Sepsis is a life-threatening condition characterized by organ dysfunction resulting from a dysregulated host response to infection. The lungs are among the first and most significantly affected organs in sepsis. Pulmonary infections or systemic inflammatory cascades triggered by various pathogens can lead to acute and diffuse pulmonary damage, often manifesting as persistent hypoxemia. The COVID-19 pandemic has highlighted critical knowledge gaps in SA-ARDS management, necessitating paradigm reevaluation under the new global definition of ARDS. This paper analyzes the pathomechanisms and subphenotype characteristics of SA-ARDS, reviews recent advances in clinical management, such as fluid resuscitation, antimicrobial therapy, immune modulation, respiratory support, microcirculatory improvement, and traditional Chinese medicine (TCM) therapies, and addresses controversial issues and areas requiring further investigation.

Background: Epstein-Barr virus (EBV) is widely infected in humans and causes various diseases. Among them, microRNAs of EBV play a key role in the progression of EBV-associated febrile diseases. There're few specific indicators for rapid differential diagnosis of various febrile diseases associated with EBV, and the lack of more reliable screening methods with high diagnostic utility has led to spaces for improvement in the accurate diagnosis and efficient treatment of relevant patients, making EBV infection a complicated clinical problem. With recent advances in plasma microRNA testing, the apparent presence of EBV microRNAs in plasma can help screen for EBV infection. The gene networks targeted by these microRNAs can also indicate potential biomarkers of EBV-associated febrile diseases. This study aimed to identify some novel miRNAs as potential biomarkers for early diagnosis of respectively EBV-associated febrile diseases. Materials and methods: A total of 110 participants were recruited for this task. First, we performed high-throughput sequencing and preliminary PCR validation of differentially expressed miRNAs in 15 participants with EBV-associated fever (divided into common EBV carriers), infectious mononucleosis (IM) and chronic active EBV infection (CAEBV), EBV-associated Hemophagocytic Lymphohistiocytosis group (EBV-HLH), and 3 healthy individuals. After a comprehensive analysis, 10 miRNAs with abnormal expression were screened, and then qRT-PCR was performed in the rest of 95 participants to detect the validation of miRNAs expression in plasma samples. Thereafter, we further investigated their potential for clinical application in EBV-related febrile diseases by using a combination of Gene Ontology analysis, Kyoto Encyclopedia of Genes and Genomes pathway analysis, and Protein-protein interaction network analysis. Results: Through identification and detailed analysis of the obtained data, we found significant differences in the expression of Hsa-miR-320d, EBV-miR-BART22, and EBV-miR-BART2-3p in blood samples from patients with different EBV-related febrile diseases. We found that the expression levels of Hsa-miR-320d, EBV-miR-BART22, and EBV-miR-BART2-3p in plasma are indicative of determining different disease types of EBV-related febrile diseases, while EBV-miR-BART22 and EBV-miR-BART2-3p may be potential therapeutic targets. Conclusion: The expression levels of Hsa-miR-320d, EBV-miR-BART22, and EBV-miR-BART2-3p suggest that they may be used as transcriptional features for early differential diagnosis of EBV-related febrile diseases, and EBV-miR-BART22 and EBV-miR-BART2-3p may be potential therapeutic targets.

At present, timely and accurate diagnosis and effective treatment of Epstein- Barr Virus (EBV) infection-associated fever remain a difficult challenge. EBV encodes 44 mature microRNAs (miRNAs) that inhibit viral lysis, adjust inflammatory response, regulate cellular apoptosis, promote tumor genesis and metastasis, and regulate tumor cell metabolism. Herein, we have collected the specific expression data of EBV-miRNAs in EBV-related fevers, including infectious mononucleosis (IM), EBVassociated hemophagocytic lymphohistiocytosis (EBV-HLH), chronic active EBV infection (CAEBV), and EBV-related tumors, and proposed the potential value of EBVmiRNAs as biomarkers to assist in the identification, diagnosis, and prognosis of EBVrelated fever, as well as therapeutic targets for drug development.

