza virus was the predominant pathogen, accounting for 17.77% (51/287) of all SARI cases. Human rhinovirus/Enterovirus and Coronavirus were both accounting for 7.32% (21/287), followed by Mycoplasma pneumoniae (5.57%, 16/287). The positive rates of parainfluenza virus, bocavirus, adenovirus, respiratory syncytial virus and human metapneumo virus were all less than 5%. Bacterial strains were identified in seven SARI cases, including Klebsiella pneumoniae (3 strains), Staphylococcus aureus (2 strains), Streptococcus pneumoniae (1 strain) and Pseudomonas aeruginosa (1 strain). Two or Three pathogens were co-detected from 40 cases, accounting for 33.61% of 119 positive cases. The most common co-detected pathogens were influenza virus and Mycoplasma pneumoniae (10 cases). Influenza cases peaked in winter-spring and summer. Mycoplasma pneumoniae peaked in winter-spring season and overlapped with influenza. The positive rates of pathogens were not significantly different between different age groups.@*Conclusions@#Various respiratory pathogens can be detected from SARI cases aged 15 years and older. Influenza virus was the predominant pathogen and the co-detection of influenza virus with Mycoplasma pneumoniae the most common one.
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@#AIM: To investigate the cause and the description of pathogenic characteristics of chronic infective keratitis in different age groups. <p>METHODS: Totally 89 patients(89 eyes)with chronic infective keratitis were diagnosed in our hospital from January 2015 to December 2017 were selected as the research objects and the cause of the disease and pathogenic characteristics of different age groups, including 13-32 years group(35 eyes in 35 patiens), 33-52 years group(28 eyes in 28 patiens)and 53-73 years group(26 eyes in 26 patiens), were retrospectively studied. <p>RESULTS: There were no significant differences in the etiological distribution of patients in the three groups(<i>P</i>=0.290). There was no significant difference in the distribution of microbial composition among the three groups(<i>χ</i><sup>2</sup>=0.258, <i>P</i>=1.000). The incidence of chronic infectious keratitis caused by fungal infection in the three groups was higher than that of other pathogenic microbes. In this study, 26 cases were positive in bacterial culture, including Staphylococcus epidermidis(50%), Pseudomonas aeruginosa(15%), Streptococcus salivarius(12%), Streptococcus pneumoniae(8%), Escherichia coli(8%)and Neisseria gonorrhoeae(8%). Pseudomonas aeruginosa and Staphylococcus epidermidis were the common bacterial strains in the positive culture results. In the cultivation of fungal strains 24 were positive cultures including Fusarium(46%), Aspergillus(17%), Alternaria(21%), Mycelium(no spore,4%), Penicillium(4%)and Curvularia(8%). Two strains of Fusarium spp. and Alternaria spp. were high of all patients. <p>CONCLUSION: There were no significant differences in the etiology of infectious keratitis among different age groups. Fungal infection is the main pathogen in the distribution of pathogens, the bacteria were mainly Streptococcus epidermidis in etiological features but in fungi, Fusarium dominates. So early prevention and prevention of infective keratitis should be strengthened and early treatment should be given.
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[Objective]To explore the prevalence trend and pathogenic characteristics of hand-food-mouth disease (HFMD) in Jiading District of Shanghai from 2007 to 2016. [Methods] Information on cases of hand-food-mouth disease in Jiading District from 2007 to 2016 was collected and analyzed. [Results]There were 37 520 reported cases from 2007 to 2016 with average age of 2.81 years old, in which 92.05% cases were aged 5 years old or below. The incidence rate showed fluctuation over years was from the lowest incidence of 217.03/105 in 2015 to the highest of 461.83/105 in 2016. There were 55.95% of reported cases from the period of April to July and 94.98% were from rural and urban-rural areas. Samples from 799 patients as pharynx swab and anal swab, etc. were found to be enterovirus 71 (EV71) , the dominant pathogen, accounting for 44.56% of total isolation. There were 0.59% severe cases, 96.23% of which were positive of EV71. [Conclusion] The HFMD prevalence in Jiading District of Shanghai showed periodicity and seasonality. Children aged 5 years old below and living in non-urban areas showed higher incidence risk. EV71 is the dominant pathogen, especially for the severe cases. These findings suggested that targeted measures should be carried out according to the prevalence and pathogenic characteristics, strengthening the prevention and control of HFMD among preschool children in rural and urban-rural areas.
