Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

Objective To explore the expression of Toll-like receptor 4(TLR4) and tumor necrosis factor-α (TNF-α) on peripheral-blood mononuclear cells(PBMCs) and their correlation with myocardial perfusion in patients with diabetic cardiomyopathy (DCM).Methods The expression of TLR4 and TNF-α mRNA on PBMCs were examined by SYBR GreenⅠreal-time quantitative reverse transcription ploymerse chain reaction (RT-PCR), the levels of TLR4 and TNF-α were examined by flow cytometric analysis and enzyme-linked immuno sorbent assay (ELISA) on DCM group (n=20) , Type 2 diabetic group (n=22) and control group (n=20). Myocardial perfusion was visualized by single-photon emission computed tomography (SPECT). Results The expressions of TLR4 and TNF-α mRNA/protein on PBMCs in DCM group were significantly higher than in Type 2 diabetic group, and higher in Type 2 diabetic group than in control groups(P<0.05); summed stress score (SSS)and summed rest score (SRS) of myocardial perfusion in DCM group were significantly higher than in Type 2 diabetic group, and higher in Type 2 diabetic group than in control groups(P<0.01).The expression of TLR4, TNF-α was positively correlated with SSS (r=0.75,P<0.05;r=0.931,P<0.005) and SRS(r=0.78,P<0.005; r=0.789,P<0.005). SSS and SRS in DCM group were also positively correlated with soluble vascular cell adhesion molecule-1 (sVCAM-1) (r=0.728,P<0.005; r=0.738,P<0.005) but there was no correlation between SSS and SRS and brain natriuretic peptide, LVEF, E/A, HbA1c, FBG, FIN and LDL-C (P>0.05).Conclusion The increased expression of TLR4 and TNF-α mRNA/protein on PBMCs and increased serum sVCAM-1 is linked with reduced myocardial perfusion in DCM group. TLR4 and TNF-α may thus play a critical role in the myocardial perfusion inflammation injury in these patients.

Objective:To observe the impact of diabetes mellitus (DM)on pacing parameters and postoperative com-plications in patients With implantation of permanent artificial cardiac pacemaker.Methods:A total of 80 patients With sick sinus syndrome,Who received implantation of permanent artificial cardiac pacemaker from Jun 2008 to Jun 2011,Were enrolled.According to complicated With DM or not,they Were divided into DM group (n=40)and non-DM control group (n=40).Pacing parameters and postoperative complications Were compared betWeen tWo groups.Results:There Were no significant difference in atrial and ventricular pacing threshold,sensing and of pace-maker impedance in baseline betWeen tWo groups (P>0.05).All parameters of pacemaker increased in tWo groups after implantation 12 months;compared With non-DM control group,there Were significant increase in pacing threshold [atrial:(0.59±0.23)V vs.(0.67±0.25)V,ventricular:(0.47±0.28)V vs.(0.54±0.35)V],sens-ing [atrial:(2.33±1.16)mV vs.(2.92±1.36)mV,ventricular:(12.21±4.82)mV vs.(12.77±5.36)mV], impedance [atrial:(537.12±115.32)Ωvs.(662.48±235.26)Ω,ventricular:(602.48±222.46)Ωvs.(762.41± 235.38)Ω]of pacemaker in DM group,P<0.05 or <0.01;and incidence rate of postoperative complications (12.5%)in DM group Was significantly higher than that of non-DM control group (5%),P<0.05.Conclusion:Electrocardiographic reconstruction is more severe in SSS patients complicated DM,in these patients postoperative complication incidence significantly elevates.

OBJECTIVETo study the clinical and pathological features of Denys-Drash syndrome (DDS).

METHODThree DDS cases who were treated in our department from December 2009 to June 2011 were subjected to this study by reviewing of literature.

RESULTBoth case 1 and case 2 were female, with karyotype 46, XX. Case 3 was male with bilateral cryptorchidism. The ages of nephropathy onset of the three cases were 1 year and 9 months, 2 years and 8 moths, and 3 months respectively. Proteinuria in case 2 and case 3 were evidenced to be resistant to steroid. Case 1 was partially responsive to tacrolimus, plasma albumin and cholesterol were improved, although proteinuria was persistent after Tacrolimus was administered. Remission was achieved in case 2 after administration of cyclosporine A and later tacrolimus, and her renal function remains normal till present (4 years and 9 months). Residue renal histology revealed diffused mesangial sclerosis (DMS) in all three patients. All of the three patients had developed right unilateral Wilms tumor. A novel WT1 missense mutation exon 9 c.1213C > G was detected in case 1. WT1 exon 9 c.1168C > T nonsense mutation and exon 8 c.1130A > T missense mutation were detected in case 2 and case 3, respectively.

CONCLUSIONThe clinical manifestation of nephropathy in DDS is variable. The majority present with early onset nephropathy and reach renal failure before the age of 4 years. But in a few patients, nephropathy can also be present much later and progress slowly. Proteinuria in DDS is resistant to steroid but is responsive to calcineurin inhibitors, including Cyclosporine A. The effectiveness of tacrolimus was also observed in this study. DDS is evidently caused by WT1 mutation. DMS is the characteristic renal pathological change in DDS.

