Seeing Your Stories: Visualization for Narrative Medicine.

Importance: Narrative medicine (NM), in which patient stories play a crucial role in their diagnosis and treatment, can potentially support a more holistic approach to patient care than traditional scientific ones. However, there are some challenges in the implementation of narrative medicine, for example, differences in understanding illnesses between physicians and patients and physicians' increased workloads and overloaded schedules. This paper first presents a review to explore previous visualization research for narrative medicine to bridge the gap between visualization researchers and narrative medicine experts and explore further visualization opportunities. Highlights: The review is conducted from 2 perspectives: (a) the contexts and domains in which visualization has been explored for narrative medicine and (b) the forms and solutions applied in these studies. Four applied domains are defined, including understanding patients from narrative records, medical communication, medical conversation training in education, and psychotherapy and emotional wellness enhancement. Conclusions: A future work framework illustrates some opportunities for future research, including groups of specific directions and future points for the 4 domains and 3 technological exploration opportunities (combination of narrative and medical data visualization, task-audience-based visual storytelling, and user-centered interactive visualization). Specifically, 3 directions of future work in medical communication (asynchronous online physician-patient communication, synchronous face-to-face medical conversation, and medical knowledge dissemination) were concluded.

[Research progress in mechanism of puerarin in treating vascular dementia].

Vascular dementia(VD) is a condition of cognitive impairment due to acute and chronic cerebral hypoperfusion. The available therapies for VD mainly focus on mitigating cerebral ischemia, improving cognitive function, and controlling mental behavior. Achievements have been made in the basic and clinical research on the treatment of VD with traditional Chinese medicine(TCM) active components, including Ginkgo leaf extract, puerarin, epimedium, tanshinone, and ginsenoside. Most of these components have anti-inflammatory, anti-apoptotic, anti-oxidant, and neuroprotective effects, and puerarin demonstrates excellent performance in mitigating cholinergic nervous system disorders and improving synaptic plasticity. Puerarin, ginkgetin, and epimedium are all flavonoids, while tanshinone is a diterpenoid. Puerariae Lobatae Radix, pungent in nature, can induce clear Yang to reach the cerebral orifices and has the wind medicine functions of ascending, dispersing, moving, and scurrying. Puerariae Lobatae Radix entering collaterals will dredge blood vessels to promote blood flow, and that entering the sweat pore will open the mind, which is in line with the TCM pathogenesis characteristics of VD. This study reviews the progress in the mechanism of puerarin, the main active component of Puerariae Lobatae Radix, in treating VD. Puerarin can ameliorate cholinergic nervous system disorders, reduce excitotoxicity, anti-inflammation, inhibit apoptosis, alleviate oxidative stress injury, enhance synaptic plasticity, up-regulate neuroprotective factor expression, promote cerebral circulation metabolism, and mitigate Aß injury. The pathways of action include activating nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE), vascular endothelial growth factor(VEGF), extracellular regulated protein kinases(ERK), phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt), Janus-activating kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3), AMP-activated protein kinase(AMPK), as well as inhibiting the tumor necrosis factor α(TNF-α), transient receptor potential melastatin 2(TRPM2)/N-methyl-D-aspartate receptor(NMDAR), p38 mitogen-activated protein kinase(p38 MAPK), Toll-like receptor 4(TLR4)/nuclear factor-kappaB(NF-κB), early growth response 1(Egr-1), and matrix metalloproteinase 9(MMP-9). By reviewing the papers about the treatment of VD by puerarin published by CNKI, Wanfang, VIP, PubMed, and Web of Science in the last 10 years, this study aims to support the treatment and drug development for VD.

Medication Rules in Herbal Medicine for Mild Cognitive Impairment: A Network Pharmacology and Data Mining Study.

