Simultaneous treatment of large hiatal hernias during Roux-en-Y gastric bypass: technical considerations and outcome.

Roux-en-Y gastric bypass (RYGB) is the preferred surgical option for patients with proven gastroesophageal reflux disease and obesity grade ≥ II (BMI ≥ 35 kg/m2). Data on simultaneous treatment of larger hiatal hernias during RYGB are scarce. From 2012 until 2022, data from all consecutive patients undergoing gastric bypass procedures were collected and retrospectively analyzed. The characteristics and surgical outcomes of patients undergoing RYGB alone (RYGBa) versus RYGB with simultaneous treatment of a large hiatal hernia (RYGB-HH) were compared. Out of 573 patients who received RYGB, we identified 12 simultaneously treated for large hiatal hernia. The characteristics of RYGB-HH versus RYGBa patients were higher age (55 vs. 44 years; p = 0.004) and lower BMI (39.2 vs. 46.9 kg/m2; p = 0.001). Duration of surgery in the RYGB-HH group was longer (144 min vs. 98 min; p < 0.001), while complications > Clavien-Dindo II were similar compared to the RYGBa group (8.3 vs. 9.4%, p = 0.56). Length of stay did not differ among the groups (4 vs. 5.5 days, p = 0.051). At a median follow-up of 12 months, there was no clinical recurrence of hiatal hernia in the RYGB-HH group. Simultaneous treatment of large hiatal hernias during Roux-en-Y gastric bypass surgery prolongs operation time but seems feasible and safe in the hands of experienced surgeons.

Efficacy of Dan'e Fukang Soft Extract in Moderate Ovarian Hyperstimulation Syndrome for Concurrent Treatment of Blood and Fluid Guided by the "Triple Prevention" Principle.

Objective: This study aimed to evaluate the therapeutic efficacy and safety of Dan'e Fukang soft extracts in moderate ovarian hyperstimulation syndrome (OHSS) for the simultaneous treatment of blood and fluid, guided by the traditional Chinese medicine principle of "triple prevention". Methods: This study conducted a retrospective analysis of clinical data from outpatients who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection embryo transfer (ICSI-ET). A total of 2245 cases were included and divided into a treatment group (1002 cases) and a control group (1243 cases). Patients in the treatment group were administered Dan'e Fukang soft extracts orally in addition to conventional Western medicine. Comparative assessments were made between the two groups on pelvic ascites volume, maximum ovary diameter, dysmenorrhea incidence post-oocyte retrieval, and safety indicators. Results: There were no statistically significant differences between the treatment group and the control group in terms of general characteristics or the levels of follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), or progesterone (P) at the time of gonadotropin (Gn) initiation. The groups did not differ significantly when we compared the levels of LH, E2, or P on the day of human chorionic gonadotropin (hCG) injection and during ovarian hyperstimulation protocols (P > 0.05 for all indicators). The differences in the volume of pelvic ascites, the maximum ovarian diameter, and the incidence of dysmenorrhea after oocyte retrieval were statistically significant between the treatment group and the control group (P < 0.05 in both). There were no instances of adverse reactions in either group. Conclusion: Based on the traditional Chinese medicine principle of "triple prevention", the use of Dan'e Fukang soft extracts for the simultaneous treatment of blood and fluid in moderate OHSS significantly improved the absorption of pelvic ascites, promoted ovarian recovery, and reduced the incidence of dysmenorrhea after oocyte retrieval.