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OBJECTIVE:To provide reference for rational use of antibiotics in clinic. METHODS:A total of 162 inpatients with infective endocarditis(IE)selected from our hospital during Jan. 2014-Jun. 2016 were analyzed retrospectively in respects of general information of patients,distribution of neoplasm,clinical manifestations,examination indexes,sample type,pathogenic composition,drug resistance,treatment and outcome. RESULTS:Among 162 IE patients,the ratio of male to female was 1.9:1, and the age of patients were mainly 41-60 years old.Totally 146 patients suffered from cardiac basic disease(90.1%). One hundred and forty-five patients suffered from positive neoplasm,which mainly involved left ventricular system. Aortic valve neoplasm was the most common(59 cases,40.7%). One hundred and thirty patients suffered from fever.Among them,white blood cell count of 66 cases and neutrophil percentage of 104 cases were increased,while red blood cell count of 69 cases and hemoglobin of 100 cas-es were decreased. ALT of 22 cases,AST of 45 cases and serum creatinine of 16 cases were increased. Among 162 IE patients, 696 blood samples and 282 positive samples were detected(positive rate of 40.5%). Blood culture of 78 patients were positive (48.1%). Eighty-eight strains of pathogens were detected,including 84 strains of Gram-positive bacteria(95.5%,mainly being Streptococcus)and 4 strains of Gram-negative bacteria(4.5%). Resistance rate of Streptococcus to penicillin was 30.4%. Twelve strains of Staphylococcus were resistant to penicillin,and resistance rates of them to oxacillin were 50.0%. Enterococcus was resis-tant to penicillin,oxacillin and amikacin.Above bacteria were all sensitive to vancomycin,teicoplanin and linezolid,with resistant rate of 0.Among 162 IE patients,140 patients underwent cardiac surgery to clear neoplasm(86.4%),158 patients were cured or recovered,2 cases died and 2 cases were discharged from hospital voluntarily. CONCLUSIONS:In our hospital,IE patients are mainly male and suffered from cardiac basic disease. Most of the patients have cardiac neoplasm,which were mainly left cardiac neoplasm. Fever patients are the majority,accompanied by anemia,liver and kidney dysfunction and other symptoms. The patho-genic bacteria causing IE are mainly Gram-positive bacteria;Streptococcus is still the most common bacteria,and drug resistance is not optimistic. Antibiotics should be selected according to local etiological data,and medication plan should be adjusted in time according to the results of drug sensitivity test so as to guaran-tee the effectiveness and safety of anti-infection treatment.
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OBJECTIVE:To provide reference for rational use of antibiotics in clinic. METHODS:A total of 162 inpatients with infective endocarditis(IE)selected from our hospital during Jan. 2014-Jun. 2016 were analyzed retrospectively in respects of general information of patients,distribution of neoplasm,clinical manifestations,examination indexes,sample type,pathogenic composition,drug resistance,treatment and outcome. RESULTS:Among 162 IE patients,the ratio of male to female was 1.9:1, and the age of patients were mainly 41-60 years old.Totally 146 patients suffered from cardiac basic disease(90.1%). One hundred and forty-five patients suffered from positive neoplasm,which mainly involved left ventricular system. Aortic valve neoplasm was the most common(59 cases,40.7%). One hundred and thirty patients suffered from fever.Among them,white blood cell count of 66 cases and neutrophil percentage of 104 cases were increased,while red blood cell count of 69 cases and hemoglobin of 100 cas-es were decreased. ALT of 22 cases,AST of 45 cases and serum creatinine of 16 cases were increased. Among 162 IE patients, 696 blood samples and 282 positive samples were detected(positive rate of 40.5%). Blood culture of 78 patients were positive (48.1%). Eighty-eight strains of pathogens were detected,including 84 strains of Gram-positive bacteria(95.5%,mainly being Streptococcus)and 4 strains of Gram-negative bacteria(4.5%). Resistance rate of Streptococcus to penicillin was 30.4%. Twelve strains of Staphylococcus were resistant to penicillin,and resistance rates of them to oxacillin were 50.0%. Enterococcus was resis-tant to penicillin,oxacillin and amikacin.Above bacteria were all sensitive to vancomycin,teicoplanin and linezolid,with resistant rate of 0.Among 162 IE patients,140 patients underwent cardiac surgery to clear neoplasm(86.4%),158 patients were cured or recovered,2 cases died and 2 cases were discharged from hospital voluntarily. CONCLUSIONS:In our hospital,IE patients are mainly male and suffered from cardiac basic disease. Most of the patients have cardiac neoplasm,which were mainly left cardiac neoplasm. Fever patients are the majority,accompanied by anemia,liver and kidney dysfunction and other symptoms. The patho-genic bacteria causing IE are mainly Gram-positive bacteria;Streptococcus is still the most common bacteria,and drug resistance is not optimistic. Antibiotics should be selected according to local etiological data,and medication plan should be adjusted in time according to the results of drug sensitivity test so as to guaran-tee the effectiveness and safety of anti-infection treatment.
