The lungs are the most common sites of metastases from non-pulmonarymalignancies. Endobronchial metastases are rare and have no specificity in clinical manifestations,thus being prone to misdiagnosis and delayed treatment.The common tumors associated with endobronchial metastasis are renal,breast,and colorectal cancers.This article reported one case of postoperative rectal cancer with endobronchial and lung metastases,which was relieved by high-frequency electrocautery ablation via bronchoscope,chemotherapy,and targeted drugs,aiming to provide a reference for clinical diagnosis and treatment.
Humans ; Rectal Neoplasms/pathology* ; Electrocoagulation/methods* ; Bronchial Neoplasms/drug therapy* ; Bronchoscopy ; Lung Neoplasms/secondary* ; Bronchoscopes

To systematically evaluate the efficacy and safety of acupuncture versus Flunarizine hydrochloride in the treatment of migraine. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and ClinicalTrail.gov were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to January 8, 2020. Randomized controlled trial(RCT) for acupuncture versus Flunarizine in the treatment of migraine were screened out according to inclusion criteria and exclusion criteria. The included studies were evaluated with the Cochrane bias risk assessment tool. The included studies was conducted by RevMan 5.3, and the outcome indicators were evaluated for evidence quality and strength of recommendation by the GRADE system. A total of 1 033 literatures were retrieved, and 23 studies were finally included. Except for 4 multiarm tests, the total sample size was 1 548, including 785 in acupuncture group and 763 in Flunarizine group. The overall quality of the included studies was not high. Meta-analysis results showed that the acupuncture group was superior to the Flunarizine group in reduction of headache frequency(SMD=-1.00, 95%CI[-1.45,-0.54], P<0.000 1). In reduction of headache intensity, acupuncture group was superior to Flunarizine group(SMD=-1.05, 95%CI[-1.41,-0.68], P<0.000 01). In reduction of headache duration, acupuncture group was superior to Flunarizine group(SMD=-1.42, 95%CI[-1.83,-1.02], P<0.000 1). The acupuncture group was superior to Flunarizine group(MD=-0.17, 95%CI[-0.21,-0.13], P<0.000 01) in reduction of the painkillers taking frequency. The acupuncture group was superior to Flunarizine group(SMD=-0.94, 95%CI[-1.35,-0.52], P<0.000 1) in allevia-tion of paroxysmal symptoms, such as nausea and vomiting. The GRADE system showed that the evidence level of the above indicators was extremely low, and the strength of recommendation was low. As for the occurrence of adverse reactions, the adverse reactions reported in the acupuncture group included in the study were all mild adverse reactions, like drowsiness, subcutaneous bleeding, local pain, subcutaneous hematoma and dizziness needle. The available evidence showed that acupuncture has a better efficacy than Flunarizine hydrochloride in the treatment of migraine in adult patients. However, due to the high bias risk in the included studies, the conclusions of this study shall be adopted with caution, and more high-quality studies shall be carried out for verification in the future.
Acupuncture Therapy ; Flunarizine/therapeutic use* ; Humans ; Migraine Disorders/therapy* ; Treatment Outcome

