Experience of Professor Chen Xiao-hu in treating"Double Heart Disease"with the method of activating blood and soothing the mind

"Double Heart Disease",that is,patients with cardiovascular disease often have mental and psychological disorders such as anxiety and depression.Professor Chen Xiao-hu is guided by the holistic concept of Chinese medicine and based on the dual physiological functions of the heart as the main blood vessel and the main god.He believes that the internal resistance of blood stasis and mental disturbance are the core pathogenesis of"Double Heart Disease".Advocating the use of activating blood to calm the nerves to treat"double heart disease",and taking advantage of the overall adjustment of traditional Chinese medicine to achieve the purpose of harmonizing viscera and balancing Yin and Yang.The article summarizes Professor Chen Xiao-hu's experience in using the method of activating blood to soothe the nerves to treat"Double Heart Disease",with a view to clinical treatment Provide new ideas.

Ethanol extract of Abelmoschus manihot suppresses endoplasmic reticulum stress in contrast-induced nephropathy

Objective:To explore the efficacy and potential mechanisms of the ethanol extract of Abelmoschus manihot(L.)Medic in contrast-induced nephropathy(CIN).Methods:CIN rat models and human renal proximal tubular cells(HK-2)with iopromide-induced injury were employed to mimic CIN conditions.The effect of Abelmoschus manihot extract on the rat models and HK-2 cells was evaluated.In rat models,kidney function,histology,oxidative stress and apoptosis were determined.In HK-2 cells,cell viability,apoptosis,mitochondrial membrane potential,and endoplasmic reticulum stress were assessed.Results:Abelmoschus manihot extract significantly improved structural and functional impairments in the kidneys of CIN rats.Additionally,the extract effectively mitigated the decline in cellular viability and reduced iopromide-induced oxidative stress and lipid peroxidation.Mechanistic investigations revealed that Abelmoschus manihot extract prominently attenuated acute endoplasmic reticulum stress-mediated apoptosis by downregulating GRP78 and CHOP protein levels.Conclusions:Abelmoschus manihot extract can be used as a promising therapeutic and preventive agent in the treatment of CIN.

眼眶减压术对甲状腺相关眼病患者脉络膜厚度的影响

目的:探究眼眶减压术对甲状腺相关眼病(TAO)患者黄斑区中心凹脉络膜厚度(CMCT)的影响。方法:前瞻性临床研究。分析2021-01/2022-01在我科治疗的TAO患者29例42眼,根据病情严重程度分为中重度组20例30眼和极重度组9例12眼。两组患者均接受眼眶减压术治疗,比较两组患者术前,术后3、6mo CMCT、最佳矫正视力、眼压、眼球突出度、活动度评分(CAS)的变化情况。结果:所有患者均完成随访。术后3、6mo,极重度组CMCT、眼球突出度、眼压、CAS评分为355.13±15.59、339.61±13.17μm, 19.33±2.23、17.83±1.70mm, 18.86±3.05、18.09±1.37mmHg, 3.75±0.87、2.42±1.00分;中重度组为325.00±10.48、321.04±11.34μm, 16.07±1.74、15.6±1.98mm, 16.65±2.04、16.03±2.3mmHg, 1.50±0.51、1.43±0.50分,与术前(极重度组:396.46±17.61μm, 22.00±2.3mm, 21.85±2.82mmHg, 5.33±1.44分;中重度组:335.77±11.60μm, 19.07±1.84mm, 18.89±3.06mmHg, 1.63±0.49分)比较均有差异(均P<0.001)。极重度组患者术前最佳矫正视力(LogMAR)为0.64±0.22,术后3、6mo分别为0.43±0.20、0.34±0.15,与术前比较均有差异(均P<0.001)。结论:眼眶减压术能有效降低TAO患者CMCT、眼压及眼球突出度,缓解眼眶静脉瘀滞,并能有效改善极重度患者的视力、降低活动性。

Structure-based multi-ligand molecular modeling to predict the synergistic effects of limonin and obacunone from Simiao pill against nitric oxide synthase 3 associated with hyperuricemia

