1.Treatment Strategies for Postoperative Complications of Lung Cancer from Protecting Healthy Qi and Treating Qi
Jiajun SONG ; Yichao WANG ; Xueqi TIAN ; Yi LIU ; Lijing JIAO ; Ling XU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):94-105
Pulmonary complications, the most common postoperative complications of lung cancer, not only affect the quality of life of the patients after surgery but also increase the prognostic risks of postoperative recurrence and metastasis, threatening the life safety. At present, a multidisciplinary model of diagnosis and rehabilitation with integrated traditional Chinese medicine (TCM) and Western medicine has been initially formed under the guidance of the concept of rapid rehabilitation post operation for lung cancer. However, the treatment that only aims at shortening hospital stay and reducing the incidence of postoperative complications does not pay enough attention to the postoperative functional rehabilitation of the lung and the impact of follow-up adjuvant therapy, which affects the completeness of rehabilitation. This paper classifies the typical postoperative symptoms and manifestations of lung cancer into five groups: Lung system, emotion, digestive tract, pain, and nerve. On this basis, this paper summarizes the three core pathogeneses of postoperative complications of lung cancer as failure of Qi to ascend and descend leading to insecurity of defensive exterior, vessel block leading to Qi stagnation and fluid retention, and lung Qi deficiency leading to spleen and kidney deficiency. Accordingly, this paper proposes the treatment principle of protecting healthy Qi and treating Qi with the core of descending-tonifying-ascending-dispersing Qi and puts forward three treatment methods. The first is replenishing Qi and consolidating exterior, and expelling phlegm and regulating lung. The second is replenishing Qi and promoting blood flow to resolve stasis and relieving pain. The third is replenishing Qi and tonifying lung, and invigorating spleen and tonifying kidney. Furthermore, this paper elaborates on the pathogenesis and treatment principles of four common postoperative complications: Lung infection, pleural effusion, atelectasis, and bronchopleural fistula. On the basis of Western medical treatment, the TCM treatment characteristics of treating symptoms in the acute phase and eradicating the root cause in the chronic phase should be played. While dispelling the pathogen, measures should be taken to protect the healthy Qi, including tonifying lung Qi, regulating spleen Qi, and replenishing kidney Qi. This study summarizes the pathogenesis and treatment strategy of common postoperative complications of lung cancer according to the principle of protecting healthy Qi and treating Qi, aiming to provide guidance for the future treatment of postoperative complications of lung cancer.
2.Temporal trend of the global prevalence rate of tension-type headache in children and adolescents in 1990-2021
Ling-Zi YAO ; De-Nan JIANG ; Jing WU ; Guang-Dian SHEN ; Jin CAO ; Si-Qing CHENG ; Shi-Yi SHAN ; Ze-Yu LUO ; Jia-Li ZHOU ; Pei-Ge SONG
Chinese Journal of Contemporary Pediatrics 2024;26(10):1058-1065
Objective To investigate the prevalence of tension-type headache(TTH)in children and adolescents aged 0-19 years globally in 1990-2021,and to provide a basis for the prevention and treatment of TTH.Methods Based on the Global Burden of Disease Study data,the age-standardized prevalence distribution of TTH and its changing trend were analyzed among the children and adolescents aged 0-19 years,with different sexes,age groups,sociodemographic index(SDI)regions and countries/territories.Results The age-standardized prevalence rate(ASPR)of TTH in children and adolescents aged 0-19 globally in 2021 was 17 339.89/100 000,which was increased by 1.73%since 1990.The ASPR in females was slightly higher than that in males(1990:17 707.65/100 000 vs 16 403.78/100 000;2021:17 946.29/100 000 vs 16 763.09/100 000).The ASPR in adolescence was significantly higher than that in school-aged and preschool periods(1990:27 672.04/100 000 vs 10 134.16/100 000;2021:28 239.04/100 000 vs 10 059.39/100 000).Regions with high SDI exhibited a higher ASPR than the other regions,with significant differences in prevalence rates across different countries.From 1990 to 2021,there was a slight increase in global ASPR,with an average annual percentage change(AAPC)of 0.06%.Females experienced a smaller increase than males based on AAPC(0.04%vs 0.07%).There was reduction in ASPR in preschool and school-aged groups,with an AAPC of-0.02%,while there was a significant increase in ASPR in adolescence,with an AAPC of 0.07%.ASPR decreased in regions with low-middle and low levels of SDI,with an AAPC of-0.02%and-0.04%,respectively,while it increased in regions with middle SDI,with an AAPC of 0.24%.Conclusions There is a consistent increase in the ASPR of TTH in children and adolescents aged 0-19 years globally,with significant differences across sexes,age groups,SDI regions and countries/territories.