Background: Although traditional Chinese medicine (TCM) has good efficacy in the treatment of mild cognitive impairment (MCI), especially memory improvement and safety, its substance basis and intervention mechanism are particularly complex and unknown. Therefore, based on network pharmacology and data mining, this study aims to explore the rules, active ingredients and mechanism of TCM in the treatment of MCI. Methods: By searching the GeneCard, OMIM, DisGeNET and DrugBank databases, we obtained the critical targets associated with MCI. We matched the components and herbs corresponding to the important targets in the TCMSP platform. Using Cytoscape 3.7.2 software, we constructed a target-component-herb network and conducted a network topology analysis to obtain the core components and herbs. Molecular docking was used to preliminarily analyze and predict the binding activities and main binding combinations of the core targets and components. Based on the analysis of the properties, flavor and meridian distribution of herbs, the rules of herbal therapy for MCI were summarized. Results: Twenty-eight critical targets were obtained after the screening. Using the TCMSP platform, 492 components were obtained. After standardization, we obtained 387 herbs. Based on the target-composition-herb network analysis, the core targets were ADRB2, ADRA1B, DPP4, ACHE and ADRA1D. According to the screening, the core ingredients were beta-sitosterol, quercetin, kaempferol, stigmasterol and luteolin. The core herbs were matched to Danshen, Yanhusuo, Gancao, Gouteng and Jiangxiang. It was found that the herbs were mainly warm in nature, pungent in taste and liver and lung in meridian. The molecular docking results showed that most core components exhibited strong binding activity to the target combination regardless of the in or out of network combination. Conclusion: The results of this study indicate that herbs have great potential in the treatment of MCI. This study provides a reference and basis for clinical application, experimental research and new drug development of herbal therapy for MCI.

[Effect of transcutaneous electrical acupoint stimulation on recovery of gastrointestinal function after cesarean section].

OBJECTIVE: To explore the effect on the recovery of gastrointestinal function after cesarean section treated with transcutaneous electrical acupoint stimulation at Zusanli (ST 36) on the basis of routine treatment. METHODS: A total of 110 primiparas after cesarean section were randomized into an observation group and a control group, 55 cases in each one. The conventional treatment was applied in the two groups, after operation, transcutaneous electrical acupoint stimulation at Zusanli (ST 36) was used immediately in the observation group, the skin electrode of disposable anti-magnetic buckle was attached to Zusanli (ST 36) and the corresponding part of the inner lower leg, with disperse-dense wave, 30 Hz/60 Hz and 15-20 mA. The treatment was given for 30 min every time, once every 8 h, until the end of the first bowel movement. The recovery of gastrointestinal function after cesarean section (the restoring time of borborygmus, the time of first anal exsufflation and the first defecation time), the time of secretion of foremilk, complications (abdominal distension, abdominal pain, nausea etc.), hospital stays after operation and the satisfaction of primiparas after bowel movement were compared between the two groups. RESULTS: The observation group was superior to the control group in the restoring time of borborygmus, the time of first anal exsufflation, the first defecation time and the time of secretion of foremilk (P<0.01, P<0.05). In the observation group, the incidence of postoperative complications such as abdominal pain, abdominal distension and nausea was 3.6% (2/55), which was lower than 16.4% (9/55) in the control group (P<0.05). Compared with the control group, the observation group had shorter hospital stays (P<0.01). The satisfaction of effect was 89.1% (49/55) in the observation group, which was superior to 72.7% (40/55) in the control group (P<0.05). CONCLUSION: Transcutaneous electrical acupoint stimulation at Zusanli (ST 36) can speed up the recovery of gastrointestinal function after cesarean section, reduce complications such as abdominal pain, abdominal distension, shorten hospital stays, promote patient nutrition intake and lactation, and improve comfort level and satisfaction of primiparas.

Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials.

BACKGROUND: Plantar heel pain can be managed with dry needling of myofascial trigger points (MTrPs); however, whether MTrP needling is effective remains controversial. Thus, we conducted this meta-analysis to evaluate the effect of MTrP needling in patients with plantar heel pain. MATERIALS AND METHODS: PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, People's Republic of China), and CNKI (National Knowledge Infrastructure, People's Republic of China) databases were systematically reviewed for randomized controlled trials (RCTs) that assessed the effects of MTrP needling. Pooled weighted mean difference (WMD) with 95% CIs were calculated for change in visual analog scale (VAS) score, and pooled risk ratio (RR) with 95% CIs were calculated for success rate for pain and incidence of adverse events. A fixed-effects model or random-effects model was used to pool the estimates, depending on the heterogeneity among the included studies. RESULTS: Extensive literature search yielded 1,941 articles, of which only seven RCTs met the inclusion criteria and were included in this meta-analysis. The pooled results showed that MTrP needling significantly reduced the VAS score (WMD =-15.50, 95% CI: -19.48, -11.53; P<0.001) compared with control, but it had a similar success rate for pain with control (risk ratio [RR] =1.15, 95% CI: 0.87, 1.51; P=0.320). Moreover, MTrP needling was associated with a similar incidence of adverse events with control (RR =1.89, 95% CI: 0.38, 9.39; P=0.438). CONCLUSION: MTrP needling effectively reduced the heel pain due to plantar fasciitis. However, considering the potential limitations in this study, more large-scale, adequately powered, good-quality placebo-controlled trials are needed to provide more trustworthy evidence in this area.