Item Screening of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome Based on Delphi Method / 中国中医药信息杂志

Objective To screen items of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome;To provide reference for the formulation and improvement of the scheme.Methods The Delphi method was used to distribute two rounds of questionnaires to 60 experts in cerebropathy or neurology across the country.Statistical analysis was performed on the questionnaire results of the scheme's items,including the disease names,etiology and pathogenesis,syndrome characteristics,rules and regulations,representative prescriptions,acupuncture and other therapies,and preventive care.Results Totally 42 and 50 valid questionnaires were collected.The experts reached the consensus for the importance of etiology and pathogenesis,rules and regulations,acupuncture and other therapies,and preventive care.In the section on syndrome characteristics,items with low relevance or causing ambiguity were removed.Items that were no longer used in modern times and different prescriptions with the same name were removed from the representative prescriptions.The names of syndromes,rules and regulations were unified.Conclusion The experts generally reached the consensus for the importance of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome.However,there are still some limitations that require further study and discussion.

[Research advances in mechanism of lipid infiltration of coronary heart disease and simultaneous treatment of phlegm and blood stasis based on phlegm-blood stasis correlation theory].

Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.

Research advances in mechanism of lipid infiltration of coronary heart disease and simultaneous treatment of phlegm and blood stasis based on phlegm-blood stasis correlation theory / 中国中药杂志

Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.

Discussion on Bufei Decoction in the treatment of stable COPD based on theory of "Latent Toxin Entering Lung" / 国际中医中药杂志

Chronic obstructive pulmonary disease (COPD) is characterized by excess in nature and deficiency in superficiality. For COPD patients, the deficiency of lung and kidney is the basis for production of the latent toxin, and repeated exogenous infection is the main factor for the latent toxin to enter the lung. The key pathogenesis of stable COPD is the entry of latent toxin into the lung and the injury of lung and collaterals. Therefore, tonifying lung and kidney, removing toxins and dredging collaterals are the core treatment methods for COPD in stable period. Bufei Decoction is with good efficacy in the treatment of COPD in stable period, which can not only tonify lung and kidney to consolidate, but also dredging collaterals to remove toxins. Based on the pathogenesis of "latent toxin entering lung", the relevant mechanisms of Bufei Decoction in treating stable COPD were further understood and explored, in order to benefit clinical practice.

Coronary Heart Disease and Obstructive Sleep Apnea Syndrome： Interpretation and Reflection Based on Simultaneous Treatment of Heart and Lung in Traditional Chinese Medicine / 中国实验方剂学杂志

As the overweight and obese population is growing， the incidence of obstructive sleep apnea is rising， and most of the cases are complicated with coronary heart disease and other cardiovascular diseases. The two diseases affect each other and seriously endanger the patients' health， becoming a major public health problem of global concern. It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome. Researchers have explored the relationship between the two based on traditional Chinese medicine（TCM） theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring， respectively， and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs. The failure of the heart to govern blood leads to the generation of blood stasis， and that of the lung to govern Qi movement leads to the generation of phlegm. The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway. This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation. Furthermore， this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm， aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.

An analysis on the compatibility principle and efficacy characteristics of Wumei Pill from the perspective of "Tang-Ye-Jing-Fa Map" / 国际中医中药杂志

Wumei Pill is a classic insect repellent prescription, which is used for ascaris lumbricoides and diarrhea. It is considered to be a representative prescription for the treatment of simultaneous occurrence of cold and heat syndromes. Its prescription is mainly composed of sour drugs ( Mume Fructus and bitter wine) and pungent drugs ( Aconiti Lateralis Radix Praeparataaconite, Cinnamomi Ramulus, Sichuan pepper, Angelicae Sinensis Radix, Zingiberis Rhizoma, and Asari Radix et Rhizoma), supplemented by bitter drugs ( Coptidis Rhizoma and Phellodendri Chinensis Cortex) and sweet drugs ( Ginseng Radix et Rhizoma and honey). From the point of view of "Tang-Ye-Jing-Fa Map", the role of liver is to disperse, whose deficiency leads to limb syncope, and excess leads to the full of hypochondrium and abdominal pain. The pungent herbs can tonify the liver-deficiency, the sour herbs can dispel the liver-excess, and sweet herbs can relive them both. The role of spleen is to moderate, whose deficiency leads to fatigue and weakness, and excess leads to the vomiting and diarrhea. The sweet herbs can tonify the spleen-deficiency, the pungent herbs can dispel the spleen-excess, and bitter herbs can relive them both. Therefore, the function of Wumei Pills is located in the liver and spleen, giving consideration to the heart and lung. It is used for the deficiency and excess mixed syndrome of liver and spleen, which is mainly characterized by chest and flank abdominal pain, limb chills, diarrhea, muscle and pulse contracture and the symptoms of the parts along the liver meridian. It is commonly used in the treatment of ascaris, diarrhea, impotence, depression. At the same time, it can also be used for the treatment of diseases about heart and lung, and cough, anxiety and other diseases.