To evaluate the efficacy and safety of Yangxue Qingnao Granules alone or combined with calcium channel blocker in treatment of migraine. In this study, four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and clinical trials registration center(ClinicalTrials.gov) were retrieved. The retrieval time was from the establishment of each database to January 8, 2020. According to the set inclusion criteria and exclusion criteria,the randomized controlled trial(RCT) of Yangxue Qingnao Granules alone or combined with calcium channel blocker was selected. The "Cochrane bias risk assessment" tool was used to evaluate the quality of the included studies. RevMan 5.3 was used to conduct Meta-analysis of the included studies and grade system was used to evaluate the evidence quality of the outcome indicators. A total of 583 documents were retrieved and finally included in 23 studies, with a total sample size of 2 308 cases, 1 171 cases in the treatment group and 1 137 cases in the control group. The overall quality of the research included was not high. Meta-analysis showed that,(1)in terms of effective rate, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(RR=1.24, 95%CI[1.17, 1.32], P<0.000 01), and there was no significant difference between Yangxue Qingnao Granules and calcium channel blocker(RR=1.36, 95%CI[0.91, 2.03], P=0.14).(2)In terms of reducing headache frequency, when the unit of headache frequency was times per month, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.39, 95%CI[-1.83,-0.95], P<0.000 01), when the unit of headache frequency was times daily, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-2.08, 95%CI[-2.34,-1.82], P<0.000 01).(3)In terms of headache intensity, when headache intensity was scored by pain intensity, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-0.70, 95%CI[-0.81,-0.59], P<0.000 01), when headache intensity was scored by VAS score, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.59, 95%CI[-2.13,-1.06], P<0.000 01).(4)In terms of reducing headache duration, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(SMD=-3.13, 95%CI[-4.12,-2.15], P<0.000 01). GRADE system showed that the evidence level of the above outcome indicators was low and extremely low. Twelve cases of adverse reactions were reported, all of which were mild. The results showed that the combination of Yang-xue Qingnao Granules can improve the effective rate, reduce the headache frequency, the headache intensity and the headache duration, and had good safety and low incidence of adverse reactions compared with the single calcium channel blocker. However, there was no difference in the effective rate between Yangxue Qingnao Granules alone and calcium channel blocker. In view of the low quality of this study, which affects the reliability of the conclusion, it is necessary to use the conclusion of this study carefully, and more high-quality randomized controlled trials are needed to further verify in the future.
Drugs, Chinese Herbal/adverse effects* ; Humans ; Migraine Disorders/drug therapy* ; Reproducibility of Results

Licorice has long been regarded as one of the most popular herbs, with a very wide clinical application range. Whether being used alone or as an ingredient in prescription, it has an important role which cannot be ignored. However, the efficacy and chemical constituents of licorice will change after honey-processing. Therefore, it is necessary to find quality markers before and after honey-processing to lay the foundation for a comprehensive evaluation of the differences between raw and processed licorice pieces. HPLC-DAD was employed to establish fingerprints of raw and processed licorice. Multivariate statistical analysis methods including principal component analysis(PCA) and orthogonal partial least squares discrimination analysis(OPLS-DA) were applied to screen out the differential components before and after processing of licorice. Based on network pharmacology, the targets and pathways corresponding to the differential components were analyzed with databases such as Swiss Target Prediction and Metascape, and the "component-target-pathway" diagram was constructed with Cytoscape 3.6.0 software to predict the potential quality markers. A total of 17 common peaks were successfully identified in the established fingerprint, and seven differential components were selected as potential quality markers(licoricesaponin G2, glycyrrhizic acid, liquiritigenin, liquiritin, isoliquiritin, liquiritin apioside and isoliquiritigenin). The HPLC fingerprint method proposed in this study was efficient and feasible. The above seven differential chemical components screened out as potential quality markers of licorice can help to improve and promote the overall quality. These researches offer more sufficient theoretical basis for scientific application of licorice and its corresponding products.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Glycyrrhiza ; Glycyrrhizic Acid/analysis* ; Honey/analysis*

Objective To evaluate the minimum inhibitory concentration (MIC) and influence factors of cefathiamidine against clinical isolates from recent years in China.Methods MIC were tested by two fold agar dilution method.The effect of various experimental conditions (such as inoculation quantity,pH value of medium,percentage of serum)on MIC of cefathiamidine was evaluated.Results A total of 794 clinical strains were tested and cefathiamidine had showed excellent antibacterial activity against gram-positive bacterial.The MIC90 of cefathiamidine against methicillin-susceptible S.aureus (MSSA) and S.epidermidis (MSSE)were 0.50,0.12 mg · L-1,respectively.The MIC90 values of cefathiami-dine had against penicillin-susceptible S.pneumoniae (PSSP) and peni-cillin-nonsusceptible S.pneumoniae(PNSSP) were 0.12 mg· L-1 and not more than 1 mg · L-1,respectively.Against S.pyogenes,the MIC90 was 8 μg · L-1.The MIC90 of cefathiamidine against ampicillin-susceptible E.faecalis and E.faecium were 1,16 mg · L-1,respectively.The MIC90 of cefathiamidine against ampicillin-susceptible Haemophilus spp.and Moraxella catarrhalis were not more than 4 mg L-1 Cefathiamidine also had some antibacterial activity against gram-positive anaerobia.The factors including inoculation quantity,pH value of medium and percentage of serum had no effect on MIC values.Conclusion Cefathiamidine exhibited good activity against gram-positive bacterial including Enterococcus spp..

