A Meta-analysis of Dachaihu Decoction combined with western medicine in the treatment of acute pancreatitis with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat

Backgroud:To evaluate the clinical efficacy and safety of Dachaihu Decoction in the treatment of acute pancreatitis(AP)with the traditional Chinese medicine(TCM)syndrome of liver qi depression and liver-gallbladder dampness-heat.Methods:We searched randomized controlled trials of Dachaihu Decoction in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat from databases in CNKI,WanFang,VIP,Embase,PubMed,and Cochrane Library(from established to August 2019).All the retrieved documents were imported into the Noteexpress software for screening and management,and the included documents were evaluated for quality and data extracted.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 132 articles were retrieved and 8 studies were included to analysis,including 679 patients.Quality evaluation of included studies suggested that the quality of the literatures is generally not high.Meta-analysis showed that the total clinical effective rate of AP was higher in the treatment group than in the control group[OR=5.00,95%CI(2.86,8.73)],and the difference was statistically significant(P<0.00001).The patient's abdominal pain relief time[MD=-0.57,95%CI(-0.86,-0.27),P=0.0002],bloating relief time[MD=-0.71,95%CI(-1.05,-0.37),P=0.04],time of serum amylase returning to normal[MD=-1.00,95%CI(-1.60,-0.40),P=0.001]and time of urinary amylase returning to normal[MD=-1.62,95%CI(-2.88,-0.37),P=0.01]all lower than the control group.But there was no statistically significant difference between the treatment group and the control group at the first defecation time[MD=-0.86,95%CI(-1.75,-0.03),P=0.06].The patient's serum TNF-a levels on the 3rd[MD=-28.53,95%CI(-49.57,-7.49),P=0.008]and 7th day[MD=-26.13,95%CI(-49.76,-2.50),P=0.03]in the treatment group were statistically lower in the treatment group than in the control group.Similarly,the patient's serum IL-6 levels on the 3rd[MD=-6.62,95%CI(-12.49,-0.75),P=0.03]and 7th day[MD=-11.98,95%CI(-22.25,-1.71),P=0.02]were also statistically lower in the treatment group than in the control group.No serious complications or adverse reactions were observed.Conclusion:Dachaihu Decoction combined with western medicine in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat can improve clinical efficacy compared with western medicine alone.In addition,the combination therapy method is safe and can be used for syndrome differentiation of AP patients in the clinic.

原发性肾小球疾病湿热证和尿MCP-1、IL-6关系临床观察

目的:观察慢性原发性肾小球疾病的患者,湿热和非湿热组尿MCP-1、IL-6之间有无差异,从而探讨湿热证和MCP-1、IL-6的关系。方法:纳入50例患者,进行临床观察,留取尿液样本,ELISA方法测尿液IL-6、MCP-1水平,使用SPSS18.0统计软件包进行中医证候以及临床资料IL-6、MCP-1的数据分析。结果:(1)原发性肾小球疾病湿热证发病率为68%,湿浊证占18%(9/50),血瘀证占26%(13/50);(2)原发性肾小球疾病湿热证患者较非湿热证患者尿MCP-1、IL-6水平高(P<0.05);结论:(1)原发性肾小球疾病邪实证中湿热证的发病率最高,(2)湿热证和肾脏的免疫发病机制可能存在关系,不仅包括细胞因子,还包括趋化因子。

龙胆泻肝汤合五味消毒饮治疗淋证(湿热下注)观察

目的:观察龙胆泻肝汤合五味消毒饮治疗淋证(湿热下注)的效果。方法:将符合纳入标准的96例患者分成治疗组和对照组,其中治疗组50例,用龙胆泻肝汤合五味消毒饮加减;对照组46例,用左氧氟沙星治疗。结果:治疗2周后治疗组治愈率为54.00%,总有效率为88.0%;对照组治愈率为32.61%,总有效率为69.57%。经卡方检验,两组治愈率(x2=4.455,P<0.05)和总有效率(x2=4.844,P<0.05)相比,差异均具有显著性。结论:龙胆泻肝汤合五味消毒饮加减治疗淋证(湿热下注)明显优于用左氧氟沙星治疗。

