Objective To investigate the distribution of gender,age,and traditional Chinese medicine(TCM)syndrome elements and syndrome types in patients suffering from novel coronavirus infection complicated with asthma,and to explore the medication rules for the patients,thus to provide reference for the formulation of clinical diagnosis and treatment plans for novel coronavirus infection complicated with asthma.Methods From December 2022 to January 2023,the information of gender,age,syndrome elements,TCM syndrome types and medication frequency of the herbal medicine was collected among the patients suffering from novel coronavirus infection complicated with asthma who were treated in outpatient clinics of the respiratory department and emergency department of Shenzhen Traditional Chinese Medicine Hospital.The information data were statistically analyzed and then the network visualization of results was presented.Results A total of 63 cases were included,including 27 males and 36 females,with an average age of 51.8 years old.Thirteen TCM syndrome types were involved,of which the three with the leading occurrence frequency were wind-phlegm syndrome(17 cases),spleen deficiency with dampness accumulation syndrome(11 cases),and phlegm-heat stagnation in the lung syndrome(8 cases).There were four disease-location syndrome elements,and the top two were lung(36 cases)and spleen(12 cases).Eight disease-nature syndrome elements were involved,and the top three were wind(36 cases),phlegm(28 cases)and qi deficiency(24 cases).A total of 128 Chinese herbal medicines were used,and their properties and flavors were predomiated by being pungent,bitter,sweet and cold.Most of the Chinese herbal medicines had the meridian tropism of lung,spleen,liver and stomach meridians,and most of the Chinese herbal medicines had the therapeutic actions of resolving phlegm,easing cough and relieving asthma.The top four Chinese herbal medicines with higher medication frequency were Glycyrrhizae Radix et Rhizoma(51 times),Ephedrae Herba(47 times),blanching Armeniacae Semen Amarum(44 times),and Schisandrae Chinensis Fructus(40 times).The core two-drug groups were Ephedrae Herba-Glycyrrhizae Radix et Rhizoma,Ephedrae Herba-Schisandrae Chinensis Fructus,and blanching Armeniacae Semen Amarum-Pinelliae Rhizoma.The core three-drug groups were Pinelliae Rhizoma-blanching Armeniacae Semen Amarum-Ephedrae Herba,and Ephedrae Herba-Schisandrae Chinensis Fructus-Glycyrrhizae Radix et Rhizoma.Conclusion Pathogenic phlegm retention in lung is the core pathogenesis of novel coronavirus infection complicated with asthma,which is protracted through the disease.The pathogenic wind is the driving factor of the disease's development and progression,and in the middle and late stages of the disease,the complicated syndrome manifestations of pathogenic heat,qi deficiency,qi and yin deficiency,and blockage of upper orifice are commonly seen.Its therapeutic principles are to relieve exterior syndrome and clear heat,resolve phlegm,ease cough and relieve asthma,thus to restore the qi movement of the zang-fu organs,support the healthy qi,eliminate pathogens and strengthen body resistance.