3.Natural clearance of high-risk HPV infection in professional women and construction of a nomogram prediction model
Yi-Jiao TANG ; De-Ling ZENG ; Song TAN ; Li TIAN
Chinese Journal of Infection Control 2024;23(5):613-620
Objective To construct and validate a nomogram prediction model for the high-risk human papilloma-virus(HPV)infection and its natural clearance in professional women.Methods Women with regular professions,who underwent professional medical examination and were confirmed with high-risk HPV infection without cervical cancer and cervical epithelial neoplasia in a hospital from March 2020 to March 2021 were studied.Patients were di-vided into the model group and the validation group in a 7:3 ratio.The model group were subdivided into the natural clearance group and the persistent infection group based on follow-up results.The general information,reproduc-tive-related treatment,sexual partner-related information,and examination results of the two groups of patients were compared.Potential factors for natural clearance of high-risk HPV infection in professional women were screened out by LASSO regression.Independent influencing factors were screened out with multivariate logistic re-gression.Based on multivariate logistic regression results,a nomogram prediction model was constructed and valida-ted using R programming language.Results A total of 329 cases were included,230 in the model group and 99 in the validation group.There was no statistically significant difference in general information between the two groups of patients(all P>0.05).Among the 230 high-risk HPV infection patients in the model group,165 turned negative at the end of follow-up,with a natural clearance rate of 71.74%.Based on LASSO regression analysis,multivariate logistic regression analysis showed that age,contraceptive method,number of sexual partners,excessive foreskin of sexual partners,initial viral load,HPV infection type,and reproductive tract inflammation were independent influ-encing factors for the natural clearance of high-risk HPV infection in professional women(all P<0.05).The re-ceiver operating characteristic(ROC)curve analysis showed that the areas under the curve(AUC)of natural clea-rance of high-risk HPV infection in professional women in the model group and validation group were 0.834(95%CI:0.776-0.893)and 0.817(95%CI:0.755-0.879),respectively.H-L goodness-of-fit test result showed that the difference between the nomogram model and the ideal model was not statistically significant(P>0.05).The cali-bration curve results showed that the predicted curves of the model group and validation group were basically fit with the standard curve,indicating a high predictive accuracy of the model.The decision curve analysis results of the model group showed that when the probability threshold of natural clearance of high-risk HPV infection in profes-sional women predicted by the nomogram model was 0.15-0.95,the net benefit rate of patients was>0.Conclusion The natural clearance rate of high-risk HPV infection in professional women is high,mainly influenced by factors such as age,contraceptive method,and number of sexual partners.The nomogram model constructed in this study has high accuracy and discrimination in predicting the natural clearance rate of high-risk HPV infection in profes-sional women.