Cyclosporine ; therapeutic use ; Denys-Drash Syndrome ; drug therapy ; genetics ; pathology ; Fatal Outcome ; Female ; Genes, Wilms Tumor ; Heterozygote ; Humans ; Infant ; Male ; Mutation ; Nephrotic Syndrome ; drug therapy ; genetics ; pathology ; Proteinuria ; drug therapy ; Sclerosis ; drug therapy ; genetics ; pathology ; Tacrolimus ; therapeutic use ; Treatment Outcome ; WT1 Proteins ; genetics ; Wilms Tumor ; drug therapy ; genetics ; pathology

OBJECTIVETo develop a primer-extension in combination with denaturing high-performance liquid chromatography (PE-DHPLC)-based assay for prenatal diagnosis of the five most common beta-thalassemia mutations in Chinese.

METHODSThe human beta-globin gene fragment was amplified by PCR, followed by a multiple PE reaction specific for each five mutations. Then the PE product mixtures were separated for genotyping of beta-globin gene mutations using fully-denaturing DHPLC analysis.

RESULTSIn a blind study, prenatal diagnosis was performed on thirty-six at-risk families for beta-thalassemia major. Reverse dot blot (RDB) analysis was used to validate each result, showing an accuracy rate of 100% for PE-DHPLC in a total of 108 samples tested. Overall, by PE-DHPLC analysis, the authors could identify the genotypes involving the five mutations and normal alleles corresponding to 94.4% (102/108) and actually make final decision for prenatal diagnosis covering 97.2% (35/36).

CONCLUSIONThe PE-DHPLC protocol can be a simple, rapid, and highly accurate assay in the prenatal detection of common beta-thalassemia mutations.

Base Sequence ; Chromatography, High Pressure Liquid ; methods ; DNA Mutational Analysis ; methods ; DNA Primers ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genotype ; Globins ; genetics ; Humans ; Molecular Sequence Data ; Point Mutation ; Pregnancy ; Prenatal Diagnosis ; beta-Thalassemia ; diagnosis ; genetics

OBJECTIVETo explore the clinical and pathological features and the diagnosis of childhood Alport syndrome (AS).

METHODSA retrospective analysis was performed on clinical data of 91 children with AS.

RESULTSHematuria was observed in all 91 patients, of whom 86 were accompanied with proteinuria. Sixty-one children with X-Linked AS (XL-AS) had positive family history. Renal biopsy was performed on 82 children. Mild to moderate mesangial proliferation was observed in 74 cases. Small amounts of immune complexes deposits in the glomerular mesangial area were observed in 48 cases. Glomerular basement membrane (GBM) attenuation, thickening and layering were observed in 53 cases by electron microscopy (EM). In 63 cases receiving renal tissue type IV collagen α3 and α5 chain immunofluorescence detection, 58 were diagnosed with AS, including 53 cases of XL-AS and 5 cases of autosomal recessive AS. In 91 cases of AS, 58 were diagnosed as AS by renal tissue type IV collagen α3 and α5 chain immunofluorescence, 21 were diagnosed by EM, one was diagnosed by skin biopsy, and 12 were diagnosed by gene detection. Six novel mutations of COL4A5 gene were found. Forty-five cases were misdiagnosed before the diagnosis of AS. Forty-one of the 45 cases received steroids and/or immunosuppressant therapy.

CONCLUSIONSThe clinical manifestations and pathological changes are not specific in children with AS, resulting in a higher rate of misdiagnosis. Typical lesions of GBM under EM are only observed in a part of patients. There is a high novel mutation rate of COL4A5 in the detected AS children.

Child ; Child, Preschool ; Collagen Type IV ; genetics ; Diagnostic Errors ; Female ; Glomerular Basement Membrane ; pathology ; Humans ; Male ; Nephritis, Hereditary ; diagnosis ; genetics ; pathology ; Retrospective Studies

OBJECTIVETo analyze the auditory capability of preschool children before and after cochlear implantation using meaningful auditory integration scale (MAIS) questionnaire.

METHODSEighty-two prelingually deaf patients participated in this study. They received a cochlear implant at the age of 3 to 6 years and 11 months. The audiologists who were trained for the research used the MAIS questionnaire. Audiologists asked for the parents' answers and recorded all the information about the device using (Q1,2) and the patient's spontaneous auditory behavioural responses including spontaneous alerting to sound Q3 approximately 6 and deriving meaning from sound (Q7 approximately 10). The evaluation was performed before operation and 1 , 3, 6 months, 1, 1.5, 2 years after switch-on.

RESULTSThe scores of question 1a and 1b were not significantly different among the different periods after switch-on. The scores of question 2 to 10 were significantly different among the different periods after switch-on.

CONCLUSIONSConsiderable variability across subjects' auditory ability after cochlear implantation was noted. Most of the patients showed no consistent response to sound in everyday life before implantation. After cochlear implantation, a significant increase in auditory capability occurred. The children demonstrated faster development of device using relative to spontaneous alerting to sound and deriving meaning from sound.