Objective: To analyze the characteristics and internal mechanism of Xue Shengbai’s prescriptions for the differentiation and treatment of gastrointestinal diseases in Xue Xue’s Medical Cases based on the traditional Chinese medicine inheritance auxiliary platform（TCMIAP） and network pharmacology, thus providing reference for traditional Chinese medicine diagnosis and treatment of digestive system diseases represented by damp-heat gastrointestinal diseases. Methods: Medical cases related to differentiation and treatment of gastrointestinal diseases in Xue Xue’s Medical Cases were screened, and these data were standardized and entered into TCMIAP to analyze the drug frequency, prescription rules, etc. The core drug combination was obtained and analyzed by protein-protein interaction（PPI） analysis, Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis, to explore its mechanism in the treatment of gastrointestinal diseases. Results:（1） A total of 191 medical cases of differentiation and treatment of gastrointestinal diseases in Xue Xue’s Medical Cases were included, involving 219 traditional Chinese medicines. According to the drug frequency, prescription rules and new prescription analysis, the core drug combination was confirmed as follow: Magnoliae Officinalis Cortex, Tsaoko Fructus, Ginseng Radix Et Rhizoma, Poria, Citri Reticulatae Pericarpium, Arecae Pericarpium, Atractylodis Macrocephalae Rhizoma, Pogostemonis Herba.（2）PPI analysis showed that proteins with high degree values included protein kinase Bα（Akt1）, tumor necrosis factor（TNF）, tumor protein p53（TP53）, vascular endothelial growth factor A（VEGFA）, proto-oncogene tyrosine-protein kinase Src（Src）, heat shock protein 90 α family class A member 1（HSP90AA1）, etc. And pathways such as phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt） signaling pathway, hypoxia inducible factor-1（HIF-1） signaling pathway, VEGF signaling pathway, cancer pathway were involved. Conclusion: Based on the analysis and summary of Xue Xue’s Medical Cases, the core drug combination for the differentiation and treatment of gastrointestinal diseases was summarized, which has the function of drying dampness by bitter herbs and resolving dampness by aromatic herbs, invigorating spleen and regulating qi, and exerts therapeutic effects such as anti-inflammation, anti-tumor, anti-oxidation, anti-bacteria through multi-component, multi-target and multi-pathway.

本文旨在了解全球范围抗病毒药物的研发现状及技术分布情况.采用计量学方法,对全球范围抗病毒药物专利的年度申请量、地域分布、申请人、高价值度专利、技术主题等进行统计分析.抗病毒药物的研发与病毒性疾病的流行呈一定的时间和空间相关性.美国、中国和日本在抗病毒药物研究领域占据技术主导地位,技术各有偏重.Gilead Sciences Inc生物制药公司在本领域技术占主导地位.有机成分中含有3,4二氢苯并吡喃结构的化合物,以及源自紫菀科或菊科植物的抗病毒药物开发较多,抗病毒活性与抗肿瘤活性多有交叉,未来3年抗病毒药物的研发可能呈现一个新的增长.美国在抗病毒药物技术领域占据首要地位,中药是中国在抗病毒药物研发领域竞争优势,开发具有重要意义.