Ecological stoichiometric characteristics and element reserves of three stands in a closed forest on the Chinese loess plateau.

Populus davidiana, Leuchtenbergia principis, and Pinus tabulaeformis are important greening tree species with a cosmopolitan distribution. However, the stoichiometric characteristics and element reserves of stands of these three species are not particularly clear. In this study, we conducted a plot-level investigation of forest stands of these species in the loess area; these have been closed forest stands more than 28 years. Trees were sampled from an area of 50 m × 20 m (in 6, 8, and 9 plots, respectively), which was sufficient for shrub (2 m × 2 m), herbal species, and litter (1 m × 1 m) investigations. The C, N, and P concentrations and the C:N:P stoichiometry in five different soil layers (0-10 cm, 10-20 cm, 20-30 cm, 30-50 cm, and 50-100 cm) and in the leaves, stems, branches, and roots of the plants were examined. The soil element concentrations and density were affected by soil depth. The element content had a significantly negative correlation with soil depth, and element density differed significantly among the soil layers. A particular element in a particular organ differed significantly between the forest stands, and the same element in different organs of the same stand was also significantly different. The C, N, and P element reserves in the soil were considerably higher than in the plants. Our results indicate that there are different stoichiometric characteristics and element reserves of the three stands in a closed forest on the Chinese loess plateau, which may provide a reference when we develop and optimize the structure of forest stands.

[Research of bimingan granule on dendritic cell in allergic rhinitis mice].

OBJECTIVE: To investigate the mechanism. METHOD: We isolate the mouse bone marrow cells and cultured with rGM-CSF and rIL-4 to stimulate bone marrow cells to transfer to immature dendritic cells. And then the immature dendritic cells were costimulated with ILPS and different concentrations of Bimingan Granule. RESULT: MHC II, CD80, CD86 were detected by flow cytometer and TNF-alpha, IL-1beta, IL-6 and IL-10 were quantified by ELISA. CONCLUSION: Our results showed that Bimingan Granule may significantly inhibit the differentiation of immature dendritic cells to mature dendritic cells.

Production and in vivo antioxidant activity of Zn, Ge, Se-enriched mycelia by Cordyceps sinensis SU-01.

Cordyceps sinensis, a traditionally edible and medicinal fungus in China, cannot be artificially solid-cultured. Zinc (Zn), germanium (Ge), and selenium (Se) are the essential trace elements for human body. In this work, C. sinensis SU-01 was cultivated in liquid medium simultaneously containing Zn, Ge, and Se. The bioactive ingredients and in vivo antioxidant activities of Zn, Ge, Se-enriched mycelia (ZGSM) of C. sinensis SU-01 were investigated. Under the determined conditions, the Zn, Ge, and Se contents of ZGSM were 2543.16 ± 158.92, 1873.85 ± 81.82, and 1260.16 ± 107.12 µg/g, respectively. The optimal concentrations of Zn, Ge, and Se had a positive effect on biosynthesis of protein, polysaccharide, cordycepic acid, and amino acids. The activities of glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) of mice blood were 3.72 ± 0.15 and 28.74 ± 2.53 % higher than that of control, respectively, and the content of malondialdehyde (MDA) was 41.01 ± 3.66 % lower than that of control.

Pre-treating algae-laden raw water by silver carp during Microcystis-dominated and non-Microcystis-dominated periods.

