简介：Whyundertakeclinicaltrials?Beforeanewtreatmentcanbewidelyusedonpatients,itmustbeproventobesafeandeffective.Clinicaltrialsareumeansofconductingexperimentsonhumanstoyieldreliableresults.Forthisreason,theyareinthebestinterestsofpatients,clinicians,pharmaceuticalcompaniesandsocietyasawbele.

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简介：Mostcytotoxicchemotherapydrugsexerttheireffectbyinhibitingoneormoreoftheprocessesinvolvedincelldivision.Itappearsthatthefateofcellsdamagedbychemotherapyistodieprimarilybyinductionofapoptosis(prograrmnedcelldeath).Chemotherapyisgenerallyusedtotreatcanceratanadvancedorearlystage.

简介：ＣＬＩＮＩＣＡＬＲＥＰＯＲＴＯＦＭＯＤＩＦＩＥＤＭＡＺＥＰＲＯＣＥＤＵＲＥＣＬＩＮＩＣＡＬＲＥＰＯＲＴＯＦＭＯＤＩＦＩＥＤＭＡＺＥＰＲＯＣＥＤＵＲＥＺｈｕＪｉａＧｕａｎｇ；ＨｅＺｈｏｎｇＬｉａｎｇ；ＬｕｏＷｅｉ；ＤｏｎｇＡｉＱｉａｎｇ；ＸｕＳｈｉＷｅ...

简介：AbstractAntiphospholipid syndrome (APS) is a thromboinflammatory disease with a variety of clinical phenotypes. Primary thrombosis prophylaxis should take an individualized risk stratification approach. Moderate-intensity vitamin K antagonist such as warfarin remains the primary strategy for secondary thrombosis prophylaxis among APS patients, especially for patients with predominantly venous disease. For now, direct oral anti-coagulants should be avoided in most APS patients, especially those with history of arterial manifestations. Obstetric APS management should be tailored based on an individual patient’s antiphospholipid antibody profile, and obstetric and thrombotic history. Pharmacological agents beyond anticoagulants may be considered for the management of microthrombotic and nonthrombotic manifestations of APS, although more data are needed. A relatively recent discovery in the area of APS pathogenesis is the implication of neutrophil extracellular traps in thrombin generation and initiation of inflammatory cascades. APS is a complex thromboinflammatory disease with a broad clinical spectrum. Personalized therapy according to an individual’s unique thrombosis and obstetric risk should be advocated.

简介：PurposeToconfirmtheeffectsofacupuncture,andChinesemedicinesincontrollingthewithdrawalsymptomsfromtheopium-likedrugs.Method96heroin-dependentsubjectsweredividedintofourgroups,whichweretreatedrespectivelybywesternmedicine(Agroup),acupuncture(Bgroup),Chineseherbs(Cgroup),andacupuncture&Chineseherbs(Dgroup).Before,duringandaftertreatment,theconcentrationofserumtestosteroneandprolactin,andimmunefunctions(serumCD3+、CD4+、CD8+andCD4+/CD8+)weretested.ResultsAftertreatment,theconcentrationofserumtestosteroneinAandBgroupwerehigherthanbeforeandduringtreatment,andinCandDgroup,duringtreatmentwerehigher.Inthefourgroups,theconcentrationofserumprolactinbeforetreatmentwasthehighest.ThelevelsofCD3+、CD4+、CD8+andCD4+/CD8+werelowestbeforetreatmentandhighestaftertreatment.ConclusionAcupunctureandChinesemedicineseffectiveinrelievingspasmandpaincancontroltheopium-likedrugwithdrawalsymptomstodifferentdegrees,especiallyacupuncture.However,acupuncturecannoteasethewithdrawalsymptomscompletely.AcupuncturedoesnotstrikinglycooperatewiththeChinesemedicineseffectiveinrelievingspasmandpain(includingM-receptorantagonists).Indetoxification,theJiajipointsaretheprimaryonesandsymptom-basedpointsthesecondaryones.

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简介：<正>Maintainingleannessandaphysicallyactivelifestyleduringadulthoodreducessystemicinflammation,anunderlyingfactorinmultiplechronicdiseases.Theanti-inflammatoryinfluenceofnear-dailyphysicalactivityinloweringC-reactiveprotein,totalbloodleukocytes,interleukin-6,andotherinflammatorycytokinesmayplayakeyroleinloweringriskofcardiovasculardisease,certaintypesofcancer,type2diabetes,sarcopenia,anddementia.Moderateexercisetrainingcausesfavorableperturbationsinimmunityandareductioninincidenceofupperrespiratorytractinfection(URTI).Duringeachboutofmoderateexercise,anenhancedrecirculationofimmunoglobulins,neutrophils,andnaturalkillercellsoccursthatpersistsforupto3-hpost-exercise.Thisexercise-inducedsurgeinimmunecellsfromtheinnateimmunesystemistransientbutimprovesoverallsurveillanceagainstpathogens.Asmoderateexercisecontinuesonanear-dailybasisfor12—15weeks,thenumberofsymptomsdayswithURTIisdecreased25%—50%comparedtorandomizedsedentarycontrols.EpidemiologicandanimalstudiessupportthisinverserelationshipbetweenURTIriskandincreasedphysicalactivity.

