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Journal of Cardiothoracic Surgery Mar 2024Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date,... (Review)
Review
BACKGROUND
Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date, fewer than 30 cases of pulmonary PNET have been reported. In this case report, we present the clinical details of a 12-year-old girl with pulmonary PNET who underwent surgical treatment. We also conducted an analysis and summary of other relevant studies and the surgical outcomes.
CASE PRESENTATION
In May 2018, a 12-year-old girl was admitted with symptoms of cough and blood-tinged phlegm. A computed tomography scan revealed a large mass, measuring 12.9 cm × 8.1 cm, in the right middle and lower lungs. A percutaneous lung biopsy confirmed poorly differentiated tumor cells with a nested growth pattern. Immunohistochemical staining demonstrated positive expression of CD99, CD56, Vimentin, and Synaptophysin. The patient was diagnosed with pulmonary PNET. Following three cycles of neoadjuvant chemotherapy, a substantial reduction in tumor volume was observed. Subsequently, the patient underwent a surgical procedure involving pneumonectomy and partial resection of the left atrium with the assistance of cardiopulmonary bypass. The patient was discharged 37 days after surgery. During a three-year follow-up period, she exhibited no signs of tumor recurrence and has successfully returned to school.
CONCLUSIONS
This case highlights the successful management of an advanced PNET with neoadjuvant chemotherapy, pneumonectomy, and partial resection of the left atrium employing cardiopulmonary bypass. The patient remained disease-free after three years. Our analysis of surgically treated cases indicates that neoadjuvant chemotherapy can contribute to improved prognoses for PNET patients. It is crucial to emphasize that complete surgical excision remains the cornerstone of treatment, underscoring the importance of surgeons considering radical surgical approaches whenever feasible for patients with pulmonary PNETs.
Topics: Female; Humans; Child; Neoplasm Recurrence, Local; Pneumonectomy; Neoadjuvant Therapy; Lung; Neuroectodermal Tumors, Primitive
PubMed: 38443970
DOI: 10.1186/s13019-024-02563-8 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Oct 2023Insomnia is a common disease and its impact on human health cannot be ignored. At present, there are 3 main clinical treatments for insomnia, including traditional...
Insomnia is a common disease and its impact on human health cannot be ignored. At present, there are 3 main clinical treatments for insomnia, including traditional Chinese medicine treatment, sedative hypnotic drug therapy, and cognitive behavioral therapy. Traditional Chinese medicine (TCM) treatment for insomnia is widely used due to its advantages of low side effects, good efficacy, and no drug dependence. This paper summarizes the pathogenesis of insomnia in the theories of traditional Chinese and Western medicine. Modern medical research generally believes that sleep-wake disorder is the main pathological mechanism of insomnia, involving many factors such as monoamine neurotransmitter disorder, cytokine imbalance and intestinal flora imbalance. TCM mainly divides the pathogenesis of insomnia into 9 kinds of syndrome types: Liver depression transforming into fire, hyperactivity of fire due to yin deficiency, phlegm-heat attacking internally, disharmony between heart and kidney, deficiency of both heart and spleen, qi deficiency of both heart and gallbaldder, stomach qi disharmony, exuberance of heart fire, and internal blockade of static blood. According to these 9 kinds of pathogenesis of insomnia, the corresponding classical prescriptions such as Longdanxiegan decoction, Suanzaoren decoction, Huanglian-Wendan decoction, Jiaotai pill and Guipi decoction were analyzed and summarized. There is evidence that traditional Chinese medicine could treat insomnia mainly by increasing the level of 5-hydroxytryptamine, reducing the levels of dopamine, noradrenaline, tumor necrosis factor α, and interlukin-6, decreasing the ratio of glutamic acid to γ-aminobutyric acid, and inhibiting the hypothalamic-pituitary-adrenal axis.
Topics: Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Sleep Initiation and Maintenance Disorders; Medicine, Chinese Traditional; Amines
PubMed: 38432879
DOI: 10.11817/j.issn.1672-7347.2023.230200 -
Medicine Mar 2024Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm... (Review)
Review
RATIONALE
Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm elimination. It has been extensively used in clinics for the treatment of many inflammation-related diseases. Currently, there are no documented cases of rhabdomyolysis resulting from Botrychium ternatum intoxication.
