Hematopoietic stem cell transplantation(HSCT)patients may develop cytomegalovirus encephalitis,a rare but life-threatening complication with a mortality rate exceeding 90％.Cytomegalovirus encephalitis is rare and does not have specific clinical manifestations,which makes clinical diagnosis more difficult.This article reports a pediatric case of acute lymphoblastic leukemia(ALL)with early onset(81 d after transplantation)cytomegalovirus encephalitis after HSCT,with palpitations presenting as the initial symptom.The patient exhibited rapid clinical progression and the treatment was ineffective.This case report can help clinicians gain further understanding of the high-risk factors and clinical features of central nervous system complications following HSCT.When encountering unexplained tachycardia,clinicians should still be vigilant for the possibility of intracranial infection even in the absence of typical neurological manifestations associated with encephalitis.Early recognition and management may help improve the outcomes of such patients.

Guanxin Tongluo capsule is a compound traditional Chinese medicine preparation for the treatment of coronary heart disease. The underlying mechanism may be related to expanding coronary artery, increasing coronary artery blood flow, reducing myocardial oxygen consumption, and decreasing whole blood viscosity, plasma viscosity, and hematocrit. This paper reviews the clinical research progress of Guanxin Tongluo capsule in the treatment of coronary heart disease from the aspects of etiology, pathogenesis, pharmacological research, and clinical research, providing evidence for scientific research and clinical application of Guanxin Tongluo capsule.

Objective:To evaluate the in vitro cross-neutralization of serum antibodies in human and mice immunized with inactivated SARS-CoV-2 vaccine against Delta and Beta variants. Methods:Human serum samples after a second and a third dose of inactivated SARS-CoV-2 vaccine and mouse serum samples after a two-dose vaccination were collected. The neutralizing antibodies in the samples against SARS-CoV-2 strains of prototype, Delta and Beta variants were detected using micro-neutralization assay in biosafety level Ⅲ laboratory. The seroconversion rates and geometric mean titers (GMTs) of antibodies were calculated.Results:The seroconversion rates of antibodies in human serum samples against different SARS-CoV-2 strains were all above 95%. After two-dose vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 109, 41 and 15, respectively. The GMTs decreased by 2.7 folds and 7.3 folds for the Delta and Beta variants as compared with the prototype strain. After the booster vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 446, 190 and 86, respectively. The GMTs of neutralizing antibodies against Delta and Beta variants decreased by 2.3 folds and 5.2 folds as compared with that against the prototype strain. The seroconversion rates of antibodies against different SARS-CoV-2 strains in mouse serum samples were all 100%. The GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 2 037, 862 and 408, respectively. The GMTs decreased by 2.4 folds and 5.0 folds for the Delta and Beta variants.Conclusions:Inactivated SARS-CoV-2 vaccine could induce a certain level of neutralizing antibodies against Delta and Beta variants in both human and mouse models. Moreover, a third dose of vaccine induced higher levels of neutralizing antibodies against Delta and Beta variants in human. This study provided valuable data for the clinical application and protective evaluation of the inactivated SARS-CoV-2 vaccine.

Objective To investigate the correlation between NOTCH3 polymorphic locus rs1043994 and white matter lesions (WML). Methods The enrolled subjects were elderly in the outpatient clinic for health check-up from January 2015 to January 2017. According to the results of cranial MR examination, 337 elderly people were divided into the WML group (n=172) and normal control group (n=165). The inclusion criteria were: (1) age ≥ 50 years old; (2) those who can cooperate with head MRI examination; (3) those who understand the study and agree to retain blood samples for SNP testing. Exclusion criteria were: (1) previous neurological diseases such as cerebrovascular disease, intracranial infection, dementia, and trauma; (2) having a history of mental illness; (3) suffering from serious diseases such as liver and kidney dysfunction, heart disease, tumors. The clinical data of the subjects were collected and the peripheral venous blood was extracted for DNA extraction. The cognitive function was evaluated by the Mini-mental State Examination. The genotyping of the subjects was carried out by restriction endonuclease. The correlation between rs1043994 polymorphism and WML was analyzed by Logistic regression. Results There was no significant difference in gender, education level, diabetes, hyperlipidemia, smoking, uric acid and Hcy between the two groups (P>0.05). Compared with the control group, the WML group had a higher average age and a higher proportion of hypertension (P<0.05), and the Mini-mental State Examination scores between the two groups were statistically significant different (P<0.01). The genotypes (AA, AG, GG) frequency and allele (A, G) frequency distribution of rs1043994 were statistically different between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age (P=0.001), hypertension (P=0.012) and AA genotype (P=0.019) were independent risk factors of WML (P<0.05). The risk of WML in AA genotype is 2.512 times higher than that in AG/GG genotype. Conclusions The rs1043994 polymorphism of NOTCH3 gene is associated with WML in the elderly population, and the A allele is a susceptibility gene for WML. The rs1043994 polymorphism of the NOTCH3 gene may be a genetic risk factor for WML in the Chinese elderly population.