Auditory Perception ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Female ; Humans ; Male ; Surveys and Questionnaires

Objective To evaluate the antibody titer distributions after primary vaccination by different sequential schedules of Sabin strain-based inactivated poliovirus vaccine(sIPV) and bivalent oral attenuated live poliomyelitis vaccine against types 1 and 3 (bOPV) in Drug Candy(DC) form or liquid dosage form. Methods Eligible infants of 2 months old selected in Liuzhou were assigned randomly in a ratio of 1:1:1:1 to 4 groups as following: sIPV+2bOPV(DC), sIPV+2bOPV(liquid), 2sIPV+bOPV(DC), 2sIPV+bOPV(liquid), and were vaccinated at 0, 28, 56 days. Polio neutralizing antibody titers against poliovirus types 1, 2 and 3 were tested prior to Dose 1 and at 28 days after Dose 3. Results The antibody titer distribution for type 1 was statistically different between sIPV+2bOPV(DC) and sIPV+2bOPV(liquid) (Z=-2.589, P=0.010) while no significant differences were detected between the two groups for type 2(Z=-0.331, P=0.741) and type 3(Z=-1.556, P=0.120). There were no significant differences between 2sIPV +bOPV(DC) and 2sIPV+bOPV(liquid) for the distributions(All P>0.05) (type 1: Z=-1.249, P=0.212; type 2: Z=-1.658, P=0.097; type 3: Z=-1.436, P=0.151). In the same dosage forms with different sequential schedules, the antibody titer distributions were significantly different between 2 doses sIPV and 1 dose sIPV groups(All P<0.05)(sIPV+2bOPV(liquid) vs 2sIPV+bOPV(liquid): type 1: Z=-2.766, P=0.006; type 2: Z=-9.137, P<0.001; type 3: Z=-5.529, P<0.001. sIPV+2bOPV(DC) vs 2sIPV+bOPV(DC): type 1: Z=-3.748, P<0.001; type 2: Z=-7.660, P<0.001; type 3: Z=-6.030, P<0.001). Conclusions Different dosage forms have similar immune effects, so appropriate dosage forms should be selected for vaccination according to the effectiveness, characteristics of subjects and the population density. In the case of sufficient supply of sIPV, 2 doses sIPV sequential program should be the first choice to complete the primary immunization.

OBJECTIVETo investigate the prognostic risk factors in incidental gallbladder cancer (IGBC) and evaluate the effect of laparoscopic cholecystectomy (LC) applied in treating IGBC.

METHODSThe retrospective study enrolled 55 patients with incidental gallbladder adenocarcinoma treated between January 2001 and December 2008. The patients were divided into three groups according to different surgical approaches: laparoscope group (n = 23), conversion group (n = 6) and laparotomy group (n = 26). Survival analysis and Cox regression model were applied to comparing the difference of survival rate between three groups and to analyzing the related prognostic risk factors of IGBC.

RESULTSThe overall 1-, 3- and 5-year survival rates were 74.3%, 47.7% and 35.8% respectively. And the median survival time was 36 months. The outcome of survival rate between three groups was not different statistically. Cox regression analysis indicated that pathologic T stage was an independent risk factor influencing IGBC (OR = 2.75, P = 0.00). The prognosis was getting worse according to the rising depth of tumor invasion. However, the other factors, such as surgical approach, tumor incisional implantation, ect.were not related to the prognosis (P > 0.05).

CONCLUSIONThe factor of pathologic T stage is related to the prognosis of IGBC for which LC, compared with open cholecystectomy, should not be regarded as a negative factor in treatment.

Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic ; Female ; Follow-Up Studies ; Gallbladder Neoplasms ; surgery ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors

Objective To explore the electrophysiological results and rehabilitation outcome of two prelingually deafened pediatric cochlear implant patients with auditory neuropathy.Methods Preoperative audiological evaluation,intra-postoperative electrically evoked auditory brainstem response(EABR)and neural response telememetry(NRT)record for the two cases were conducted in Beijing Tongren Hospital.A one year follow-up was performed.Data collected before and at 6,12-month intervals after implantation were compared with that from control pediatric cochlear implant patients matched for the same duration of implant use as this two cases. Results The two children implanted had not had any postoperative medical or cochlear implant device complications. Intraoperative EABR and NRT were elicited in case 1 with unrepeatable waveforms. After 12 months of training,Case 1 had shown significant improvements in sound detection,speecn perception abilities and communication skills,which was better than the control group.and the eJectrophysiological results became normal.Case 2 had also benefited from cochlear implantation, even though no recognizable NRT was found until he returned 12 month after the operation.Conclusions The desynchronization of auditory path had been changed after the electrical stimulation ongoing 12 months for children with auditory neuropathy.The two children had not had any complications postoperatively,and eacn child had shown improved listening and communication skills. Cochlear implantation COUld help patients witn auditory neuropathy to improve their communication skill and go back to the main stream.