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Dengue fever is an acute infectious disease caused by dengue virus , which is mainly endemic in tropical and subtropical regions .Dengue virus can be classified into four serological serotypes ( DV-1 , DV-2 , DV-3 , and DV-4 ) .All of these serotypes are epidemic in China , but the dominant one thereof is DV-1.Since 1978, dengue fever epidemic has been reported almost every year , especially in the severely-afflicted area, Guangdong province , where more than 40 thousand people were infected with dengue fever in 2014 , thus arousing serious public concern .However , even now the public lack the knowledge about dengue fever , thus affecting the effects of prophylactic and control measures for public health.To solve this problem ,this paper introduces and analyzes dengue fever in terms of epidemic distri-bution rules, pathogenic characteristics of virus , clinical features for relevant diseases , prophylactic and control measures for dengue epidemic , etc.
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Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.
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OBJECTIVE To investigate current status of ventilator-associated pneumonia(VAP) and to provide prevention measures associated with nursing.METHODS Clinical data,such as incidence,categories of pathogenic bacteria and prevention measures associated with nursing,were retrospectively analyzed in 106 patients who received ventilator treatment in our hospital during 2004-2006.RESULTS The positive rate of microorganism culture in these patients was 95.3%.Totally 178 strains of microorganisms were cultured,including 63 strains of fungi,48 strains of nonfermanters,34 strains of Staphylococcus,33 strains of Enterobacteriaceae.There were many risk factors contributed to pathogenesis of VAP.Among these factors,underlying disease was one of the important internal causes and invasive medical procedure was one of the important external causes.The incidence of VAP was reducing yearly as improving of prevention measures associated with nursing.CONCLUSIONS Nurse acts an important role in prevention of VAP.Enhancing nursing management,improving nursing procedure and adopting appropriate intensive care measurement will reduce incidence of VAP.
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Objective To study the pathogenic characteristics of hepatic depression syndrome (HDS) through clinical epidemiologic survey. Methods By using the method of epidemiologic cluster sampling, the cases complicated with HDS from the hospitalized cases from January 2000 to December 2001 of the First Affiliated Hospital, the Second Affiliated Hospital and the Third Affiliated Hospital of Hunan University of TCM, and survey forms were fiUed. The data was counted and analyzed by using SPSS statistical analysis software. Result By the method of epidemiologic survey, the pathogenic characteristics of HDS were demonstrated as follows: universality-HDS could occur in many dieases, complexity-HDS often changed into other syndromes, orientation-HDS often influenced the function of spleen and stomach. Conclusion The method is an effective way to study pathogenesis of TCM. It is objective, truthful and consistent with the clinical situation.
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This article aims at clarifying the formation and accumulation of the'phlegm'in the body.If the phlegm can't be dispelled,it would do great harm to the body health from many aspects,even leading to various diseases which are complex and hard to cure.'Becloud deities','Qi activities blocking','the blood vessels choking','muscular striae overflowing','tumor accumulated','inveterate phlegm loss the path',are the outstanding pathogenic characteristics of the 'phlegm'.Ancient and modern physicians accumulated rich experiences on preventing and treating the phlegm diseases.Those are worth to excavating,organizing,clarifying deeply for being used to the prevention,diagnosis and treatment of the phlegm diseases efficiently.