OBJECTIVE: To evaluate the effect and safety of Chinese medicine (CM) Fuzheng Huazhuo Decoction (FHD) in treating patients with coronavirus disease 2019 (COVID-19) who persistently tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: This retrospective cohort study was conducted at Shanghai New International Expo Center shelter hospital in China between April 1 and May 30, 2022. Patients diagnosed as COVID-19 with persistently positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test results for ⩾8 days after diagnosis were enrolled. Patients in the control group received conventional Western medicine (WM) treatment, while those in the FHD group received conventional WM plus FHD for at least 3 days. The primary outcome was viral clearance time. Secondary outcomes included negative conversion rate within 14 days, length of hospital stay, cycle threshold (Ct) values of the open reading frame 1ab (ORF1ab) and nucleocapsid protein (N) genes, and incidence of new-onset symptoms during hospitalization. Adverse events (AEs) that occurred during the study period were recorded. RESULTS: A total of 1,765 eligible patients were enrolled in this study (546 in the FHD group and 1,219 in the control group). Compared with the control group, patients receiving FHD treatment showed shorter viral clearance time for nucleic acids [hazard ratio (HR): 1.500, 95% confidence interval (CI): 1.353-1.664, P<0.001] and hospital stays (HR: 1.371, 95% CI: 1.238-1.519, P<0.001), and a higher negative conversion rate within 14 days (96.2% vs. 82.6%, P<0.001). The incidence of new-onset symptoms was 59.5% in the FHD group, similar to 57.8% in the control group (P>0.05). The Ct values of ORF1ab and N genes increased more rapidly over time in the FHD group than those in the control group post-randomization (ORF1ab gene: β =0.436±0.053, P<0.001; N gene: β =0.415 ±0.053, P<0.001). The incidence of AEs in the FHD group was lower than that in the control group (24.2% vs. 35.4%, P<0.001). No serious AEs were observed. CONCLUSION FHD was effective and safe for patients with persistently positive SARS-CoV-2 PCR tests. (Registration No. ChiCTR2200063956).
Humans ; Drugs, Chinese Herbal/adverse effects* ; Retrospective Studies ; Male ; Female ; Middle Aged ; COVID-19 Drug Treatment ; SARS-CoV-2/drug effects* ; COVID-19/virology* ; Adult ; Aged ; Treatment Outcome

OBJECTIVE To observe the changes of cardiac function,local inflammation level and macrophage M2 polarization in mice with acute myocardial infarction(AMI after electroacupuncture preconditioning at the Neiguan point,and to explore the possible mechanisms from the perspective of regulating the DNA-PK/Rictor/Myc signaling pathway.METHODS Male C57BL/6J mice were randomly divided into sham group,model group and electroacupuncture group,with 10 mice in each group.The electroacupuncture group received bilateral electroacupuncture interventions at the Neiguan points,sparse-dense wave,2/15 Hz,1 mA,20 min/time,once a day for 3 consecutive days,and AMI models were performed 0.5 h after the electroacupuncture interventions.The myocardial ischemia model was prepared by ligating the left anterior descending branch.Echocardiography was used to detect cardiac ejection frac-tion(EF and fractional shortening(FS to evaluate cardiac function;HE and TUNEL staining were used to observe the pathological morphology of myocardium and apoptosis of cardiomyocytes,and immunohistochemistry and ELISA were used to detect IL-1β,TNF-α and NLRP3 in infarcted myocardium and peripheral blood to evaluate the level of inflammation;flow cytometry was used to detect cardiac macrophage polarization status,and Western blot method to detect the protein expression levels of DNA-PK,p-DNA-PK,Rictor and Myc in infarcted myocardium.RESULTS Compared with the sham group,the model group showed significantly lower EF and FS(P<0.000 1,significant inflammatory cell infiltration,significantly higher cardiomyocyte apoptotic index(P<0.001,up-regulated expression of IL-1β,NLRP3 and TNF-α in the myocardium and serum(P<0.01,P<0.001,a significant increase in the percentage of macrophages(P<0.001,a decrease in the percentage of cardiac M2-type macrophages(P<0.000 1,and a significant decrease in the expression levels of p-DNA-PK,Rictor and Myc proteins in myocardium(P<0.05,P<0.000 1.Compared with the model group,EF and FS were significantly higher in the electroacupuncture group(P<0.000 1,inflammatory cell infiltration was re-duced,cardiomyocyte apoptotic index was decreased(P<0.01,and the expression of IL-1β,NLRP3 and TNF-α was down-regula-ted in myocardium and serum(P<0.05,P<0.01,P<0.001;the macrophage percentage was decreased(P<0.05,cardiac M2-type macrophage percentage was increased(P<0.01,and p-DNA-PK,Rictor and Myc protein expression was enhanced in myocardium(P<0.05,P<0.01,P<0.000 1.CONCLUSION Electroacupuncture preconditioning may promote macrophage M2 polarization,attenuate local inflammation,and reduce cardiomyocyte apoptosis by modulating the DNA-PK/Rictor/Myc signaling pathway,thus im-proving cardiac function and achieving myocardial protective effects.

