Prognostic significance of identification of traditional Chinese medicine syndromes in colorectal cancer

Background:Traditional Chinese medicine(TCM)syndrome is the basic unit of TCM treatment,which help clinicians assess the disease progression and treatment preoperative of tumor patients.However,the prognostic significance of TCM syndrome is still unclear.This study aims to detect the differences in overall survival between different TCM syndrome and further develop a new nomogram with TCM syndrome for predicting overall survival in colorectal cancer.Methods:A total of 324 patients with colorectal cancer were enrolled and categorized into three groups based on TCM syndrome:deficiency,excess,and deficiency-excess.The prognosis of colorectal cancer patients with different TCM syndromes was evaluated using Kaplan-Meier analysis and Cox regression analysis.Results:The proportion of advanced stage and lymph metastasis in the patients with deficiency syndrome was higher,and the overall survival was shorter than other syndromes.Meanwhile,the TCM syndrome(P<0.001),tumor invasion depth(P<0.001),lymph metastasis(P=0.018),organic metastasis(P=0.005)and tumor node metastasis(TNM)stage(P=0.029)were the independent prognostic factor.Then,a new nomogram with TCM syndrome was established and assessed.324 colorectal cancer patients were randomly divided into training(n=215)and validation cohorts(n=109).A nomogram incorporating preoperative TCM syndrome,gender,age,T,N,and M status was developed,which had good discrimination and calibration.Conclusion:Taken together,our results indicated that TCM syndrome could assess the prognosis of colorectal cancer.The nomogram incorporating TCM syndromes and tumor information is helpful for risk stratification and prognostic predictions in colorectal cancer preoperatively.

A cross-sectional study on traditional Chinese medicine syndromes distribution for chronic atrophic gastritis based on data mining

Background:Chronic atrophic gastritis(CAG)is a common digestive system disease characterized by reduced gastric mucosa inherent glands and often accompanied by intestinal metaplasia and dysplasia.Traditional Chinese medicine believes that syndrome elements dampness and blood stasis are closely related to the occurrence and development of CAG and promote the occurrence of precancerous lesions of gastric cancer.However,there is a lacking of more in-depth and detailed study on the above syndrome elements.This study aimed to made a quantitative description by cross-sectional study on the frequency of key syndrome elements dampness and blood stasis of CAG.Methods:201 CAG patients who met with inclusion criteria were divided into 4 groups including:only dampness group,only blood stasis group,none of dampness and blood stasis group,dampness and blood stasis group according to their four diagnostic information.The severities and levels of patients’clinical symptoms,pathological signs and patient-reported outcome scale used as evaluation indexes were collected.Data mining method of exploratory factor analysis was used for statistics.Results:The results suggested that the frequencies of dampness and blood stasis were reflected in the severity and levels of gastric symptoms,helicobacter pylori infection and the distribution and severity of dysplasia.And blood stasis played a more prominent role in promoting the progression of the CAG to cancer.Conclusion:Our results might provide a quantitative syndrome description for the traditional Chinese medicine differentiation in treating precancerous lesions of gastric cancer and preventing gastric cancer.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Characteristics and Correlation Analysis of Negative Emotions, Quality of Life, and Chinese Medicine Syndromes in Patients with Lung Cancer after Surgery: A Cross-sectional Study

Objective:The objective of the study was to observe and analyze the characteristics of negative emotions and quality of life(QoL)in patients with nonsmall cell lung cancer(NSCLC)from 1 to 3 months after surgery,and summarize their population characteristics after surgery.Materials and Methods:The consolidation rehabilitation period was defined as 1 to 3 months after surgery.The main observation indicators were the general Hospital Anxiety and Depression Scale,the European Organization for the Research and Treatment of Cancer Core QoL Questionnaire(EORTC QLQ-C30),and EORTC QLQ-Lung Cancer-13.The secondary observation indicators were peripheral blood cytokines and immune function indicators.Statistical methods such as one-way analysis of variance and logistic regression were used to analyze the characteristics of this part of the population.Results:Among patients who underwent lung surgery,the overall incidence of anxiety during consolidation recovery was 13.66%,and that of depression was 10.38%.The scores of fatigue,pain,dyspnea,insomnia,and loss of appetite were significantly higher than those of other symptoms(P=0.000).The presence of anxiety was associated with the site of surgery(P<0.05)and the presence of depression was associated with emotional functioning and dyspnea(P<0.05).Conclusions:The occurrence of negative emotions in the postoperative NSCLC population is related to gender,and the degree of emotions is negatively correlated with QoL and positively correlated with the degree of symptoms.The main relevant syndromes are the pulmonary and meridian categories.

