RÉSUMÉ
Chronic bronchitis (CB) is a common respiratory system disease that is classified as a lung disease in traditional Chinese medicine (TCM) and is closely related to lung dysfunction. Lung Yang is the Yang Qi of the lungs,which drives the physiological activities within the lungs. It has physiological functions such as warming the lung system,regulating lung fluid,and dispersing the protective Yang. It can be distributed on the surface of the airway's Yin skin through sweat pores in the form of airflow and fluid,playing a protective and nourishing role. If the protective Yang fails to guard the Yin skin or if the lung fluid cannot nourish the Yin skin,the structural integrity of the airway's Yin skin may be compromised. This may weaken lung Yang's functions, such as clearing phlegm turbidity,dispersing lung fluid,and resisting external pathogens. Consequently, the retention of phlegm turbidity,insufficient nourishment of the Yin skin,and invasion by external pathogens all damage the lung Yang,burn the lung fluid,and exacerbate the pathological state of Yin skin unprotected,forming a vicious cycle that ultimately results in lung Yang asthenia and then the onset of CB. Based on the intrinsic connection between "Yin skin unprotected" and "lung Yang asthenia",this paper interprets the etiology and pathogenesis of CB. It proposes that "Yin skin unprotected" in the airway is the basic cause of CB and "lung Yang asthenia" caused by "Yin skin unprotected" is the core pathogenesis of CB. By integrating micro differentiation indicators with macro differentiation syndromes, the study explores its modern biological basis. Guided by the theory of "warming the lung Yang and protecting the Yin skin" and based on modern pharmacology research,this study further explores the scientific connotation of single TCM and compound formulations for treating TCM by warming the lung Yang and protecting the Yin skin. Furthermore, it proposes methods for dispelling pathogenic factors and protecting the Yin skin during the acute exacerbation phase,as well as nourishing and warming lung Yang during the remission phase,in order to provide new ideas for the early prevention and treatment of TCM.
RÉSUMÉ
Objective:To analyze the application value of metagenomic next-generation sequencing (mNGS) in the detection of pathogenic bacteria in brain abscesses.Methods:The data of patients with brain abscess in Tianjin Huanhu Hospital from January 2019 to December 2021 were retrospectively analyzed. All patients underwent stereotaxic abscess puncture and drainage. According to the different methods of pathogen detection, they were divided into bacterial culture group (bacterial culture only) and mNGS group (bacterial culture with mNGS). The clinical symptoms, abscess site, bacterial culture and mNGS results, antibiotic application protocol and prognosis of the patients were analyzed. The bacterial detection results of the two groups were analyzed, and the antibiotic application and prognosis were compared. χ 2 test, exact probability method and Mann Whitney test were used to compare the difference between the two groups. Results:A total of 43 patients with brain abscess were enrolled, including 21 cases in bacterial culture group and 22 cases in mNGS group. The positive rate of bacteria culture group was 42.9% (9/21), the positive rate of bacteria culture group was 45.5% (10/22), and the positive rate of mNGS detection was 100% (22/22). Only 3 cases in the bacterial culture group could have a clear bacterial source, while 17 cases in the mNGS group could have a clear bacterial source according to the bacterial results, showing a significant statistical difference between the two groups (χ 2=19.69, P<0.001). The return time of bacterial culture was 7.0 (4.0,7.0) days, and the average return time of mNGS was 1.5 (1.5,1.5) days, the difference of bacterial return time between the two groups was statistically significant ( Z=0.00, P<0.001). The cost of antibiotic use in bacterial culture group was 24.00 (5.60,31.00) thousands yuan, and the cost of antibiotic use in mNGS group was 12.00 (2.10, 20.00) thousands yuan, and there was significant statistical difference between them ( Z=5.22, P=0.026). Conclusions:MNGS can quickly and accurately identify the types and sources of brain abscess pathogens, guide the clinical application of antibiotics more targeted, reduce the cost of antibiotic use, and is an effective method for the detection of brain abscess pathogenic bacteria.
RÉSUMÉ
Objective:To investigate the clinical manifestations, pathogenesis,diagnosis and treatment of negative pressure hydrocephalus (NPH).Methods:A retrospective analysis was performed on the 5 patients with NPH admitted to the Department of Neurosurgery, Tianjin Huanhu Hospital from January 2019 to December 2021. All of the patients underwent lumbar puncture and ventricular puncture to test the pressure. Three patients underwent endoscopic third ventriculostomy (ETV), the outcome of the patients was observed.Results:The pressure of subarachnoid was not equal to intraventricular, and the pressure of intraventricular was negative. Cisternography showed cerebrospinal fluid circulation obstruction in all 5 cases. The symptoms of 1 patient were improved after external negative pressure drainage, 3 patients were improved after further ETV and 1 patient had pulmonary infection without further surgical treatment.Conclusion:With the obstruction of cerebrospinal fluid circulation, the pressure of lateral ventricle and subarachnoid is different, when the pressure of brain or subarachnoid drop, the ventricular expansion under the effect of pressure gradient, intraventricular pressure drop even for the negative pressure. CT cisternography provides strong evidence for the diagnosis of this disease. External ventricular drainage with negative pressure and ETV are effective treatment methods.
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Objective To investigate the clinical significance of HCV core antigen (HCV-cAg )in hepatitis C screening. Methods From October 2014 to October 2015 ,a total of 8000 serum samples were collected from the outpatient and inpatient. HCV-cAg and hepatitis C antibody (HCV-Ab) were detected by using ELISA.The positive samples of HCV-cAg or HCV-Ab were performed the confirmative diagnostic detection by PCR.Results Among 8000 serum samples ,82 positive samples were screened out ,in which 73 cases were HCV-RNA positive by elementary screening with the standard of HCV-cAg or HCV-Ab positive ,a-mong which 72 were HCV-RNA positive and and 9 cases were HCV-RNA negative by HCV-RANA confirmation.The sensitivity and specificity of HCV-cAg were 45.83% and 99.98% ,sensitivity and specificity of HCV-Ab were 94.44% and 99.90% ,which of HCV-cAg and HCV-Ab combined detection were 100.00% and 98.86% respectively.Conclusion HCV-cAg and HCV-Ab play complementary role in HCV screening.Their combined detecting contributes to increase the screening rate of HCV.