Objective To explore Wang Xingkuan’s rules of syndrome and treatment of chest blocking and heartache (Xiongbixintong).Methods Collection of professor Wang Xingkuan’s 267 consilia of patients with Xiongbixintong for outpatients. Chinese medicine terminology was regulated and Excelldatabase was established. Symptom, syndrome element, pathogenesis and treatment were statistically described by using Weka3.6 software, and Apriori algorithm was adopted for the main pathogenesis→treatment analysis of association rules.Results Symptoms include:chest pain, heart palpitations, shortness of breath, pale tongue (dark) red, etc. Syndrome elements include:in liver, and heart, and blood stasis, phlegm, qi stagnation, etc. The key pathogenesis is liver-heart imbalance, including stagnation of liver qi, heart and blood stasis, deficiency of heart qi-ying, disturbing heart-mind, etc. The principle of treatment is liver-heart Tongzhi, so the treatment is of“liver” with Shu gan-mu;treatment of“heart” contains freeing channels, eliminating phlegm and blood stasis, quiet the heart, replenishing qi-ying, etc. The main pathogenesis related credibility→treatment was higher than 0.50;with high reliability, the liver-heart imbalance→liver-heart Tongzhi was 0.71. Medication includes catharsis and tonic,“catharsis” to salvia, allium macrostemon, pseudo-ginseng, bupleurum, etc;“tonic” to white ginseng, ophiopogon japonicus, radix paeoniae alba, poria with hostwood, polygala tenuifolia, etc. Conclusion “Xintongzhigan, liver-heart Tongzhi, catharsis and tonic” is Wang Xingkuan’s thoughts and experience in treating Xiongbixintong.

The clinical features, laboratory tests, imaging findings, treatment and outcomes of 26 non-HIV infection patients with Pneumocystis jirovecii pneumonia (PJP) diagnosed in our hospital from January 2017 to February 2022 were retrospectively analyzed. There were 19 males and 7 females, with an average age of 44(30, 51)years. All patients had underlying diseases of immunosuppression. The main symptoms included fever in 18 cases (69.2%), cough in 15 cases (57.7%), shortness of breath in 11 cases(42.3%). The laboratory test results showed elevated levels of CRP in 22 cases (95.7%), PCT in 18 cases (78.3%), lactate dehydrogenase in 17 cases (17/19), G test in 14 cases (14/20), and decreased CD4 +T cell count in 14 cases (14/19). Pneumocystis jirovecii pathogen was detected in bronchoalveolar lavage fluid in 16 cases (61.5%), in blood samples in 10 cases (38.5%). Pneumocystis jirovecii was not detected in sputum or bronchoalveolar lavage fluid using smear microscopy. Chest CT showed ground-glass opacity in 25 cases (96.1%). All patients received compound sulfamethoxazole tablet, 21 patients (80.8%) were also treated with other anti-fungal drugs. Among the 26 patients, 1 case (3.9%) received extra-corporeal membrane oxygenation (ECMO), 5 cases (19.2%) received non-invasive ventilation, 7 cases (27.0%) received invasive ventilation, and 13 cases (50.0%) received nasal cannula oxygen therapy. Of the 26 cases, 19 cases(73.1%)developed severe pneumonia. Finally, 21 patients (80.8%) improved and discharged, and 5 patients (19.2%) died. In conclusion, non-HIV infection patients with Pneumocystis jirovecii pneumonia were mainly middle-aged or elderly people with underlying diseases of immunosuppression. The clinical symptoms are mainly fever, cough, and shortness of breath. The imaging manifestations are mainly ground-glass opacity and consolidation opacity. Laboratory tests show elevated CRP, PCT, LDH, and G tests, and decreased CD4 +T cells. Compound sulfamethoxazole-based comprehensive treatment is effective for PJP. The disease is characterized by high proportion of severe pneumonia, fast remission and high risk of mortality.

The clinical presentation,chest image and electrocardiogram of 4 cases of premature complex-induced chronic cough admitted in the First Affiliated Hospital of Guangzhou Medical University from March 2008 to February 2009,were retrospectively analyzed.And other 6 cases of premature complex-induced chronic cough were retrieved for literature review.In total 10 patients,there were 3 males and 7 females aged 58(36-74) years,with a disease duration of 10.5 (3.0,264.0) months.The main clinical presentations were chronic dry cough with post-sternal thump and premature beats as shown by auscultation and 24 h-electrocardiogram examination.Cough was relieved after the premature beats were controlled with the treatment of arrhythmia drugs or radiofrequency ablation.Premature complex-induced cough is rare but it should be considered when the chief complaint of patients with premature beat is chronic cough.