Bone Marrow Angiogenesis in Patients Presenting with Differential Chinese Medicine Syndrome:Correlation with the Clinico-pathological Features of Aplastic Anemia

Objective： To explore differences in bone marrow angiogenesis seen in aplastic anemia （AA） patients presenting with differential Chinese medicine （CM） syndrome, and to correlate these differences with clinical pathology. Methods： Thirty-five patients were enrolled, including 18 with ＂yang deficiency syndrome＂ and 17 with ＂yin deficiency syndrome.＂ Bone marrow biopsies and serum were collected. Microvessel density （MVD） and positive expression of vascular endothelial-derived growth factor （VEGF） were detected by immunohistochemisty. Hypoxia inducible factor -α （HIF-α ）, and VEGF expression were assayed by enzyme-linked immunoabsorbent assay （ELISA）, serum lactate dehydrogenase （LDH） was tested by enzyme method and liquid chip technology was used to detected the expression of interleukin （IL）-2, IL-4, IL-6, IL-10, interferon （IFN）-＇y and tumor necrosis factor （TNF）-α. Results： Counts for leukocytes, absolute neutrophils and platelets in ＂yin deficiency syndrome＂ were lower than those found in ＂yang deficiency syndrome＂ （P〈0.05）. MVD and VEGF expression, and the positive rate of CD34 and VEGF in bone marrow were lower in hA, especially in ＂yin deficiency syndrome＂ （P〈0.01 or P〈0.05）. ＂Yin deficiency syndrome＂ displayed decreased VEGF and LDH expression, and enhanced expression of HIF-α as compared to ＂yang deficiency syndrome＂ （P〈0.05）. Levels of IL-4 and IL-6 were higher in AA （P〈0.01）, but IL-10 was decreased （P〈0.05）. High TNF-c~ expression was seen in ＂yang deficiency syndrome＂ and IFN- γ expression was decreased in ＂yin deficiency syndrome＂ as compared with normals （P〈0.01 and P〈0.05, respectively）. Conclusion： AA patients have lower MVD than normals, especially in ＂yin deficiency syndrome.＂ MVD might differentially correlate to disease severity, and could be dependent on bone marrow or serum VEGF expression and LDH. Additionally, IL-2, IL-10, IL-4 and IFN- γ were negatively associated while IL-6 and TNF- α were positively associated with MVD.

Circulating Levels of Inflammatory Cytokines in Patients with Psoriasis Vulgaris of Different Chinese Medicine Syndromes