PATIENT CONCERNS
A 57-year-old male presented with a complaint of low back discomfort accompanied by tea-colored urine lasting for 4 days. The patient also exhibited markedly increased creatine phosphate kinase and myoglobin levels. Prior to the onset of symptoms, the patient consumed 50 g of Botrychium ternatum to alleviate pharyngodynia.
DIAGNOSES
The patient was diagnosed with rhabdomyolysis due to Botrychium ternatum intoxication.
INTERVENTIONS
The patient underwent a substantial volume of fluid resuscitation, diuresis, and alkalization of urine, as well as correction of the acid-base balance and electrolyte disruption.
OUTCOMES
Following a 10-day treatment plan involving massive fluid resuscitation, diuresis, and alkalization of urine, the patient showed notable improvement in his lower back pain and reported the absence of any discomfort. Following reexamination, the levels of creatine phosphate kinase and myoglobin were restored to within the normal ranges. Additionally, no abnormalities were detected in liver or renal function. As a result, the patient was considered eligible for discharge and was monitored.
CONCLUSIONS
Botrychium ternatum intoxication was associated with the development of rhabdomyolysis. To manage this condition, it is recommended that patients provide massive fluid resuscitation, diuresis, alkalization of urine, and other appropriate therapeutic interventions.
LESSON
Currently, there are no known cases of rhabdomyolysis resulting from Botrychium ternatum intoxication. However, it is important to consider the potential occurrence of rhabdomyolysis resulting from Botrychium ternatum intoxication when there is a correlation between the administration of Botrychium ternatum and the presence of muscular discomfort in the waist or throughout the body, along with tea-colored urine. Considering the levels of creatine phosphate kinase and myoglobin, the diagnosis or exclusion of rhabdomyolysis caused by Botrychium ternatum intoxication should be made, and suitable treatment should be administered accordingly.
Topics: Male; Humans; Middle Aged; Myoglobin; Phosphocreatine; Rhabdomyolysis; Fluid Therapy; Creatine Kinase; Tea
PubMed: 38428852
DOI: 10.1097/MD.0000000000037304 -
Journal of Thoracic Disease Jan 2024Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such...
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such as exposure to vapors, gases, dust and fumes (VGDF)] for accelerate disease progression has important significance.
METHODS
We conducted COPD surveillance in six cities of southern China between 2014 and 2019. We recorded the diagnosis of chronic bronchitis, respiratory symptoms, occupational exposure to VGDF and other covariates by using a structured questionnaire. Logistic regression and multivariate linear regression model were adopted for analysis. We performed sensitivity analyses based on two methods of propensity score (PS) methods to evaluate the robustness of our results.
RESULTS
A total of 7,418 participants were included. Cough [odds ratios (ORs): 1.60, 95% confidence interval (CI): 1.22 to 2.08] and phlegm (OR: 1.49, 95% CI: 1.19 to 1.85) correlated significantly with exposure to dust. There was an increased risk of cough (OR: 1.53, 95% CI: 1.11 to 2.07) for occupational exposure to gas/vapor/fume. Dual exposure to dust and gas/vapor/fume was associated with a significantly increased risk of chronic bronchitis (OR: 1.74, 95% CI: 1.20 to 2.52), cough (OR: 1.43, 95% CI: 1.15 to 1.79) and phlegm (OR: 1.49, 95% CI: 1.24 to 1.79). In 5,249 participants with complete data of spirometry, gas/vapor/fume was associated with a decreased ratio of forced expiratory volume in one second and forced vital capacity (FEV/FVC) (β: -1.05, 95% CI: -1.85 to -0.26) and maximal mid-expiratory flow (MMEF) (β: -0.15, 95% CI: -0.23 to -0.07). Dual exposure to dust and gas/vapor/fume was significantly associated with decreased FEV/FVC (β: -0.74, 95% CI: -1.28 to -0.20) and MMEF (β: -0.06, 95% CI: -0.12 to -0.01). Results of sensitivity analysis were not materially changed.
CONCLUSIONS
VGDF exposure is associated with chronic bronchitis, respiratory symptoms and decreased lung function, suggesting that VGDF contributes to the pathogenesis and progression of COPD.
PubMed: 38410603
DOI: 10.21037/jtd-23-646 -
Food Chemistry: X Mar 2024Pericarpium citri reticulatae (PCR) is the dried mature fruit peel of Blanco and its cultivated varieties in the Brassicaceae family. It can be used as both food and...