Defining the role of bariatric surgery in polycystic ovarian syndrome patients

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women.To meet PCOS criteria,women must have a combination of hyperandrogenism,anovulation and ultrasound findings.Almost 10% of all reproductive age women worldwide show signs of PCOS.Although women often seek care for gynecological or body image concerns,many PCOS women are at risk for metabolic syndrome (MS).Many of the metabolic consequences are overlooked and un-dertreated by physicians because these patients tend to be young,reproductive age women.MS and obesity coexist commonly with PCOS.These young women are predisposed to glucose abnormalities and ulti-mately diabetes mellitus,dyslipidemia and eventually cardiovascular disease.Bariatric surgery can be an ef-fective means of weight loss in PCOS women.Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss.Surgical options have also in-creased,giving patients more choices.Bariatric surgery may prevent or reverse metabolic syndrome.Bariatric surgery may also have reproductive benefits in PCOS patients.Although bariatric surgery has historically been performed in older,reproductive aged women,it has recently gained favor in adolescents as well.This is of particular importance due to the prevalence of both PCOS and MS in adolescents.Treatment of PCOS and MS certainly requires a combination of medical therapy,psychological support and lifestyle modifications.These treatments are difficult and often frustrating for pa-tients and physicians.Bariatric surgery can be effective in achieving significant weight loss,restoration of the hypothalamic pituitary axis,reduction of cardiovascular risk and even in improving pregnancy outcomes.Ulti-mately,bariatric surgery should be considered part of the treatment in PCOS women,especially in those with MS.

High-sensitivity cardiac troponins in everyday clinical practice

High-sensitivity cardiac troponin(hs-cTn) assays are increasingly being used in many countries worldwide,however,a generally accepted definition of high-sen-sitivity is still pending.These assays enable cTn mea-surement with a high degree of analytical sensitivity with a low analytical imprecision at the low measuring range of cTn assays(coefficient of variation of < 10% at the 99th percentile upper reference limit).One of the most important advantages of these new assays is that they allow novel,more rapid approaches to rule in or rule out acute coronary syndromes(ACSs) than with previous cTn assay generations which are still more commonly used in practice worldwide.hs-cTn is also more sensitive for the detection of myocardial damage unrelated to acute myocardial ischemia.Therefore,the increase in early diagnostic sensitivity of hs-cTn assays for ACS comes at the cost of a reduced ACS specificity,because more patients with other causes of acute or chronic myocardial injury without overt myocardial isch-emia are detected than with previous cTn assays.As hs-cTn assays are increasingly being adopted in clinical practice and more hs-cTn assays are being developed,this review attempts to synthesize the available clinical data to make recommendations for their everyday clini-cal routine use.

Magnetic resonance imaging correlates of bee sting induced multiple organ dysfunction syndrome: A case report

Occasionally systemic complications with high risk of death,such as multiple organ dysfunction syndrome(MODS),can occur following multiple bee stings.This case study reports a patient who presented with MODS,i.e.,acute kidney injury,hepatic and cardiac dysfunc-tion,after multiple bee stings.The standard clinical findings were then correlated with magnetic resonance imaging(MRI)findings,which demonstrates that MRI may be utilized as a simpler tool to use than other mul-tiple diagnostics.

Nifekalant in the treatment of life-threatening ventricular tachyarrhythmias

The aim of the present study is to review the literature and discuss nifekalant's potential use as a first aid drug in an emergency care setting.The PubMed database was used to identify papers,using Keywords nifekalant,MS-551,amiodarone and lidocaine.Nifekalant hydrochloride,formally known as MS-551,is a classⅢ antiarrhythmic agent which acts only by increasing the time course of myocardial repolarization.It was developed and is currently being used only in Japan for the treatment of ventricular tachyarrhythmias.It is a non-selective K+channel blocker without any β-blocking actions.Administration of nifekalant suppressed sustained ventricular tachyarrhythmias in acute coronary syndrome patients,and in cardiac arrest victims as well as during or after cardiac surgery.The major adverse effect of nifekalant is QT interval prolongation and occurrence of torsades de pointes which requires frequent monitoring of the QT interval during nifekalant infusion with adequate dose adjustment.Nifekalant is a possible effective antiarrhythmic agent for refractory ventricular tachyarrhythmias.Further clinical studies are required before nifekalant is routinely used in the emergency care setting.