Objective： To investigate whether the serum levels of inflammation-related cytokines might be different between the healthy individuals and the psoriatic patients diagnosed of three varied Chinese medicine （CM） syndromes [blood-stasis syndrome （BSS）, blood-dryness syndrome （BDS） and wind-heat syndrome （WHS）]. Methods： A total of 62 psoriatic patients were recruited and assigned to 3 groups according to their CM syndromes, including 27 patients of BSS, 21 of BDS and 14 of WHS. Another 20 sex- and age- matched healthy subjects were enrolled into the control group. Serum concentrations of multiple cytokines, including monocyte chemotactic protein-1 （MCP-1）, macrophage inflammatory protein-1α （MIP-1α）, soluble CD40 ligand （SCD40L）, tumor necrosis factor-α （TNF-α）, epidermal growth factor （EGF）, interleukin-8 （IL-8）, interleukin-17 （IL-17）, interferon γ inducible protein-10 （IP-10） and vascular endothelial growth factor （VEGF）, were measured by a multiplexed flow cytometric assay. Results： The circulating levels of MIP-1α, TNF-α, IL-8, and IP-10 were significantly increased in the psoriatic patients compared with the healthy controls （P〈0.01）. Male and female patients tended to have higher serum levels of MCP-1 and IP-10, respectively （P〈0.05）. Interestingly, compared with the control group, 6 out of the 9 cytokines （MCP-1, MIP-1α, TNF-α, EGF, IL-8 and IP-10） were substantially increased in the BSS group （P〈0.05 or P〈0.01）, whereas only MIP-1α and IL-8 levels were elevated in the BDS group （P〈0.05 or P〈0.01） concurrent with lowered concentrations of SCD40L and IL-17 （P〈0.05）. In the WHS group, MIP-1α was the only cytokine whose level was evidently increased （P〈0.01）, in contrast to IL-17 which was decreased as compared with the control （P〈0.05）. The psoriatic patients overall owned higher levels of MIP-1 a and IL-8 in the circulation which were comparable among the 3 groups of CM syndromes （P〈0.01）. In contrast, TNF-α level of the BSS group was the highest among the three （P〈0.01）, followed by the BDS and the WHS groups. Conclusions： The expression profiles of cytokines in the circulation might not be necessarily identical for psoriatic patients with different CM syndromes. Accordingly, the serum concentrations of certain cytokines could potentially be used as the ancillary indices for the clinical classification of psoriatic CM syndromes.

Exploring Molecular Mechanism underlying Chinese Medicine Syndrome:A Study on Correlation between Chinese Medicine Syndrome and Biomarkers for Ischemic Stroke

Objective：To investigate whether Chinese medicine（CM）syndrome is associated with particular molecular mechanism,we explored the correlation between CM syndrome and changes of intercellular adhesion molecule-1（ICAM-1）,matrix metalloproteinase 9（MMP-9）and heat shock protein 70（HSP70）in patients with ischemic stroke,which were reported to play an important role in the inflammatory and apoptosis cascade.Methods：CM syndrome factors of 175 patients with ischemic stroke were assessed using Ischemic Stroke CM Syndrome Factor Diagnostic Scale（ISTSFDS）.The patients were grouped according to the main syndrome factor combinations at different time points based on distribution probability of syndrome factor combinations.Blood levels of ICAM-1,MMP-9 and HSP70 were quantified by enzyme-linked immunosorbent assay.Results：ICAM-1 expression was significantly higher in the internal-wind＋phlegm-dampness＋blood-stasis,phlegmdampness＋blood-stasis,internal-fire＋phlegm-dampness＋blood-stasis group than that in the blood-stasis＋qideficiency group within 72 h from stroke onset（P〈0.05）;HSP70 expression was significantly lower in the phlegm-dampness＋blood-stasis,internal-fire＋phlegm-dampness＋blood-stasis,blood-stasis group than that in the phlegm-dampness＋blood-stasis＋qi-deficiency group on the 7th day from stroke onset（P〈0.05）.Conclusions：Phlegm-dampness and blood-stasis exist through the whole process of ischemic stroke.An increased level of ICAM-1 and a reduced level of HSP70 reflect the pathological state of phlegm-stasis mutual binding.These results suggest that inflammation and apoptosis induced by cerebral vascular injury in the pathological processes of ischemic stroke are more prominent in the excess syndrome state like phlegm-dampness and blood-stasis.

Expression of PYCARD Gene Transcript Variant mRNA in Peripheral Blood Mononuclear Cells of Primary Gout Patients with Different Chinese Medicine Syndromes