Objective: To study the expression of TNF-α and PCNA in human breast tissue with polyacrylamide hydrogel(PAHG) injection, and to provide the initial theory basis for its prognosis and clinical treatment. Methods: Immunohistochemistry was used to measure the expression of tumor necrosis factor α(TNF-α)and proliferating cell nuclear antigen (PCNA) in 20 normal breast tissues and 40 cases with PAHG injection, analysis was also done by HE staining. Results: ①HE staining showed that there were a large number of homogeneous amorphous gel-like injections under optical microscope. Around PAHG there were different degrees of fibrous tissue hyperplasia with or without fibrous degeneration and lots of inflammatory cells. Local foreign body giant cell reaction and ductal dilatation also can be seen around PAHG. ②The IA levels of TNF-α and PCNA in the experimental group were 3.9± 0.3 and 3.2 ± 0.2, the IA levels of TNF-α and PCNA in the control group were 1.0 ± 0.1 and 1.3 ± 0.3, the IA level in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. The positive rates of TNF-α and PCNA in the experimental group were 90% (36/40)and 85% (34/40)respectively; the positive rates of TNF-α and PCNA in the control group were 30% (6/20), 40% (8/20). The positive expression rate in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. TNF-α and PCNA has Pearson positive relevance in the changes(r=0.3, P=0.040), the difference was statistically significant. Conclusions TNF-α and PCNA are involved in the immunoreaction of mammalian breast tissue injected with polyacrylamide hydrogel, which may induce the aseptic inflammation, fibrous tissue hyperplasia and related issues through mutual influence.

Traditional Chinese medicine thinking is the core method of diagnosis and treatment of traditional Chinese medicine. Thus, cultivating the clinical thinking of traditional Chinese medicine in the orthopeadics department has become the importance. TCM tendon and muscle injuries were well characterised by the TCM, becoming an important part of TCM orthopedics., The tendon and muscle injuries were used to explore the application and cultivation of traditional Chinese medicine thinking. This will help to improve the clinical curative effect, complement the modern Chinese medicine.

BACKGROUND:Hyperbaric oxygen (HBO) therapy can aleviate the skin flap congestion by improving the angiogenesis and increasing the oxygen content of blood in skin flaps. Although the HBO therapy ability to increase flap survival has been wel described, the research on the application of HBO pretreatment in skin flap transplantation does not arouse adequate concern.
OBJECTIVE: To investigate the effect of HBO pretreatment on early-stage flap congestion in the rat model of over-length dorsal random skin flaps.
METHODS: Thirty-six SD rats were randomly divided into control group (n=12), HBO pretreatment group (n=12) and HBO treatment group (n=12). Rats in the HBO pretreatment group received 4 days of HBO therapy prior to transplantation, once a day. Rats in the HBO treatment group received 4 days of HBO therapy after transplantation. Rats in the control group were raised in the normal conditions after flap transplantation. At postoperative days 3 and 5, rats were sacrificed and the samples were colected. The inflammation of flap tissues was detected using hematoxylin-eosin staining. The expression of vascular endothelial growth factor and transforming growth factor-β was analyzed by immunohistochemistry staining. The flap survival rate was calculated at postoperative day 5.
RESULTS AND CONCLUSION:The flap survival area of the HBO pretreatment group and HBO treatment group was larger than that of the control group (P < 0.05). At postoperative days 3 and 5, the expression levels of vascular endothelial growth factor and transforming growth factor-β in the flap tissue were higher in the HBO pretreatment group and HBO treatment group than the control group (P < 0.05). However, there was no significant difference in the flap survival area and the expression of vascular endothelial growth factor and transforming growth factor-β between HBO pretreatment and HBO treatment groups (P > 0.05). HBO pretreatment can increase the expression of vascular endothelial growth factor and transforming growth factor-β and promotes angiogenesis in random pattern flaps,thereby improving skin flap survival.