4.The effect of different inhaled drugs on the treatment of patients with frequent cough in chronic obstructive pulmonary disease
Xueshan LI ; Qing SONG ; Wei CHENG ; Cong LIU ; Ling LIN ; Yuqin ZENG ; Rong YI ; Xin LI ; Ping CHEN
Journal of Chinese Physician 2024;26(6):805-810
Objective:To compare the therapeutic effects of different inhaled medications on patients with frequent cough in chronic obstructive pulmonary disease (COPD), including changes in symptoms and acute exacerbation.Methods:This study was based on the RealDTC study, and the study subjects were stable COPD patients from the Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University from December 2016 to March 2023. The demographic characteristics, smoking status, history of biofuel exposure, history of acute exacerbation in the past year, lung function, COPD Assessment Test (CAT) score, modified British Medical Research Council Respiratory Difficulty Questionnaire (mMRC) score, and inhalation medication regimen of the patients were collected. Patients with frequent cough are defined as having a cough score of ≥2 in the first item of the CAT score. According to the type of inhaled medication, patients with frequent cough are divided into l long-acting muscarine anticholinergic (LAMA), long-acting β2 agonists (LABA)+ LAMA, inhaled corticosteroids (ICS)+ LABA, and ICS+ LABA+ LAMA groups. At the 6th month follow-up, CAT scores were collected and symptom control was evaluated, including minimum clinical improvement (MCID) (defined as a decrease of ≥2 points from baseline in CAT scores at the 6th month) and improvement in cough symptoms (defined as a decrease of ≥1 point from baseline in cough scores). During a one-year follow-up, the number of acute exacerbations was evaluated. The relationship between different inhaled medications and prognosis in patients with frequent cough in COPD was evaluated using multivariate logistic regression analysis.Results:A total of 653 patients with frequent cough in COPD were included, with a CAT score of (16.4±6.1) and a cough score of 3(2, 3). After 6 months of follow-up, 403 patients (61.7%) achieved MCID, and 394 patients (60.3%) had improved cough symptoms; During a one-year follow-up, 227 patients (34.8%) experienced acute exacerbation. After receiving inhalation medication treatment, the CAT scores and cough scores of four groups of patients with frequent cough, namely LAMA, LABA+ LAMA, ICS+ LABA, and ICS+ LABA+ LAMA, decreased compared to before treatment (all P<0.05). There was a statistically significant difference in the proportion of △CAT score, MCID, and acute exacerbation among the four groups of LAMA, LABA+ LAMA, ICS+ LABA, and ICS+ LABA+ LAMA (all P<0.05), while there was no statistically significant difference in the proportion of △cough score and cough score reduction ≥1 point (all P>0.05). The results of multivariate logistic regression analysis showed that compared with patients treated with LAMA or ICS+ LABA drugs, patients with frequent cough in COPD treated with LABA+ LAMA or ICS+ LABA+ LAMA drugs were more likely to achieve MCID and less likely to experience acute exacerbation (all P<0.05). Conclusions:Compared with LAMA or ICS+ LABA, patients with frequent cough in COPD who receive LABA+ LAMA or ICS+ LABA+ LAMA drug treatment are more likely to improve symptoms and have a lower risk of acute exacerbation.
5.Mandibular condyle localization in orthognathic surgery based on mandibular move-ment trajectory and its preliminary accuracy verification
Xinyu XU ; Ling WU ; Fengqi SONG ; Zili LI ; Yi ZHANG ; Xiaojing LIU
Journal of Peking University(Health Sciences) 2024;56(1):57-65
Objective:To establish and assess the precision of pre-surgical condyle position planning using mandibular movement trajectory data for orthognathic surgery.Methods:Skull data from large-field cone beam computed tomography(CBCT)and dental oral scan data were imported into IVSPlan 1.0.25 software for 3D reconstruction and fusion,creating 3D models of the maxilla and mandible.Trajectory da-ta of mandibular movement were collected using a mandibular motion recorder,and the data were inte-grated with the jaw models within the software.Subsequently,three-dimensional trajectories of the con-dyle were obtained through matrix transformations,rendering them visually accessible.A senior oral and maxillofacial surgeon with experience in both diagnosis and treatment of temporomandibular joint disease and orthognathic surgery selected the appropriate condyle position using the condyle movement trajectory interface.During surgical design,the mobile mandibular proximal segment was positioned accordingly.Routine orthognathic surgical planning was completed by determining the location of the mandibular distal segment,which was based on occlusal relationships with maxilla and facial aesthetics.A virtual mandible model was created by integrating data from the proximal and distal segment bone.Subsequently,a solid model was generated through rapid prototyping.The titanium plate was pre-shaped on the mandibular model,and the screw hole positions were determined to design a condylar positioning guide device.In accordance with the surgical plan,orthognathic surgery was performed,involving mandibular bilateral sagittal split ramus osteotomy(SSRO).The distal segment of the mandible was correctly aligned inter-maxillary,while the proximal bone segment was positioned using the condylar positioning guide device and the pre-shaped titanium plate.The accuracy of this procedure was assessed in a study involving 10 patients with skeletal class Ⅱ malocclusion.Preoperative condyle location planning and intraoperative po-sitioning were executed using the aforementioned techniques.CBCT data were collected both before the surgery and 2 weeks after the procedure,and the root mean square(RMS)distance between the preope-rative design position and the actual postoperative condyle position was analyzed.Results:The RMS of the condyle surface distance measured was(1.59±0.36)mm(95%CI:1.35-1.70 mm).This value was found to be significantly less than 2 mm threshold recommended by the expert consensus(P<0.05).Conclusion:The mandibular trajectory may play a guiding role in determining the position of the mandibular proximal segment including the condyle in the orthognathic surgery.Through the use of a con-dylar positioning guide device and pre-shaped titanium plates,the condyle positioning can be personalized and customized with clinically acceptable accuracy.