Objective： To study the expression level and role of apoptosis-associated speck-like protein containing a caspase recruitment domain （PYCARD） gene transcript variant mRNA in peripheral blood mononuclear cells （PBMCs） of primary gout （PG） patients with different Chinese medicine （CM） syndromes. Methods： The expressions of PYCARD gene transcript variant mRNA and interleukin-1β （IL-1β） mRNA in PBMCs were investigated in 96 PG patients with acute phase （APPG, 44 cases） and non-acute phase （NAPPG, 52 cases） and 30 healthy controls （HCs） by reverse transcription-polymerase chain reaction （PCR） and/or real-time quantitative PCR. PYCARD and nuclear factor-κB （p50） [NF-κB （p50）] protein was detected by Western blot in PBMCs respectively. IL-1β, IL-4 and IL-10 protein levels in plasma of HCs and PG patients were measured by enzyme-linked immuno sorbent assay. Results： The main CM syndromes in APPG patients were obstruction of dampness and heat syndrome （ODHS, 36.36%） and intermingled phlegm-blood stasis syndrome （IPBSS, 27.27%）, while in NAPPG patients were Pi （Spleen）-deficiency induced dampness syndrome （PDIDS, 40.38%） and qi-blood deficiency syndrome （QBDS, 26.92%）. It showed statistical significances of the expressions of PYCARD gene and its transcript variant mRNA, the protein of PYCARD and NF-κB （p50） and the plasma IL-1β, IL-4 and IL-10 in APPG, NAPPG, ODHS, IPBSS, PDIDS and QBDS groups, compared with the HC group respectively （P〈0.05 or P〈0.01）. There were also significant differences of mRNA expressions of PYCARD-1 and PYCARD-2 as well as protein expressions of IL-1β, IL-4 and IL-10 among the 4 CM syndromes groups （P〈0.05 or P〈0.01）. Correlation analysis showed positive correlation between the mRNA expressions of PYCARD-1 gene transcript variant and IL-1β in APPG patients （r=0.3088, P=0.0183）. Conclusion： PYCARD gene and its transcript variant may play a critical and regulative role in the inflammatory response of PG patients with different phases and CM syndromes.

Study on Chinese Medicine Syndrome of Colorectal Carcinoma in Perioperative Period

Objective：To explore the distribution characteristics of Chinese medicine（CM） syndromes and the rule of dynamic evolvement in patients with colorectal cancer at the perioperative period by applying a mathematical statistics methodology.Methods：By using the overall sample date,and cross-sectional descriptive and prospective researching methods,the clinical data of CM symptoms of patients with colorectal cancer from the first day of preoperative care to the third,seventh,and tenth days after the operation were collected.The distribution characteristics of CM syndromes and dynamic evolution were concluded upon by experts,and then by building up a database through the use of EpiData3.1 the frequency statistics and cluster analyses were applied utilizing SAS9.2software.Results：Among 210 cases of patient,on the day before the operation,the main route of syndrome was blood deficiency（33.33%）,followed by the syndrome of deficiency of both qi and yin（28.57%）.On the third day after surgery,the main syndrome was qi deficiency（47.62%）,followed by yin deficiency inner-heat.On the seventh day after surgery,the main syndrome was both yin deficiency inner-heat（33.33%） and phlegm-dampness（33.33%）.On the tenth day after surgery,the main syndrome was a deficiency of both qi and yin（38.09%）,followed by dampness and hot accumulative knotting（33.33%）.Conclusion：Research in the field of the distribution characteristics of CM syndromes and dynamic evolution will provide an objective basis for syndrome differentiation for patients in the perioperative period,further advancing the study of preventing and decreasing relapse and metastasis in CM therapy.

Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome

Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different TCM syndromes.However,in the stage of diagnosis,the standard criteria for the classification of TCM syndrome were still deficient.Through serum metabolic profiling,this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes,which can assist in diagnosis of the disease.Methods:Serum samples were collected from healthy controls(30 cases),IBS-D patients with LiverStagnation and Spleen-Deficiency syndrome(LSSD,30 cases),Yang Deficiency of Spleen and Kidney syndrome(YDSK,11 cases)and Damp Abundance due to Spleen-Deficiency syndrome(DASD,22 cases).Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry.The potential biomarkers were screened by orthogonal partial least square-discriminate analysis,while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in Metabo Analyst 4.0.Results:Overall,34 potential biomarkers were identified in LSSD group,36 in YDSK group and 31 in DASD group.And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D.Glycerophospholipid metabolism was disturbed significantly in IBS-D patients,which may play a role in IBS-D through inflammation.What’s more,three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.Conclusion:The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways,whose metabolism was disturbed differently among three TCM syndromes in IBS-D.Therefore,the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators,which can facilitate the TCM-syndrome objective classification of IBS-D.