Hyperuricemia(HUA)mainly occurs because of purine metabolism disorders.We recently proposed that limonin from Simiao pill may have therapeutic effects on nitric oxide synthase 3(NOS3)that is related to HUA.Concurrently,our previous work employed a new method,structure-based multi-ligand molecular modeling,to identify potential agents from a herbal formula that may produce synergistic effects and may have the potential to develop combination drugs.Therefore,we employed multi-ligand modeling to seek compounds with potential synergistic effects with limonin against NOS3.We obtained 403 multi-ligand docking results between 403 compounds and the limonin-NOS3 complex(average affinity–8.297 kcal/mol).Then we selected the top 10 highest binding affinity compounds for virtual pharmacokinetic and toxicity screening and we found that only obacunone passed all filters.We further subjected obacunone,bound to limonin and NOS3,to molecular dynamics simulations.We found that the NOS3-limonin-obacunone complex was more stable than the NOS3-limonin complex,based on the root mean square deviation of backbone Cαatoms and root mean square fluctuation,which suggests that synergistic effects may exist between limonin and obacunone.Further cell and animal experimental research is required to verify our results.

角膜塑形镜控制青少年单眼近视的临床观察

目的:观察角膜塑形镜控制青少年单眼近视的临床效果。方法:选取2014-06/2016-03于我院视光门诊单眼验配角膜塑形镜的单眼近视患者56例112眼,将配戴角膜塑形镜的眼作为试验组,未作处理的另一眼作为对照组。观察戴镜前和戴镜12mo后屈光度、角膜曲率、眼轴长度变化情况。结果:戴镜12mo后,试验组屈光度增加量(0.29±0.15D)与对照组(0.76±0.41D)差异显著(t=2.8631,P<0.001);试验组水平角膜曲率变化量(0.27±0.11D)与对照组(0.20±0.14D)无差异(t=0.8204,P>0.05);试验组眼轴长度增加量(0.14±0.10mm)与对照组(0.32±0.14mm)差异显著(t=2.7518,P<0.001)。结论:角膜塑形镜可通过减缓眼轴增长来控制近视度数的增加,从而延缓近视的发展。

外直肌截除术治疗分开不足的临床观察

目的:观察外直肌截除术治疗分开不足的临床效果。方法:回顾性分析2011-02/2017-10在我院就诊的37例分开不足型患者。临床表现为看远内斜视伴同侧复视,视近为内隐斜视无复视,单眼、双眼运动正常。术前作屈光、斜视度、近立体视、负向融合力检查,然后行单眼或双眼外直肌截除手术。结果:所有病例术后复视消失,术后1a复查时复视无复发。术前远距内斜视度为+15^△^+28△(平均18.4^△±5.7^△),近距内斜视度为+5^△^+16^△(平均10.3^△±3.6^△),远距近距斜视度差异值为8.1^△±2.3^△;术后1wk远距斜视度-5.4^△±1.5^△,近距斜视度-7.2^△±1.6^△,差异值为1.8^△±0.6^△;术后1a远距斜视度-1.9^△±1.2^△,近距斜视度-3.4^△±1.4^△,差异值为1.5^△±0.8^△。术后1wk,1a的远近距斜视度较术前明显减小(P<0.05),术后1wk,1a的远近距斜视度比较有差异(P<0.05),患者术前的远近距斜视度之差值与术后1wk,1a的远近距斜视度之差值比较有差异(P<0.05)。术前远距负向融合力为3^△~9^△(平均5.1^△±1.8^△),近距负向融合力为15^△~24^△(平均19.4^△±3.2^△)。术后1wk远近距负向融合力分别为10.1^△±3.3^△、19.7^△±4.1^△,术后1a远近距负向融合力分别为11.2^△±3.6^△、20.2^△±4.8^△。患者术前与术后1wk的远距负向融合力比较有差异(q=4.551,P=0.013),术后1wk与术后1a比较无差异(q=0.713,P=0.115)。患者近距融合力术前与术后1wk,1a比较无差异(P>0.05)。结论:外直肌截除术治疗分开不足可有效降低术后的远近距斜视度差,消除患者的复视症状,改善患者术后的近立体视锐度及远距负向融合力。