简介：AbstractAntiviral therapy with antiviral agents is a very important component of treatment for the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is important to clarify how to evaluate efficacy and safety of antiviral agents in treatment of COVID-19 during the pandemic of this disease. We need to answer the following questions: do we still need to use rigorously designed randomized controlled clinical trials (RCTs)? Or, will it be enough if we use loosened criteria, observational studies or even retrospective case series and case reports? The answer is "No, we still need to use the strictly designed preferably blinded multicenter RCTs to evaluate the antiviral agents." In this article, we reviewed almost all the RCT reports on monotherapies and combined therapies with antiviral agents for COVID-19, and found that among the reports on monotherapies, only remdesivir, and among combined antiviral agents, only the combined regimen with interferon-β1b, lopinavir-ritonavir and ribavirin were effective and safe based on evidences from RCTs. The results of five RCTs for chloroquine or hydroxychloroquine consistently showed that they were ineffective and unsafe in the treatment of COVID-19, especially at larger doses. Many aspects in the design of the clinical trials may be related to success or failure of a trial and the relevant factors need to be analyzed, discussed and emphasized from the specific requirements and considerations of antiviral therapies. We hope such discussions be of certain use in designing clinical trials for pediatric antiviral therapies.

简介：SyphilisisafocalpointinpreventionandcontrolofSTDs.Syplhilisnowpresentsdifferentepidemiologicalandclinicalfeaturestothepast,andthesyphilisepidemicisnotseriousaspreviously-latesyphilisandcongenitalsyphilisbeingrelativelyrareinthewholecountry.Theclinicalfeaturesofskinlesionsinprimaryandsecondarysyphilishavenotchangedsubstantiallybuttheproportionofvarioustypesoflesionsisdifferenttothepast.AssyphilishasnotbeenpresentinChinaformorethan15years,someyoungmedicalworkershavenoexperienceinthediagnosisandtreatmentofthisdisease.Theyoftenmisdiagnoseormissdiagnosis.Thesemedicalworkersneedbetterknowledgeandtreatmentskills.Inordertocontrolsyphilisassoonaspossiblethroughearlydiagnosisandtreatment,thisarticlegivesanintroductiontothisissueforcolleaguesbywayofacomparisonofthepaststatusandthepresent.

简介：AbstractDesmoplakin (DSP), encoded by the DSP gene, is the main desmosome component and is abundant in the myocardial tissue. There are three DSP isoforms that assume the role of supporting structural stability through intercellular adhesion. It has been found that DSP regulates the transcription of adipogenic and fibrogenic genes, and maintains appropriate electrical conductivity by regulating gap junctions and ion channels. DSP is essential for normal myocardial development and the maintenance of its structural functions. Studies have suggested that DSP gene mutations are associated with a variety of hereditary cardiomyopathy, such as arrhythmia cardiomyopathy, dilated cardiomyopathy (DCM), left ventricular noncompaction, and is also closely associated with the Carvajal syndrome, Naxos disease, and erythro-keratodermia-cardiomyopathy syndrome with skin and heart damage. The structure and function of DSP, as well as the clinical manifestations of DSP-related cardiomyopathy were reviewed in this article.

简介：Statusasthmaticusisaformofbronchialasthmaattack.Thesevereonecancausefailureofrespiratoryfunction.Toalleviatethesymptomsquickly,routinetherapycouldcombinedwithcompoundsalviamiltrorrhizainjectionandvitaminK3.Comparedthe36patientsintwogroupsandfoundtheeffectswereobvious.Intravenousdripwithcompoundsalviamihiorrhizainjectioncandilatethevessel,improvethemicrocirculationandpulmonarycirculation,correctoxygendeficitandquickelydispelsputum,thusit'sconductivetotheeliminationofconvulsionofairway.VitaminK3canpromotethesynthesisandconversionofcyclicAMPandalleviatetheinflammatoryexudation,thusimproveandstrengthenthefunctionofventiliation.

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简介：AcupointShousanli(LI10)isalsocalledShangsanli,Guixie,locatesattheradialaspectofthebackoftheforearm,2cunbelowQuchi(LI11),onthelinejoiningYangxi(LI5)andQuchi(LI11).Shousanli(LI10)wasfirstlyrecordedinZhenJiuJiaYiJing(A-BCanonofAcupunctureand

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简介：目的：观察针刺治疗失眠症的临床疗效。方法：以调理督脉、健脑安神为治则，对41例失眠症患者采用针刺治疗，比较治疗前、后的匹兹堡睡眠质量指数（PSQI）、九十项症状自评表（SCL-90）评分。结果：PSQI、SCL-90各成分及总分治疗前后均有统计学差异（P〈0．01）。SCL-90总积分治疗前后的差值与PSQI总分治疗前后的差值之间的相关系数为0．34（P〈0．05）。结论：调督健脑针刺法能显著改善失眠症患者的睡眠质量及心身症状，且心身症状的改善程度与睡眠质量的改善程度呈正相关。