Study of the Relationship between Carotid Intima-media Thickness and Traditional Chinese Medicine Syndrome of Dyslipidemia

Objective:The study aimed to explore the relationship between the carotid intima-media thickness (IMT),lipids,high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy) and other indices of laboratory and the traditional Chinese medicine(TCM) syndrome of dyslipidemia.Methods:A total of 152 dyslipidemia patients and 8 healthy people(taken as the control group) were recruited.According to the theory of the TCM syndrome,152 dyslipidemia patients were assigned to 4 groups:the stagnation of phlegm(SP) group,t...

Analysis on the Chinese Medicine Syndromes and Demographic Characteristics of Patients with Influenza-Like IIlness in Clinics of China

Objective： To investigate Chinese medicine （CM） patterns and epidemiological characters of patients with influenza-like illness （ILI） syndromes in clinics in China. Methods： A prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM pattems. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison. Results： A total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group （56.2%） was the largest; students （41.0%） were more than other occupations. Majority of the patients had the wind-heat invading Lung （Fei） syndrome （76%）, while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue （80.9%）, cough （72.2%）, sore throat （67.2%）, muscular soreness （67.1%）, headache （65.4%）, aversion to cold （60.1%）, thirst （55.1%） and nasal obstruction （48.1%）. Conclusions： The ILl patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILl patients may be relevant to age and region distribution.

Correlation between Characteristics of Coronary Plaque and Chinese Medicine Syndromes of Coronary Heart Disease:A Cross-Sectional Study Analysed by Intravascular Ultrasound

Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were divided into different groups based on Chinese medicine(CM)syndrome differentiation.The baseline demographics and clinical variables were collected from the medical records.Additionally,the characteristics of plaque and pathological manifestations in coronary artery were evaluated intravascular ultrasound(IVUS).Results:A total of 213 CHD patients were enrolled in two groups:184 were diagnosed with PBS and the remaining 29 were diagnosed with BSS.There were no significant differences in age,body mases index,proportions of patients with high blood pressure,diabetes mellitus,smoking,hyperlipidemia,history of coronary artery bypass graft and percutaneous coronary intervention,medications,index from cardiac ultrasound image,blood lipids and C-reactive protein between the two groups(P>0.05),except gender,weight and proportions of OVUS observed target vessels(P<0.05 or P<0.01).More adverse events such as acute myocardial infarction(P=0.003)and unstable angina(P=0.048)were observed in BSS.Additionally,dissection,thrombus and coronary artery ectasia were significantly increased in BSS(P<0.05 or P<0.01).In contrast,PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX(synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery)scores(P<0.05 or P<0.01).Moreover,dense-calcium was significantly elevated in PBS(P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM syndromes.Patients with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis,indicating poor clinical prognosis but with a low probability of acute coronary events.On contrast,the degree of calcified plaque in patients with BSS remained relatively low,and plaque was more vulnerable,resulting in the possibility of the occurrence of acute coronary events remaining high.

Correlation between Different Chinese Medicine Syndromes and Changes in Microcirculation in Septic Shock Patients

Objective： To investigate the correlation between different Chinese medicine （CM） syndromes and variations in microcirculation in septic shock patients. Methods： seventy Septic shock patients were divided into four groups： heat damaging qi-yin group （HDQY, 23 cases）; yin exhaustion and yang collapse group （YEYC, 26 cases）; excessive heat in Fu organ group （EHFO, 10 cases）; and heat damaging nutrient-blood group （HDNB, 11 cases）. Sublingual microcirculation parameters were observed by sidestream dark-field （SDF） imaging and scored by Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） and the Sequential Organ Failure Assessment （SOFA）, and parameters of microcirculation perfusion variations and prognoses were analyzed. Results： Compared with those with qi-yin heat damage, perfused vessel density （PVD） in other groups decreased dramatically （P〈0.05）, and APACHE H scores increased significantly （P〈0.05）. In addition, the recovery time was prolonged substantially （P〈0.05）, and the mixed venous oxygen saturation （SVO2） decreased （P〈0.05）. Blood lactic acid increased significantly （P〈0.05）, and the mixed SVO2 decreased （P〈0.05）, in the YEYC group. Compared with the thermal injury camp blood group, sublingual microcirculation parameter variations showed no obvious difference in the YEYC and EHFO groups （P〉0.05）. There were significant positive correlations between CM syndromes and APACHE Ⅱ scoring in different groups （r=0.512, P〈0.05）. There were negative correlations between PVD and APACHE Ⅱ scoring （r=-0.378, P=0.043）, the proportion of perfused vessels （PPV） and APACHE g scoring （r=0.472, P=0.008）, as well as between the microvascular flow index （MFI） and APACHE Ⅱ scoring （r=-0.424, P=0.023） in different patients. Conclusion： Sublingual microcirculation may serve as a clinical diagnostic parameter of the patient condition, as well as being a prognostic indicator.

