From the perspective of narrative medicine， focusing on the “three focal points，” integrating the “three elements，” and grounding in the “four relationships，” this study employed a close reading framework of “metaphor， time， space， and voice” to conduct a detailed interpretation on the approach and methodology of the medical narrative in the classic traditional Chinese medical case record Yi’s Medical Case. The close reading revealed that the author of the case record， Yi Dagen， demonstrated exceptional sensitivity to time and space. He excelled in tracing the complete process of disease occurrence and development within the natural rhythms of life， and in discerning the full truth of disease within the unified “body-society-nature” heaven-human field. When facing different subjects in diagnosis and treatment， Yi Dagen consistently rejected one-way knowledge inculcation and instead chose egalitarian dialogue. He was particularly adept at using metaphorical tools to embed obscure medical theories into patients’ disease stories through the form of life experience， thereby building shared medical understanding among different subjects and achieving the “co-creation of meaning” of disease stories. Through a reflective representation of the findings from the close reading， it was argued that Yi Dagen’s diagnostic and therapeutic narrative logic of “pulse-pattern-symptom-treatment” and the metaphorical narrative possessing dual functions of ontological cognition and an interpretive tool were an important means for fostering empathy and facilitating healing， as well as a concentrated manifestation of Yi Dagen’s “patient-centered” medical attitude. Analyzing Yi Dagen’s sophisticated narrative strategies and techniques provides wisdom references for cultivating medical staff’s narrative competence and offers historical insights for the localized development of narrative medicine.

Adipose-derived stem cells(ASCs)have become important seed cells in tissue engineering,because of their unique advantages.Extensive research has been conducted to determine the ideal method of cryopreservation for ASCs.In this review,we summarize the basic cryobiology and cryopreservation protocols for ASCs,and look forward to future research into cryopreservation protocols for ASCs.

Adipose-derived stem cells(ASCs)have become important seed cells in tissue engineering,because of their unique advantages.Extensive research has been conducted to determine the ideal method of cryopreservation for ASCs.In this review,we summarize the basic cryobiology and cryopreservation protocols for ASCs,and look forward to future research into cryopreservation protocols for ASCs.

Objective:This study aimed to provide basic data for the prevention, diagnosis and treatment of pediatric viral myocarditis (VMC) in China through analyzing the epidemic characteristics and disease burden of pediatric inpatients with VMC from 2016 to 2021.Methods:We performed a descriptive statistical analysis to the age, genders, seasons, regions and hospitalization cost and days of pediatric VMC inpatients and the death. All of the information was obtained from 27 Children′s hospitals or Maternal and Child Health hospitals of 23 provinces of China from 2016 to 2021.Results:A total of 7 647 599 cases including 1 646 VMC inpatients were admitted into our study. The annual numbers of hospitalizations were 173, 227, 313, 301, 295 and 337, with the hospitalized constituent ratios being 14.9/100 000, 17.9/100 000, 23.0/100 000, 20.5/100 000, 26.5/100 000 and 26.4/100 000 from 2016 to 2021. In recent 6 years, the proportion of VMC hospitalizations had increased yearly ( P<0.001), and had associated with the onset age ( P<0.001). Aged 12-≤18 years owned the highest hospitalized constituent ratio. The Northeast of China owned the largest number of VMC inpatients, and the East second to it. Among the 1 646 VMC children, there were 68 deaths, with the hospitalized case fatality rate of 4.13%. There were no significant differences between genders, age, seasons, years and fatality rate of VMC inpatients. For the diseases burden, the median of hospitalization days of all VMC inpatients was 10 days (IQR 6, 21), and the median of hospitalization cost was 1 1 842.3 RMB (IQR 6 969.22, 19 714.78). The median of hospitalization days of deceased VMC children was only 1 day (IQR 1, 3), the median cost could be 8 874.03 RMB (IQR 5 277.94, 5 6 151.59). Conclusions:In this study, we found that proportion of hospitalization of VMC children increased year by year, adolescence might be a risk factor of VMC. The fatality of VMC inpatients could be up to 4.13%, and the death led to a huge economic burden of society, family and individuals.

