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This study was carried out to investigate the clinical efficacy of Gegen Qinlian Decoction combined with a Chinese herbal hot package in the treatment of acute gastroenteritis (AGE), and to analyze the effects on serum PCT, CRP and IL-6 levels. For this purpose, 100 patients with AGE admitted to the hospital from January 2019 to January 2022 were selected for the study and randomly divided into observation and control groups, with 50 cases in each group. Patients in the control group were given conventional Western medical treatment, while patients in the observation group were treated with Gegen Qinlian Decoction combined with a Chinese herbal hot package on this basis. The clinical efficacy, symptom relief time, main symptom scores and serum PCT, CRP and IL-6 levels before and after treatment were compared between the two groups. Results showed that the total effective rate of patients in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the disappearance time of diarrhea, abdominal pain, fever and vomiting was significantly shorter in the observation group than in the control group (P<0.05). After treatment, the stool properties, number of stools and abdominal pain symptom scores of patients in both groups were lower than those before treatment, and the symptom scores of patients in the observation group were lower than those in the control group (P<0.05). The PCT, CRP and IL-6 levels of patients in both groups were significantly lower after treatment than before treatment, and the PCT, CRP and IL-6 levels of patients in the observation group were significantly lower than those in the control group (P<0.05). It was concluded that the clinical efficacy of Gegen Qinlian Decoction combined with Chinese herbal hot package in the treatment of AGE is remarkable, which can effectively improve the clinical symptoms and reduce the inflammatory reaction of patients and is worthy of clinical promotion.

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The cellular composition of the tumor microenvironment, including tumor, immune, stromal, and endothelial cells, significantly influences responses to cancer therapies. In this study, we analyzed the impact of oxidative stress, induced by cold atmospheric plasma (CAP), on tumor cells, T cells, and macrophages, which comprise part of the melanoma microenvironment. To accomplish this, cells were grown in different in vitro cell culture models and were treated with varying amounts of CAP. Subsequent alterations in viability, proliferation, and phenotype were analyzed via flow cytometry and metabolic alterations by Seahorse Cell Mito Stress Tests. It was found that cells generally exhibited reduced viability and proliferation, stemming from CAP induced G2/M cell cycle arrest and subsequent apoptosis, as well as increased mitochondrial stress following CAP treatment. Overall, sensitivity to CAP treatment was found to be cell type dependent with T cells being the most affected. Interestingly, CAP influenced the polarization of M0 macrophages to a "M0/M2-like" phenotype, and M1 macrophages were found to display a heightened sensitivity to CAP induced mitochondrial stress. CAP also inhibited the growth and killed melanoma cells in 2D and 3D in vitro cell culture models in a dose-dependent manner. Improving our understanding of oxidative stress, mechanisms to manipulate it, and its implications for the tumor microenvironment may help in the discovery of new therapeutic targets.

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Basal cell carcinoma has a potential for early and late metastasis. Depending on the location of the primary site, the relevant lymphatic drainage routes have to be monitored. Regional lymph edema may be a first indicator for metastasizing disease.

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INTRODUCTION: Since the KDPFC was first described by Behan et al. in 2003, there have been a number of publications about this technique with case series between 1 and 300 flaps, and some have described further modifications of the design of the flap. The flap design resembles the keystone of a Roman arch and is based on the angiosome concept. The flap is a perforator flap, but does not require microsurgical dissection or preparation of the perforators. The technique is efficient and relatively simple to perform. With a few exceptions, it can be performed anywhere on the body. Although there are a large number of publications, not much data has been published on the complications, limitations and disadvantages of the technique. METHODS: This is a retrospective analysis of the outcomes of 35 patients who underwent keystone flap reconstruction for soft tissue defects over 36 months. The flap design followed the original KDPFC description. Flap selection was based on the requirements of each defect. RESULTS: Thirty-six flap procedures were performed on 35 patients. The mean defect size was 21 cm2 (range 2-100 cm2). Delayed wound healing occurred in 12 patients and flap loss was observed in 4 patients. One patient required further surgical revision. The wounds of the remaining patients healed by secondary intention. Four out of 10 patients who were on anticoagulants had delayed wound healing, compared with 12 out of 25 who were not on anticoagulants. Seven of the 16 patients with delayed wound healing, including 3 patients with flap loss, had defects reconstructed on the very distal lower leg and foot. DISCUSSION: The KDPFC is a valuable addition to the reconstructive armamentarium. Although delayed wound healing has been observed in some cases, this flap concept can replace other local or regional flaps, also in more complex situations. Care must be taken in patient selection and, in particular, in large defects and difficult topographical areas on the distal lower leg. In these situations, other reconstructive options may be more appropriate.

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INTRODUCTION: Despite the increasing incidence of melanoma little is known about patients' emotional distress associated with this disease. Supplemented by the problem list (PL), the distress thermometer (DT) is a recommended screening instrument to measure psychosocial distress in cancer patients. Our objective was to explore the acceptance and the feasibility of the DT and PL as a concise screening tool in an ambulatory setting for routine care and to elucidate determinants of distress in melanoma patients with regard to sociodemographic and clinical variables. METHODS: Consecutive melanoma outpatients were asked to complete the DT with the PL prior to their scheduled consultation. Demographic and clinical data were obtained from the patients' charts. Clinical data included melanoma stage, time since diagnosis, previous treatment, current treatment, and other cancer disease. RESULTS: Out of 734 patients recruited into the study, 520 patients (71%) completed both the DT and the PL. Forty-seven percent met the ≥5 cut-off score for distress. Younger and employed patients reported higher distress than older and retired patients. A cut-off score of ≥5 was closely associated with self-reported emotional sources of distress, with practical problems, especially at work, family problems (dealing with the partner), and physical problems like pain, appearance, getting around, and nausea. Apart from higher distress under current systemic treatment, no associations were found between distress and clinical data. CONCLUSION: The DT together with the PL seems to be an economically reasonable screening tool to measure psychosocial distress in melanoma patients. In particular, younger melanoma patients who are currently employed are prone to experience distress at some point after diagnosis, but there appears to be almost no association between clinical data and the extent of distress. To characterize the impact of distress on disease outcome and quality of life in melanoma patients, further research is needed.

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