Pericarpium citri reticulatae (PCR) is the dried mature fruit peel of Blanco and its cultivated varieties in the Brassicaceae family. It can be used as both food and medicine, and has the effect of relieving cough and phlegm, and promoting digestion. The smell and medicinal properties of PCR are aged over the years; only varieties with aging value can be called "Chenpi". That is to say, the storage year of PCR has a great influence on its quality. As the color and smell of PCR of different storage years are similar, some unscrupulous merchants often use PCRs of low years to pretend to be PCRs of high years, and make huge profits. Therefore, we did this study with the aim of establishing a rapid and nondestructive method to identify the counterfeiting of PCR storage year, so as to protect the legitimate rights and interests of consumers. In this study, a classification model of PCR was established by e-eye, flash GC e-nose, and Fourier transform near-infrared (FT-NIR) combined with machine learning algorithms, which can quickly and accurately distinguish PCRs of different storage years. DFA and PLS-DA models were established by flash GC e-nose to distinguish PCRs of different ages, and 8 odor components were identified, among which (+)-limonene and γ-terpinene were the key components to distinguish PCRs of different ages. In addition, the classification and calibration model of PCRs were established by the combination of FT-NIR and machine learning algorithms. The classification models included SVM, KNN, LSTM, and CNN-LSTM, while the calibration models included PLSR, LSTM, and CNN-LSTM. Among them, the CNN-LSTM model built by internal capsule had significantly better classification and calibration performance than the other models. The accuracy of the classification model was 98.21 %. The R of age, (+)-limonene and γ-terpinene was 0.9912, 0.9875 and 0.9891, respectively. These results showed that the combination of flash GC e-nose and FT-NIR combined with deep learning algorithm could quickly and accurately distinguish PCRs of different ages. It also provided an effective and reliable method to monitor the quality of PCR in the market.
PubMed: 38384686
DOI: 10.1016/j.fochx.2024.101220 -
Heliyon Feb 2024is one of the biggest and complex genera of the Acanthaceae family. is commonly known as 'Adosa'. It is an ayurvedic medicine with a medicinal history of more than a... (Review)
Review
is one of the biggest and complex genera of the Acanthaceae family. is commonly known as 'Adosa'. It is an ayurvedic medicine with a medicinal history of more than a thousand years in India. Traditionally, it is used to treat cough, asthma, phlegm, bleeding hemorrhoids, for both adults and youth. This plant possesses antiarthritis, antiseptic, antimicrobial, anti-tuberculosis, anti-inflammatory and abortifacient properties. Alkaloids are the major phytoconstituents present in the plant in the form of pyrrolo-quinazoline derivatives vasicine, vasicinone, vasicinol, adhatodine, adhatodinine, adhavasinone and anisotine etc. The asserted objectives are to conduct a systematic review on the phytochemistry, pharmacology and traditional uses of , as well as highlighting the challenges found in the research. This will promote the utilization of at extract level and further development of new drug leads based on the compounds isolated and used for treatment of various ailments. The present review covers the literature survey from 1888 to 2023. The relevant data has been collected from various peer-reviwed journals, and books Sci-Finder, PubMed, Science Direct, Google Scholar, EBSCO, online electronic journals, SpringerLink and Wiley. This paper aims to present a systematic review of known traditional applications, pharmacological and chemical aspects in .
PubMed: 38379997
DOI: 10.1016/j.heliyon.2024.e25727 -
Frontiers in Pharmacology 2024Traditional Chinese medicine (TCM) is effective for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD); however, there is no...
Exploration of biomarkers for efficacy evaluation of traditional Chinese medicine syndromes of acute exacerbation of chronic obstructive pulmonary disease based on metabolomics.