Impact of different ultrasound-assisted processes for preparation of collagen hydrolysates from Asian bullfrog skin on characteristics and antioxidative properties.

This study focused on impact of ultrasound-assisted process (UAP) at pre-treatment (UP) and simultaneous treatment (US) during papain hydrolysis for preparing collagen hydrolysate (CH) from Asian bullfrog skin. Ultrasonication times were varied (10, 20, 30 min), and CH prepared using papain hydrolysis without UAP was used as control. Different UAPs provided CH with various hydroxyproline contents, α-amino group contents, surface hydrophobicities, and antioxidative activities. UP at 20 min (UP-20) and US at 30 min (US-30) provided highly antioxidative CHs, which were selected for further studies on their Oxygen reactive absorbance capacity (ORAC) and molecular characteristics. CHs from UP-20 and US-30 had higher ORAC than that of control group (p ≤ 0.05). Slight difference in amino acid composition was detected between samples. Based on these results, molecular characteristic styles, molecular weight profile, antioxidative peptide content, and secondary structure of each sample were obtained. These results indicate that UP and US used varied enzymatic hydrolysis patterns and modified molecular conformation of CH, resulting in enhanced antioxidative activity. Therefore, different UAPs as UP and US could be effectively used in preparation of CH using papain hydrolysis from Asian bullfrog skin, which could improve production process efficiency by enhancing their bioactivity, particularly antioxidative activity.

[Exploration of mechanism of "simultaneous treatment of brain and heart" of Naoxintong Capsules based on Toll-like receptor signaling pathway].

This study aims to explore the mechanism of "simultaneous treatment of the brain and the heart" of Naoxintong Capsules(NXT) under cerebral ischemia based on Toll-like receptor(TLR) signaling pathway.Male SD rats were randomized into sham operation group, model group, NXT group, and positive drug group.Middle cerebral artery occlusion(MCAO) model rats were used in model group, NXT group, and positive drug group, respectively.Neurological function was scored with the Bederson scale, and brain infarct rate was measured by 2,3,5-triphenyltetrazolium chloride(TTC) staining.Brain edema was detected with wet-dry weight method.Hematoxylin-eosin(HE) staining and TdT-mediated dUTP nick-end labeling(TUNEL) staining were used to observe and count apoptotic cardiocytes.In addition, serum myocardial enzymes were measured.The expression of 8 TLR signaling pathway-related proteins interferon-α(IFN-α), interferon regulatory factor-3(IRF3), interferon regulatory factor-7(IRF7), TLR2, TLR4, TLR7, TLR9, and tumor necrosis factor-α(TNF-α) in the cerebral cortex and heart of rats was detected by Western blot. Brain infarct rate, neurological function score, and brain water content in NXT group decreased significantly compared with those in the model group. At the same time, the reduction in apoptosis rate of cardiocytes and the content of serum aspartate aminotransferase(AST), alanine aminotransferase(ALT), creatine kinase(CK), and lactate dehydrogenase(LDH) were decreased in the NXT group.Systems pharmacological results and previous research showed that TLR signaling pathway played an important role in immune inflammatory response.The study of TLR signaling pathway and related proteins is helpful to elucidate the mechanism of "simultaneous treatment of the brain and the heart". Western blot results showed that NXT significantly inhibited the expression of IRF3, IRF7, TLR2, TLR7, and TNF-α in cerebral cortex and heart under cerebral ischemia.Cerebral ischemia influences cardiac functions, and TLR signaling pathway is one of the pathways for "simultaneous treatment of the brain and the heart" of NXT.