Objective To observe the clinical efficacy of Huxinkang Pills in treating patients with unstable angina pectoris (UAP) and its effects on the tumor necrosis factor-α (TNF-α) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Methods Sixty patients with UAP were randomly divided into the treatment group and the control group, 30 cases in each group. Patients in the treatment group were treated with Huxinkang Pills based on the basic western medicine, while the patients in the control group were treated with Tongxinluo Capsules based on the basic western medicine. The treatment course was 4 weeks. Clinical efficacy and the change of the TNF-α and NT-proBNP levels before and after treatment were observed. Results The general efficacy, electrocardiograph efficacy, angina pectoris efficacy, TCM syndrome efficacy and glonoine reduction of the two groups had statistically difference (P<0.05) respectively, and the efficacy of the treatment group was superior to that of the control group (P<0.05). The TNF-α and NT-proBNP levels in both groups before and after treatment had statistically difference (P<0.05) respectively. The differences in TNF-α and NT-proBNP levels between both groups after treatment were all statistically significant (P<0.05), and these indexes of treatment group were superior to those of the control group (P<0.05). Conclusion Huxinkang Pills are remarkable in treating patients with UAP, and able to restrain the levels of TNF-α and NT-proBNP.

Objective To explore the clinical value of ω-3 fatty acids (ω-3PUFA)immune nutrition therapy for the patients with acute ischemic stroke,and analyze its mechanism.Methods 40 patients with acute ischemic stroke were selected.They were divided into the treatment group and the control group,each group in 20 cases. The patients of the control group were given indwelling tube admitted to hospital within 24 hours,given the homogenized meal configured by nutriology department.The treatment group received ω-3PUFA enteral nutrition based on the control group.The neurologic recovery,nutritional status,lipid levels and the incidence of complications were evalua-ted.Results The total effective rate of the treatment group was 90.0%,which was higher than that of the control group (60.0%,χ2 =4.8,P <0.05).The incidence rate of complication of the treatment group was 30.0%,which was lower than the control group (65.0%,χ2 =4.91,P <0.05).The indicators such as NIHSS score,GCS score, TSF and AMC in the treatment group were better than those in the control group[(13.38 ±1.21)points vs.(10.12 ± 1.33)points;(12.9 ±2.6)points vs.(14.1 ±1.7)points;(14.06 ±7.16)mm vs.(14.8 ±4.18)mm;(26.32 ± 1.42)mm vs.(29.40 ±1.08)mm,t =3.51,6.44,3.22,5.19;all P <0.05].TG and LDL -C in the treatment group were lower than those in the control group[(1.60 ±0.71)mmol/L vs.(1.41 ±0.67)mmol/L;(3.11 ±0.60)mmol/L vs.(2.67 ±0.66)mmol/L,t =5.97,4.22;all P <0.05 ].Conclusion The clinical curative effect is better for application of ω-3PUFA on immune nutrition treatment for the patients with acute ischemic stroke.The patients'nerve function,blood lipid levels and nutritional status were significantly improved,and the complications were reduced.

Half of the heart failure patients are the diastolic heart failure (DHF) patients, and the occurrence of DHF increases as the patients’ age increases, which has seriously affected the quality of life of the elderly. However, there is presently no valid medication of DHF, thus the treatment of DHF is one of the hotspot of the medicine research. This article reviewsed the TCM in the cognition and treatment of DHF these years, in order to provide references for TCM in treating DHF.