直肌松解后退术联合眶脂肪切除治疗甲状腺相关性眼病限制性斜视

目的:探讨直肌松解后退术联合眶脂肪切除对甲状腺相关性眼病限制性斜视的临床治疗效果。方法:回顾分析2018-03/2019-06在我科住院的甲状腺相关性眼病限制性斜视病例27例34眼。所有患者均在全身麻醉下行直肌松解后退联合眶脂肪切除术。眶脂肪切除范围根据眼突的程度选择鼻下、颞下、鼻上或颞上等不同象限。25眼行下直肌后退术,5眼行内直肌后退术,4眼行上直肌后退术。术中根据眼球突出程度分别选择切除鼻下、颞下、鼻上或颞上等不同象限肌锥内、外脂肪,根据术前斜视度以及眼外直肌挛缩程度设计直肌手术的后退量,术中估计则依靠被动转动试验抗力的大小。术中切除脂肪量根据术前眼球突度,按切除约1mL脂肪眼球突度后退1mm设计。术后随访时间为每周1次,1mo后每月1次,3mo后不定期随访,所纳入手术患者随访时间在6mo以上。结果:术中切除脂肪量2.1~3.4(平均2.6)mL。术后1mo视力为0~0.2(平均0.11±0.16),术后6mo视力为0~0.3(平均0.12±0.17),术前术后视力无差异(P>0.05)。术后1mo眼球突出度为13~16(平均14.4±0.8)mm,术后矫正眼球突出度2~4(平均2.4)mm(q=10.737,P<0.01)。术后6mo眼球突出度为13~15.5(平均14.5±0.6)mm,与术后1mo无差异(q=0.624,P=0.173)。术后1mo斜视度为2^△~10^△(平均6.7^△±2.3^△),均为欠矫(q=18.068,P<0.01),术前所有患者第一眼位均有复视,术后1mo第一眼位复视消失,6例患者下转15°眼位残留复视症状。所有患者的代偿头位均得到明显改善。术后6mo患者斜视度(欠矫)0^△~7^△(平均3.4^△±1.2^△),与术后1mo有差异(q=5.385,P=0.015)。术后1mo眼压17.12±1.89mmHg,与术前眼压有差异(q=4.258,P=0.018)。术后6mo眼压17.53±1.67mmHg,与术后1mo无差异(q=0.729,P=0.154)。结论:眶脂肪切除可改善眼突,并未对限制性斜视的手术设计及效果有明显影响,直肌松解后退术联合眶脂肪切除术治疗甲状腺相关性眼病限制性斜视合并突眼是一种可控的手术方案。

深外侧壁联合内侧壁眼眶减压术治疗甲状腺相关性眼病

目的:探究深外侧壁联合内侧壁眼眶减压术治疗甲状腺相关性眼病的临床治疗效果及安全性。方法:分析我科既往住院患者病历,纳入2019-01/2020-05在我科住院的符合纳入标准的甲状腺相关性眼病患者17例。所有患者均在全身麻醉下行深外侧壁联合内侧壁眼眶减压术,比较患者术前术后的视力、暴露性角膜炎恢复情况、突眼度、眼压以及并发症情况。结果:所纳入研究的对象中,有甲状腺相关眼病视神经病变(DON)8例9眼,术前的最佳矫正视力0.78±0.15,术后1mo 0.36±0.12,与术前视力相比有差异(P<0.01),术后6mo 0.38±0.12,与术后1mo无差异(P=0.594)。术前眼球突出度23.75±2.55mm,术后1mo为14.85±1.53mm,与术前突眼度相比有差异(P<0.01),术后6mo为14.60±1.64mm,与术后1mo基本保持稳定(P=0.658)。术前眼压25.56±3.23mmHg,术后1mo为18.42±2.35mmHg,与术前相比有差异(P<0.01),术后6mo眼压降至15.82±2.57mmHg,与术后1mo眼压相比有差异(P<0.01)。术前有暴露性角膜炎6例6眼,术后1mo有4眼好转,2眼治愈,术后6mo 6眼全部治愈。术后患者复视情况均有不同程度减轻,并有部分患者复视症状在此后6mo持续好转,未出现其他严重并发症。结论:深外侧壁联合内侧壁眼眶减压术可以有效地改善眼突,对DON及暴露性角膜炎等严重并发症也有良好的疗效,并发症少,是治疗严重甲状腺相关性眼病的有效手术方案。

