Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Lysine deficiency impaired growth performance and immune response and aggravated inflammatory response of the skin,spleen and head kidney in grown-up grass carp (Ctenopharyngodon idella)

This dissertation was primarily focused on the immune response,inflammatory response and molecular mechanisms in the skin,head kidney and spleen of grown-up grass carp(Ctenopharyngodon idella).Six iso-nitrogen diets differing in lysine concentrations(5.6,8.5,11.6,14.4,17.5 and 20.7 g/kg)were fed to 540 grass carp(164.85±0.79 g)for 60 d.After that,grass carp were challenged by Aeromonas hydrophila for 6 d.This study revealed that lysine deficiency(1)suppressed the growth performa,nce of the fish and decreased their ability to resist skin lesion morbidity,(2)impaired the immune organ s immune response by decreasing the gene expressions of mucin,liver-expressed antimicrobial peptide(LEAP)-2B,β-defensin-1 and LEAP-2A and the production of antibacterial compounds of grown-up grass carp,and(3)aggravated the inflammatory response of immune organs in the fish by increasing the gene expressions of pro-inflammatory cytokines(interferon y2[IFN-γ2],tumor necrosis factorα[TNF-α],interleukin[IL]-15,IL-17D,IL-12p40,IL-6 and IL-8)and down-regulating anti-inflammatory cytokines(IL-11,transforming growth factorβ1[TGF-β1],IL-10 and IL-4/13A),which were tightly correlated with signal transducer and activator of transcription(STAT)1 and STAT3 signaling pathway,respectively.The different phenomenon in the skin,spleen and head kidney of fish may be correlated with the difference in gene subtype.In addition,using quadratic regression analysis of percent weight gain(PWG),skin lesion morbidity,and the lysozyme activities in the spleen and head kidney,the dietary lysine requirements for grown-up grass carp were estimated to be 13.58,13.51,14.56 and 14.18 g/kg,respectively.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

基于高效液相色谱-质谱联用技术的脾阴虚糖尿病认知功能障碍大鼠血清代谢组学研究

目的从代谢组学层面上观察脾阴虚(Spleen-Yin deficiency,SD)糖尿病认知功能障碍(Diabetes-associated Cognitive Decline,DACD)大鼠的代谢产物变化,探究脾阴虚糖尿病认知功能障碍潜在标志物及其意义。方法建立SD、DACD及SD-DACD大鼠模型。采用高效液相色谱-四极杆-飞行时间质谱联用技术(High performance liquid chromatography-quadrupole time-of-flight mass spectrometry,HPLC-Q-TOF/MS)对大鼠血清样品的代谢产物进行分析。结果各组大鼠血清代谢存在显著差异。研究建立的代谢物分析方法可以区分SD组、DACD组、SD-DACD组与空白对照(blank control,BC)组,SD组与SD-DACD组,DACD组与SD-DACD组。其中,与BC组大鼠相比,吡哆胺(pyridoxamine)在SD组和SD-DACD组中分别上调约24倍和25倍,在DACD组中则下调约21倍,可将SD组与DACD组、SD-DACD组与DACD组大鼠相区别。吡哆胺可作为一个潜在的生物标志物用于诊断脾阴虚DACD。涉及的苯丙氨酸代谢通路的紊乱主要发生在SD组和SD-DACD组大鼠的差异代谢产物之间。结论吡哆胺和苯丙氨酸代谢途径参与脾阴虚糖尿病认知功能障碍的发病机制,并且可能是脾阴虚和糖尿病认知功能障碍之间相关性的基础。研究结果可为基于代谢组学的SD-DACD筛查及病因研究提供参考资料。

CLINICAL RESEARCH ON TREATMENT OF CHRONIC PROSTATITIS WITH ACUPUNCTURE

In the present study, the authors put forward that Zhibian(BL 54) and Sanyin-jiao(SP 6) are the effective acupoints for treatment of chronic prostatitis and possess an unique cura-tive effect in treatment of this disease with the type of deficiency of both the spleen and the kidney. Atotal effective rate was 92% in group of 1OO cases treated with acupuncture and comparison betweenpre- and post-treatment in examinations of prostatic fluid and other 6 items showed, significantly bet-ter than that of oral compound Sinohan(P【0. 01 ).

