OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

Abstract: Objective　To analyze the distribution characteristics of the main pathogens of HIV/AIDS patients with wound infections and provide basis for clinical diagnosis and treatment. Methods　The clinical data of 294 patients with positive secretions or pus specimens from 2016 to 2020 were analyzed retrospectively. Results　A total of 357 strains of pathogenic bacteria were isolated from 294 cases, of which 123 strains of Gram-negative bacilli (G-b), accounting for 34.5%, were mainly Escherichia coli (15.4%), Klebsiella pneumoniae (3.9%), and Pseudomonas aeruginosa (3.6%); Gram-positive bacilli (G+b) 14 strains, accounting for 3.9%; 108 Gram-positive cocci (G+c), accounting for 30.3%, of which 44 strains were coagulase-positive Staphylococcus aureus (12.3%), Coagulase-negative staphylococci were mainly Staphylococcus epidermidis (4.2%) and Staphylococcus hemolyticus (2.8%); 37 strains of fungi, accounting for 10.4%, were mainly Candida albicans (5.9%); 75 strains of Mycobacterium, accounting for 21.0%, including 41 strains of Mycobacterium tuberculosis (11.5%) and 34 strains of non-tuberculosis mycobacteria (9.5%). 52 of the 294 HIV/AIDS patients had mixed infections, accounting for 17.7%. There was significant difference in the distribution of G+c, G-b, mycobacteria and mixed infection among different specimen sources (P<0.05), and there was significant difference in the distribution of mycobacteria among different CD4+T lymphocyte counts (P<0.05). There was significant difference in the level of CD4+T lymphocytes between patients of different ages (P<0.05), and there was significant difference in the level of CD4+T lymphocytes from postoperative incision and other parts (P<0.05). Conclusions　Patients with HIV/AIDS are prone to combined wound infections with various pathogenic bacteria. We should strengthen the research on wound infection in HIV/AIDS patients, and timely send patients with a low number of CD4+T lymphocytes for secretion or pus culture, so as to carry out targeted treatment and improve the prognosis of patients.

BACKGROUND: There is limited information about thymosin α1 (Tα1) as adjuvant immunomodulatory therapy, either used alone or combined with other treatments, in patients with non-small cell lung cancer (NSCLC). This study aimed to evaluate the effect of adjuvant Tα1 treatment on long-term survival in margin-free (R0)-resected stage IA-IIIA NSCLC patients. METHODS: A total of 5746 patients with pathologic stage IA-IIIA NSCLC who underwent R0 resection were included. The patients were divided into the Tα1 group and the control group according to whether they received Tα1 or not. A propensity score matching (PSM) analysis was performed to reduce bias, resulting in 1027 pairs of patients. RESULTS: After PSM, the baseline clinicopathological characteristics were similar between the two groups. The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly higher in the Tα1 group compared with the control group. The multivariable analysis showed that Tα1 treatment was independently associated with an improved prognosis. A longer duration of Tα1 treatment was associated with improved OS and DFS. The subgroup analyses showed that Tα1 therapy could improve the DFS and/or OS in all subgroups of age, sex, Charlson Comorbidity Index (CCI), smoking status, and pathological tumor-node-metastasis (TNM) stage, especially for patients with non-squamous cell NSCLC and without targeted therapy. CONCLUSION Tα1 as adjuvant immunomodulatory therapy can significantly improve DFS and OS in patients with NSCLC after R0 resection, except for patients with squamous cell carcinoma and those receiving targeted therapy. The duration of Tα1 treatment is recommended to be >24 months.
Carcinoma, Non-Small-Cell Lung/surgery* ; Chemotherapy, Adjuvant ; Humans ; Immunomodulation ; Lung Neoplasms/surgery* ; Neoplasm Staging ; Propensity Score ; Retrospective Studies ; Thymalfasin

OBJECTIVEStudy on quality of life of asymptomatic HIV infected persons with traditional Chinese medical, which can provide the clinical basis for improving the quality of life.

METHODThis study applied a randomized, double-blind, and placeb-parallel control designed method to select 1 200 persons in the asymptomatic period of HIV infection as the subjects. The subjects were randomly divided into the treatment group and the control group at the ratio of about 2:1. According to the results of monthly differential diagnosis of TCM, the test group and the control group were given homologue Chinese drugs preparations and model Chinese drugs. The total study period was 18 months. Using PRO scale and the world health organization AIDS determination of quality of life short scale form (WHOQOL-HIV-BREF) to investigate asymptomatic HIV infected persons, according to different times, we calculated the total score and each domain score of quality of life of the treatment group and control group, we did statistical analysis.