Objective:To investigate the clinical characteristics and prognosis of Epstein-Barr virus-related diseases in adults.Methods:The clinical data of 59 patients with Epstein-Barr virus-related diseases in Huashan Hospital, Fudan University, Shanghai from January 2017 to August 2019 were analyzed retrospectively. The clinical manifestations of patients with infectious mononucleosis (IM), chronic active Epstein-Barr virus infection (CAEBV) and lymphoma in patients were compared. Patients were divided into acute course group (IM) and chronic course group (CAEBV+ lymphoma), and the results of labratory indications (blood rontine, liver function, imflammatory indications, Epstein-Barr virus DNA, Epstein-Barr virus antibody and T lymphocyte) were compared between two groups. Statistical analysis was performed by Mann-Whitney U test, chi-square test or Fisher exact probability test. Results:Among the 59 patients, 23 cases (39.0%) were diagnosed with IM, 23 cases (39.0%) were lymphoma and 13 cases (22.0%) were CAEBV. The clinical manifestations of patients with Epstein-Barr virus-related diseases were fever (57/59, 96.6%), lymphadenopathy (37/59, 62.7%) and splenomegaly (36/59, 61.0%). There were 17 patients in the chronic course group experienced hemophagocytic lymphohistiocytosis (HLH). The white blood cell counts, hemoglobin levels and platelet counts of patients in the chronic course group (4.07(1.94, 8.35)×10 9/L, 89.5(74.5, 108.0) g/L and 100(37, 161)×10 9/L, respectively) were all lower than those in the acute course group (9.91(6.75, 17.38)×10 9/L, 132.5(118.2, 152.0) g/L and 197(129, 233)×10 9/L, respectively), with statistically significant differences ( U=3.69, 5.22 and 3.61, respectively, all P<0.01). The levels of procalcitonin, C-reactive protein and serum ferritin in the chronic course group (0.45(0.15, 1.13) μg/L, 47.75(17.57, 84.67) mg/L and 2 000(682, 2 002) μg/L, respectively) were all higher than those in the acute course group (0.12(0.07, 0.28) μg/L, 6.39(3.13, 11.38) mg/L and 482(159, 1 271) μg/L, respectively), with statistically significant differences ( U=-2.95, -3.77 and -4.16, respectively, all P<0.01). The counts of CD4 + T lymphocytes, CD8 + T lymphocytes, CD19 + B lymphocytes and natural killer cells in the chronic course group (259.15(101.98, 509.26), 214.69(119.31, 529.47), 46.14(4.44, 135.87) and 81.09(41.53, 118.46)/μL, respectively) were all lower than those in the acute course group (738.88(592.20, 893.94), 1 609.17(920.88, 3 952.34), 144.52(83.65, 215.14) and 309.82(123.78, 590.68)/μL, respectively), with statistically significant differences ( U=3.66, 3.80, 2.90 and 3.40, respectively, all P<0.01), while the CD4 + /CD8 + T lymphocytes ratio in the chronic course group was higher (0.90(0.60, 1.70) vs 0.45(0.10, 1.28))( U=-2.29, P=0.02). Twenty-three patients with IM were all cured, while 10 patients with lymphoma died and 13 received chemotherapy. Seven patients with CAEBV died and six improved. Conclusions:The clinical characteristics of Epstein-Barr virus-related diseases in adults are fever, lymphadenectasis, splenomegaly.Chronic Epstein-Barr virus infection may be associated with HLH. The prognosis of adults with acute Epstein-Barr virus infection is good, while that of long-term chronic Epstein-Barr virus infection is poor.

《素问·调经论》中"阴虚生内热"被认为是李东垣"阴火学说"的源头,后世对"阴虚生内热"的解释一般也着眼于脾胃.但脾、胃属性有别,不应合而论之,而当分而论之.从脾虚与胃虚两个方面阐述"生内热"的情况,提出"阴虚生内热,脾胃当分治;治脾宗东垣,治胃法天士"的观点,并结合消渴病病程发展与治疗进行分析,供同侪参考.

EB病毒是一种感染人类B淋巴细胞的疱疹病毒,对于免疫功能异常的感染者,则可能引发一系列具有发热性质的急性病症或淋巴组织增生性疾病.本研究介绍了EBV致发热患者临床流行病学特征及临床症状,剖析其致病免疫机制,进而从中医温病学视角,探讨该类疾病卫气营血辨证分型特征,为中医温病学辨证论治提供参考借鉴.