滋补脾阴方药对脾阴虚糖尿病大鼠大脑皮质内质网应激的影响

目的观察脾阴虚糖尿病大鼠大脑皮质磷酸化(p)RNA依赖的蛋白激酶样内质网激酶(PERK)、真核起始因子2α-亚单位(eIF2α)、p-eIF2α、葡萄糖调节蛋白78(GRP78)的变化,探讨脾阴虚糖尿病相关认知下降发病机制及滋补脾阴方药的作用机制。方法将大鼠随机分为对照组、糖尿病组、脾阴虚组、脾阴虚糖尿病组(病证组)、脾阴虚糖尿病+滋补脾阴方药组(治疗组)。采用高脂喂养4周联合小剂量链脲佐菌素注射方法建立2型糖尿病模型。在此基础上采用饮食不节、劳倦过度及灌服伤阴药方法建立脾阴虚糖尿病模型。治疗组给予滋补脾阴方药灌胃,其余各组给予等体积生理盐水灌胃,连续15 d,取大脑皮质。采用Western Blot、RT-PCR方法观察PERK、eIF2α、p-eIF2α、GRP78表达变化。结果糖尿病组、脾阴虚组、病证组PERK、p-eIF2α蛋白表达及GRP78 mRNA表达较对照组增强(P<0.05),糖尿病组、病证组GRP78蛋白表达较对照组增强(P<0.05),治疗组上述分子表达较糖尿病组、病证组均减弱(P<0.05)。结论内质网应激参与脾阴虚糖尿病相关认知下降的发病,滋补脾阴方药通过减轻内质网应激改善学习记忆障碍。

滋补脾阴方药对脾阴虚糖尿病大鼠下丘脑胰岛素信号的调控作用

目的:通过观察胰岛素信号通路中关键分子的变化,进一步探讨脾阴虚糖尿病认知功能障碍的发病机制及滋补脾阴方药的作用机制,以期为糖尿病认知功能障碍的治疗提供新思路和新线索。方法:将大鼠随机分为空白对照组(Cont),糖尿病组(DM),脾阴虚组(pi),脾阴虚糖尿病组(piDM),滋补脾阴方药治疗组(ZBPYR)5组。采用Western blotting的方法观察下丘脑中胰岛素受体底物1(IRS-1)丝氨酸磷酸化水平及蛋白激酶C(PKC/Akt)丝氨酸磷酸化水平,以判定胰岛素信号传导是否出现障碍。结果:DM组、pi组、piDM组p-IRS-1ser表达较Cont组增加(P<0.05),DM组、piDM组p-Akt表达减弱(P<0.05)。ZBPYR组p-IRS-1ser较DM组、piDM组减弱(P<0.05),p-Akt表达较DM组、piDM组增加(P<0.05)。结论:DM组、pi组、piDM组大鼠下丘脑中胰岛素信号未正常向下传导,可能发生了胰岛素信号转导障碍。ZBPYR具有纠正胰岛素信号转导障碍的作用。

滋补脾阴方药调节下丘脑中自噬及内质网应激改善脾阴虚糖尿病认知功能障碍机制研究

目的:探讨滋补脾阴方药(ZBPYR)调节自噬及内质网应激(ERS)改善脾阴虚糖尿病认知功能障碍的作用机制。方法:将大鼠随机分为空白对照组(cont),糖尿病组(DM),脾阴虚组(pi),脾阴虚糖尿病组(pi DM),脾阴虚糖尿病+滋补脾阴方药治疗组(ZBPYR)。Western Blot观察微管相关蛋白1A/1B轻链3Ⅱ(LC3Ⅱ)、抑制物阻抗性酯酶1α亚基(IRE1α)、c-Jun氨基端激酶(JNK)的蛋白表达。结果:DM组、pi组、pi DM组LC3Ⅱ较cont组降低(P<0.05),ZBPYR组LC3Ⅱ较DM组、pi DM组增加(P<0.05)。与cont组比较,DM组、pi DM组p-IRE1α、pi组、pi DM组p-JNK1均有所增加(P<0.05),ZBPYR组p-IRE1α、p-JNK1与DM组、pi DM组比较有所降低(P<0.05)。结论:ZBPYR调节自噬及ERS改善脾阴虚糖尿病认知功能障碍。