Prevalence of restless legs syndrome in patients with irritable bowel syndrome

AIM:To determine the prevalence of restless legs syndrome(RLS)in patients with irritable bowel syndrome(IBS).METHODS:Patients with diarrhea-predominant IBS(n=30),constipation-predominant IBS(n=30),or mixed-symptom IBS(n=30)were recruited from the community between March 2008 and February 2009.Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel over-growth in all patients.The presence of RLS was assessed via an RLS questionnaire and polysomnography.RESULTS:Twentysix patients with IBS(29%)were diagnosed with RLS using the RLS questionnaire.Twenty-four of the 26 patients(92%)underwent polysomnog-raphy,and all had confirmation of RLS.A greater percentage of patients with RLS had diarrhea-predominant IBS(62%)compared with patients with constipation-predominant IBS(4%)or mixed-symptom IBS(33%).CONCLUSION:Restless legs syndrome is prevalent in patients with IBS,especially those with diarrheal symptoms.Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

Nerve biopsy findings contribute to diagnosis of multiple mononeuropathy: 78% of findings support clinical diagnosis

Multiple mononeuropathy is an unusual form of peripheral neuropathy involving two or more nerve trunks. It is a syndrome with many different causes. We reviewed the clinical, electrophysi- ological and nerve biopsy findings of 14 patients who suffered from multiple mononeuropathy in our clinic between January 2009 and June 2013. Patients were diagnosed with vasculitic neurop- athy （n = 6）, perineuritis （n = 2）, chronic inflammatory demyelinating polyradiculoneuropathy （n = 2） or Lewis-Sumner syndrome （n = 1） on the basis of clinical features, laboratory data, elec- trophysiological investigations and nerve biopsies. Two patients who were clinically diagnosed with vasculitic neuropathy and one patient who was clinically diagnosed with chronic inflamma- tory demyelinating polyradiculoneuropathy were not confirmed by nerve biopsy. Nerve biopsies confirmed clinical diagnosis in 78.6% of the patients （11/14）. Nerve biopsy pathological diagno- sis is crucial to the etiological diagnosis of multiple mononeuropathy.

Evidence-Based Dampness-Heat ZHENG(Syndrome) in Cancer: Current Progress toward Establishing Relevant Animal Model with Pancreatic Tumor

Cancer is one of the deadliest diseases affecting the health of human beings. With limited therapeutic options available, complementary and alternative medicine has been widely adopted in cancer management and is increasingly becoming accepted by both patients and healthcare workers alike. Chinese medicine characterized by its unique diagnostic and treatment system is the most widely applied complementary and alternative medicine. It emphasizes symptoms and ZHENG(syndrome)-based treatment combined with contemporary disease diagnosis and further stratifies patients into individualized medicine subgroups. As a representative cancer with the highest degree of malignancy, pancreatic cancer is traditionally classified into the "amassment and accumulation". Emerging perspectives define the core pathogenesis of pancreatic cancer as "dampness-heat" and the respective treatment "clearing heat and resolving dampness" has been demonstrated to prolong survival in pancreatic cancer patients, as has been observed in many other cancers. This clinical advantage encourages an exploration of the essence of dampness-heat ZHENG(DHZ) in cancer and investigation into underlying mechanisms of action of herbal formulations against dampness-heat. However, at present, there is a lack of understanding of the molecular characteristics of DHZ in cancer and no standardized and widely accepted animal model to study this core syndrome in vivo. The shortage of animal models limits the ability to uncover the antitumor mechanisms of herbal medicines and to assess the safety profile of the natural products derived from them. This review summarizes the current research on DHZ in cancer in terms of the clinical aspects, molecular landscape, and animal models. This study aims to provide comprehensive insight that can be used for the establishment of a future standardized ZHENG-based cancer animal model.

The prescription rule analysis of the New Theory on Spleen Dampness Syndrome by Academician TONG Xiaolin

Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.

