1.Patent foramen ovale and cryptogenic stroke
International Journal of Cerebrovascular Diseases 2010;18(9):680-686
Epidemiological studies have shown that the incidence of patent foramen ovale (PFO) in patients with cryptogenic stroke is significantly higher than general population.The close association between cryptogenic stroke and PFO supports the hypothesis that paradoxical embolism is a cause of stroke.However,the detection of PFO alone does not establish the diagnosis of paradoxical embolism in patients with cryptogenic stroke. The risk of ischemic stroke will increase significantly when PFO and other factors coexist.Some studies tave shown that there is significant difference between the MRI lesion patterns in patients with cryptogenic stroke and PFO in those without cryptogenic stroke,particularly in multiple ischemic lesions.Therefore,it does not support the theory of paradoxical embolism as a cause of stroke in patients with PFO.The PFO detection methods include transthoracic echocardiography,transesophageal echocardiography (TEE) and transcranial Doppler (TCD).TCD and TEE have a good consistency.Accordingly,TCD should be recommended as a simple,noninvasive,and reliable technique,while TEE should be only restricted to the selected patients.The treatment options of PFO include antiplatelet drugs,anticoagulant drugs,percutaneous vascular closure,and thoracotomy.Percutaneous vascular closure should only be considered the recurrent events during the medical treatment,the contraindications of medical treatment,and PFO with some anatomical high risks for patients with cryptogenic stroke with PFO before the completion of several large randomized controlled trials.
2.Regulated cell death in cancer: from pathogenesis to treatment
Linjing GONG ; Dong HUANG ; Yujun SHI ; Zong’an LIANG ; Hong BU
Chinese Medical Journal 2023;136(6):653-665
Regulated cell death (RCD), including apoptosis, pyroptosis, necroptosis, and ferroptosis, is regulated by a series of evolutionarily conserved pathways, and is required for development and tissue homeostasis. Based on previous genetic and biochemical explorations of cell death subroutines, the characteristics of each are generally considered distinctive. However, recent in-depth studies noted the presence of crosstalk between the different forms of RCD; hence, the concept of PANoptosis appeared. Cancer, a complex genetic disease, is characterized by stepwise deregulation of cell apoptosis and proliferation, with significant morbidity and mortality globally. At present, studies on the different RCD pathways, as well as the intricate relationships between different cell death subroutines, mainly focus on infectious diseases, and their roles in cancer remain unclear. As cancers are characterized by dysregulated cell death and inflammatory responses, most current treatment strategies aim to selectively induce cell death via different RCD pathways in cancer cells. In this review, we describe five types of RCD pathways in detail with respect to tumorigenesis and cancer progression. The potential value of some of these key effector molecules in tumor diagnosis and therapeutic response has also been raised. We then review and highlight recent progress in cancer treatment based on PANoptosis and ferroptosis induced by small-molecule compounds, immune checkpoint inhibitors, and nanoparticles. Together, these findings may provide meaningful evidence to fill in the gaps between cancer pathogenesis and RCD pathways to develop better cancer therapeutic strategies.
3.Scientific Research Paradigm and Technological Layout Ideas Based on Clinical Dominant Disease of Traditional Chinese Medicine (Allergic Rhinitis)
Lili LIU ; Zheng GONG ; Linjing ZHANG ; Haiyang ZHANG ; Xiaoxiao ZHANG ; Zhanfeng YAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):241-251
To implement the instructions and directives of General Secretary Xi Jinping on important documents related to traditional Chinese medicine (TCM), adhere to the equal emphasis on TCM and Western medicine, and promote mutual complementarity, win-win cooperation, and coordinated development between TCM and Western medicine, the China Association of Chinese Medicine has organized seminars on the clinical dominant diseases of TCM in multiple professional fields, achieving a series of results. The aim is to implement the research on dominant diseases of TCM described in the Law of the People's Republic of China on Traditional Chinese Medicine and the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance, Innovation and Development of Traditional Chinese Medicine, thus serving the construction of advantageous specialties, clinical talent cultivation, national scientific and technological layout, and academic innovation leadership. In the field of otolaryngology, the China Association of Chinese Medicine and many Chinese and Western medicine experts across the country have conducted multiple in-depth discussions and research. At the 10th Clinical Dominant Disease Series Youth Salon, they have elaborated and demonstrated the basic and specific suggestions and consensus on the clinical advantages of TCM and integrated TCM and Western medicine in the treatment of allergic rhinitis (AR), making great progress. However, there is still a lack of detailed research paths. Under the guidance of the China Association of Chinese Medicine and based on the TCM Dominant Disease Series Salon for AR, this study analyzed the difficulties encountered in AR diagnosis and treatment according to the occurrence and development law of AR. Based on the advantages and characteristics of AR diagnosis and treatment by TCM and integrated TCM and Western medicine, it explored the research paradigm and technological layout points of AR and put forward suggestions. The layout involved four aspects: Optimization of the AR diagnosis and treatment system, prevention and control of comorbidities, management of chronic diseases, and a platform for TCM inheritance. Additionally, suggestions for layout and research directions, expected goals and values, and priority levels for funding were proposed. The study is expected to provide a theoretical basis and development ideas for the future prevention and treatment of AR with TCM and integrated TCM and Western medicine and promote the high-quality development of TCM.
4.Treatment of Allergic Rhinitis with Traditional Chinese Medicine: A Review
Linjing ZHANG ; Yingying ZHAO ; Lili LIU ; Zheng GONG ; Mingsheng ZHANG ; Jianhua LIU ; Zijun DONG ; Jingyi HU ; Xiaoxiao ZHANG ; Zhanfeng YAN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(9):268-273
This article reviews the clinical studies about the treatment of allergic rhinitis (AR) with traditional Chinese medicine (TCM) in recent years. AR is a common and frequently occurring disease in the department of otolaryngology. The common manifestations of AR include nasal congestion, sneezing, runny nose, and nasal itching. AR, belonging to the category of rhinitis, is a dominant disease in the TCM treatment of otorhinolaryngologic diseases and head and neck diseases. The ancient literature has laid a solid theoretical basis on the etiology and pathogenesis of AR. According to the ancient literature, the theoretical basis, and their own experience, modern doctors classified the causes of AR into the disorders in Zang-fu organs and six meridians. Most of the explanations focus on the disorders in Zang-fu organs, especially the lung, spleen, and kidney. The clinical studies in this field mainly involve TCM treatment alone, integrated TCM and Western medicine treatment, and TCM external treatment. These therapies have good efficacy in the clinical treatment of AR. Among them, TCM treatment alone has significant advantages in alleviating the symptoms and nasal signs, declining the scores of related scales, and reducing the eosinophil count (EOS) of nasal secretions, with definite long-term efficacy. Integrated TCM and Western medicine treatment can complement with each other. The TCM external treatment methods include acupuncture, moxibustion, acupoint catgut embedding, acupoint application, and nasal irrigation with TCM, which are safe, simple, acceptable by patients and have good therapeutic effect. Finally, the clinical research status of TCM treatment of AR was summarized, and suggestions were put forward from three aspects: standardizing the clinical research protocol of TCM, encouraging pure TCM research, and exploring the mechanism of TCM treatment on the basis of frontier research achievements. This review aims to provide higher-level evidence for subsequent clinical research and promote the research on dominant AR diseases.