Nervous function and manifestations of mental psychology in patients with post-stroke depression of different syndrome types of traditional Chinese medicine

BACKGROUND： Poly-criteria pathogenesis of patients with stroke causes diversity of syndrome types of traditional Chinese medicine （TCM）; meanwhile, complexity and diversity of pathological mechanism also play a key role in determining severity so as to induce effects on nervous function and manifestation of mental psychology in patients with post-stroke depression （PSD）. OBJECTIVE： To analyze the syndrome types of TCM with nervous function and manifestations of mental psychology in PSD patients so as to provide evidence for the treatment based on the syndrome differentiation. DESIGN： Contrast observation. SETTING： Departments of Neurology and Traditional Chinese Medicine, General Hospital of Fuxin Mining Industry Group. PARTICIPANTS： A total of 469 outpatients or inpatients with stroke were selected from the Department of Neurology, General Hospital of Fuxin Mining Industry Group from April 2002 to July 2005. All subjects met the diagnostic criteria of stroke established by the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were finally diagnosed with CT and MRI. Totally, 177 PSD patients were involved in the final analysis and provided the confirmed consent. There were 121 males and 56 females aged from 46 to 79 years. METHODS： （1） All the enrolled subjects were diagnosed for syndrome differentiation by senior TCM physicians within 1 week before discharge based on Diagnostics of Traditional Chinese Medicine, which was classified into 5 types, including sputum-stasis stagnation syndrome, qi stagnation and blood stasis, kidney-essence deficiency, deficiency of the spleen and stomach and phlegm-fire disturbing the heart. In addition, they were also assessed by neurologic deficit scale （NDS; 45 points in total; the higher the scores were, the severer the deficit was）, Fugl-Meyer assessment, （FMA; 100 points in total, including 66 points of upper limbs and 34 points of lower limbs; the higher the scores were, the stronger the motor function was）, modified Barthel index [BI; 100 points in total; the higher the scores were, the better the activity of daily life （ADL） was], symptom checklist-90 （SCL-90; including total scores, positive scores, mean and average scores of positive items）, Hamilton depression rating scale （HAMD） and Hamilton anxiety rating scale （HAMA, the higher the scores were, the severer the degree was）. （2） Patients were divided into one symptom type, two symptom types and ≥ 3 symptom types; meanwhile, they were also divided into deficiency symptom, excess symptom and deficiency-excess symptom. Scores among various groups were compared simultaneously. MAIN OUTCOME MEASURES： Comparison of nervous function and mental psychology of PSD patients with various symptoms. RESULTS： （1） Differences of various symptoms： Among 177 patients, there were 43 subjects in the types of sputum-stasis stagnation, 64 in qi stagnation and blood stasis, 21 in kidney-essence deficiency, 33 in deficiency of the spleen and stomach, and 16 in phlegm-fire disturbing the heart. In the comparison of the scores of nervous function and psychological tests among different syndrome types, the scores of most motor functions of upper and lower limbs, total scores of FMA and ADL in PSD patients of sputum-stasis stagnation, qi stagnation and blood stasis, kidney-essence deficiency were obviously lower than those of the total samples and PSD patients of deficiency of the spleen and stomach and phlegm-fire disturbing the heart, whereas the total scores of NDS, HAMD, HAMA, SCL-90 and SCL-90 positive items, average number of SCL-90 positive items and average score of SCL-90 positive items in the former three groups were all obviously higher than those in the latter three groups （P 〈 0.05 - 0.01）. （2） Different number of syndrome types： In the comparison of the scores of nervous function and psychological tests among the PSD patients with different number of syndrome types, the scores of most motor functions of upper and lower limbs, total scores of FMA and ADL in PSD patients with one or two syndrome types were obviously higher than those of the total samples and the PSD patients with three or more syndrome types, whereas the total scores of NDS, HAMD, HAMA, SCL-90 and SCL-90 positive items, average number of SCL-90 positive items and average score of SCL-90 positive items were all obviously lower in the former two than in the latter two （P 〈 0.05 - 0.01）. （3） There were no obvious differences in the scores of most items of nervous function and psychological tests among the PSD patients of deficiency syndrome, excess syndrome and the deficiency-excess syndrome （P 〉 0.05）. CONCLUSION： The damages of nervous function and mental psychology are more serious in PSD patients with the syndrome types of sputum-stasis stagnation, qi stagnation and blood stasis, kidney-essence deficiency, as well as those with several （three or more） syndrome types, and the conditions may be improved by the treatment based on TCM syndrome differentiation.

Urrets-Zavalia syndrome in different methods of keratoplasty

INTRODUCTIONUrrets-Zavalia was first described as a syndrome consisting of a fixed,dilated pupil with iris atrophy following penetrating keratoplasty（PKP）in 1963 and back then it was thought that this syndrome was only related to keratoconus patients.Other findings that were not essential for the diagnosis were posterior synechiae,ectropion uvea,pigment dispersion,anterior subcapsular lens opacities and secondary glaucoma syndrome.

Association of Metabolic Syndrome with Inflammation in Chinese Adults with Different Kidney Function

Chronic kidney disease （CKD） has become a worldwide public health problem, and currently, it affects approximately 10% of adults in the United States[I]. Meanwhile, it also has emerged as an important social challenge in China[2]. CKD has been reported to be a major risk factor for cardiovascular diseases, premature death, and end-stage renal diseaseTM. Thus, it is necessary to determine the risk factors for CKD.

Differentially Expressed Serum Protein Profiling in Esophageal Squamous Cell Carcinoma Patients with Different Chinese Medicine Syndromes

Objective:Esophageal carcinoma is the eighth most common malignant tumor and ranked the sixth cause of death in the worldwide careinoma.To find out effective serum markers for early diagnosis and targeted treatment is important to improve esophageal carcinoma survival rate.The aim of this study was to screen differ-entially expressed serum protein profiling in esophageal squamous cell careinoma(ESCC)patients with differ-ent Chinese medicine syndrome and establish ESCC syndrome diagnosis model,to explore the signifcance of ESCC serum differential protein in traditional Chinese medicine(TCM)syndrome diagnosis and provide exper-imental and theoretical basis for the diagnosis,clinical treatment of ESCC.Methods:Serum specimens of 80 ES-CC patients with different syndrome and 20 healthy people were selected according to distribution of their sex and age.Magnetic beads based weak cation exchange combined w ith matrix-assist ed laser desorption/ionization time-of-flight mass spectrometry prot eomic technology and Autoflex Analysis and ClinProTools software were applied to screen differentially expressed serum protein profiling.Then establishing each syndrome group diag-nosis model and verifying with new samples to evaluate the diagnosis value of each syndrome group diagnosis model.Results:18 significantly differential expression protein peaks were screened between the whole ESCC patients sera and the healthy control group.Compared with normal control group,among which,ten were signif-cant down-regulation with m/z values of4210,4267,4054,4248,2106,4091,2991,5337,3952,822,and eight were significant up-regulation with m/z values of 2900,2883,1467,1617,2862,2600,895,811.There were 16,12,11,15 differentially expressed protein peaks in phlegm and qi stagnat ion syndrome(Group P),fluid insufficiency and heat agglomeration syndrome(Group F),blood stasis syndrome(Group B),qi and yang deficiency syndrome(Group Q),respectively.Protein with m/z of4210,4091,4054 and 5337 presen-ted obviously low expression in all syndrome groups,while protein with m/z of2883,1617 presented obvious-y high expression.Protein with m/z of 4644 is an obvious and significative biomarker in the comparison of dif-ferent syndrome of ESCC.Establishing ESCC each syndrome serum different ial protein profiling diagnosis mod-el showed that the specificity and veracity in four syndrome groups were all≥80.00%.Conclusion:Our study achieved differentially expressed protein profiling in ESCC patients with different TCM syndromes,established relatively high sensitivity and specificity of different syndrome of ESCC serum differential protein profiling diag-nosis model,which implied the screened syndrome related serum differential expression protein in TCM syn-drome differentiation and diagnosis had great clinical meaning,could be the assistant diagnosis biomarker of ESCC.

Knee osteoarthritis treated with acupuncture based on syndrome differentiation:a randomized controlled trial

Objective To compare the efficacy differences between acupuncture and western medicine in treating osteoarthritis of knee joints.Methods One hundred and twenty cases were randomly divided into an acupuncture group and a western medication group with 60 cases in each group.In the acupuncture group,acupuncture was applied mainly at Nèixīyǎn（内膝眼 EX-LE 4）,Dúbí（犊鼻 ST 35）,Yīnlíngquán（阴陵泉 SP 9） and Yánglíngquán（阳陵泉 GB 34） plus other acupoints selected according to syndrome differentiation.In the medication group,Glucosamine Hydrochloride capsules were orally given 3 times daily with 2 capsules each time.Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,Medical Outcomes Study 36-Item Short Form Health Survey（SF-36,Chinese version） were used to assess therapeutic effects before treatment,after 4 weeks treatment and 9 weeks after treatment,respectively.Results After 4 weeks of treatment,the total effective rates were 86.7%（52/60） and 88.3%（53/60） in the acupuncture group and the western medication group,respectively,without significant difference（P〈0.05）.In 9 weeks after treatment,the total effective rates were 83.3%（50/60） and 61.7%（37/60） in the acupuncture group and the western medication group,respectively,with significant difference between the two groups（P〈0.05）.According to WOMAC and SF-36,the scores were all improved in both groups（P〈0.05,P〈0.01）,with significant difference in follow-up visit of 9 weeks after treatment between the two groups（P〈0.05,P〈0.01）,but not after 4 weeks of treatments（both P〈0.05）.Conclusion Short-term of therapeutic effects of acupuncture and oral administration of Glucosamine Hydrochloride on osteoarthritis of knee joints are similar,but long-term efficacy in the acupuncture group is better than that in the western medication group.

