We report a case of a long-term survivor of heart transplant who developed severe COVID-19 and was treated with a traditional Chinese medicine combined with conventional medicine. Throughout the treatment， the patient received active conventional medical treatment， and traditional Chinese medicine interventions included tonifying qi， invigorating the spleen and transforming phlegm， promoting yang and eliminating stagnation， resolving dampness and dissipating phlegm， and promoting blood circulation and eliminating stasis. The main therapeutic principles adopted were to recuperating depleted yang and rescuing the patient from collapse and to resolve phlegm and promote water. Pogezilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications was administered. In summary， it is crucial to the timely adjust the immunosuppressive regimen， combine use of various anti-infective agents with a focus on COVID-19， to protect of cardiac and renal function， and to integrate traditional Chinese medicine in the entire treatment process. As this case is rare， the diagnostic and therapeutic methods in traditional Chinese medicine， the use of immunosuppressive agents， and follow-up monitoring strategies can be a valuable reference.

Objective: To investigate the trends in incidence of stroke in Jindong District, Jinhua City, Zhejiang Province from 2016 to 2022, so as to provide to the evidence for improving the stroke control strategy. Methods: The incidence of stroke in Jindong District from 2016 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The gender-, age- and subtype-specific incidence of stroke was calculated, and the trends in stroke incidence were investigated with average annual percent change (AAPC). Results: A total of 9 159 stroke cases were reported in Jindong District from 2016 to 2022, with crude incidence of 386.52/105 and standardized incidence of 276.75/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=3.704%, 95%CI: 0.792%-6.700%, P<0.05), while the standardized incidence showed no significant changing patterns (P>0.05). The crude incidence of stroke was significantly higher among men than among women (438.69/105 vs. 334.66/105; χ2=14.028, P<0.05), and the standardized incidence of stroke was significantly higher among men than among women (316.58/105 vs. 237.31/105; χ2=6.985, P<0.05). The crude incidence of stroke appeared a tendency towards a rise with age（χ2=5 290.180, P<0.05), and the crude incidence of stroke appeared a tendency towards a decline with age among residents at ages of 45 to 64 years (AAPC=-9.135%, 95%CI: -15.003% to -2.861%, P<0.05), while no significant changing patterns were found in the crude incidence of stroke among residents at other age groups (P>0.05). The crude incidence of ischemic stroke was significantly higher than that of hemorrhagic stroke (306.08/105 vs. 76.89/105; χ2=137.184, P<0.05). Conclusions The incidence of stroke appeared a tendency towards a rise in Jindong District from 2016 to 2022, with ischemic stroke as the predominant subtype. Male and middle-aged and elderly populations should be given a high priority for stroke control.

This paper reported a case of severe COVID-19 in the recovery stage with acute lymphoblastic leukemia treated by integrated traditional Chinese and western medicine， with the intention of shedding light on the clinical diagnosis and treatment of similar conditions. The patient， who had acute lymphoblastic leukemia， developed COVID-19 infection during the bone marrow suppression period after chemotherapy. Treatment with western medicine was mainly anti-infection， symptomatic management， and supportive care. During the recovery stage， considering the patient's chemotherapy history and disease progression， the overall syndrome was identified as deficiency of both qi and yin and binding of phlegm and blood. Based on the “state-target” combined treatment strategy， herbal prescriptions were selected and modified to address the “deficiency state”， “disease target”， and “symptom target”. In addition to western medicine， the patient was administered with Shengmai Powder （生脉散） and Compound Zhebei Granules （复方浙贝颗粒） in its modifications to boost qi， nourish yin， and reinforce healthy qi， nourish and cool the blood， ultimately achieving satisfactory therapeutic effects.