Traditional Chinese medicine (TCM) is effective for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD); however, there is no objective index for the evaluation of TCM syndrome efficacy. This study aimed to screen biomarkers related to the efficacy of TCM syndrome using metabolomics. We recruited AECOPD patients with phlegm-heat congesting lung (PH)/phlegm-damp amassing lung (PD) syndrome and treated them with Chinese herbal medicine (Qingre Huatan or Zaoshi Huatan granules) in addition to conventional medicine for 7 days. Data on clinical symptoms and sign scores, modified British Medical Research Council (mMRC), COPD assessment test (CAT), and inflammation indicators, including white blood cell (WBC) count, percentage of neutrophil count (NEU%), and C-reactive protein (CRP), were collected before and after treatment to evaluate the therapeutic effect. Serum samples were collected before and after treatment for metabolomic analysis to screen differential metabolites. A total of 69 patients with AECOPD were enrolled, including 41 and 28 patients in the PH and PD groups, respectively. The clinical symptoms and sign scores, CAT, mMRC, NEU%, and CRP levels after treatment were lower than those before treatment in both groups ( < 0.05). Serum metabolomics analysis showed that there were 13 differential metabolites in the PH group and 16 differential metabolites in the PD group before and after treatment ( < 0.05, variable importance projection (VIP) ≥ 1.00). In the PH group, lysophosphatidylcholine (LPC) (16:0), LPC (17:1), LPC (18:3), LPC (18:2), and LPC (17:0) negatively correlated with clinical symptoms and sign scores ( < 0.05); LPC (16:0), LPC (17:1), LPC (16:1), and LPC (17:0) negatively correlated with WBC ( < 0.05) and NEU% ( < 0.05); and LPC (16:0) negatively correlated with CRP levels. In the PD group, L-phenylalanine positively correlated with CRP levels ( < 0.05), and 2-methylbutyroylcarnitine positively correlated with clinical symptoms and sign ( < 0.05) and CAT scores ( < 0.05). DL-carnitine positively correlated with clinical symptoms and sign scores ( < 0.05). Serum metabolites may be potential indicators to objectively evaluate the efficacy of TCM syndromes; however, further large controlled trials are required to verify these findings.
PubMed: 38344179
DOI: 10.3389/fphar.2024.1302950 -
International Journal of General... 2024This study was to investigate the mechanism of action and clinical efficacy of fire-needle therapy in improving neurological function in patients with acute cerebral...
OBJECTIVE
This study was to investigate the mechanism of action and clinical efficacy of fire-needle therapy in improving neurological function in patients with acute cerebral infarction (identified as a wind-phlegm-blood stasis syndrome in traditional Chinese medicine).
METHODS
We included patients diagnosed with acute cerebral infarction (wind-phlegm-blood stasis syndrome) admitted to the Encephalopathy and Acupuncture Center of the Second Affiliated Hospital of Tianjin University of Chinese Medicine. We randomly allocated them into the treatment and control groups, with 45 cases in each group. Acupuncture treatments that focused on regulating the mind and dredging the collaterals were used in the control group, while the treatment group additionally received fire-needle therapy. Our indicators included the National Institutes of Health Stroke Scale (NIHSS) scores, the Fugl-Meyer Assessment (FMA) scale, peripheral blood tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), hypersensitivity C-reactive protein (hs-CRP), and intestinal metabolites short-chain fatty acids (SCFAs). We measured these indicators before treatment and 14 days after treatment.
RESULTS
The post-treatment NIHSS scores of the two groups were significantly reduced ( < 0.05), and the treatment group showed a more significant decline in the score when compared to the control group ( < 0.05). The treatment group showing significant improvement in the domains of reflex activity, mobility, cooperative movement, and finger movement ( < 0.05). Both groups showed a significant decrease in the IL-17 and hs-CRP levels ( < 0.05), with the treatment group demonstrating a significant declining trend when compared to the control group ( < 0.05). The levels of acetic acid, propionic acid, butyric acid, and valeric acid all increased significantly in the two groups ( < 0.05), with acetic acid and butyric acid increasing significantly in the treatment group when compared to the control group ( < 0.05). Clinical efficacy rate: 78.6% of patients in the treatment group had an excellent rate, whereas it was 30.0% in the control group, and the difference was statistically significant ( < 0.001).
CONCLUSION
Fire-needle therapy was effective in upregulating the SCFA content in patients with acute cerebral infarction (wind-phlegm-blood stasis syndrome), inhibiting the level of the inflammatory response, and improving the recovery of neurological functions.
CLINICAL REGISTRATION NUMBER
Registration website link: https://www.chictr.org.cn. Registration date: 2022/9/27. Registration number: ChiCTR2200064122.