Rule of Chinese Medicine Syndrome Differentiation in the Patients with Thoracic Diseases at Perioperation Stage

Objective： To study the rule of syndrome differentiation in the patients with thoracic diseases at perioperation stage. Methods： A standard was created referring to the related literature, and it was applied to differentiate the Chinese medicine syndrome in 150 patients before and three days after thoracic operation. Results： Before operation, Chinese medicine syndromes were as differentiated as phlegm type in 45.3%, blood stasis type in 17.3%, and qi-stagnancy type in 16.0%. The patients with asthenia syndrome markedly increased after operation, accounting for 34.0% （51 patients, including qi-, yin-, and blood-deficiency syndromes）. The most frequently seen intermixed syndromes were qi-deficiency with phlegm-stasis syndrome and Pi （脾）-deficiency with phlegm-dampness syndrome. The intermixed syndromes revealed in 37.5% and 42.0% of the patients before and after operation, respectively. Conclusion： The syndrome in the patients with thoracic disease before operation was mostly the excessive syndrome, mainly the phlegm syndrome type; at postoperation stage, Chinese medicine syndrome in patients become asthenia in essence with excessive superficiality, which is mostly revealed as Pi-deficiency with phlegm-dampness.

DNA Methylation and Transcription of HLA-F and Serum Cytokines Relate to Chinese Medicine Syndrome Classification in Patients with Chronic Hepatitis B

Objective:To explore the molecular bases of Chinese medicine(CM) syndrome classification in chronic hepatitis B(CHB) patients in terms of DNA methylation,transcription and cytokines.Methods:Genome-wide DNA methylation and 48 serum cytokines were detected in CHB patients(DNA methylation:15 cases;serum cytokines:62 cases) with different CM syndromes,including dampness and heat of Gan(Liver) and gallbladder(CHB1,DNA methylation:5 cases,serum cytokines:15 cases),Gan stagnation and Pi(Spleen) deficiency(CHB2,DNA methylation:5 cases,serum cytokines:15 cases),Gan and Shen(Kidney) yin deficiency(CHB3,DNA methylation:5 cases,serum cytokines:16 cases),CHB with hidden symptoms(HS,serum cytokines:16 cases) and healthy controls(DNA methylation:6 cases).DNA methylation of a critical gene was further validated and its mRNA expression was detected on enlarged samples.Genome-wide DNA methylation was detected using Human Methylation 450 K Assay and further verified using pyrosequencing.Cytokines and mRNA expression of gene were evaluated using multiplex biometric enzyme-linked immunosorbent assay(ELISA)-based immunoassay and reverse transcription-quantitative polymerase chain reaction(RT-qPCR),respectively.Results:Totally 28,667 loci,covering 18,403 genes were differently methylated among CHB1,CHB2 and CHB3(P<0.05 and|△β value|> 0.17).Further validation showed that compared with HS,the hg19 CHR6:29691140 and its closely surrounded 2 CpG loci were demethylated and its mRNA expressions were significantly up-regulated in CHB1(P<0.05).However,they remained unaltered in CHB2(P>0.05).Levels of Interleukin(IL)-12 were higher in CHB3 and HS than that in CHB1 and CHB2 groups(P<0.05).Levels of macrophage inflammatory protein(MIP)-1αand MIP-1β were higher in CHB3 than other groups and leukemia inhibrtory factor level was higher in CHB1 and HS than CHB2 and CHB3 groups(P<0.05).IL-12,MIP-1α and MIP-1β concentrations were positively correlated with human leukocyte antigen F(HLA-F)mRNA expression(R;=0.238,P<0.05;R;=0.224,P<0.05;R;=0.447,P<0.01;respectively).Furthermore,combination of HLA-F mRNA and differential cytokines greatly improved the differentiating accuracy among CHB1,CHB2 and HS.Conclusions:Demethylation of CpG loci in 5’ UTR of HLA-F may up-regulate its mRNA expression and HLA-F expression was associated with IL-12,MIP-1α and MIP-1β levels,indicating that HLA-F and the differential cytokines might jointly involve in the classification of CM syndromes in CHB.(Registration No.ChiCTR-RCS-13004001)