Efficacy and safety of traditional Chinese medicine in the treatment of coronary heart disease complicated with anxiety and/or depression after PCI:A systematic review and meta-analysis

Objective:The clinical efficacy and safety of traditional Chinese medicine in the treatment of anxiety and/or depression after PCI for coronary heart disease were systematically evaluated.Methods:The databases of CNKI,Wanfang,VIP,CMB,PubMed,Web of Science,PubMed,Web of Science and Cochrane Library were searched by computer,and the Chinese and English randomized controlled trials(RCTs)of traditional Chinese medicine in the treatment of anxiety and/or depression after PCI of coronary heart disease published from the database to November 2020 were included.The Cochrane bias risk tool and the modified Jadad scale were used to evaluate the quality of the included literature,and the RevMan 5.3 and Stata 16.0 software were used for Meta-analysis.Results:A total of 23 RCTs were included,including 1837 subjects,including 917 cases in the treatment group of traditional Chinese medicine,920 cases in the control group,the baseline situation between groups was consistent,comparable.Meta-analysis results show that TCM treatment improves the total clinical effective rate[OR=2.34,95%CI(1.61,3.40),P<0.00001],and the efficacy of TCM syndrome[OR=5.19,95%CI(2.74,9.86),P<0.00001],reduce Hamilton anxiety scale HAMA score[SMD=-0.96,95%CI(-1.78,-0.14),P=0.02],Hamilton Depression Scale HAMD score[SMD=-1.10,95%CI(-1.79,-0.41),P=0.002],SAS self-rating scale score[SMD=-1.20,95%CI(-1.75,-0.65),P<0.0001],SDS self-rating scale score[SMD=-1.14,95%CI(-1.62,-0.65),P<0.00001]and other indicators are better than the control group,and the difference is statistically significant(P<0.05).Conclusion:The combination of traditional Chinese medicine intervention and conventional western medicine treatment after PCI can further improve the clinical efficacy of patients with anxiety and/or depression after PCI of coronary heart disease and has good safety.Due to the general quality of the literature included in this study,the above conclusions need to be further confirmed by high-quality randomized controlled double-blind clinical trials.

Correlation between crystal structure and mechanical performance of Cr-implanted 300M high-strength steel using X-ray diffraction method

In order to study the influence of crystal structure change due to implantation dose on the hardness and wear performance of 300M high-strength steel,samples were surface modified by Cr implantation with dosages of 5.0 × 10^16,1.5 × 10^17 and 3.0 × 10^17 ions/cm^2.X-ray diffraction method,which was already applied in studies on the microstructure of deformed and heat-treated materials,was used to study the crystal structure of the implanted steel,and the results were corrected with the hardness and wear performance.The solid solution strengthening effect and microstructure vary with increase in implantation dose.Owing to strong solid solution hardening of Cr,small average crystallite size and high dislocation density,the hardness and wear resistance of implanted steel with dose of 5.0 × 10^16 ions/cm^2 were found to be the highest compared with other samples.Moreover,although the crystal lite size of the implanted sample with dose of 3 × 10^17 ions/cm^2 was similar to that of substrate and the dislocation density was lower than that of the substrate,its higher hardness and lower specific wear rate were due to the solid solution hardening and perhaps Cr clusters reinforcement.