To investigate the effects of emodin on inflammation and autophagy in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages and reveal its underlying mechanism. 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was conducted to find the appropriate dose for emodin. RAW264.7 cells pretreated with different concentrations (0–50 μmol/L) of emodin or vehicle for 2 h prior to exposure to LPS for 16 h. Cell morphology was examined and propidium iodide staining was used to examine cell cycle. Expressions of inflammation-related proteins [nuclear factor-kappaB (NF-κ B) and I-kappaB (I κ B)α] and autophagy-related proteins [light chain (LC)3, P62/sequestosome 1, mammalian target of rapamycin (mTOR), and p-mTOR] were examined using Western blot analysis. Expression of inflammation-related cytokines including tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 were detected by enzyme-linked immunosorbent assay. Autophagy was examined with LC3B fluorescence intensity and aggregation. The effect of emodin on autophagy was conducted with an autophagy inhibitor, 3-methyladenine (3-MA). The expression of NF-κ B in LPS-induced cells was significantly increased (P<0.01) and simultaneously I κ B α decreased compared with the normal cell (P<0.05). The expressions of TNF-α, IL-β, and IL-6 proteins in the LPS-induced RAW264.7 cells were significantly higher than in the normal cell (P<0.05 or P<0.01). LPS increased the percentage of cells in the G0/G1 phase, which was recovered by emodin at different doses (12.5, 25, and 50μ mol/L, P<0.05 or P<0.01). The medium-dose (25 μ ml/L) emodin decreased the expressions of NF-κ B, P62 and p-mTOR (P<0.01) and increased I κ B α expression, LC3B II/I ratio as well as LC3B fluorescence intensity (P<0.05 or P<0.01). Meanwhile, the enhanced autophagic effects of emodin, such as the increment of LC3B II/ratio and the decrement of P62 expression, were suppressed by autophagy inhibitor 3-MA. Emodin could inhibit inflammation of mice RAW264.7 macrophages induced by LPS, possibly through activating autophagy.

分析温病学术理论发展与温病学教学、临床应用现状,认为有关温病文献研究可从深度与广度进行再拓展、再挖掘.介绍"扎根理论"研究方法,结合温病学科学术性质及特点,探讨"扎根理论"在该学科学术理论建设中可行的研究模式与研究思路,剖析该研究对于温病学科学术建设的理论价值及应用前景.同时,基于"扎根理论"研究难点,提出研究过程中需注意的问题.

Prostate cancer is one of the most common malignancies diagnosed in males. Cancer‑related inflammatory factors include tumor necrosis factor, inflammasomes, cytokines, chemokines, transcription factors, infiltrating or circulating immune cells, reactive oxygen species, and sex hormone receptors. These are mainly associated with the local immune response at the tumor site. Emodin, a chemical compound that can be isolated from the plant rhubarb among others, has been shown to exhibit anti‑inflammatory and anticancer properties in prostate cancer. This review summarizes the effects of emodin on prostate cancer and analyzes whether it interferes with prostate cancer through anti‑inflammatory pathways. New information regarding the development of emodin derivatives including their increased solubility and reduced side effects through chemical structure modifications is also reviewed.

针对中医临床经典课程的德育融入内容,在《温病学》教学过程中,根据古代医家史料与近期实际事例,撰写温病学数字故事,融入课堂,引导学生置身于中医药治疗外感热病的现实和历史情境中学习理论,使学生既学到医学技能,又得以传统人文思想的熏陶,提升课程的德育内涵.

To guide the diagnosis and treatment of infectious diseases with characteristics of heating,the theory of syndrome differentiation of weifen,qifen,yingfen and xuefen which was founded by YE Tian-shi is of great significance.The discovery of what kinds of specific diseases YE Tian-shi practice this theory on could help for deep understanding of the theoretical connotation and more accurate application to clinical infectious diseases.This paper get the main warm diseases entities through digging historical records and YE's medical literature,and then discussed the clinical apply theory of syndrome differentiation of weifen,qifen,yingfen and xuefen to provide reference for TCM syndrome differentiation and treatment of infection diseases.