6.A Precise and Portable Detection System for Infectious Pathogens Based on CRISPR/Cas Technology
Yi-Chen LIU ; Ru-Jian ZHAO ; Bai-Yang LYU ; De-Feng SONG ; Yi-Dan TANG ; Yan-Fang JIANG ; Bing-Ling LI
Chinese Journal of Analytical Chemistry 2024;52(2):187-197
Nucleic acid-based molecular diagnostic methods are considered the gold standard for detecting infectious pathogens.However,when applied to portable or on-site rapid diagnostics,they still face various limitations and challenges,such as poor specificity,cumbersome operation,and portability difficulties.The CRISPR(Clustered regularly interspaced short palindromic repeats)/CRISPR-associated protein(Cas)-fluorescence detection method holds the potential to significantly enhance the specificity and signal-to-noise ratio of nucleic acid detection.In this study,we developed a portable grayscale reader detection system based on loop-mediated isothermal amplification(LAMP)-CRISPR/Cas.On one hand,in the presence of CRISPR RNA(crRNA),the CRISPR/Cas12a system was employed to achieve precise fluorescent detection of self-designed LAMP amplification reactions for influenza A and influenza B viruses.This further validated the high selectivity and versatility of the CRISPR/Cas system.On the other hand,the accompanying independently developed portable grayscale reader allowed for low-cost collection of fluorescence signals and high-reliability visual interpretation.At the end of the detection process,it directly provided positive or negative results.Practical sample analyses using this detection system have verified its reliability and utility,demonstrating that this system can achieve highly sensitive and highly specific portable analysis of influenza viruses.
7.Exploration of the Disease Mechanism and Treatment of Colorectal Cancer Based on the "One Qi Circulation"
Zhiying WANG ; Ling XU ; Jialin YAO ; Jiajun SONG ; Yun LI ; Shujuan FU ; Yabin GONG ; Yi ZHONG
Journal of Traditional Chinese Medicine 2024;65(10):1068-1071
Based on the theory of "one qi circulation" founded by HUANG Yuanyu, the core disease mechanism of colorectal cancer is the innate spleen deficiency and stomach qi failing to bear downward, which leads to the turbidity assemble in large intestine, forming the carcinoma toxin, and ultimately transforms into colorectal cancer. The treatment should base on recovering the circulation of qi, Huangya Decoction (黄芽汤) as the basic formula, the circulation of qi ascending and descending as the base, adjusting ascending and descending together with Xiaqi Decoction (下气汤), and differentiating the syndrome on yin-yang excess-deficiency; for spleen-kidney yang deficiency syndrome, treated with Tianhun Decoction (天魂汤) to supplement liver, kidney and assist yang; for liver-kidney yin deficiency syndrome, treated wtih Dipo Decoction (地魄汤) to supplement lung, kidney, and assist yang. They jointly prompt one qi circulation to provide the thoughts for the treatment of colorectal cancer by traditional Chinese medicine.
8.Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients
Qiulin XIANG ; Ling LIU ; Yi YANG ; Guoxing LI ; Song CHEN ; Yingying YANG ; Xian YU
China Pharmacy 2024;35(14):1765-1769
OBJECTIVE To investigate the effects of CYP3A5 gene polymorphism and Wuzhi capsule (WZ) on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients. METHODS A total of 132 patients who underwent renal transplantation and received tacrolimus + mycophenolic acids + prednisone after operation in our hospital from September 2021 to September 2023 were selected and divided into four groups according to genotypes (CYP3A5*1 or CYP3A5*3/*3) and with or without WZ (“ +WZ” meant drug combination, “ +NO WZ” meant without combination). The blood trough concentration/daily dose (c0/D) values of the four groups were analyzed on the 14th day, 1 month and 3 months after renal transplantation. The incidence of acute rejection and the incidence of tacrolimus-related adverse reactions within 3 months after transplantation were compared among 4 groups. RESULTS On the 14th day, 1 month and 3 months after surgery (except for the CYP3A5*1+WZ group), c0/D values of CYP3A5*1 genotype patients were significantly lower than those of CYP3A5*3/*3 genotype patients regardless of whether they were treated with WZ additionally (P<0.05). Within 3 months after surgery, although there was no significant difference in the incidence of acute rejection and tacrolimus-related adverse reactions among the four groups (P> 0.05), the incidence of hyperglycemia in patients with CYP3A5*3/*3 was higher (41.67%). CONCLUSIONS CYP3A5 gene polymorphism is significantly related to tacrolimus c0/D in kidney transplant patients. Under the premise of c0 monitoring of tacrolimus, patients with CYP3A5*1 genotype should be given WZ as soon as possible after surgery to accelerate tacrolimus to reach the therapeutic concentration range, while CYP3A5*3/*3 genotype is not recommended to be given WZ because of the higher risk of hyperglycemia.