Dampness-Heat Accelerates DMBA-Induced Mammary Tumors in Rats

Objective： To investigate the impact of dampness-heat （DH） on the development of mammary tumors in 7,12-dimethylbenz（a）anthracene （DMBA）-induced rats. Methods： Forty rats were randomly divided into 3 groups in a randomized block design, including the control group （n=13）, DMBA group （n=14）, and DMBA plus DH group （n=13）. Rats in the DMBA group and DMBA plus DH group were intragastrically administrated with DMBA （100 mg/kg） for twice, once per week, while rats in the control group were treated with equivalent volumes of sesame oil. After DMBA administration, rats in the DMBA plus DH group were exposed to a simulated climate chamber with ambient temperature （33.0 ± 0.5 ℃） and humidity （90% ± 5%） for 8 weeks, 8 h per day. The body weight, time of tumor formation, and number of tumors were measured weekly to calculate tumor incidence, average latency period, average number of tumors, and average tumor weight. At the end of the experiment, the levels of matrix metalloproteinase 9 （MMP-9） and tissue inhibitor of metalloproteinases 1 （TIMP-1） in serum, and the contents of tumor necrosis factor- α （TNF- α ） and interleukin （IL）-1β in serum and tumor tissue were measured, respectively. Some tumor tissues were processed for hematoxylin-eosin staining to determine the histopathological changes. Results： Compared with DMBA, DMBA plus DH significantly increased the average number of tumors, average tumor weight, levels of serum MMP-9, TiMP-1, TNF- α and IL-1β, and contents of tumor tissue TNF- α and IL-1β （P〈0.05 or P〈0.01）. Conclusion： DH could accelerate the development of mammary tumors through increasing the expressions of MMP-9, TIMP-1, TNF- α and IL-1β in DMBA-induced rats.

Efficacy and Safety of Guihuang Formula in Treating Type Ⅲ Prostatitis Patients with Dampness-Heat and Blood Stasis Syndrome: A Randomized Controlled Trial

Objective: To observe the efficacy and safety of Guihuang Formula(GHF) in treating patients with type Ⅲ prostatitis and Chinese medicine syndrome of dampness-heat and blood stasis. Methods: Sixty-six type Ⅲ prostatitis patients with dampness-heat and blood stasis syndrome were randomly divided into the treatment group(GHF) and the control group(tamsulosin) using a random number table, with 33 cases each group. The treatment group received GHF twice a day, and the control group received tamsulosin 0.2 mg once daily before bedtime. Patients in both groups received treatment for 6 weeks and was followed up for 2 weeks. The outcomes included the National Institute of Health Chronic Prostatitis Symptom Index(NIH-CPSI) score, Chinese Medicine Symptoms Score(CMSS), expressed prostatic secretions(EPS) and adverse events(AEs). Results: After treatment, the NIH-CPSI total score and domain scores of pain discomfort, urination and quality of life decreased significantly from the baseline in both groups(P<0.05). The CMSS score decreased in both groups(P<0.05). The white blood cell(WBC) count decreased and lecithin body count increased in both groups(P<0.05). GHF showed a more obvious advantage in reducing the pain discomfort and quality of life domain scores of NIH-CPSI, reducing the CMSS score, increasing the improvement rate of the WBC and lecithin body counts, compared with the control group(P<0.05). There were no significant differences in decreasing urination domain score of NIH-CPSI between two groups(P>0.05). In addition, no serious AEs were observed. Conclusion: GHF is effective in treating type Ⅲ prostatitis patients with dampness-heat and blood stasis syndrome without serious AEs.(Registration No. ChiCTR1900026966)

Effective Common Chinese Herbal Medicines Used in Treating Chronic Cholecystitis with Liver-Gallbladder Dampness-Heat Syndrome: A Review of Clinical Studies in the Past 10 Years

The objective of the study is to identify the effective common Chinese herbal medicines used in treating chronic cholecystitis with liver-gallbladder dampness-heat syndrome(CCLGDHS) through reviewing relevant clinical studies published in the past 10 years. Data were collected from Science Direct and Chinese National Knowledge Infrastructure. Data screening was carried out for the abstracts and full texts of the data. The top 15 Chinese herbal medicines with the highest occurring frequency were selected, statistically analyzed, and classified by their medicinal properties, actions, and indications according to the Chinese Pharmacopoeia 2015 edition. The top 15 effective common Chinese herbal medicines comprise Chai Hu, Huang Qin, Jin Qian Cao, Bai Shao, Yin Chen, Yu Jin, Chuan Lian Zi, Yan Hu Suo, Zhi Shi, Ban Xia, Bai Zhu, Pu Gong Ying, Gan Cao, Zhi Zi, and Qing Pi. The predominant natures were cold, cool, and warm. This combination can clear stagnant heat, warm Yang, and regulate Qi dynamics. In addition, bitter, pungent, and sweet were the predominant flavors. They can clear dampness-heat, regulate Qi dynamics to relieve cramps and pain, as well as tonify the deficiency. Along with entering the liver and gallbladder meridians, these herbal medicines also entered the spleen, stomach, and lung meridians to prevent potential disease transmission. The combinatorial medicinal actions of the effective common Chinese herbal medicine highlight the importance of the holistic concept of traditional Chinese medicine when treating CCLGDHS. In addition, the inclusion of activating blood to promote blood circulation, relieving cramps and alleviating pain, and tonifying the spleen and stomach represents a new finding in the treatment principle for CCLGDHS.

