Advances in Chinese medicine treatment and research on endocrine diseases in 2021

This paper reviews the progress in treatment regimens involving traditional Chinese medicine and research on common clinical endocrine diseases in 2021,to provide a reliable basis for the traditional Chinese medicine treatment of endocrine diseases.In 2021-2022,research on traditional Chinese medicine for endocrine diseases has been focused on pathogenesis.We have summarized the results of the use of traditional Chinese medicine and herbal extracts for treating common endocrine system diseases in 2021,focusing on the following aspects.(1)Chinese herbal extracts or active ingredients,such as echinatin,breviscapine,and puerarin,can treat metabolic-associated fatty liver disease by inhibiting inflammation and oxidative stress,improving lipid metabolism,and regulating intestinal flora.(2)Chinese herbal extracts or active ingredients,such as Juglandis Semen extracts,Momordica charantia saponins,and Anemarrhenae Rhizoma extracts can treat type 2 diabetes by reducing insulin resistance,improving pancreatic beta cell function,and regulating intestinal microbial disorders.(3)Chinese herbal extracts or active ingredients,such as berberine,astragaloside IV,and Scutellariae Barbatae Herba polysaccharides,can treat diabetes-related complications by improving mitochondrial function,regulating autophagy,and inhibiting apoptosis and pyroptosis.(4)Chinese herbal medicines and herbal extracts or active ingredients,such as berberrubine and Resedaodorata,can treat hyperuricemia by activating the Janus kinase 2/signal transducers and activators of transcription 3 signaling pathway and inhibiting toll-like receptor 4/NOD-like receptor family,pyrin domain-containing protein 3 signaling to increase urate excretion.(5)Herbal extracts or active ingredients,such as ginsenoside Rb1,corylin,and Scutellariae Radix polysaccharides,can exert anti-obesity effects by promoting the browning of white adipocytes,activation of brown adipose tissue,and regulation of intestinal flora.(6)Chinese herbal extracts or active ingredients,such as diosgenin and Prunellae Spica extract,are able to treat thyroid-related diseases by inhibiting nucleotide-binding oligomerization domain-like receptor protein 3 inflammatory vesicle activation,regulating the expression of proliferating cell nuclear antigen,and cadherin 1,and upregulating the ubiquitination of interferon regulatory factor 4.

Treatment of stellate ganglion block in diseases:Its role and application prospect

The stellate ganglion(SG),as a type of sympathetic ganglion,consists of the sixth and seventh cervical vertebrae and the first thoracic sympathetic ganglia.SG block(SGB)is a minimally invasive injection that aims to inject low-concentration local anesthetics to induce a broad sympathetic blocking effect near the SG.There have been no changes and progress in the clinical application of SGB since the 1830s due to several potential risks,including hematoma from blood vessel injury,hoarseness from recurrent laryngeal nerve injury,and cardiopulmonary arrest.The feasibility and safety of SGB have greatly improved since the appearance of ultrasound-guided SGB.In recent years,SGB has been widely applied in the field of non-anesthesiology sedation,with significant therapeutic effects on pain,immunological diseases,somnipathy,psychological disorders,arrhythmias,and endocrine diseases.The present study reviews the present application of SGB in clinical practice.

Endocrine causes of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) is the most common cause of chronic liver disease in the industrialized world. The prevalence of NAFLD is increasing, becoming a substantial public health burden. NAFLD includes a broad spectrum of disorders, from simple conditions such as steatosis to severe manifestations such as fibrosis and cirrhosis. The relationship ofNAFLD with metabolic alterations such as type 2 diabetes is well described and related to insulin resistance, with NAFLD being recognized as the hepatic manifestation of metabolic syndrome. However, NAFLD may also coincide with endocrine diseases such as polycystic ovary syndrome, hypothyroidism, growth hormone deficiency or hypercortisolism. It is therefore essential to remember, when discovering altered liver enzymes or hepatic steatosis on radiological exams, that endocrine diseases can cause NAFLD. Indeed, the overall prognosis of NAFLD may be modified by treatment of the underlying endocrine pathology. In this review, we will discuss endocrine diseases that can cause NALFD. Underlying pathophysiological mechanisms will be presented and specific treatments will be reviewed.

Type 1 diabetes and associated autoimmune diseases

BACKGROUND Common autoimmune diseases(AID)tend to occur together in the same individual and families.Type 1 diabetes(T1D)is caused by an autoimmuneinduced inflammatory destruction of the pancreatic tissue and clusters with several other AID.AIM To compare the demographic,clinical,and serological features of patients with single T1D vs those with T1D and associated AID.METHODS From October 1999 to February 2020,a total of 665 patients with T1D and their first-degree relatives were evaluated.RESULTS Compared to patients with isolated T1D,those with T1D+AID were older and had a higher female:male ratio.Average patient age and age at disease onset were higher in T1D+AID vs T1D only.The average time interval between T1D onset and the onset of a second glandular AID was markedly shorter than the time interval between T1D and the occurrence of a non-endocrine AID.T1Dspecific autoantibodies were more frequent in patients with T1D+AID and relatives vs those with T1D only.However,the prevalence of AID and autoantibodies against various tissues were found to be higher in relatives of patients with T1D only compared to relatives of patients with T1D+AID.CONCLUSION Annual serological and subsequent functional screening for AID in patients with T1D and their first-degree relatives is recommended.

Standard NER Tagging Scheme for Big Data Healthcare Analytics built on Unified Medical Corpora

The motivation for this research comes from the gap found in discovering the common ground for medical context learning through analytics for different purposes of diagnosing,recommending,prescribing,or treating patients for uniform phenotype features from patients’profile.The authors of this paper while searching for possible solutions for medical context learning found that unified corpora tagged with medical nomenclature was missing to train the analytics for medical context learning.Therefore,here we demonstrated a mechanism to come up with uniform NER(Named Entity Recognition)tagged medical corpora that is fed with 14407 endocrine patients’data set in Comma Separated Values(CSV)format diagnosed with diabetes mellitus and comorbidity diseases.The other corpus is of ICD-10-CM coding scheme in text format taken from www.icd10data.com.ICD-10-CM corpus is to be tagged for understanding the medical context with uniformity for which we are conducting different experiments using common natural language programming(NLP)techniques and frameworks like TensorFlow,Keras,Long Short-Term Memory(LSTM),and Bi-LSTM.In our preliminary experiments,albeit label sets in form of(instance,label)pair were tagged with Sequential()model formed on TensorFlow.Keras and Bi-LSTM NLP algorithms.The maximum accuracy achieved for model validation was 0.8846.

Pharmacological efficacy of the traditional Chinese medicinal formula Kun-Tai-1A in the treatment of letrozole-induced polycystic ovary syndrome

Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.