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome patterns and medication characteristics in corona virus disease 2019(COVID-19)patients complicated with chronic bronchitis at the initial phase of the termination of pandemic control policy in Shenzhen,and to provide evidence for TCM syndrome differentiation and treatment of these patients.Methods A retrospective analysis was performed on 76 COVID-19 patients complicated with chronic bronchitis who visited the Department of Respiratory and Critical Care Medicine or the Emergency Internal Medicine Clinic at Shenzhen Traditional Chinese Medicine Hospital between December 15,2022 and February 28,2023,an initial phase of the termination of pandemic control policy in Shenzhen.Data of demographics,TCM syndrome patterns,and herbal prescriptions were collected.TCM syndrome distribution and medication patterns of the COVID-19 patients complicated with chronic bronchitis were summarized to enhance understanding of post-COVID sequelae,post-COVID syndrome,long COVID,post-infectious cough,and chronic cough,and to provide references for TCM management of acute/chronic post-COVID cough,long COVID syndrome,and emerging respiratory infectious diseases.Results A total of 76 medical records with full information were included,covering 63 herbal formulas and 140 herbal medicinals were analyzed.The most common TCM syndrome pattern was phlegm-turbidity obstructing the lung syndrome,followed by phlegm-heat stagnating the lung syndrome and lung qi deficiency syndrome.The properties of the herbs used were predominantly warm,cold,or mild;their flavors were bitter,pungent,or sweet;and their meridian tropisms primarily involved the lung,spleen,stomach,and liver.Twenty-five medicinals used exceeding 15 times in the formulas were identified,including Glycyrrhizae Radix et Rhizoma(Gancao),Ephedrae Herba(Mahuang),Coicis Semen(Yiyiren),and Poira(Fuling).Association rule analysis revealed the frequent herbal pairs of Gancao-Mahuang,Belamcandae Rhizoma(Shegan)-Mahuang,Gancao-Fuling,Fuling-Yiyiren,etc.Cluster analysis categorized high-frequency herbs into four distinct groups.Conclusion The retrospective analysis highlights the complexity of clinical manifestations in COVID-19 patients complicated with chronic bronchitis at the initial phase of the termination of pandemic control policy in Shenzhen.The pathogenic factors of the patients predominantly involve phlegm-turbidity and phlegm-heat.Therapeutic principles for the patients focus on diffusing the lung to alleviate adverse flow of qi,resolving phlegm and removing dampness,and clearing and draining damp-heat.Commonly prescribed formulas include San'ao Decoction,Yuebi Plus Banxia Decoction,Xiaoqinglong Decoction,Shegan Mahuang Decoction,and Suhuang Zhike Decoction,and the formulas are used by modification according to the symptoms.

Objective:To investigate the efficacy of Balanophora involucrata Hook.f.in treatment of hyperuricemia(HUA)based on network pharmacology,molecular docking,and hyperuricemia models in vivo and in vitro,and to clarify the main targets of its active components and related signaling pathway mechanism.Methods:The potential targets of Balanophora involucrata Hook.f.in treatment of HUA were identified by Databases such as the Traditional Chinese Medicine Database in Taiwan,the Chinese Herbal Medicine Identification Database,Professional Chemical Database,TargetNet Database,SwissTargetPrediction Database,GeneCards,Therapeutic Target Database(TTD),DrugBank Database,DisGeNET Database,Online Mendelian Inheritance in Man(OMIM)Database,and Venny Database.STRING Database and Cytoscape software were used to construct the active component-predictive target network and protein-protein interaction(PPI)network for Balanophora involucrata Hook.f.;topological analysis was used to select the main active components and core targets;Gene Ontology(GO)functional and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were performed by R software;AutoDock Vina software was used for molecular docking validation.The NRK-52E cells were divided into blank control group,blank administration group,model group,and different concentrations(2.0,10.0,and 50.0 μmol·L-1)of erythrodiol(EDT)groups.High-performance liquid chromatography culture(HPLC)was used to detect the uric acid(UA)levels in the cell culture supernatants in various groups.The male ICR mice were divided into blank control group,blank administration group,model group,and EDT group;the mice in the last two groups were used to prepare the HUA models;kits were used to detect the levels of UA,creatinine(Cr),and blood urea nitrogen(BUN)in serum of the mice in various groups;the bilateral kidney tissue of the mice was harvested and weighed;the kidney indexes of the mice in various groups were calculated;TUNEL staining was used to