滋补脾阴法对脾阴虚糖尿病大鼠脑组织β淀粉样蛋白及胰岛素降解酶的调节作用

目的:观察脾阴虚糖尿病大鼠海马及大脑皮质中不同形式的β淀粉样蛋白(Aβ)、胰岛素降解酶(IDE)变化,及其在脾阴虚糖尿病认知功能障碍中的作用,并观察滋补脾阴法对其影响。方法:将大鼠随机分为空白对照组(Cont)、糖尿病组(DM)、脾阴虚组(pi)、脾阴虚糖尿病组(piDM)、滋补脾阴方药治疗组(ZBPYR)5组。采用梯度离心的方法提取可溶性与不可溶Aβ,通过ELISA方法测定各组大鼠海马及大脑皮质中可溶性与不可溶的Aβ1-42及Aβ1-40的含量变化,通过Western blot方法观察各组大鼠海马及皮质中IDE蛋白表达变化。结果:DM组、piDM组大鼠海马、大脑皮质可溶性与不可溶Aβ1-42均高于Cont组(P<0.05),ZBPYR组较DM组、piDM组降低了海马、大脑皮质可溶性与不可溶Aβ1-42的表达(P<0.05)。DM组、pi组、piDM组大脑皮质可溶性Aβ1-40较Cont组增加(P<0.05),ZBPYR组较DM组、piDM组有所下降(P<0.05)。DM组、piDM组海马IDE蛋白表达较Cont组降低(P<0.05),ZBPYR组海马较DM组、piDM组升高(P<0.05);DM组、pi组、piDM组大鼠大脑皮质IDE蛋白水平较Cont组降低(P<0.05),ZBPYR组大脑皮质较DM组降低(P<0.05)。结论:脑组织中Aβ1-42增加可能是糖尿病大鼠、脾阴虚糖尿病大鼠认知功能障碍的主要病理变化,IDE表达下降可能是导致Aβ1-42增加的原因之一,滋补脾阴法可能通过上调IDE蛋白表达降低Aβ1-42的含量。

主观认知下降中医证型分布特点研究

目的:探讨主观认知下降(SCD)患者中医证型分布特点,为该类患者的辨证论治提供依据。方法:将符合纳入标准的患者临床资料进行统计分析,频数描述为计数资料,应用聚类分析方法进行对计量资料进行正态性分析。结果:SCD患者证型分布以虚证居多,肝脾肾虚为主,病理产物如气滞、痰浊、瘀血等均占有一定比例。由四诊总频数分析提示SCD患者以虚证指标居多,以气虚、肾虚、肝虚和脾虚为主。中医辨证肝肾亏虚、脾肾不足分别聚为第1、2类,其中肝肾亏虚证出现频率最高,聚为第1类,其次为脾肾不足。结论:SCD患者的中医证型分布具有自身特点,其证型以肝肾亏虚、脾肾不足为主。

中西医结合治疗慢性肾功能衰竭临床研究

目的:观察中西医结合治疗慢性肾功能衰竭的的临床效果。方法:将60例慢性肾功能衰竭患者随机分为对照组22例和治疗组38例,对照组采用西医一般治疗,治疗组在对照组治疗的基础上采用中药治疗,并随证加减。结果:对照组22例,显效11例,有效5例,无效6例,有效率为72.7%,治疗组38例,显效24例,有效11例,无效3例,有效率为92.1%,两组有效率比较,差异有显著性(P<0.05)。结论:中西医结合治疗肾功能衰竭疗效显著。

抑郁症病机演变及其内涵探析

根据“病机辨证”理论,课题组提出郁病初在肝,继则及脾,终至命门火衰的病机演化规律。疏泄不及,肝气自郁;木不疏土,土壅木郁;脾虚及肾,命门火衰,一方面概括了郁病脏腑传变,另一方面体现三脏相互为用、互资互制的调节情志之功。在此基础上,深入分析肝郁、脾虚与肾阳虚的病机本质,发现病机的演变与单胺类递质的紊乱、脑-脏腑交流(crosstalk)障碍、脑能量代谢及功能连接异常相关。审察疾病演变规律,扭转核心病机,对疏肝法、逍遥散疗效不佳的抑郁症病人提出了以温阳为主的辨治新思路,既是对抑郁症病机论精华的传承,又是对病机内涵的创新发现。

从脾肾阳虚论治肝癌癌性腹泻举隅

腹泻的病因从中医角度看主要为感受外邪、饮食所伤、情志失调、禀赋不足、病后体虚。在临床中某些疾病的终末期,患者肝、脾、肾三脏衰弱,脾虚湿胜,肾阳不温,从而导致关门失守,泄泻不止。现将我科收治1例以腹泻为主要症状的肝癌患者的诊治过程整理如下,总结中医治疗肝癌患者病后体虚腹泻的相关经验。