RESULTForm the PRO scale,we can see that the treatment group showed a trend of stability, compared with the control group with significant statistical difference (P < 0.05) after 6 months; from the WHOQOL-HIV scale analysis, we can see that compared with before treatment, the quality of life of the treatment group was increased, the difference was significant (P < 0.05), but the quality of life of the control quality of life was decreased, the differences was significant (P < 0.05).

CONCLUSIONDialectical therapy of Chinese medicine can significantly improve the patient's quality of life, which can provide the basis for the prevention and control policy formulation and implementation with asymptomatic HIV infected persons.

Asymptomatic Diseases ; Follow-Up Studies ; HIV Infections ; therapy ; Humans ; Medicine, Chinese Traditional ; Quality of Life ; Treatment Outcome

BACKGROUNDPathological fractures signify a potentially more aggressive subset of the original disease with higher misdiagnosis rates and inferior oncologic results. The purpose of the present study was to explore the clinical features of neoplastic pathological fracture in extremities.

METHODSFrom August 2002 to December 2010, a consecutive series of 139 patients suffering neoplastic pathological fracture were recruited, including 79 males and 60 females with a mean age of 31.3 years. Fractures were classified into five groups: tumor-like lesions (55), benign bone tumors (13), giant cell tumors (7), primary malignant bone tumors (28), and metastatic bone tumors (36). Based on their inducing forces, pathologic fractures were classified into four grades: spontaneous fracture, functional fracture, minor injury, and traumatic injury. Patients' age, fracture site, histological diagnoses, fracture forces, prodromes, and misdiagnosis were well reviewed. Kruskal-Wallis and χ(2) tests were used to compare forces and prodromes within different types of bone tumors.

RESULTSThe highest pathologic fracture morbidity was 32.3% (45/139), which lay in the 11 - 20 year group, and 86.1% of metastatic tumors occurred in the 50 - 80 year group. The common sites of fractures were femur, humerus, and tibia. The fracture forces in benign bone tumors and tumor-like lesions are the strongest, followed by metastatic tumors and primary malignant bone tumors (H(C) = 80.980, P = 0.000). Sixty-seven patients (48.2%) had local prodromes before pathologic fracture. The incidence rates of prodromes between primary malignant tumors and metastatic bone tumors had no significant difference (P = 0.146), but they were all obviously higher than that of benign bone tumors and tumor-like lesions. Twenty patients experienced misdiagnosis.

CONCLUSIONMinor injury forces and local prodromes are clinical features of neoplastic pathologic fractures and they are also the critical factor avoiding misdiagnoses.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; pathology ; Child ; Child, Preschool ; Diagnostic Errors ; Female ; Fractures, Spontaneous ; diagnosis ; Humans ; Male ; Middle Aged

Objective To explore the existence of natural loci on Marmota himalayana plague in Sichuan province and to provide basis for prevention and control of the disease. Methods Both epidemiological investigation and laboratory tests were used to provide the host animal and fleas of the vectors with Yersinia pestis carriers. Results 30 species of animals were found to belong to 10 orders. Ochotona curzoniae and M.himalayana were the most common ones while 7 species of the fleas belonged to 7 genera and 3 families. M.himalayana was the main reservoirs while Callopsylla dolabris and Oropsylla silantiewi served as vectors. The 13 Y.pestis were identified from 43 Marmota samples. 8 samples were identified under IHA, with the highest titer of herding-dogs serum as 1 : 10 240. 19 samples were F1 antigen positive using RIHA and the highest titer of M.himalayana serum was 1:409 600. The major foci was 4545 km2, distributed at Dege county in Sichuan province. Conclusion We have confirmed the existence of natural foci on M. Himalayana plague in Sichuan province.

OBJECTIVETo present a new method for reduction of the prominent malar complex by using the curved osteotomy through intraoral incision.

METHODSAccording to the anatomical characteristics of the malar complex, a new curved osteotomy was designed for reduction of the prominent malar complex. This method, that made malar arch move toward backside, inside and upside, lowered the whole malar complex and gain better contour of malar area.

RESULTSFrom 2001 to 2003, 41 patients were treated with the intraoral curved osteotomy [for reduction of the prominent malar complex. All patients obtained good results.

CONCLUSIONSThrough the intraoral approach, the curved osteotomy method could lower the whole prominent malar complex and get better contour of malar area.Intraoral curved osteotomy for reduction of the prominent malar complex could be an ideal method with better face contour, simpler technique, and fewer complications.

Adult ; Female ; Humans ; Male ; Middle Aged ; Mouth ; surgery ; Osteotomy ; methods ; Reconstructive Surgical Procedures ; methods ; Young Adult ; Zygoma ; surgery