Development and application of lanthanum peroxide loaded sepiolite nanocomposites for simultaneous removal of phosphate and inhibition of cyanobacteria growth.

The ecological and environmental problem caused by harmful algal blooms (HABs) is challenging to humans. The simultaneous elimination of cyanobacteria and phosphate from eutrophic waters is of great importance. Herein, a new lanthanum peroxide-loaded sepiolite nanocomposite was fabricated via a facile in-situ co-precipitation method and demonstrated the excellent properties on removal of phosphate and inhibition of cyanobacteria growth. The optimized nanocomposite (termed as LPS30) prepared with a La-to-Sepiolite mass ratio of 0.3:1 demonstrated the best cyanobacteria removal with an effective duration of at least 3 months, due to the even dispersion of high-content LP nanoparticles in the sepiolite. LPS30 exhibited a high phosphate uptake (52.68 mg-P/g), fast uptake kinetics (∼45 min to reach 80% of ultimate uptake), and relatively higher selectivity in the presence of competing matters. The pH-dependent phosphate sorption resulted from the ligand exchange between phosphate and surface functional groups (e.g., peroxo and hydroxyls), and the electrostatic attraction. The efficient and long-lasting inhibition for cyanobacteria regrowth was attributed to the combined effect of the oxidative species (i.e., LaOO-) and the efficient removal of phosphate through the coagulation flocs. Our study demonstrated that LPS30 is a promising material to simultaneously treat phosphate and algae for HABs management.

The Econometric Model for Causal Policy Analysis.

This paper discusses the econometric model of causal policy analysis and two alternative frameworks that are popular in statistics and computer science. By employing the alternative frameworks uncritically, economists ignore the substantial advantages of an econometric approach, resulting in less informative analyses of economic policy. We show that the econometric approach to causality enables economists to characterize and analyze a wider range of policy problems than alternative approaches.

Add-On Effect of Simultaneous Intravitreal Dexamethasone to Intravitreal Bevacizumab in Patients with Macular Edema Secondary to Branch Retinal Vein Occlusion.

Purpose: To report the effect of simultaneous dexamethasone and bevacizumab combination treatment in patients with macular edema secondary to branch retinal vein occlusion (BRVO). Methods: Treatment-naive patients who had a macular edema secondary to BRVO with a duration of less than 1 month were treated either with intravitreal bevacizumab (Group-1) or intravitreal bevacizumab simultaneously combined with dexamethasone intravitreal implant (Group-2). In both groups, patients received monthly bevacizumab injection during the first 3 months. Between months 3 and 12, all patients were allowed to receive pro-re-nata bevacizumab. In Group-2, the first dexamethasone implant injection was simultaneously received with first bevacizumab injections. The patients were evaluated for re-treatment after 6 months and 11 months for second and third dexamethasone simultaneously with intravitreal bevacizumab. Results: In Group-1, 35 eyes of 35 patients and in Group-2, 32 eyes of 32 patients were treated. The mean gains in BCVA were +10.7 letters in the Group-1 and +21.3 letters in the Group-2 (P = 0.021) at month 12. The mean reduction in Central Macular Thickness (CMT) from the baseline were -173.74 µm in the Group-1 and -257.97 µm in the Group-2 (P = 0.0018). In Group-1, the mean intravitreal bevacizumab injection number was 7.18 ± 1.05. In Group-2, the mean intravitreal bevacizumab and dexamethasone injection number was 5.15 ± 1.24. There was a significant difference in mean injection numbers between 2 groups (P = 0.044). Conclusion: In the early period of macular edema adding dexamethasone to bevacizumab therapy does improve visual acuity and CMT, and reduce the injection frequency more than bevacizumab alone.