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ²=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ²=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ²=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4⁺， and CD4⁺/CD8⁺ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19^-， HLA/DR⁺， and CD25⁺ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4⁺， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.

Objective: To investigate the characteristics of attentional bias in emotional faces of policemen with different trait anxiety levels. Methods: By using the State-Trait Anxiety Inventory (STAI), 44 policemen (23 males and 21 females) were included in the higher trait anxiety level group and 44 policemen (25 males and 19 females) were included in the lower trait anxiety level group. The 2 anxiety style ((higher trait anxiety level, lower trait anxiety level) × 2 emotional type (positive, negative) × 2 clue type (identical side, opposite side) hybrid design was used to investigate the attentional bias of the response time differences between the two groups of policemen on keystroke responses of different emotional types and different types of clues by using a dot probe. Results: The positive emotional face reaction of the higher trait anxiety level group was less than that of the negative emotional face reaction[ (638. 0 ± 12. 4) ms vs. (651. 7 ± 13. 1) ms, P ＜ 0. 01], while the lower trait anxiety level police had no statistical significance on the reaction of positive emotional face and negative emotional face (P＞ 0. 05). The clue types in the higher trait anxiety level group were identical side less than opposite side response time [ (640. 3 ± 12. 6) ms vs. (649. 5 ± 13. 0) ms, P ＜ 0. 05], and there was no statistical significance in the lower trait anxiety level group about identical side and opposite side response time (P＞ 0. 05). The clue type in identical side, there was no significant difference in the response of two groups to positive emotional faces and negative emotional faces (P＞ 0. 05); while the clue type in opposite side, the response of higher trait anxiety level group to negative emotional faces was higher than that of positive emotional faces [ (663. 1 ± 9. 8) ms vs. (651. 4 ± 8. 9) ms, P ＜ 0. 05]. Conclusion: It suggests that the policemen with higher level of trait anxiety have selective attentional bias to negative emotional faces, which induced by impaired attentional disengagement.

INTRODUCTIONPatients with metastatic nasopharyngeal carcinoma (NPC) have variable survival outcomes. We have previously shown that an elevated peripheral blood lymphocyte-to-monocyte ratio (LMR) is associated with an increased metastatic risk in patients with primary NPC. The present study aimed to investigate the prognostic value of pretreatment LMR in a large cohort of metastatic NPC patients.

METHODSClinical data of 672 patients with metastatic NPC diagnosed between January 2003 and December 2009 were analyzed. The peripheral lymphocyte and monocyte counts were retrieved, and LMR was calculated. Receiver operating characteristic (ROC) curve analysis and univariate and multivariate COX proportional hazards analyses were performed to evaluate the association of LMR with overall survival (OS).