Objective To evaluate in vitro synergy between palmatine and commonly used antibiotic against main clinical isolated strains in recent three years.Methods All of 118 strains isolated in recent three years and 2 standard strains were studied.Minimal inhibition concentrations (MIC) were tested by agar dilution method and combination effects were measured by checkerboard method.Results Palmatine showed moderate in vitro activity against Staphylococcus.Synergy was detected with palmatine in combination with levofloxacin against gram-positive and negative strains,though synergistic rate less than 20％.Synergy was not show between palmatine and linezolid.Additive effect was found widely between palmatine and two agents against almost all tested species.Conclusion The results of in vitro synergy tests may be different sometimes on account of various strains,methods,etc.So,more deeper understanding of action mechanism of traditional Chinese medicine and correlation between in vitro test and clinical outcomes will help medical to select antibiotic more suitablly.

Objective To evaluate the in vivo antibacterial effect of cefathiamidinein against mouse septicemia.Methods Experimental model of mouse septicemia was established by intraperitoneally injection with 0.5 mL minimum lethal dose (MLD) bacteria.The 0.2 mL different concentrations of drugs were injected through caudal vein.Cefathiamidine,cefazolin and ampicillin adopted two methods of dose regimen,which are single-dose and two-dose;while,both ceftriaxone and levofloxacin adopted single-dose.The survival time of the infected mouse was monitored for 1-7 d.The 50％,95％ effective doses(ED50,ED95) were determined by the Bi-level integrated system synthesis (BLISS) method.The antibacterial activities between cefiazine and control drugs were compared.In vivo protection experiments were carned out on 3 standard strains and 7 pathogenic strains isolated through single dose.Results The cefathiamidine had good antibacterial activity in vivo against Streptococcus pneumonia and Enterococcus faecalis.The ED50 of single-dose was between 1.43-1.71 mg · kg-1,which was significantly superior to cefazolin and was similar to levofloxacin.According to the results of two -dose regimen,the ED50 values of cefathiamidine against Sreptococcus pneumonia,Staphylococcus aureus and Haemophilus influenza significantly declined,which were between 0.78-14.78 mg · kg-1.However,with regard to Enterococcus faecalis,the ED50 value of two-dose increased compared to that of single-dose,which could be related to the fact that low plasma concentration affected protective effects in vivo.Conclusion Cefathiamidine had a better antibacteria effect in vivo against gram-positive bacteria,especially Streptococcus pneumonia and Enterococcus faecalis.Through the comparison between single-dose and two-dose,it is more reasonable to adopt two-dose or multiple-dose of cefathiamidine with regard to most strains.

Oxazolidinones are a potent class of synthetic antimicrobial agents with activity mainly against Gram-positive strains.In this review,we summarize the mechanism of action and resistance,as well as the safety from clinical experience of oxazolidinones.The structural modifications and structure-activity relationships of oxazolidinones derivatives will also be presented.

Intestine,the body's largest digestive and immune organ,always affects the occurrence and development of cardiovascular disease process.Especially the trimethylamine N-oxide as one of the metabolic derivatives produced by intestinal microbiota,can increase the risk of atherosclerosis and promote cardiovascular diseases such as chronic heart failure.Therefore,changing the level of trimethylamine N-oxide in the circulation by taking different measures to intervene the structure,composition and metabolic activity of intestinal flora can affect the occurrence and development of the disease.Thus,the intestinal flora is recognized as a new target for the treatment of cardiovascular diseases.

Purpose To explore the effects of ploidy analysis on thoracic neoplasms based on DNA image cytometry (DNA-ICM), and to look for a meaningful novel diagnostic assay for tumor patients. Methods 4 402 patients who were diagnosed with thoracic disease were recruited in 2 years. By the DNA-ICM analysis, all the specimens were diagnosed as three types——positive, equivocal and negative ones. The results of701 specimens were compared with biopsy and clinical followup. Results DNA aneuploidy detected by DNA-ICM were65％ in confirmed malignant samples, 64％ in equivocal malignancy, and 8％ in non-malignant diseases. The comprehensive performance of DNA-ICM in malignancy was 73％, 93％, 71％, 94％ respectively for sensitivity, specificity, positive predictive value and negative predictive value. OR analysis found that the risk ratio of aneuploidy in malignancy was 23.236 compared to non-malignancy. Conclusion DNA-ICM can be applied in thoracic malignancy and have more potential values to be explored in oncology.