Performance of pre-treating algae-laden raw water by silver carp during a non-Microcystis-dominated period (period I) and a Microcystis-dominated period (period II) was investigated in terms of algae cell concentration, total phosphorus content, chlorophyll a and phytoplankton species structure. During period I the ineffective filter-feeding for small green algae resulted in the increase of small single algae, which led to the negative removal of chlorophyll a, and when the biomass was higher, the negative was more significant. However, due to the effective filter-feeding of silver carp for Microcystis flos-aquae, the average removal efficiency exceeded 50% at all stocking biomass levels (20-120 g/m(3)) used in experiments during period II. Total phosphorus removal efficiencies could exceed 50% at silver carp biomass stocking levels of 60-80 g/m(3) during both period I and period II. The experimental results indicated that silver carp stocking contributed to the removal of colony-forming cyanobacteria, but led to the increase of single-cell algae (mainly green algae and diatoms) during both period I and period II. The initial phytoplankton community structure and the control of nutrient level were important factors in the choice of silver carp stocking biomass when used to purify algae-loaded water.

Extensively infiltrating colon adenocarcinoma similar to Crohn's disease: a case report.

A 38-year-old Chinese man presenting with chronic diarrhea and secondary incomplete intestinal obstruction was hospitalized in April 2010. Electronic colonoscopy and barium enema examination initially showed longitudinal scar-like strictures and cobblestone appearance in the colon that was similar to those in Crohn's disease. After subtotal colectomy and partial intestinal resection, the pathological examination indicated colon adenocarcinoma that diffusely infiltrated along the colon longitudinal axis rather than the initial diagnosis of Crohn's disease. Pathological examination revealed colon adenocarcinoma with excessive desmoplastic reaction and infiltrating cancer cells along the colon longitudinal axis that may have accounted for the morphological similarities to Crohn's disease in this case. The findings in the present case suggest that colon carcinoma should be considered when Crohn's disease-like findings are encountered, not only in individuals with concurrent cancer in other sites, but also in patients with a long history of gastrointestinal symptoms such as chronic diarrhea or abdominal pain.

[Effects on function rehabilitation of vocal cord after vocal cord polyps surgery treated with acupuncture at Sheng's four points of throat].

OBJECTIVE: To observe the effects on function rehabilitation of vocal cord after vocal cord polyps surgery treated with acupuncture at Sheng's Four Points of Throat. METHODS: Sixty cases were randomly divided into a combined therapy group of Four Points of Throat and medication (group 1, 30 cases) and a medication group (group 2, 30 cases). In group 1 Four Points of Throat were punctured and routine medication was applied; in group 2, only routine medication was applied. The scores of symptom-sign and status of voice were observed and analyzed before and after treatment in two groups. RESULTS: At 4th day after the surgery, the improvement of the symptom-sign scores in group 1 was more significant than that in group 2 (P < 0.05); and the voice analysis status in group 1 was superior to that in group 2 (all P < 0.05). The total effective rate was 83.3% (25/30) in group 1, which was superior to that of 60.0% (18/30) in group 2 (P < 0.05). CONCLUSION: The effect on function rehabilitation of vocal cord after vocal cord polyps surgery treated with the combined therapy group of Four Points of Throat and routine medication is favorable, superior to that with routine medication therapy.

[SHENG MAI ZHUSHEYE improves the viability and movement parameters of human sperm in vitro].

OBJECTIVE: To observe the effect of SHENG MAI ZHUSHEYE on the movement parameters and viability of human sperm in vitro. METHODS: We collected sperm samples from 33 normal fertile men, divided each into two, and cultured them in vitro with SHENG MAI ZHUSHEYE + Hams-F10 and Hams-F10 alone, respectively. Then we measured the straight line velocity (VSL), curvilinear velocity (VCL), average path velocity (VAP) and the amplitude of lateral head displacement (ALH) of the sperm by computer-aided semen analysis at 0.5, 1, 2, 4, 8 and 12 h. And the sperm viability was detected. RESULTS: VCL was significantly higher at 8 h (P < 0.05) and very significantly higher at 12 h (P < 0.01) in the SHENG MAI ZHUSHEYE + Hams-F10 group than in the Hams-F10 group. VSL, VAP and ALH were significantly increased in the former group at 4, 8 and 12 h as compared with the latter (P < 0.05). The sperm viability was significantly decreased in the Hams-F10 group at 12 h (P < 0.05). CONCLUSION: SHENG MAI ZHUSHEYE can improve sperm movement parameters and increase sperm viability in vitro.