An Innovative Process for Mature Landfill Leachate and Waste Activated Sludge Simultaneous Treatment Based on Partial Nitrification, In Situ Fermentation, and Anammox (PNFA).

An innovative partial nitrification, in situ fermentation, and Anammox (PNFA) system was developed to achieve mature landfill leachate and waste activated sludge simultaneous treatment. Three separate sequencing batch reactors (SBRs) were used for partial nitrification (PN-SBR), integrated fermentation-denitrification (IFD-SBR), and partial nitrification-Anammox (PNA-SBR). After 200 days of continuous operation, a satisfactory nitrogen removal efficiency (NRE) of 99.2 ± 0.1% was obtained, with an effluent total nitrogen (TN) of 15.2 ± 3.2 mg/L. In IFD-SBR, the volatile fatty acids generated from fermentation drove efficient denitrification, obtaining sludge and nitrogen reduction rates of 4.2 ± 0.7 and 0.61 ± 0.04 kg/m3·day, respectively. Furthermore, unwanted fermentation metabolites (134.1 mg/L NH4+-N) were further treated by PNA-SBR using a combination of step-feed and intermittent aeration strategies. In PNA-SBR, Anammox significantly contributed to 82.1% nitrogen removal, and Anammox bacteria (Candidatus Brocadia, 2.3%) mutually benefited with partially denitrifying microorganisms (Thauera, 4.2%), with 66.3% of generated nitrate reduced to nitrite and then reutilized in situ by Anammox. Compared with the conventional nitrification-denitrification process, PNFA reduced oxygen energy consumption, external carbon source dosage, and CO2 emission by 21.3, 100, and 38.9%, respectively, and obtained 50.1% external WAS reduction efficiency.

Simultaneous Treatment of Heart and Brain and Its Transformation of Chinese Medicine： History， Present Situation and Thinking / 中国实验方剂学杂志

The high morbidity and fatality rates of cardiovascular and cerebrovascular diseases seriously harm human health，greatly affect the quality of life and increase the burden of disease. Thus， more and more attention has been paid to the relationship between heart and brain. "Simultaneous treatment of heart and brain" is the continuous deepening and development of the theory of "simultaneous treatment of different diseases" in traditional Chinese medicine （TCM）， and exploring the relationship between heart and brain as well as the current situation of Chinese medicine treatment has important clinical significance for the establishment of integrated traditional Chinese and western medicine diagnosis and treatment programs of cardiovascular and cerebrovascular diseases. Through a systematic theoretical tracing of the "simultaneous treatment of heart and brain"，the authors held that cardiovascular and cerebrovascular diseases had the same origin，and that heart and brain took blood as the material basis and governed mind jointly. They also expounded the modern biological relationship of the simultaneous treatment of heart and brain. In other words，the pathogenic factors of cardiovascular and cerebrovascular diseases were the same， with complicated comorbidities， and the disorders of neurohumoral reflex and endocrine system and immune system regulation could affect each other's function. Additionally，the present situation of clinical application of Chinese medicine for simultaneous treatment of heart and brain and its intervention effect on cardiovascular and cerebrovascular diseases were discussed. It was found that these Chinese medicines could protect cardiovascular and cerebrovascular diseases through multi-target，multi-pathway and multi-link regulation. Combined with the existing problems in the current research，the authors thought and looked forward to the practical strategies of treating cardiovascular and cerebrovascular diseases with Chinese medicine by paying attention to key groups，focusing on dominant diseases，giving full play to the value of Chinese medicine，and scientifically explaining the connotation of simultaneous treatment of heart and brain， in order to provide ideas and reference for the follow-up transformation application research and better guidance of clinical practice.