The anti-inflammatory effect of sodium houttuyfonate (SH), an herbal-originated drug that used in China clinically, was investigated on chronic obstructive pulmonary disease (COPD) inflammatory model rats induced by combination usage of cigarette smoke (CS) and lipopolysaccharide (LPS). The morphology of the lung tissue, the expression levels of cytokines in the bronchoalveolar lavage fluid (BALF), the protein levels of TLR4, NF-κB p65, and SIGIRR, and the mRNA levels of TLR4, MyD88, NF-κB p65, and SIGIRR in lung tissues were investigated, respectively. After treated by SH (24.3 mg/kg), the abnormal morphology changes of lung tissues in COPD rats, such as neutrophil infiltration and airway obstruction, were considerably alleviated, as well as both proinflammatory cytokines, TNF-α and IL-1β, significantly decreased in BALF. The mRNA level of TLR4, MyD88, and NF-κB p65 and protein expression of TLR4 and NF-κB p65 in lung tissues decreased significantly after SH treatment, while both SIGIRR mRNA and protein levels increased significantly. These results suggest that SH markedly attenuated the pulmonary inflammation induced by CS and LPS and protected the lung tissue in COPD model rat. The anti-inflammatory effects were related to suppress the TLR4/NF-κB pathway dependent on MyD88. TIR8/SIGIRR might contribute to the protective effects of SH on pulmonary inflammation.

把握温病学文化是准确把握温病学术的前提.建立课程网络温病医家史料资源,还原温病医家生活的时代背景和医家形象,融入温病学教学,丰富课程文化内涵;引导学生利用课余时间精读温病名著,于历史情境中思考温病学说的形成与发展,拓展温病辨证思维,提升学生自主研习中医经典的能力.通过网络平台与微博、微信互动以及合理的考核方式,反馈得出这种教学方法有效促进了学生学习温病学的热情,提升了学生中医人文素养,在一定程度上提高了温病学教学水平.

温病名家叶天士创立的卫气营血辨证理论是温病的临床辨证纲领,为确立温病治法方药的重要前提.将叶天士卫气营血辨证理论与感染性、传染性疾病的病程发病阶段相关联,进行系统研究,建立相应辨证标准与用药标准,对于温病学术理论指导现代感染性、传染性疾病的临床实践具有实用价值.文章以叶天士《温热论》及《临证指南医案》为主要依据,结合叶天士生活年代可能流行的和现代常见的感染性、传染性疾病的发病特征与叶天士诊治这一类疾病的临床用药经验,提炼叶天士卫气营血理论辨证标准与常用方药,以期为当今临床感染性疾病及新发传染性疾病提供中医证治参考.

[Objectives]To extract the main study results about Ye Tianshi ’s theories and his clinical experience in Warm Disease for exploring his academic essence further. [Methods] With the keywords“Ye Tianshi ”,“YeGui”,“The Theories about Warm Disease”using CNKI database to retrieve the related papers about Ye’s theories,to summarize the important viewpoint. [Results] TCM scholars have studied Ye’s life experience, works, warm disease’s differentiation theory of wei qi ying xue and treatment extensively in last 30 years ,these results have great significances in analyzing the core comments about Warm Disease theory and guiding the clinical thoughts. [Conclusion]Based on the existing results, to study Ye ’s clinical experience in infectious disease connected with historical background information in depth wil have great value for clinical application.

The authors review the incidence and treatment of the epidemics during periods of high incidence in Chinese his-tory, extract valuable and referential points which throw light on the prevention and treatment of acute contagious and infectious dis-eases nowadays, and explore methodology for the study of epidemics, so as to provide thoughts for further study of the incidence and prevalence of epidemics, and prevention and treatment with traditional Chinese medicine and western medicine during different peri-ods of Chinese history.