【Objective】 To establish a management information system (referred to as the system) for plasma collection stations in Zhejiang province, so as to explore the current situation of plasma donors and implement effective supervision in Zhejiang. 【Methods】 The system was developed and connected to four plasma collection stations that were officially operating in Zhejiang in terms of plasma station setting and approval, as well as the publicity, recruitment and management of plasma donors, information management of the whole process of plasma collection, management of deferral plasma donors, plasma quality management and administrative supervision etc. Relevant plasma donor information was uploaded to the system by each plasma station, and information before (January 2016 to December 2020) and after (January 8, 2021 to June 2021) the system was collected. Information included the number of plasma donors/donations, demographic information of eligible plasma donors in the past 5 years, the type of plasma donors, and the deferral donors after the system was activated. The online approval of Plasma Donation Certificate and the intelligent supervision of key points of plasma apheresis stations in Zhejiang were also conducted. The frequency and composition ratio were described, and chi-square test was used for statistical analysis. 【Results】 The system (V1.0) was established and was officially launched on January 8, 2021, realizing the interconnection of blood donation and plasma donation information as well as the unified management of 24 quality indicators. Since the system was applied (January 8, 2021-June 2021), the proportion of donors both donated blood and plasma over the province was 3.56 (832/23 389), and 352 deferred donors were masked by the system. And 30.11% (106/352) , who intended to donate plasma, were deferred due to insufficient interval after blood donation; 11.65% (41/352) due to permanent masking in blood donations; 23.86% (23.86%) , who intended to donate blood, were deferred due to insufficient interval after plasma donation ( 84/352); 34.38% (121/352) due to permanent masking in plasma donations. The median approval rate of four plasma stations applying for Plasma Donation Certificate before the system (January 1, 2016 to January 7, 2021) and after the system (January 8 to June 2021) were 93.38% (10 609/11 361) vs 99.50% (2 602/2 615). Before the system was put into launch, the ratio of male to female donors and the proportion of regular donors showed an overall upward trend, while the age decreased slightly. The median proportion of women in the past 5 years was 61.52 %, significantly higher than that in last 6 months after the launch(58.86%). 【Conclusion】 The application of the system can realize information interconnection between blood centers and plasma collection stations in Zhejiang as well as the real-time supervision of plasma collection process, which is helpful to overcome the shortcomings in plasma donor management.

Objective : To analyze the status and influencing factors of the intention of people aged 18 to 25 years to primary medical institutions and their satisfaction for health services in Zhejiang Province, so as to provide basis for the improvement of health services in primary medical institutions. Methods: During November and December in 2019,the 18-25 year-old people in Zhejiang Province were recruited to investigate the general information, intention to seek medical advice and satisfaction for health services in primary medical institutions through WeChat. Logistic regression was performed to analyze the influencing factors of the intention and the satisfaction. Importance matrix was used to analyze the key drivers of the satisfaction. Results: Among the 620 people surveyed, with a response rate of 93.37%, 142 (22.90%) chose primary medical institutions for advice. Actually 516 (83.23%) people went to primary medical institutions last year, and 384 ( 74.42% ) of them were satisfied with the health services. The results of multivariate logistic regression analysis showed that the people aged 18-25 years who were under the new rural cooperative medical care system ( OR=3.062, 95%CI: 1.745-5.373 ) and who had records in community health centers ( OR=0.547, 95%CI: 0.308-0.970 ) were more likely to go to primary medical institutions for medical advice; the ability of doctors ( OR=1.478, 95%CI:1.168-1.871 ) ,the drug notification by medical staff ( OR=1.308, 95%CI: 1.065-1.606 ) , routine examination items ( OR=1.523, 95%CI: 1.227-1.889 ) , the ways of payment ( OR=1.168, 95%CI: 1.017-1.340 ) , the comfort of environment ( OR=1.785, 95%CI: 1.437-2.219 ) and the bulletin boards of health knowledge ( OR=1.302, 95%CI: 1.086-1.561 ) were associated with the satisfaction. The results of importance matrix analysis showed that the ability of doctors and routine examination items were the priorities to improve, followed by the drug notification by medical staff; the comfort of environment had competitive advantages; the ways of payment and the bulletin boards of health knowledge needed to be further analyzed. Conclusions The 18-25-year-old people in Zhejiang Province were less intended to seek medical advice in primary medical institutions, which was associated with the type of medical insurance and records in community health centers. They were satisfied with the health services, the ability of doctors and routine examination items were the key drivers.