PubMed: 38333018
DOI: 10.2147/IJGM.S450027 -
Heliyon Feb 2024Few studies have focused on the relationship between the traditional Chinese medicine constitution (TCMC) and metabolic dysfunction-associated fatty liver disease...
BACKGROUND
Few studies have focused on the relationship between the traditional Chinese medicine constitution (TCMC) and metabolic dysfunction-associated fatty liver disease (MAFLD) in older populations. We sought to investigate the distribution of MAFLD and the TCMC in older people, and provide a theoretical basis for TCMC-based management of MAFLD in this population.
METHODS
A cross-sectional study was conducted among older (≥65 years) individuals in Zhongshan, China. Information on common sociodemographic characteristics, medical history, anthropometric measurements, and the TCMC was collected. The chi-square test, multivariable logistic regression analysis, subgroup analysis, and inverse probability weighting of the propensity score were used to explore the relationship between MAFLD and the TCMC.
RESULTS
Of 7085 participants, 1408 (19.9 %) had MAFLD. The three most common TCMC types in MAFLD patients were "phlegm-dampness", "gentleness", and "yin-deficiency". After adjustment for gender, age, tobacco smoking, alcohol consumption, body mass index, abnormal waist-to-hip ratio, hypertension, diabetes mellitus, and dyslipidemia, MAFLD was positively associated with the phlegm-dampness constitution (PDC) (OR (95 % CI) = 1.776 (1.496-2.108), < 0.001), and negatively correlated with the qi-depression constitution (0.643 (0.481-0.860), 0.003). A stronger correlation between the PDC and MAFLD was observed in men compared with women (OR = 2.04 (95%CI = 1.47-2.84) . 1.70 (95%CI = 1.39-2.08), = 0.003) as well as between people who smoked tobacco and non-tobacco-smoking individuals (2.11 (1.39-3.21) . 1.75 (1.45-2.12), 0.006).
CONCLUSIONS
A positive relationship was observed between MAFLD and the PDC in older people living in Zhongshan. Early detection and treatment of the PDC (especially in men and smokers) could prevent the occurrence and development of MAFLD.
PubMed: 38317874
DOI: 10.1016/j.heliyon.2024.e24905 -
Medicine Feb 2024Castleman disease (CD) was first included in the CSCO lymphoma diagnosis and treatment guidelines in 2021. Its diagnosis relies on lymph node pathological examination....
RATIONALE
Castleman disease (CD) was first included in the CSCO lymphoma diagnosis and treatment guidelines in 2021. Its diagnosis relies on lymph node pathological examination. Observation, surgical resection of the lesion, radiotherapy, chemotherapy, and medical therapy (e.g., rituximab, siltuximab, steroids) can be used. Due to the traumatic, incurable, and recurrent nature of surgical treatment, drug therapy has many side effects and is expensive. Exploring effective traditional Chinese medicine (TCM) comprehensive treatment methods for this disease is important and necessary.
PATIENT CONCERNS
The main symptom was recurrent lymphadenopathy, which had been surgically removed 5 times in the past. This time, lymph node enlargement occurred again, and the local hospital recommended surgical resection again. The patient could not tolerate another surgical treatment. Other targeted treatments are not available due to financial constraints.
DIAGNOSES
The case was diagnosed as CD by pathological examination, which is an important basis for the diagnosis of this disease.
INTERVENTIONS
The patient was treated with surgery in the early stage several times, later came to our hospital for the trinity of TCM integrated treatment program, which combines oral TCM with external application of TCM and intravenous drip of TCM as a syndrome of positive deficiency and phlegm-toxin internalization, and the therapeutic principle.
OUTCOMES
After nearly 3 years of comprehensive treatment with TCM, the enlarged lymph nodes could not be touched, and there was no fatigue, fever, or weight loss. During this period, the patient did not undergo surgery, chemotherapy and other western medicine treatment, and lived a normal life. It not only met the patient's expectation but also confirmed that the TCM treatment was indeed effective.
LESSONS
This case report confirms that TCM is safe and effective in the treatment of CD, which is worthy of promotion. In clinical practice, the individualized treatment for the patient, the duration of treatment, and the different disease states also affect the treatment outcome.
Topics: Humans; Castleman Disease; Medicine, Chinese Traditional; Treatment Outcome; Lymphadenopathy
PubMed: 38306555
DOI: 10.1097/MD.0000000000037110