[Effect of Glycyrrhiza inflata and Daphne genkwa on permeabilities of rhodamine 123, a P-glycoprotein substrate across rat jejunum membranes in vitro].

OBJECTIVE: To investigate the modulation of Glycyrrhiza inflata and Daphne genkwa on the permeability characteristics of rhodamine 123 (R123), one P-glycoprotein (P-gp) substrate, across the jejunum membranes. And then approach the possible permeability mechanism of the drugs after co-administration of G. inflata and D. genkwa in gastrointestinal tract. METHOD: The permeability of R123 or fluorescein sodium (CF) via Wistar rat jejunum membranes was evaluated by in vitro diffusion chamber system after oral administration of four different decoctions and 0.9% sodium chloride (20 mL x kg(-1)) for 1 week. And the concentration of R123 or CF was determined by the fluorospectrophotometry. The apparent permeability coefficient (P(app)) was calculated by the equation P(app) = dQ/d(t) x (1/A x C0), where P(app) was expressed in cm/s, dQ/dT was the slope of the linear portion of the permeation curves, A was the diffusion area, and C0 was the initial concentration of rebamipide in the donor side, and then compare their differences were compared with control group. RESULT: After oral administration of G. inflata decoction, D. genkwa decoction and decoction of the combination of the previous decoctions, the absorptive directed transport of R123 was significantly increased (P < 0.05, compared with control group). On the other hand, D. genkwa could also decrease the permeability of secretory directed transport (P(app) = 2.98 +/- 0.59), while no action of G. inflata was found on the secretory transport of R123 ( P(app) = 5.24 +/- 3.98) across the jejunum tissues, while P(app) of control group was 4.38 +/- 1.18. Meanwhile, G. inflata had no effect on transport of CF across the jejunum tissues, though the other three groups could decrease the permeability of CF, as compared with control group. CONCLUSION: G. inflata may slightly inhibit P-glycoprotein function in the intestinal membrane, while D. genkwa may be a relatively strong inhibitor of P-gp. For another, some compositions in D. genkwa inhibit P-gp function, and some others strengthen the tight junction between cells in the intestinal membrane to decrease permeability of CF. As the inhibitory action to P-gp was enhanced by combination of G. inflata and D. genkwa, based on the results, it may be one of the mechanisms of creating toxicity once co-administration of G. inflata and D. genkwa.

[The effect of Chinese medicine yiqihuoxuetang on T-lymphocyte subpopulation in peripheral blood of infertile men with antisperm antibodies].

OBJECTIVES: To study whether Chinese Medicine Yiqihuoxuetang(YQHXT) could inhibit antisperm antibodies in infertile men, and to explore the therapeutical mechanism of YQHXT. METHODS: Thirty infertile men with antisperm antibodies took YQHXT continuously for 60 days. Indirect immuno-fluorescence technique (IFT) was used to detect the levels of CD3, CD4, CD8 and CD4/CD8 ratio before and after treatment. RESULTS: CD4 value and CD4/CD8 ratio after treatment were significantly lower than before treatment (P < 0.05); CD8 value became significantly higher(P < 0.05). CONCLUSIONS: The results indicated that YQHXT could inhibit antisperm antibodies by keeping the balance of T-lymphocyte subpopulation in immunoinfertile men.

[Study on the preserving techniques of squeezed juice of fresh ginger and Glutinous rehannia].

OBJECTIVE: To study the preserve techniques of squeezed juice of Chinese medicinal materials. METHOD: The techniques of refrigeration, rapid freezing, 60Cogamma-ray sterilization, freeze-drying and spray-drying were used for preservation of squeezed juice of Ginger and Glutinous Rehannia. Different results were compared. RESULT: The period of preservation was half or one year. CONCLUSION: The rapid freezing, freeze-drying and spray-drying are suitable for preservation of squeezed juice of Chinese medicinal materials.