RESULTSUnivariate analysis revealed that an elevated absolute lymphocyte count (≥1.390×10(9)/L) and LMR (≥2.475) as well as a decreased monocyte count (<0.665×10(9)/L) were significantly associated with prolonged OS. Multivariate Cox proportional hazard analysis showed that LMR (hazard ratio [HR]=0.50, 95% confidence interval [CI]=0.41-0.60, P<0.001), absolute lymphocyte count (HR=0.77, 95% CI=0.64-0.93, P=0.007), and monocyte count (HR=1.98, 95% CI=1.63-2.41, P<0.001) were independent prognostic factors. By stratification analyses, only LMR remained a significant predictor of prognosis.

CONCLUSIONWe identified pretreatment LMR as an independent prognostic factor for patients with metastatic NPC. Independent validation of our findings is needed.

Introduction:Patients with metastatic nasopharyngeal carcinoma (NPC) have variable survival outcomes. We have previously shown that an elevated peripheral blood lymphocyte-to-monocyte ratio (LMR) is associated with an increased metastatic risk in patients with primary NPC. The present study aimed to investigate the prognostic value of pretreatment LMR in a large cohort of metastatic NPC patients. Methods:Clinical data of 672 patients with metastatic NPC diagnosed between January 2003 and December 2009 were analyzed. The peripheral lymphocyte and monocyte counts were retrieved, and LMR was calculated. Receiver operating characteristic (ROC) curve analysis and univariate and multivariate COX proportional hazards analyses were performed to evaluate the association of LMR with overall survival (OS). Results:Univariate analysis revealed that an elevated absolute lymphocyte count (≥1.390 × 109/L) and LMR (≥2.475) as well as a decreased monocyte count (<0.665 × 109/L) were significantly associated with prolonged OS. Multivariate Cox proportional hazard analysis showed that LMR (hazard ratio [HR]=0.50, 95%confidence interval [CI]=0.41–0.60, P<0.001), absolute lymphocyte count (HR=0.77, 95%CI=0.64–0.93, P=0.007), and monocyte count (HR=1.98, 95%CI=1.63–2.41, P<0.001) were independent prognostic factors. By stratification analyses, only LMR remained a significant predictor of prognosis. Conclusion:We identified pretreatment LMR as an independent prognostic factor for patients with metastatic NPC. Independent validation of our findings is needed.

Objective To explore the relationship between surgical treatment combined with drug therapy and the recovery of hepatic function following tumor resection of primary liver cancer ( PLC) , and to provide reasonable recommendations for clinical treat-ment of the disease .Methods One hundred and twenty cases , which were diagnosed as primary liver cancer and given tumor resection from January 2009 to December 2010 in our hospital were selected and analyzed retrospectively .There were 82 cases that had complete records and could be used for effective analysis .Based on "the China National Formulary"(2010) and the mechanism of drugs , hepa-to-protectants were divided into 6 categories:⑴A=anti-inflammatory drug , B=membrane system stabilizing drug , C=combined de-toxification drug, D=enhanced energy supply drug, E=regeneration promotion drug and F =the category of other drugs.Results (1) When the A+D treatment profile was compared with the C +D treatment profile, the k value of total bilirubin (TB) was P=0.046 and the k value of aspartate aminotransferase (AST) was P=0.035.The C+D treatment profile was superior to that of the A +D treatment profile.(2) Positive correlation could be noted between the k values of ALT and AST (P<0.01).(3) The k value of TB and AST were negatively correlated with the blocking time of portal vein , cirrhosis type and other variables .Conclusion After tumor resection of the primary liver cancer , the C +D treatment profile was superior to the A +D treatment profile in enhancing recovery of hepatic function .

Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma (NPC); however, it is not known whether locoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of locoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing locoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations (P < 0.05). Both locoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival (OS). The mortality risk was similar in the group undergoing locoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio (HR) = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment (HR = 0.4, P = 0.004) and 130% higher than that of the group undergoing both systemic chemotherapy and locoregional radiotherapy (HR = 2.3, P < 0.001). In conclusion, locoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Lung Neoplasms ; drug therapy ; radiotherapy ; secondary ; surgery ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Staging ; Paclitaxel ; administration & dosage ; Palliative Care ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate ; Young Adult