Correlations among Persistent Viral Infection,Heart Function and Chinese Medicine Syndromes in Dilated Cardiomyopathy Patients

Objective：To investigate the correlations among persistent viral infection,heart function and Chinese medicine（CM） difined-syndromes in patients with dilated cardiomyopathy（DCM）.Methods：Fifty patients with DCM in the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2009 to December 2011 were selected as the research subjects,and 30 healthy people were simultaneously selected as the normal control group to detect persistent viral infections after admission.The CM syndrome type and grade of heart function were then evaluated.The expression level of Coxsackie adenovirus receptor（CAR） was detected using the flow cytometry（FCM） technique,coxsackie virus RNA（CVB-RNA） using reverse transcription polymerase chain reaction（RTPCR）,and the plasma brain natriuretic peptide（BNP） level with a Triage meter plus diagnosis instrument.Finally,the parameters such as left ventricular end diastolic diameter（LVEDd） and left ventricular ejection fraction（LVEF） were measured by ultrasonic cardiogram.Person correlation analysis was used for measured data,Spearman correlation analysis for rating data,and the Chi-square test for numerical data.Results：CVB-RNA was positive in 22 patients（44%） with DCM,while only 6 cases（20%） were CVB-RNA-positive in the normal control group,with a significant difference between the two groups（P〈0.01）.The expression level of CAR was significantly elevated in the DCM group compared with the normal control group（P〈0.01）.In CVB-RNA-positive patients（22 cases）,the expression level of CAR was significantly higher than in CVB-RNA-negative patients（28 cases;P〈0.01）.In the DCM patients,there was a positive correlation between the CAR expression and the BNP level（r=0.34,P〈0.05）,while no significant difference was found between the CAR expression and the LVEF and LVEDd（r=-0.32,0.30,P〉0.05）.There was no clear correlation between virus infection and the CM syndrome types in DCM patients（r=-0.22,P〉0.05）.According to the sequence of syndrome types：phlegm → qi deficiency → blood stasis → hydroretention with asthenic yang（from low to high）,a positive correlation was existed between the BNP levels and CM syndrome types（r=0.139,P〈0.05）.Conclusion：The expression of CAR on the surface of white cells could be used to detect persistent viral infection.The expression level of CAR and heart function in DCM patients were highly correlated.The expression level of BNP may serve as an objective index for differentiating CM syndromes for patients with DCM.

To Explore the Chinese Medicine Syndrome Types and Integrative Therapy from Clinical Relative Factors of Patients with Advanced Prostate Cancer

Current Situation and Problems of the Treatment in Advanced Prostate Cancer In recent years,the incidence of prostate cancer shows a rising trend in China with an increase of 70%and has been the first place in the growth rate of malignant tumor in the male reproductive system. Prostate cancer has become a serious threat to male senior’s health.Because of the application of

Characteristics of Traditional Chinese Medicine Syndrome in Patients with Coronary Heart Disease at Different Disease Stages

Coronary atherosclerotic heart disease(CHD)has a high incidence,disability rate,and mortality rate,which severely affect people’s health,work,and life.Based on its clinical manifestations,traditional Chinese medicine(TCM)has classified CHD as“chest impediment”and“heart pain”for the treatment.The course of CHD is protracted,and the pathogenesis is complex and changeable.Moreover,different disease stages have different syndrome characteristics.Thus,this article aimed to summarize the classification and distribution characteristics of the TCM syndrome in various stages of CHD,such as before and after percutaneous coronary intervention therapy,disease progression,age,and complications,to provide references for the TCM clinical diagnosis and treatment of CHD.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU