Liver surface depressions in the presence of diaphragmatic muscular bands on trans-illumination

Traditional descriptions of liver anatomy refer to a smooth,convex surface contacting the diaphragm.Surface depressions are recognized anatomic variants.There are many theories to explain the cause of the depressions.We discuss the theory that these are caused by hypertrophic muscular bands in the diaphragm.

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.

Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B(CHB)Patients with Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome

Objective:This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common traditional Chinese medicine(TCM)Syndromes—damp heat syndrome and liver depression and spleen deficiency syndrome.Methods:According to the diagnostic criteria of Western medicine,TCM and screening exclusion criteria,65 cases of CHB with damp heat syndrome and 28 cases of CHB with liver depression and spleen deficiency syndrome were finally included in the study.All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing.16S rDNA of gut microbiota was sequenced using Illumina hiseq 2,500 high-throughput sequencing platform.Based on the optimized sequence,Operational Taxonomic Units(OTU)clustering analysis and taxonomic annotation were carried out.Results:The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients.Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales,Alphaproteobacteria and Lachnospira were higher in the damp heat syndrome.LDA Effect Size(LEfSe)analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusion:The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.

基于Thinc-it工具分析抑郁症不同证型患者认知功能

目的:通过Thinc-it工具探讨抑郁症不同证型患者认知功能特点。方法:从2020年6月至2022年7月宁波市第一医院心身医学科确诊为抑郁症的患者中选取肝气郁结、气郁化火、痰气郁结、心脾两虚证型患者各50例为受试者,并选取同期在医院健康体检志愿者50例为健康对照组。应用汉密尔顿抑郁量表(hamilton depression scale,HAMD)、汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)对各组受试者临床症状进行评估,并分别通过Thinc-it工具进行认知功能评估,具体包括认知损害5项问卷(5-item questionnaire for cognitive impairment,PDQ-5-D)、选择反应时间任务(selection response time,CRT)、1-Back记忆任务(selection response time,1-Back)、数字符号替代测试(digit symbol substitution test,DSST)和连线测试B(line test B,TMT-B)测试。结果:抑郁症各证型组病程、HAMD评分、HAMA评分比较,痰气郁结证组和心脾两虚证组病程时间相对更长,但组间比较,差异无统计学意义(P>0.05)。郁证各证型组HAMD评分、HAMA评分高于健康对照组,差异具有统计学意义(P<0.05)。郁证各证型组PDQ-5-D评分高于健康对照组(P<0.05),郁证各证型组间比较,差异无统计学意义(P>0.05)。与健康对照组比较,郁证各证型组CRT计数减少,CRT反应时间延长,差异具有统计学意义(P<0.05)。组间比较,心脾两虚证组CRT计数高于肝气郁结证组,痰气郁结证组CRT反应时间长于肝气郁结证组,差异具有统计学意义(P<0.05)。与健康对照组比较,郁证各证型组1-Back计数减少,痰气郁结证组、心脾两虚证组1-Back反应时间延长,差异具有统计学意义(P<0.05),郁证各证型组间比较,差异无统计学意义(P>0.05)。与健康对照组比较,郁证各证型组DSST计数减少,DSST反应时间、TMT-B耗时延长,差异具有统计学意义(P<0.05)。心脾两虚证组、痰气郁结证组DSST反应时间长于肝气郁结证组、气郁化火证组,差异具有统计学意义(P<0.05)。结论:抑郁症各证型患者均存在主观认知功能、注意力、记忆力、执行功能、信息加工处理速度等方面的损害,且各证型受损程度不一,且痰气郁结证组、心脾两虚证组在注意力、执行功能、处理速度方面较肝气郁结证组和气郁化火证组受损更严重。

Biological basis of “depression with liver-qi stagnation and spleen deficiency syndrome”: A digital gene expression profiling study

Objective:To investigate the biological basis of“depression with liver-qi stagnation and spleen deficiency syndrome”.Methods:A digital gene expression profiling method was conducted to explore global changes in the mRNA transcriptome in a rat model of depression with liver-qi stagnation and spleen deficiency syndrome.Real-time quantitative polymerase chain reaction(q-PCR)was performed to verify the five genes most interest based on the Kyoto Encyclopedia of Genes and Genome(KEGG)analysis.Sini San,which disperses stagnated liver qi and strengthens the spleen,was administered to the model rats to observe whether it could reverse these genetic changes in the liver.Results:Forty-six differentially expressed genes were identified.Three of the five genes of most interestdHnf4a,Hnf4g and Cyp1a1dbased on KEGG analysis,were confirmed by realtime q-PCR.Sini San reduced the gene expression changes of Hnf4a,Hnf4g and Cyp1a1 in the rat model.Conclusions:Hnf4a,Hnf4g and Cyp1a1 are involved in“depression with liver-qi stagnation and spleen deficiency syndrome”.These findings indicate that depressed rats with liver-qi stagnation and spleen deficiency syndrome are at risk of liver diseases.Furthermore,our results will inform exploration of the etiology of depression and help in the development of effective therapeutic strategies.

Analysis of the Relationship between PI3K/Akt Signaling Pathway and Insomnia of Liver Depression Syndrome

Some studies have shown that the co-morbidity of insomnia and anxiety and depression is very prominent, among which 70% of anxiety patients are accompanied by sleep disorders, which is commonly referred to as insomnia of liver depression syndrome in traditional Chinese medicine. The etiology and pathogenesis of traditional Chinese medicine is liver-qi discomfort, and soothing liver and relieving depression should be taken as the basic treatment method and treatment principle. By sorting out the relevant literature on PI3K/Akt signaling pathway, the relationship between PI3K/Akt signaling pathway and depression and insomnia was sorted out, and the possible mechanism of Liver-soothing and Depression-Relieving therapy for insomnia of liver-depression syndrome was found.

Research Progress of the Liver–Brain Cotreatment of Depression with Supplemented Danzhi Xiaoyao Powder

Traditional Chinese medicine(TCM)has unique advantages in preventing and treating depression based on holistic concepts and syndrome differentiation and treatment.Liver depression and spleen deficiency are the main syndrome of depression.Danzhi Xiaoyao powder has the efficacy of soothing the liver and relieving depression,nourishing blood,and strengthening spleen.Present studies have proven that it has antidepressant efficacy for the syndrome of liver depression and spleen deficiency.The basic research on pharmacodynamic substances has found that the main active ingredients of Danzhi Xiaoyao powder in the treatment of depression include bupleurum saponin,paeonol,gardenoside,angelica polysaccharide,sulfate polysaccharide,paeoniflorin,albiflorin,atractylone,etc.In clinical practice,Danzhi Xiaoyao powder is often modified to make it more suitable according to the characteristics of pathogenesis and changes in the disease condition.Our research group has found that“brain and spirit failure and liver failing to disperse”are the main pathogenesis of depression.Based on the theory of“liver–brain cotreatment,”the treatment principle of“dispersing the liver and relieving depression,strengthening brain and benefiting intelligence”was put forward.On the basis of Danzhi Xiaoyao powder,Shichangpu(Acori Tatarinowii Rhizoma)was added to enlighten the mind and Yuanzhi(Polygalae Radix)to calm the mind and benefit intelligence.The modified Danzhi Xiaoyao powder was formulated,and its clinical effects on depression were remarkable.Animal experiments also confirmed that modified Danzhi Xiaoyao powder can significantly improve the depression-like behavior of depression model rats and the mechanism may be related to the regulation of the hypothalamic–pituitary–adrenal axis,the increase of the content of 5-hydroxytryptamine,and norepinephrine,which provides a reference for the further promotion of the clinical application of modified Danzhi Xiaoyao powder in the treatment of depression.

Effects of Xiaoyao San on exercise capacity and liver mitochondrial metabolomics in rat depression model

Objective: This study aimed to investigate the therapeutic effects of Xiaoyao San(XYS), a herbal medicine formula, on exercise capacity and liver mitochondrial metabolomics in a rat model of depression induced by chronic unpredictable mild stress(CUMS).Methods: A total of 24 male SD rats were randomly divided into four groups: control group(C), CUMS control group(M), Venlafaxine positive treatment group(V), and XYS treatment group(X). Depressive behaviour and exercise capacity of rats were assessed by body weight, sugar-water preference test, open field test, pole test, and rotarod test. The liver mitochondria metabolomics were analyzed by using liquid chromatography-mass spectrometry(LC-MS) method. TCMSP database and Gene Cards database were used to screen XYS for potential targets for depression, and GO and KEGG enrichment analyses were performed.Results: Compared with C group, rats in M group showed significantly lower body weight, sugar water preference rate, number of crossing and rearing in the open field test, climbing down time in the pole test,and retention time on the rotarod test(P < 0.01). The above behaviors and exercise capacity indices were significantly modulated in rats in V and X groups compared with M group(P < 0.05, 0.01). Compared with C group, a total of 18 different metabolites were changed in the liver mitochondria of rats in M group.Nine different metabolites and six metabolic pathways were regulated in the liver mitochondria of rats in X group compared with M group. The results of network pharmacology showed that 88 intersecting targets for depression and XYS were obtained, among which 15 key targets such as IL-1β, IL-6, and TNF were predicted to be the main differential targets for the treatment of depression. Additionally, a total of 1 553 GO signaling pathways and 181 KEGG signaling pathways were identified, and the main biological pathways were AGE-RAGE signaling pathway, HIF-1 signaling pathway, and calcium signaling pathway.Conclusion: XYS treatment could improve depressive symptoms, enhance exercise capacity, positively regulate the changes of mitochondrial metabolites and improve energy metabolism in the liver of depressed rats. These findings suggest that XYS exerts antidepressant effects through multi-target and multi-pathway.

Anxiety and depression propensities in patients with acute toxic liver injury

AIM:To investigate anxiety and depression propensities in patients with toxic liver injury.METHODS:The subjects were divided into three groups:a healthy control group(Group 1,n=125),an acute non-toxic liver injury group(Group 2,n=124),and a group with acute toxic liver injury group caused by noncommercial herbal preparations(Group 3,n=126).These three groups were compared and evaluated through questionnaire surveys and using the Hospital Anxiety-Depression Scale(HADS),Beck Anxiety Inventory(BAI),Beck Depression Inventory(BDI),and the hypochondriasis scale.RESULTS:The HADS anxiety subscale was 4.9±2.7,5.0±3.0 and 5.6±3.4,in Groups 1,2,and 3,respectively.The HADS depression subscale in Group 3 showed the most significant score(5.2±3.2,6.4±3.4 and 7.2±3.4in Groups 1,2,and 3,respectively)(P<0.01 vs Group 1,P<0.05 vs Group 2).The BAI and BDI in Group 3showed the most significant score(7.0±6.3 and 6.9±6.9,9.5±8.6 and 8.8±7.3,10.7±7.2 and 11.6±8.5in Groups 1,2,and 3,respectively)(BAI:P<0.01 vs Group 1,P<0.05 vs Group 2)(BDI:P<0.01 vs Group1 and 2).Group 3 showed a significantly higher hypochondriasis score(8.2±6.0,11.6±7.5 and 13.1±6.5in Groups 1,2,and 3,respectively)(P<0.01 vs Group 1,P<0.05 vs Group 2).CONCLUSION:Psychological factors that present vulnerability to the temptation to use alternative medicines,such as herbs and plant preparations,are important for understanding toxic liver injury.

Escitalopram-induced liver injury: A case report and review of literature

BACKGROUND Depression is a growing public health problem that affects over 350 million people globally and accounts for approximately 7.5%of healthy years lost due to disability.Escitalopram,one of the first-line medications for the treatment of depression,is a selective serotonin reuptake inhibitor and one of the most commonly prescribed antidepressant medications worldwide.Although thought to be generally safe and with minimal drug-drug interactions,we herein present an unusual case of cholestatic liver injury,likely secondary to escitalopram initiation.CASE SUMMARY A 56-year-old Chinese lady presented with fever and cholestatic liver injury two weeks after initiation of escitalopram for the treatment of psychotic depression.Physical examination was unremarkable.Further investigations,including a computed tomography scan of the abdomen and pelvis and tests for hepatitis A,B and C and for autoimmune liver disease were unyielding.Hence,a diagnosis of escitalopram-induced liver injury was made.Upon stopping escitalopram,repeat liver function tests showed downtrending liver enzymes with eventual normalization of serum aspartate aminotransferase and alanine aminotransferase one-week post-discharge.CONCLUSION Clinicians should be aware of the possibility of escitalopram-induced liver injury when initiating depressed patients on antidepressant treatment.This requires extra vigilance as most patients may remain asymptomatic.Measurement of liver function tests could be considered after initiation of antidepressant treatment,especially in patients with pre-existing liver disease.

Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

BACKGROUND Depression,anxiety,and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients.Depending on the severity of the underlying liver disease,signs and symptoms of anxiety and depression may become more pronounced.AIM To evaluate the factors affecting depression,anxiety and self-care abilities of liver transplant recipients.METHODS Recipients who are≥18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study.Sample size analysis showed that the minimum number of recipients should be 301(confidence level=95%,confidence interval=2.5,population=1382).Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed.The dependent variables were the Beck Depression Scale,State-Trait Anxiety Scale(Form I and II),and Self-Care Agency Scale.The independent variables of the study were sociodemographic characteristics,biliary complications,hepatocellular carcinoma,recommending liver transplantation to other patients,and the interval of out-patient clinic visits.RESULTS Self-care ability scores were lower(P=0.002)and anxiety scores were higher(P=0.004)in recipients with biliary complications.On the other hand,in recipients with hepatocellular carcinoma,self-care scores were lower(P=0.006)while depression(P=0.003)and anxiety scores(P=0.009)were higher.Liver transplantation recipients with a monthly income<3000 Turkish liras had higher depression(P<0.001)and anxiety(P=0.003)scores.The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores(P=0.002),higher depression(P<0.001),higher state anxiety(P=0.02),and trait anxiety(P<0.001)scores.CONCLUSION Presence of biliary complications and hepatocellular carcinoma,low income level,and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability,depression,and anxiety.

A Traditional Chinese Medicine Approach in Treating Depression by Promoting Liver Qi Circulation: A Western Medicine Perspective

Depression is a prevalent mental illness in developed countries. In Western medicine, experimental and clinical investigations have demonstrated that depression is associated with the dysregulation of neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic intervention. However, patients taking antidepressant drugs often experience serious side effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views depression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating depression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis stating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is involved in the processing of macronutrients into molecules to fuel energy metabolism in brain neurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain, thereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation, the failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production in neurons. Because neurotransmitter release and neurotropin transport are driven by ATP, the deficiency in release and transport processes resulting from insufficient ATP production could lead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression, the promotion of liver qi circulation by Chinese herbs might offer a promising prospect for the effective treatment of depression.

基于CiteSpace的肝郁气滞证研究现状及趋势可视化分析

目的基于文献计量学方法和CiteSpace软件分析常见中医证型肝郁气滞证的研究现状及趋势,为今后临床实践和相关研究提供参考。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(Wanfang)、中文科技期刊数据库(VIP)和中国生物医学文献服务系统(SinoMed)2002年6月1日-2022年6月1日肝郁气滞证相关研究文献,经筛选后采用CiteSpace6.1.R2软件对发文情况、作者、机构、关键词等进行可视化分析。结果经筛选后共纳入肝郁气滞证相关文献4437篇,发文量呈上升趋势。发文量最多的作者是周宝宽,发文21篇。以北京中医药大学为核心的研究机构在该领域研究中最具影响力。关键词分析得出,研究集中在中医证型分类、相关疾病、中医药临床治法等方面。结论肝郁气滞证研究受到持续广泛的关注。肝郁气滞证相关疾病、辨证和治疗是研究的主要内容,尤其是中西医结合和客观化诊断指标近年来受到重视。结合社会、心理因素的研究可能是今后的研究方向。

Effect of Monosodium Glutamate on Behavioral Phenotypes, Biomarkers of Oxidative Stress in Brain Tissues and Liver Enzymes in Mice

The effects of oral administration of low doses of monosodium glutamate (MSG) on behavioral phenotypes, biomarkers of oxidative stress in the brain and liver enzymes in mice were evaluated in this study. Mice were treated orally with MSG (100, 250 and 500 mg/kg) daily for 21 days before testing for behavioral phenotypes;memory, anxiety, spontaneous motor activity (SMA) and depression. Thereafter, the brain levels of malondialdehyde (MDA) and glutathione (GSH) as well as the activities of liver enzymes, aminotransferase (AST) and alanine aminotransferase (ALT) were determined spectrophotometrically. MSG did not produce significant (P?> 0.05) impairment of memory in the Y-maze test. It also failed to modify the behaviors of mice in the elevated plus maze and light/dark transition tests of animal models of anxiety. MSG had no significant effect on SMA but produced depressive-like symptoms in the forced swim test at a dose of 500 mg/kg. Moreover, it increased the levels of MDA and decreased GSH concentrations in brain tissues of mice. The activity of AST and ALT were elevated in the blood of MSG-treated mice suggesting liver injury. Taken together, these findings suggested that MSG induced oxidative stress in the brain and impaired liver functions but did not produce any behavioral abnormalities in mice at lower doses.

Treatment of Sjogren's Syndrome with Liver Depression

Liu Chunying is a famous old Chinese medicine doctor for more than 30 years.He has rich experience in the understanding and treatment of Sjogren's syndrome(SS).Liu Shi systematically discusses the etiology and pathogenesis of SS from the angle of liver depression.In the treatment,it is emphasized that"Muyu Da Zhi"is the first,with the addition and subtraction of the disease,to provide a new idea for the treatment of Sjogren's syndrome from liver depression,and to attach a test case.

乙肝肝硬化患者血清IL-21 IFN-γOPN水平与抑郁情绪的关系研究

目的分析乙肝肝硬化患者血清白细胞介素-21、γ-干扰素、骨桥蛋白水平变化及其与抑郁情绪的关系。方法将69例乙肝肝硬化患者设为肝硬化组、71例乙肝无肝硬化患者设为无肝硬化组。检测两组患者血清白细胞介素-21、γ-干扰素和骨桥蛋白水平,采用抑郁自评量表评估两组患者抑郁情绪,分析肝硬化组患者血清白细胞介素-21、γ-干扰素和骨桥蛋白水平及其与抑郁情绪的关系。结果肝硬化组患者血清白细胞介素-21、γ-干扰素、骨桥蛋白水平及抑郁指数均高于无肝硬化组,差异有统计学意义(P<0.01)。69例乙肝肝硬化患者中,39例抑郁指数≥0.50,其中轻度抑郁13例、中度抑郁21例、重度抑郁5例。轻度、中度和重度肝硬化患者血清白细胞介素-21、γ-干扰素、骨桥蛋白水平及抑郁指数均逐渐增高,差异有统计学意义(P<0.01)。进一步分析,组间两两比较差异有统计学意义(P<0.01)。抑郁指数≥0.50的患者血清白细胞介素-21、γ-干扰素、骨桥蛋白水平均高于抑郁指数<0.50患者,差异有统计学意义(P<0.01)。Logistic回归分析提示血清白细胞介素-21、γ-干扰素和骨桥蛋白水平均是乙肝肝硬化患者抑郁情绪的独立影响因素(P<0.01)。Pearson相关分析显示乙肝肝硬化患者血清白细胞介素-21、γ-干扰素和骨桥蛋白水平与抑郁指数呈正相关(P<0.01)。结论乙肝肝硬化患者存在明显抑郁情绪,其病情程度和抑郁情绪均与血清白细胞介素-21、γ-干扰素和骨桥蛋白水平密切相关,重视患者抑郁情绪防治及血清白细胞介素-21、γ-干扰素和骨桥蛋白水平监测,对患者病情控制和预后改善有重要意义。

Study on the pharmacological mechanism of chaihu shugan powder in the treatment of hepatocellular carcinoma

Liver depression and qi stagnation type liver cancer accounts for a high proportion of primary liver cancer,western medicine has no special treatment for this type of liver cancer in addition to routine treatment,while patients with this type of liver cancer often show pain in the right flank,mass under the right side,chest depression and other clinical symptoms seriously affect the quality of life of patients with liver cancer and bring great trouble to patients and their families.Chaihu Shugan San,which originated from the General order of Medicine in the Ming Dynasty,has a serious impact on the quality of life of patients with liver cancer and brings great trouble to patients and their families.It is the representative prescription of soothing the liver and regulating qi in traditional Chinese medicine.in recent years,its clinical application and pharmacological action in liver cancer have been studied more and more deeply,but the anti-tumor pharmacological research and effective components of Chaihu Shugan Powder are still lack of systematic summary.Based on the relevant studies at home and abroad,this paper summarizes the anti-tumor mechanism and possible effective components of Chaihu Shugan Powder,so as to provide further pharmacodynamic material basis and mechanism reference for the further clinical application of primary liver cancer.

基于肝脏蛋白质组学探讨加味丹栀逍遥散的抗抑郁作用及机制

[目的]探讨加味丹栀逍遥散对慢性不可预知性温和应激(CUMS)抑郁小鼠模型的干预作用及可能机制.[方法]C57BL/6N小鼠分为正常组、模型组、加味丹栀逍遥散组和氟西汀组.采用CUMS复制抑郁模型,模型成功后灌胃给药4周.末次给药后进行行为学测试,采用串联质谱标签法(TMT)蛋白质组学分析小鼠肝脏差异蛋白的表达谱,通过Kyoto encyclopedia of genes and genomes(KEGG)通路富集加味丹栀逍遥散抗抑郁的相关通路和蛋白;血液生化检测总胆固醇及总胆汁酸含量.[结果]与正常组相比,模型组小鼠糖水偏好率下降,自主活动次数减少,加味丹栀逍遥散给药后上调小鼠糖水偏好率及自主活动次数.蛋白组学结果显示模型组与加味丹栀逍遥散给药组之间肝脏差异表达蛋白20个,其中上调11个,下调9个.KEGG通路富集分析发现差异表达蛋白主要参与了胆固醇代谢、初级胆汁酸的合成等.生化检测发现,与正常组相比,模型组总胆固醇含量下降而胆汁酸含量升高,加味丹栀逍遥散给药能显著增加总胆固醇含量而减少总胆汁酸含量.[结论]加味丹栀逍遥散具有良好的抗抑郁效应,其机制可能与调节肝脏胆固醇异常代谢、降低血液总胆汁酸有关.

基于“肝脾同调”阐析慢性肝病的中医治疗

慢性肝病是临床常见疾病,“郁、虚、湿、毒、瘀”是其核心病机,在疾病的不同阶段各有侧重,其中,以“郁、虚”为核心的肝脾失调是慢性肝病发生发展的关键。“肝脾同调”是治疗慢性肝病的基本治法,在慢性肝病不同阶段,其“肝脾同调”内涵同中有异。根据肝、脾生理病理特性,治脾明辨虚实,厘清轻重,活用运脾、健脾、温脾、醒脾、补脾等法;调肝体用并重,精准辨证,活用疏肝、缓肝、散肝、柔肝等法。临床上,治脾与调肝相辅相成,治调并举,常获良效。

帕金森病抑郁治肝的中西医契合点之探讨与应用

帕金森病抑郁是帕金森病非运动症状中常见的症状,但该症状在临床中却未得到充分的认识和治疗。目前中西医尚缺乏根治的办法。文章从帕金森病抑郁的病机及其与肝脏相关的西医机制之间的密切关系,探讨共同治“肝”之契合点的理论与应用,以期为各位同道提供参考与借鉴。