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Based on the theory of qi， blood and fluids， and taking into account of the pathogenesis evolution process from constraint to phlegm， stasis and then mass in pulmonary nodules， an attempt has been made to construct a three-dimensional differentiation system for pulmonary nodules from the dimensions of time and space. The temporal progression of the early， middle， and late stages of pulmonary nodules reflects the pathological changes from constraint to phlegm and then stasis in the metabolism disorders of qi， blood and fluid. The spatial structures such as size， density， and morphology of pulmonary nodules reflect the pathological states of the duration， severity， and primary and secondary conditions of qi， blood and fluid metabolism disorders. Based on the temporal progression， the therapeutic principles have been proposed， which are dispelling pathogenic factors and promoting the use of beneficial factors to interrupt the growth momentum in the early stage， removing turbidity and dispersing phlegm to reduce the degree of nodules in the middle stage， and dispersing nodulation and eliminating abnormalities in the late stage. Based on the spatial structures， the suggested therapeutic methods are using wind herbs， employing multiple approaches to treat phlegm， and promoting blood circulation to resolve stasis， so as to provide theoretical reference for the systematic diagnosis and treatment of pulmonary nodules in traditional Chinese medicine.
RESUMEN
Pulmonary nodule is a key window for moving ahead the diagnosis and treatment of lung cancer. Traditional Chinese medicine （TCM） can delay the transformation of lung nodules into lung cancer， improve the prognosis of patients， effectively fill the treatment gap during the follow-up period of pulmonary nodules， and has been applied it in the whole cycle and multi-dimensional management of pulmonary nodules. This paper discussed the construction ideas and feasible paths of the whole process management diagnosis and treatment system of pulmonary nodules in TCM， proposed the diagnosis and treatment database of TCM for pulmonary nodules based on the social module of “family-community-hospital”. Through artificial intelligence， we can develop， improve and promote the multi-level and multi-modal “disease-symptom combination” risk prediction model and effectiveness evaluation system of pulmonary nodules. At the same time， the biological connotation of the prevention and treatment of pulmonary nodules by TCM is excavated， which provided empirical evidence for the construction of TCM diagnosis and treatment system， in order to further improve the quality and diagnosis and treatment level of the whole course management of pulmonary nodules.
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Objective:To evaluate the effects of propofol on inflammatory responses in substantia nigra in mice with Parkinson′s disease (PD) and its relationship with α-synuclein (α-syn) expression.Methods:Thirty-three SPF healthy male C57BL/6 mice, aged 12 weeks, weighing 24-26 g, were divided into 3 groups ( n=11 each) using a random number table method: control group (group Con), group PD and propofol group (group Pro). In PD and Pro groups, 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) 30 mg/kg was intraperitoneally injected once a day for 5 consecutive days to induce PD.Propofol 50 mg/kg was intraperitoneally injected at 2 h after the last injection of MPTP in group Pro, while the equal volume of normal saline was given instead in Con and PD groups.The rotarod test was performed at 24 h after administration.The animals were then sacrificed and substantia nigra was removed for determination of contents of interleukin-1β (IL-1β) and tumor necrosis factor (TNF)-α (by enzyme-linked immunosorbent assay), the expression of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and p-caspase-1 (by Western blot) and the expression of α-syn (by immunofluorescence staining). Results:Compared with Con group, the first fall-off time was significantly shortened, the number of falling off was increased, the contents of IL-1β and TNF-α were increased, and the expression NLRP3, p-caspase-1and α-syn was up-regulated in substantia nigra in group PD ( P<0.05). Compared with PD group, the first fall-off time was significantly prolonged, the number of falling off was decreased, the contents of IL-1β and TNF-α were decreased, and the expression NLRP3, p-caspase-1and α-syn was down-regulated in substantia nigra in group Pro ( P<0.05). Conclusion:Propofol can improve behaviors of the mice through inhibiting inflammatory responses in substantia nigra, and the mechanism is related to down-regulating the expression of α-syn.
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@#Lidocaine is an amide local anaesthetic. In recent years, clinical evidence shows that perioperative intravenous lidocaine injection plays an active role in anti-inflammation, analgesia, anti-tumor and organ protection. Postoperative pain is severe in patients after thoracic surgery, and the incidence of pulmonary complications and cognitive impairment is high. These adverse reactions and complications are closely related to the inflammatory reaction after thoracic surgery. Intravenous infusion of lidocaine may have some effects on alleviating these adverse reactions and complications. Thus, this article reviews the current status of intravenous lidocaine injection in thoracic surgery and explores the related mechanisms to optimize the management of anaesthesia during the perioperative period of thoracic surgery.