Haoqin Qingdan Decoction(蒿芩清胆汤)and Ribavirin Therapy Downregulate CD14 and Toll-Like Receptor 4 in Febrile Disease with Dampness-Heat Syndrome in A Mouse Model

Objective： To evaluate the effect of Chinese medicine Haoqin Qingdan Decoction （蒿芩清胆汤, HQD） for febrile disease dampness-heat syndrome （FDDHS）. Methods： Forty mice were divided into four groups, including normal control, FDDHS （induced by Radix et Rhizoma Rhei recipe and influenza virus A1 FM1 model）, HQD, and the ribavirin groups （10 in each）. The normal control and FDDHS groups were administered normal saline. HQD and the ribavirin groups were administered HQD and ribavirin intragastrically once daily at a dose of 64 g/（kg.d） and 0.07 g/（kg.d）, respectively for 7 days. Lethargy, rough hair, diarrhea, tongue color and sole color were evaluated for pathological changes in morphology. The tongue and lung tissues were collected for histology. The CD14 and toll-like receptor 4 （TLR4） expression levels were measured using real-time quantitative polymerase chain reaction. Results： More than 80% of the FDDHS mice showed hypokinesia and lethargy, and pathological changes associated with rough hair, diarrhea, tongue color and sole color. With advanced treatment for 7 days, the thick greasy tongue fur of the HQD and ribavirin groups were thinner than that of the FDDHS group （P〈0.05）, and it was the thinnest in the ribavirin group as compared with that in other groups （P〈0.05）. The CD14 and TLR4 expression levels in the lung tissues of HQD and ribavirin groups significantly delined compared with the model group （P〈0.05 or P〈0.01）. CD14 was down-regulated more remarkably in the HQD group compared with the ribavirin group （P〈0.05）, whereas the converse was true with TLR4 （P〈0.05）. Conclusions： We established a FDDHS mouse model showing systemic clinical symptoms. Both HQD and ribavirin can inhibit the expression of CD14 and TLR4 in FDDHS mice, while the effect of ribavirin might be much more violent. The expression changes of CD14 and TLR4 consistently refers to lipopolysaccharide, the commonly and hotly inducing factor in FDDHS.

Efficacy and safety of Traditional Chinese Medicine for the treatment of acquired immunodeficiency syndrome:a systematic review

OBJECTIVE:To systematically review the efficacy and safety ofTraditional Chinese Medicine(TCM)interventions,compared with control interventions(placebo or conventional Western medical therapy),in the treatment of acquired immunodeficiency syndrome(AIDS).METHODS:Electronic databases including PubMed,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched to identify relevant randomized controlled trials(RCTs)published as of May 2012.Studies were selected according to the specified inclusion and exclusion criteria and then subjected to methodological quality assessment,data extraction,and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.RESULTS:Twelve RCTs involving 881 patients with AIDS were included.Methodological quality assessment showed that two were high-quality,two were moderate-quality,and eight were low-quality.Meta-analysis showed that TCM interventions were associated with significantly reduced plasma viral load compared with placebo[odds ratio OR=2.46,95%confidence interval CI(1.02,5.94);P=0.04].However,the reductions in plasma viral load significantly favored conventional Western medical therapy alone over integrated traditional Chinese and Western medical therapy[OR=0.16,95%CI(0.05,0.55);P=0.004].Patients receiving TCM interventions had significantly higher CD4+T lymphocyte counts compared with those on placebo[OR=2.54,95%CI(1.40,4.60);P=0.002].In addition,TCM interventions were significantly more likely to have improved clinical symptoms[OR=2.82,95%CI(1.85,4.31);P<0.00001].TCM interventions conferred a similar risk of adverse events(AEs)compared with control interventions[OR=1.87,95%CI(0.58,6.01);P=0.29].CONCLUSION:Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and increasing CD4+T lymphocyte count in patients with AIDS.When compared with conventional Western medical therapy,TCM interventions were significantly less effective in reducing plasma viral load,although they were associated with a higher percentage of patients with improved symptoms.Patients receiving TCM interventions did not seem to be at an increased risk of AEs.