observe the apoptosis in kidney tissue of the mice in various groups;Western blotting method was used to detect the expression levels of protein kinase B(AKT),phosphorylated AKT(p-AKT),phosphoinositide 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax),and matrix metalloproteinase-9(MMP-9)proteins in kidney tissue of the mice in various groups.Results:Six active components of Balanophora involucrata Hook.f.were identified,involving 116 intersecting targets and 14 core targets.The enrichment analysis yielded 1 828 GO terms and 145 signaling pathways.The molecular docking results showed that EDT had good binding activity with MMP-9.The high uric acid cell experiment results showed that compared with blank control group,the UA level in the cells in model group was significantly increased(P<0.01);compared with model group,the UA levels in the cells in 2.0,10.0,and 50.0 μmol·L-1 EDT groups were significantly decreased(P<0.01).Compared with blank control group,the levels of UA,Cr,and BUN in serum of the mice in model group were increased(P<0.01),and the kidney indexes were significantly increased(P<0.01);compared with model group,the levels of UA,Cr,and BUN in serum of the mice in EDT group were decreased(P<0.05 or P<0.01),and the kidney index was significantly decreased(P<0.05 or P<0.01).Compared with blank control group,the number of apoptotic cells in kidney tissue of the mice in model group was increased;compared with model group,the number of the apoptotic cells in kidney tissue of the mice in EDT group was significantly decreased.Compared with blank control group,the ratios of p-AKT/AKT and p-PI3K/PI3K and expression level of Bcl-2 protein in kidney tissue of the mice in model group were significantly decreased(P<0.05 or P<0.01),while the expression levels of Bax and MMP-9 proteins were significantly increased(P<0.01);compared with model group,the ratios of p-AKT/AKT and p-PI3K/PI3K and expression level of Bcl-2 protein in kidney tissue of the mice in EDT group were significantly increased(P<0.05 or P<0.01),and the expression levels of Bax and MMP-9 proteins were significantly decreased(P<0.01).Conclusion:The active component of Balanophora involucrata Hook.f.,EDT,has a UA-decreasing effect and may inhibit the apoptosis and alleviate the kidney injury by activating the PI3K/AKT signaling pathway.

Objective:To summarize the HRCT and MRI appearances of stapical footplate fistula related to inner ear malformation (SFF-Re-IEM).Methods:The HRCT and MRI materials of 48 cases (53 ears) SFF-Re-IEM were retrospectively analyzed. Among them, 25 SFF-Re-IEM ears were confirmed by surgery. Their CT and MRI findings including associated IEM type, internal auditory canal (IAC) malformation, tympanic fluid, its density and signal features, and accompanied labyrinthitis were recorded.Results:Among 48 cases (53 ears) with SFF-Re-IEM, 17 ears with incomplete partition type Ⅰ, accounting for 32.1%, 13 ears with common cavity for 24.5%, 13 ears with cochlear aplasia for 24.5%, 7 ears with cochlear dysplasia Ⅱ for 13.2%, and 3 ears with Mondini for 5.7%,were found respectively. 94.3% of them were associated with a defect or dysplasia in the found of the IAC. They were divided into 4 types according to the intact of the stapical footplate and accompanied CSF otorrhea: 22 ears were diagnosed as the stapical footplate leaking, of them, 2 ears might come from the stapical footplate bony defect, 6 ears were from the stapical footplate hernia. 1 ear belonged to the peristapical footplate leaking. 30 ears with the isolated the stapical footplate hernia were another found. The bony defect in 2 ears with the stapical footplate bony defect were not presented on CT and MRI.The focal bony defect of the affected stapical footplate of 36 ears with the stapical footplate hernia were demonstrated, which presented the hemispherical protruding into the tympana, the soft-tissue density on CT, and CSF-like signal on the MR heaved-T2WI images. Among 22 ears with the stapical footplate leaking, their imaging appearances varied from the different amount of the leaking CSF. Besides the focal bony defects of the affected stapical footplates, there were much more CSF-like density or signal in the ipsilateral tympanic cavity in 17 affected ears connecting with the vestibule through the defect area. In the CSF leaking ears with less CSF leaking in 5 ears, the CSF-like cysts like SFH were shown on the stapical footplate defect area, but their outer edges were irregular, and the CSF-like signal scattering in the tympanic cavity did not connect with the protruding cysts at the stapical area.Conclusion:The variable appearances of the SFF-Re-IEM ears based on the different subtypes are its characteristic HRCT and MRI appearances. This is helpful for the SFF-Re-IEM diagnosing to grasp its imaging features.