Traditional Chinese Medicine Prevention and Treatment Strategy of Cognitive Impairment Secondary to Cardiovascular Disease and Simultaneous Treatment of Heart and Brain / 中国实验方剂学杂志

Cognitive impairment secondary to cardiovascular disease is a common complication in the elderly population， which seriously threatens the health of patients and affects the long-term quality of life. Cardiovascular diseases can lead to vascular endothelial injury， cerebral hypoperfusion， and brain lesions， and then cause cognitive impairment. Cardiovascular risk factors also increase the risk of secondary cognitive impairment in patients. It is particularly important to seek for early diagnosis and traditional Chinese medicine （TCM） and western medicine prevention and treatment. Based on the "holistic concept"， TCM puts forward the theory of "the connection of heart and brain". The heart and brain are connected and both are in charge of mental activities. Heart injury affects the brain， resulting in abnormal consciousness， which is considered to be the pathogenesis of cognitive impairment secondary to cardiovascular disease in TCM. Later generations of doctors propose the theory of "simultaneous treatment of the heart and the brain" on the basis of "treating different diseases with the same treatment" and "the connection of heart and brain". The theory contains two meanings. One is that different diseases can be treated by the same method because of the same etiology and pathogenesis. The other is the coexistence of different diseases and the treatment should be targeted to the same risk factors. This paper systematically discussed the TCM pathogenesis of cognitive impairment secondary to cardiovascular disease and the prevention and treatment strategy of "simultaneous treatment of the heart and the brain". In this paper， the deficiency of qi and blood was the foundation， and the interaction of blood stasis and poison and the obstruction of the pulse and the loss of the body were the key factors. Activating blood， detoxifying arteries， and connecting the orifices were the main treatment method for the disease. This paper is expected to enrich the connotation of "simultaneous treatment of the heart and the brain"， and provide new ideas for the prevention and treatment of cognitive impairment secondary to the cardiovascular disease with TCM.

[Cordyceps sinensis combined with Jujing Pills for male infertility].

OBJECTIVE: To observe the clinical effect and safety of Cordyceps sinensis (CS) combined with Jujing Pills (JJP) in the treatment of male infertility. METHODS: We randomly divided 90 male infertility patients into three groups of an equal number and treated them with JJP tid 5g once, CS bid 1g once and CS+JJP, respectively, all for 12 weeks. Before and after 4, 8 and 12 weeks of medication, we obtained the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS) and sperm DNA fragmentation index (DFI), and compared them between the two groups of patients. RESULTS: The total therapeutic effectiveness rate was significantly higher in the CS+JJP than in the CS and JJP groups (96.42% vs 78.57% and 63.33%, P < 0.05), and so was PMS (ï¼»30.05 ± 10.24ï¼½% vs ï¼»24.74 ± 11.24ï¼½% and ï¼»22.71 ± 13.60ï¼½%, P < 0.01). The CS+JJP group also showed a higher percentage of MNS than the JJP group (ï¼»4.16 ± 2.86ï¼½% vs ï¼»2.73 ± 1.86ï¼½%, P < 0.01) but lower than the CS group (ï¼»5.03 ± 2.99ï¼½%) (P < 0.05). The sperm DFI was markedly lower in the CS+JJP than in the CS and JJP groups (ï¼»15.26 ± 6.93ï¼½% vs ï¼»15.90 ± 7.39ï¼½% and ï¼»16.85 ± 8.52ï¼½%, P < 0.05). CONCLUSIONS: Cordyceps sinensis combined with Jujing Pills can effectively improve sperm quality and reduce sperm DFI. Based on the TCM theory of "mutual generation between metal and water", Cordyceps sinensis can significantly enhance the effectiveness of the kidney-tonifying therapy.

Gut microbiota as the critical correlation of polycystic ovary syndrome and type 2 diabetes mellitus.