9.Expert consensus on the diagnosis and therapy of endo-periodontal lesions
Chen BIN ; Zhu YANAN ; Lin MINKUI ; Zhang YANGHENG ; Li YANFEN ; Ouyang XIANGYING ; Ge SONG ; Lin JIANG ; Pan YAPING ; Xu YAN ; Ding YI ; Ge SHAOHUA ; Chen FAMING ; Song ZHONGCHEN ; Jiang SHAOYUN ; Sun JIANG ; Luo LIJUN ; Ling JUNQI ; Chen ZHI ; Yue LIN ; Zhou XUEDONG ; Yan FUHUA
International Journal of Oral Science 2024;16(3):381-389
Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.
10.Study on the Correlation Between Sleep Status and Traditional Chinese Medicine Constitution Types of Sub-healthy Population in Lingnan Area
Bai-Shu CHEN ; Jin-Ling LONG ; Yan CHEN ; Qing-Song ZHANG ; Yi LUO ; Shu-Hui CHEN ; Ying-Zhen LI
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(7):1676-1681
Objective To explore the correlation between sleep status and traditional Chinese medicine(TCM)constitution types of sub-healthy population in Lingnan area.Methods From May 2022 to May 2023,an investigation was carried out in a sub-healthy population of 688 persons who lived in Shenzhen for more than 5 years,had no serious cardiovascular disease and were confirmed by the sub-health rating scale.The questionnaire survey of Pittsburgh Sleep Quality Index(PSQI)scale and the TCM constitution classification rating scale was conducted,and multiple linear regression analysis was performed to explore the correlation between the sleep status and TCM constitution types.Results(1)A total of 688 questionnaires were released,of which 19 were lost to follow-up,and 669 were responded.After weeding out the 29 invalid questionnaires,640 valid questionnaires were finally included for the analysis.(2)According to the PSQI score,the population was divided into excellent sleep group(total PSQI score<8)of 350 cases and poor sleep group(total PSQI score≥8)of 290 cases.The item scores of time for falling asleep,sleep time and sleep disorder as well as the total PSQI score of the excellent sleep group were significantly lower than those of the poor sleep group(P<0.05 or P<0.01).(3)The persons with excellent sleep usually had the balanced constitution(86.86%),while the persons with poor sleep often had the biased constitution(79.64%).The top three biased constitution types in the persons with poor sleep were damp-heat constitution(15.52%),phlegm-damp constitution(13.79%)and qi-stagnation constitution(13.10%).(4)Multiple linear regression analysis showed that the time for falling asleep was positively correlated with phlegm-damp constitution and qi-stagnation constitution(P<0.01),and was negatively correlated with balanced constitution(P<0.05);the sleep efficiency was positively correlated with damp-heat constitution and inherited special constitution(P<0.05 or P<0.01),and was negatively correlated with balanced constitution(P<0.05);sleep disorder was positively correlated with qi-stagnation constitution and yin-deficiency constitution(P<0.01);hypnotic drugs were positively correlated with yin-deficiency constitution(P<0.01);daytime dysfunction was positively correlated with phlegm-damp constitution(P<0.05).Conclusion The sleep status of sub-healthy population in Lingnan area has a certain correlation with TCM constitution types.Damp-heat constitution,phlegm-damp constitution,qi-stagnation constitution,yin-deficiency constitution,balanced constitution and inherited special constitution are the six constitution types that affect sleep status.It is of great significance to guide the sub-healthy population to achieve the purpose of prevention before illness by improving their constitution after the identification of TCM constitution types.

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