Differences in acquired immune deficiency syndrome treatment and evaluation strategies between Chinese and Western Medicine

Complementary and alternative medicine, including Chinese medicine(CM), has been used to treat acquired immune deficiency syndrome(AIDS) for almost 30 years. We aimed to compare the main differences between AIDS treatment and evaluation strategies between CM and Western Medicine(WM), and analyze advantages and disadvantages.The characteristics of integrative medicine(IM),based on CM and WM, include a patient-centered mode of medicine based on evidence. IM focuses on complex intervention and management with systemic and individual treatment. The evaluation indexes of IM might consist of objective indicators and subjective indexes. IM might be a more valuable method for treating AIDS in the future instead of WM or CM alone.

Ultrastructure Characteristics of Different Chinese Medicine Syndromes of Helicobacter pylori-Correlated Gastric Diseases

Objective: To explore the ultrastructure characteristics of patients with dampness-heat of Pi(Spleen)-Wei(Stomach) syndrome(DHPW) and Pi-qi deficiency syndrome(PQD), both of which are Helicobacter pylori(Hp)-correlated gastric diseases(HPCG), and implicate a helpful hint for the clinical microcosmic syndrome differentiation. Methods: Fourteen gastric mucosa samples from 6 chronic gastritis(CG) and 6 active peptic ulcer(including 8 DHPW, 4 PQD) as well as 2 healthy volunteers were collected and tested for Hp infection. The ultrastructure of gastric mucosa was observed under the transmission electron microscope(TEM). Results: Among 14 gastric mucosa samples, 8 of them were Hp positive(6 DHPW and 2 PQD), which were all accordance with the results screened by supermicro-pathological method. Under TEM, the normal gastric mucosa, with tidy microvilli and abundant in mucus granules, mitochondria and rough endoplasmic reticulum distributed evenly, and with smooth nucleus membrane. But in those specimens of DHPW with Hp infection, microvilli were presented with burr shape. Especially, those samples from dampnessheat syndrome with predominant heat type(DHSH) patients were more obvious, with microvilli damaged, mitochondria concentrated and distributed in disorder, secretory tubule extended. In dampness-heat syndrome with predominant dampness type(DHSD) patients, mucus granules aggregated obviously, mitochondria swelled and blurred, and rough endoplasmic reticulum crowded. For 2 samples of DHPW without Hp infection, their microvilli were intact, with mitochondria increased and gathered but well-distributed, and secretory tubule extended mildly. In 2 PQD patients with Hp positive, the specimens of microvilli were sparse, and their mucus granules and mitochondria were decreased, with fractured crests and vacuole, secretory tubules extension to nucleus membrane, and rough endoplasmic reticulum extension in a pool-like way, and nucleus condensed. The 2 samples from PQD patients without Hp infection were characterized with intact microvilli, decreased mitochondria, fractured crest and extended rough endoplasmic reticulum in a pool-like way. Conclusion: It is obvious different in ultrastructure of DHPW and PQD patients under TEM, which may give a helpful hint for the microcosmic syndrome differentiation of HPCG.

Effectiveness of Jinying capsule on pelvic inflammatory disease in patients with symptom pattern of damp and heat accumulation: a double-blinded, multicenter, randomized, placebo-controlled clinical trial

OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.

Survival rate:an indicator of the management of acquired immune deficiency syndrome using Traditional Chinese Medicine

Complementary and alternative medicine,including Traditional Chinese Medicine(TCM),has been used as therapy against acquired immune deficiency syndrome(AIDS) for almost 30 years. Based on evaluation indicators for AIDS treatment using TCM,we discuss why the survival rate(which has been used widely in Western Medicine) should be adopted as a new important indicator of TCM treatment for AIDS. We advise that further prospective or retrospective cohort studies should be carried out to confirm this hypothesis.