2型糖尿病合并肌少症发病机制及中医药治疗进展

2型糖尿病与肌少症关系密切,2型糖尿病可通过多种途径影响肌少症的发生、发展,概述了胰岛素抵抗、炎症反应、脂质沉积、线粒体损伤等与2型糖尿病合并肌少症的相关性。中医认为2型糖尿病归属消渴范畴,病机与五脏衰弱、脾肾不足相关。肌少症在中医理论中可归类于痿证、虚劳的范畴,病机与脾肾不足、五脏衰败有关。两者病本在脾胃亏虚、肾气乏力,治以调理脾肾法,兼以解郁化瘀,临床常用八珍汤、补中益气汤、济生肾气丸、血府逐瘀汤等方剂。并综述了单味中药如黄芪、人参、当归、五味子、枸杞子等能通过抑制炎症因子、改善胰岛素抵抗等途径治疗2型糖尿病合并肌少症。参考文献84篇。

陈延基于肝脾阴虚病机拓展资生丸的临床运用

资生丸为明代名医缪希雍治疗妇女阳明脉衰、胎无所养之胎堕而创立的方剂,具有益气安胎的功效。该方由人参、白术、茯苓、淮山药、莲子肉、芡实、陈皮、桔梗、炒薏苡仁、白扁豆、白豆蔻、藿香叶、泽泻、黄连、山楂、麦芽、甘草组成。陈延主任立足资生丸治疗阳明脉衰的本意,深入分析该方适用病证的病位、病机,认为资生丸适用病证的关键病位在肝脾,关键病机在于肝脾阴虚,对临床因肝脾阴虚而出现的不思食、食入难化、腹部胀满、大便溏薄、小便频数、四肢无力、肌肉萎缩、形体消瘦、面色无华、少气懒言等病症,可加减运用资生丸以治阳明厚肝体(补脾以养肝阴缓肝急)。陈延主任对资生丸的古方新用,进一步拓展了该方的临床应用范围,为临床诊疗及用药提供了思路。

中医辨治早期糖尿病肾病28例

目的:观察中医辨治早期糖尿病肾病的临床疗效。方法:选取早期糖尿病肾病患者28例,所有患者均给予中医辨证施治。结果:28例早期糖尿病肾病患者中,治愈19例,好转7例,无效2例,有效率为92.86%。结论:中医辨治早期糖尿病肾病疗效显著。

Lei Genping’s Experience in Treating Recurrent Urinary Tract Infection

In modem medicine,the therapeutic effect in recurrent urinary tract infection is often unsatisfactory.Lei Genping believes that urinary tract infection is mainly caused by the evil of dampness and heat invading the lower jiao(area below the navel).A prolonged disease course would result in the deficiency of spleen and kidney as well as the stagnation of liver and qi.The initial treatment should focus on clearing heat and detoxifying dampness.In the long run,the treatment criteria include tonifying the spleen and kidney,while clearing heat and dampness as well as regulating liver qi.

糖尿病脾阴虚大鼠下丘脑内质网应激及滋补脾阴方药调节作用研究

目的探讨滋补脾阴方药调节糖尿病脾阴虚大鼠下丘脑内质网应激的作用机制。方法将大鼠随机分为空白组,糖尿病组,脾阴虚组,糖尿病脾阴虚组,糖尿病脾阴虚+滋补脾阴方药组共5组。通过蛋白免疫印迹(Western blot)法观察各组大鼠下丘脑内质网应激标志分子RNA依赖的蛋白激酶样内质网激酶(PERK)、真核起始因子2的α亚单位(e IF2α)、葡萄糖调节蛋白78(GRP78)的变化。通过逆转录聚合酶链反应(RT-PCR)法观察GRP78 mRNA表达变化,评价滋补脾阴方药对内质网应激的影响。结果糖尿病组、糖尿病脾阴虚组大鼠下丘脑p-PERK、p-e IF2α、GRP78蛋白表达较空白组均增加(P<0.05),糖尿病脾阴虚+滋补脾阴方药组较糖尿病组、糖尿病脾阴虚组减弱(P<0.05),e IF2α蛋白水平各组间无统计学差异。糖尿病组、脾阴虚组、糖尿病脾阴虚组大鼠下丘脑GRP78 mRNA表达较空白组均增强(P<0.05),糖尿病脾阴虚+滋补脾阴方药组下丘脑GRP78 mRNA与糖尿病组、糖尿病脾阴虚组比较均有所降低(P<0.05)。结论糖尿病组、糖尿病脾阴虚组大鼠下丘脑中发生内质网应激,滋补脾阴方药具有减轻内质网应激的作用。