Treatment of 33 Cases of Nerve Tinnitus by Acupuncture on Syndrome Differentiation

Summary： Thirty-three cases of nerve tinnitus were treated mainly by needling acupoints Baihui（GV 20）, Tinggong（SI 19）, Tinghui（GB 2）, Yifeng（TE 17） and Zhongzhu（TE 3）. In the presence of kidney deficiency, Shenshu（BL 23） and Mingmen（GV 4） were added; in the presence of liver-gallbladder fire preponderance, Taichong（LR 3） and Qiuxu（GB 40） were added; in the presence of exogenous wind heat, Waiguan（TE 5） and Hegu（LI 4） were added. After 6-course treatments, 6 cases were cured, 22 cases improved and 2 cases failed, with the total effective rate of 93.9%.

Clinical Observation on Treatment of Post-operative Gastrointestinal Syndrome with Combined Acupuncture and Herbs

Objective： To observe the therapeutic effect of treating postoperative gastrointestinal syndrome with combined needles and herbs. Method： Altogether 117 in-patients were randomly allocated into the treatment group of 86 cases and control group of 31 cases. Point injection was mainly adopted in the treatment group plus Chinese herbal decoction, while Western medicine was adopted in the control group. And then the therapeutic effect of the two groups was compared. Result： The total effective rate of the treatment group and control group were 96.5% and 80.6% respectively, and the treatment course of the treatment group was significantly shorter than the control group （P 〈 0.01）. Conclusion： Combined needles and herbs have excellent effect in treating postoperative gastrointestinal syndrome and were superior to Western medicine.

Clinical Study of Tuina on Tension-type Headache with Syndrome Differentiation

The 6 point behavioral rating scale and Stead＇s grading method of diagnostic scale were applied to evaluate objectively the therapeutic effects of Tuina on 150 patients with tension-type headache in the experimental and controlled groups in this study. The results indicated that abdominal Tuina method of invigorating blood circulation and regulating qi had better effect than the routine Tuina method in treating tension-type headache. Meantime, it is considered that eliminating the immoderate defensive response caused by the process of headache-muscular contraction headache is the academic basis of the marked effect.

Acupuncture Treatment of Irritable Bowel Syndrome Based on Differentiation of Symptoms and Signs

According to differentiation of traditional Chinese medicine, Irritable Bowel Syndrome was classified into two types, disharmony of the liver and spleen and deficiency of the heart and spleen, which were treated with acupuncture respectivdy. As a result, of 31 cases, 25 cases had marked effectiveness, 5 cases had effectiveness and 1 case had ineffectiveness.

Genome-wide analysis of differential DNA methylation in Silver-Russell syndrome

Silver-Russell Syndrome(SRS) is clinically heterogeneous disorder characterized by low birth weight, postnatal growth restriction, and variable dysmorphic features. Current evidence strongly implicates imprinted genes as an important etiology of SRS. Although almost half of the patients showed DNA hypomethylation at the H19/IGF2 imprinted domain, and approximately7%–10% of SRS patients have maternal uniparental disomy of chromosome 7(UPD(7) mat); the rest of the SRS patients shows unknown etiology. In this study, we investigate whether there are further DNA methylation defects in SRS patients. We measured DNA methylation in seven SRS patients and five controls at more than 485,000 CpG sites using DNA methylation microarrays. We analyzed methylation changes genome-wide and identified the differentially methylated regions(DMRs) using bisulfite sequencing and digital PCR. Our analysis identifies epimutations at the previously characterized domains of H19/IGF2,providing proof of principle that our methodology can detect the changes in DNA methylation at imprinted loci. In addition,our results showed a novel SRS associated imprinted gene OSBPL5 located on chromosome 11p14 with the probe cg25963939,which is hypomethylated in 4/7 patients(P=0.023, β=.0.243). We also report DMRs in other genes including TGFβ3, HSF1,GAP43, NOTCH4 and MYH14. These DMRs were found to be associated with SRS using GO pathway analysis. In this study,we identified the probe cg25963939, located at the 5′UTR of imprinted gene OSBPL5, as a novel DMR that is associated with SRS. This finding provides new insights into the mechanism of SRS etiology and aid the further stratification of SRS patients by molecular phenotypes.