The incidence of depression is increasing year by year,seriously affecting people's work and life.With the continuous in-depth study of its pathogenesis,it is found that depression is closely related to intestinal flora.The imbalance of intestinal flora can cause central nervous system diseases through the microbial-brain-gut axis,which involves neurotransmitters,neuroendocrine,neurotrophic factors,inflammatory response and other mechanisms.This paper introduced intestinal flora and relevant regulatory factors related to various mechanisms of depression,listed experimental examples of intestinal flora imbalance leading to depression,and then summarized relevant studies on the anti-depression mechanism of traditional Chinese medicine through regulation of intestinal flora according to the mechanism of action,among which the regulation of microbial metabolism,inflammatory factors and neurotransmitters was mainly studied.The conclusion is expected to provide some reference for the study of anti-depression effect of Chinese medicine.

The incidence of depression is increasing year by year,seriously affecting people's work and life.With the continuous in-depth study of its pathogenesis,it is found that depression is closely related to intestinal flora.The imbalance of intestinal flora can cause central nervous system diseases through the microbial-brain-gut axis,which involves neurotransmitters,neuroendocrine,neurotrophic factors,inflammatory response and other mechanisms.This paper introduced intestinal flora and relevant regulatory factors related to various mechanisms of depression,listed experimental examples of intestinal flora imbalance leading to depression,and then summarized relevant studies on the anti-depression mechanism of traditional Chinese medicine through regulation of intestinal flora according to the mechanism of action,among which the regulation of microbial metabolism,inflammatory factors and neurotransmitters was mainly studied.The conclusion is expected to provide some reference for the study of anti-depression effect of Chinese medicine.

Patients with malignant pleural mesothelioma (MPM) usually present with poor prognosis and short survival period, and there has been a lack of effective treatment options for a long time. Chemotherapy has limited improvement in the clinical outcome of advanced patients (the median survival is less than one year), and it is difficult to find suitable targets for targeted therapy. Recent in-depth research on immunotherapy has changed the treatment pattern of MPM. Especially, the dual immunotherapy regimen significantly improved the survival outcome of patients across subgroups and prolonged the survival time of MPM patients. Therefore, it has been approved for unresectable MPM as first-line treatment for patients. The exploration of other mono or combo immunotherapy regimens in the first and second-line settings of MPM is also underway. How to identify the best beneficial population of each regimen through predictive biomarkers is also a hot spot for researchers. This article will focus on the most up-to-date progress of MPM epidemiology, histological characteristics, pathogenesis, treatment patterns and the advances of immunotherapy in the disease.
.
Combined Modality Therapy ; Humans ; Immunotherapy ; Lung Neoplasms/drug therapy* ; Mesothelioma/drug therapy* ; Mesothelioma, Malignant ; Pleural Neoplasms/drug therapy*

Objective:To investigate the clinical effect of free deep femoral artery third perforating flap repaired soft tissue loss after Pilon fracture surgery in I stage.Methods:Fifteen patients were treated from April, 2013 to January, 2020. Miller AO classification: 8 cases 43-C1, 4 cases 43-C2 and 3 cases 43-C3. All cases were accompanied with severe soft tissue contusion and skin necrosis. After fracture reduction, soft tissue defects, internal fixation exposure and tendon exposure around the wound. Free deep femoral artery third perforating flap (3.5 cm ×15.5 cm to 5.5 cm×12.5 cm) for the repair of soft tissue defects around ankle in the I stage, the blood vessels of the flap were end-to-side anastomosed with vessels of the posterior tibial or anterior tibial. Regular follow-up after surgery.Results:One case of venous crisis occurred, other 14 cases survived, were followed-up from 5 to 18 months, the ankle joint function was good, did not affect the foot shoes, with excellent color and texture, the flap restored protective sensation, and leaving only linear scar, no muscle adhesion.Conclusion:Free deep femoral artery third perforating flap repaired soft tissue loss of surgical incision after fracture operated than significantly reduce the postoperative fracture infection and protect the blood supply around the fracture. It is an effective method of repair.

Lung transplantation is an effective treatment for many end-stage lung diseases. Lung cancer was considered to be a contraindication of lung transplantation for a long time. However, multifocal diffuse adenocarcinoma has been indicated for lung transplantation nowadays. In the preoperative course of lung transplantation for chronic end-stage lung diseases, patients should be examined thoroughly to exclude malignant tumors. If malignant tumors were incidentally found in recipient' s explanted lung, a careful evaluation of tumor stage and the prognosis of recipient is needed. Lung transplantations for metastatic lung tumors have only been reported in a few case reports, limiting the application of transplantation in current clinical practice.