Objective:To summarize the imaging presentations of the fallopian canal cerebrospinal fluid leaking (FCCFL).Methods:The high resolution CT (HRCT)and MRI materials of 4 patients (4 ears) with FCCFL confirmed by surgery between August 2016 to November 2023 were retrospectively analyzed. Among these, there were 2 males and 2 females, their ages ranged from 6 to 69 years.Results:All of the FCCFL were unilateral, including 2 on the left and 2 on the right.Clinically, the patients with FCCFL suffered from clear nasal fluid flow, ear tightness, and hearing loss. On CT, all of the affected ears were depicted markedly dilatation of the proximal portion of fallopian canal(FC), the labyrinthine segment and geniculate fossa were involved in 4 cases, and involvement of tympanic segment in 1 case at the same time. The geniculate fossa in the affected side were significantly enlarged, protruding upwards into the tympanic cavity, with one case simultaneously involving the cochlea. On MRI, the hyposignal on T 1WI and hypersignal on T 2WI or water sequence like cerebrospinal fluid (CSF) were shown in the enlargement FC, without diffusion restriction, and non-enhancing with administration Gadolinium contrast.CSF-like signal effusion was shown in all of the affected tympanum, of which, the CSF-like signal effusion was demonstrated in the area along the superficial petrosal nerve, the right pterygopalatine fossa and the parapharyngeal space. The adjacent intracranial meninges were presented thickening in 3 cases. Conclusion:The imaging appearances of FCCFL present some characteristics:on HRCT, the proximal portions of the affected FC depicts markedly enlargement,especially the geniculate fossa.While they present CSF-like signal, no diffusion restriction, and no enhancement administration, Gadolinium contrast on MRI, accompanying the CSF-like signal effusion in the affected tympanum.

Objective:To evaluate the reliability of cardiac late iodine enhancement dual-energy CT (LIE-DECT) multiparameter post-processing technique for evaluating the presence, location, and extent of cardiac scars in patients with heart failure (HF), using cardiac MR (CMR) late gadolinium enhancement (LGE) as a reference standard.Methods:Thirty-nine HF patients who underwent cardiac LIE-DECT and LGE-CMR examinations in the Second Affiliated Hospital of Nantong University from November 2019 to November 2021 were prospectively collected, all enrolled HF patients underwent LIE-DECT post-processing to reconstruct monoenergetic plus (Mono+) map (40 keV), iodine map and Rho/Z map, to evaluate the enhancement degree, location and extent of left ventricular myocardial LIE on the left ventricular short-axis map, respectively, and compared with LGE-CMR. Cohen′s Kappa test was used to assess the intra-and inter-observer consistency of LIE by DECT multiparameter technique and the consistency of LIE presence and location by DECT multiparameter technique and by CMR. The diagnostic efficacy of DECT multiparameter technique in diagnosing myocardial scar was calculated.Results:Of the 39 patients included, 32 patients were detected by CMR with LGE in 147 segments, including 37 subendocardial patterns, 19 transmural patterns, 74 mid-wall patterns, and 17 epicardial patterns. The intra-observer consistency Kappa values of 40 keV Mono+map, iodine map and Rho/Z map were 0.878, 0.930 and 0.835 ( P all<0.001), respectively. The inter-observer consistency Kappa values were 0.838, 0.892 and 0.808 ( P all<0.001), respectively. The LIE of 40 keV Mono+map, iodine map and Rho/Z map were in good agreement with CMR, Kappa values were 0.903, 0.883 and 0.810 ( P all<0.001), respectively. For the per-patient analysis, the accuracies of 40 keV Mono+map, iodine map and Rho/Z map were 92.3% (36/39), 92.3% (36/39) and 82.1% (32/39), respectively. For the segment-based analysis, the accuracies of 40 keV Mono+map, iodine map and Rho/Z map accuracy were 96.1% (492/512), 95.3% (488/512) and 92.6% (474/512), respectively. In Bland-Altman analysis, the consistency bias between scar extent measured by 40 keV Mono+map, iodine map, Rho/Z map and that measured by LGE-CMR were -2.03%, -2.21%, -2.65%, and the 95% limit of agreement were -12.20%-8.14%, -12.69%-8.28% and -14.85%-9.58%, respectively. Conclusion:LIE-DECT multiparameter technique can detect myocardial scar in HF patients well, which is consistent with LGE-CMR.