Gut microbiota forms a symbiotic relationship with the host and maintains the ecological balance of the internal and external environment of the human body. However, dysbiosis of the gut microbiota and immune deficiency, as well as environmental changes, can destroy the host-microbial balance, leading to the occurrence of a variety of diseases, such as polycystic ovary syndrome (PCOS), type 2 diabetes mellitus (T2DM), and obesity. Meanwhile, diseases can also affect gut microbiota, forming a vicious cycle. The role of the intestinal microbiota in different diseases have been proven by several studies; however, as a common target of PCOS and T2DM, there are few reports on the treatment of different diseases through the regulation of intestinal microbiota as the critical correlation. This review analyzed the common mechanisms of intestinal microbiota in PCOS and T2DM, including the dysbiosis of gut microbiota, endotoxemia, short-chain fatty acids, biotransformation of bile acids, and synthesis of amino acid in regulating insulin resistance, obesity, chronic inflammation, and mitochondrial dysfunction. The possible therapeutic effects of probiotics and/or prebiotics, fecal microbiota transplantation, bariatric surgery, dietary intervention, drug treatment, and other treatments targeted at regulating intestinal microbiota were also elucidated.

Early effect of simultaneous intravitreal dexamethasone and bevacizumab combination treatment in patients with persistent diabetic macular edema.

PURPOSE: To report the early effect of simultaneous intravitreal dexamethasone and bevacizumab combination treatment in patients with persistent diabetic macular edema (DME). METHODS: In this single-center prospective non-randomized study, 65 eyes of 59 patients with persistent DME were included. In the combined group (Group 1), we treated 35 eyes of 29 persistent DME patients with a simultaneous combination of intravitreal dexamethasone and bevacizumab, and in the control group (Group 2), we treated 30 eyes of 30 patients with intravitreal bevacizumab. Changes in Best Corrected Visual Acuity (BCVA), Central Macular Thickness (CMT) and Intraocular Pressure (IOP) from the initial visit to each subsequent follow-up visit (1st, 2nd and 3rd months) were recorded. RESULTS: In Group 1, the mean baseline Early Treatment Diabetic Retinopathy (ETDRS) BCVA letter score was 44.1±19.3 (range 20-51), improving significantly to 58.8±18.2 (range 42-73) in the first month (P<0.05), 57±19.2 (range 40-72) in the second month (P<0.05) and 55.4±18.4 (range 34-71) in the third month (P<0.05). In Group 2, the mean pre-injection BCVA ETDRS letter score was 43.3±18.8 (range 20-56) and did not improve significantly; the letter score was 44.3±18.1 (range 20-49) in the third month. In Group 1, the mean BCVA change from baseline to the 3rd month was 11.3 ETDRS letters. In Group 2, the mean BCVA change from baseline to the 3rd month was 1 ETDRS letter. In Group 1, the mean reduction in CMT from baseline was -142.25µm. In Group 2, the mean reduction in CMT from baseline was -17.30µm. In Group 1 at the third month, 12 (34.2%) eyes with a CMT>300µm needed an additional injection. No serious ocular or systemic side effects occurred in any patient. CONCLUSION: Simultaneous intravitreal dexamethasone and bevacizumab combination treatment is effective and can be used safely in persistent DME.

An algal assisted constructed wetland-microbial fuel cell integrated with sand filter for efficient wastewater treatment and electricity production.

In this study we report on a three-stage design of algal assisted constructed wetland -microbial fuel cell incorporated sand filter for efficient treatment of wastewater and bioelectricity generation, simulating a core of it. It aims for the complete removal of organic matter and other inorganic pollutants such as NO3-, NH4+ and PO43-. The conductive material equipped anode region of constructed wetland (CW) performed better for organic removal, and the system efficiently removed COD up to 96.37 ± 2.6%. The algal biomass passively aerated the cathode region and resulted in efficient removal of 85.14 ± 10.73% of NH4+ and 69.03 ± 10.14% of PO43-. The additional sand filter provided anaerobic situation favorable for removal of NO3- up to 68.41 ± 7.63%. The maximum power and current densities achieved in the system were 33.14 mW m-3 and 235.0 mA m-3, respectively.