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.
Age Factors ; Aged ; COVID-19/therapy* ; China ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Odds Ratio ; Propensity Score ; Retrospective Studies ; Survival Rate

Objective To investigate the value of bone turnover markers(BTMs) in forecasting the variance of bone mineral density (BMD) by studying the relationships between BTMs and BMD in persons aged 80 and above.Methods A sample of 1 509 subjects aged 80 and above was recruited.All subjects underwent BMD measurement by dual energy X-ray absorptiometry,and BTMs (C-telopeptide of type 1 collagen,N-terminal propeptide of type 1 procolagen,osteocalcin) measurements.The relationships among all the BTMs,and between BMD and BTMs were analysed.Results In subjects aged 80 and above,the relationships among BTMs were moderately positive(all P＜0.05).In men aged 80 and above,BMDs were inversely associated with BTMs(all P＜0.05),and in women,BMDs were inversely associated with osteocalcin (P＜ 0.05).Conclusions The clinical significance of BTMs in persons aged 80 and above indicates bone resorption when BTMs are raised.In men aged 80 and above any of BTMs may be selected to evaluate bone metabolism ; while in women,osteocalcin should be selected.

OBJECTIVETo investigate serum cortisol level and glucocorticoid receptors (GR) mRNA expression in peripheral blood mononuclear cells (PBMCs) in patients with severe alopecia areata and liver-kidney deficiency syndrome and their involvement in the pathogenesis of severe alopecia areata.

METHODSIn 32 patients with severe alopecia areata, serum cortisol levels were measured by chemiluminescence assay and GR mRNA expression in the PBMCs was detected using reverse transcription real-time fluorescence quantitative PCR before and after treatment, with 20 normal subjects serving as the controls.

RESULTSSerum cortisol level showed no significant difference between the cases and the normal controls (P>0.05). The expression of GR mRNA in the PBMCs was significantly lower in the patients than in the normal controls (P<0.05). The expression of GR mRNA was even lower after treatments in patients with alopecia areata (P<0.01).

CONCLUSIONSGC-GR disorder exists in severe alopecia areata. A decreased GR mRNA expression in the PBMCs can be involved in the pathogenesis of severe alopecia areata, and such pathological changes at the receptor and genetic levels might also serve as the microscopic basis of liver-kidbey deficiency syndrome in severe alopecia areata.

Adult ; Alopecia Areata ; blood ; Case-Control Studies ; Diagnosis, Differential ; Female ; Humans ; Hydrocortisone ; blood ; Leukocytes, Mononuclear ; metabolism ; Male ; Medicine, Chinese Traditional ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Receptors, Glucocorticoid ; genetics ; metabolism ; Young Adult

[Objective]To evaluate and compare the of the ideals surgical technique for intertrochanteric fractue between DHS and arthroplasty.[Method]A total of 40 gerontal patients with the different surgical treatment from January 1999 to May 2004 were chosen. The mean age of the patients was 82 (75～90).Among the patients, 23 patients by DHS,17 by arthroplasty.[Result]The duration of follow-up averaged 1.5 years.The time in bed were 3 and 1 weeks due to DHS and arthroplasty, the full weight-bearing time were 10 and 6 weeks.[Conclusion]arthroplasty is ideal choice for the un-stable intertrochanteric fractue.

Objective: To investigate effect of Zhuanggu Granula medicated serum on proliferation and differentiation of bone marrow stromal cells(BMSCs) in vitro. Methods: Isolated BMSCs were cultured in vitro. The cells were treated with Zhuanggu Granula medicated serum, and the blank serum as the control group. The proliferation of cells was detected by MTT assay, the macroscopic histology, HE staining and immunohistoc-hemical examinations. Results: Zhuanggu Granula medicated serum effectively stimulated BMSCs proliferation (P