Influence of constitution differences among races on application of acupuncture therapy

Based on the constitution differences among races, the influence of the different constitutions on TCM therapies is approached, raising the differences of different races in tolerance and adaptability to acupuncture, and different treatment principles of acupuncture therapy for different races, and each one case of the black race, the white race and the yellow race recorded in practicing medicine in Britain is taken for discussion. It is expected to be beneficial to the researches on TCM constitutional theories of races and the clinical application.

Treatment of 102 Cases of Tourette＇s Syndrome with Acupuncture plus Herbal Medicine

102 cases of Tourette＇s syndrome were divided into three types of the liver and kidney yin deficiency, phlegm and damp blockage and spleen and stomach deficiency. Acupuncture, auricular-plaster therapy, cupping therapy and herbal medicine were combined to treat this syndrome. As a result, 30 cases were satisfactorily effective, 61 cases were improved and 11 cases were ineffective with a total effective rate of 98.2% and no side effects were noticed during treatment.

Jiāwèi Wǔbèizǐsǎn(Supplemented Galla Chinensis Powder) application on the navel for different syndromes of profuse sweating after tumor chemotherapy

Objective To observe the clinical efficacy of Jiāwèi Wǔbèizǐ sǎn（加味五倍子散,Supplemented Galla Chinensis Powder） application on the different syndromes of profuse sweating after tumor chemotherapy.Methods One hundred and sixty patients with profuse sweating after tumor chemotherapy were randomly divided into a control group（n=80） and a treatment group（n=80）.Placebo application was carried out in the control group,and traditional Chinese medicine application was conducted in the treatment group.Treatment for 7 days was considered as 1 course of treatment.Results In treatment group,48 patients were cured,improvement was found in25 cases,and ineffectiveness was seen in 7 cases.For the patients with lungwei insecurity syndrome,19 cases were cured,improvement was found in10 cases,and ineffectiveness was seen in 1 case;for the patients with deficiency of both qi and yin,27 cases were cured,improvement was found in 9 cases,and ineffectiveness was seen in 2 cases;for the patients with vigorous fire due to yin deficiency,3 cases were cured,improvement was found in5 cases,and ineffectiveness was seen in 4 cases.According to statistical analysis,the total efficacy of treatment group was superior to that of control group（P0.05）.The efficacy on lung-wei insecurity and deficiency of both qi and yin of treatment group was superior to that of control group（both P0.05）,but there was no obvious difference between treatment group and control group in the efficacy on vigorous fire due to yin deficiency（P0.05）.Conclusion Supplemented Galla Chinensis Powder application on the navel can effectively improve the profuse sweating syndrome of patients in the types of lung-wei insecurity and deficiency of both qi and yin after tumor chemotherapy,but the efficacy is not so good for the patients in the type of vigorous fire due to yin deficiency.

Optimization of acupuncture treatment programs for facial paralysis

Objective To optimize acupuncture treatment programs for facial paralysis.Methods Sixty-three cases of facial paralysis were randomly grouped according to orthogonal design L9（3）4 table,and treated by different combined programs of 4 factors,A（acupuncture opportunity）,B（combination of points）,C（stimulating quantity）,D（electroacupuncture time） and 3 levels,and changes of the functional score of the facial nerve were observed,and the different combined programs of the 4 factors,A（acupuncture opportunity）,B（combination of point）,C（stimulating quantity）,D（electroacupuncture time） and 3 levels influencing acupuncture therapeutic effect on facial paralysis were optimized.Results B（combination of points） and D（electroacupuncture time） were obvious factors（P0.05）,among them,B（combination of points） was the most main influencing factor;among the 3 levels of B（combination of points） and D（electroacupuncture time）,B3 （alternately needling two groups of acupoints） and D3 （electroacupuncture treatment at sparse-dense wave for 30 min） were the best.Conclusion Electroacupuncture at sparse-dense wave for 30 min,alternately needling two groups of acupoints is the best program for treatment of facial paralysis.

Integrated Chinese-western therapy versus western therapy alone on survival rate in patients with non-small-cell lung cancer at middlelate stage

OBJECTIVE: To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate prognostic factors. METHODS: We selected 98 inpatients with middle-late stage NSCLC diagnosed from March 2009 to March 2011 and randomly divided them into two groups, with 49 cases in each group, and the clinical data were analyzed retrospectively.The control group was treated by the combined methods of Western Medicine, including chemotherapy, supportive treatment and symptomatic treatment. The observation group was treated by injection and prescriptions of Chinese medicine based on Traditional Chinese Medicine syndrome differentiation and by the same combined methods of western treatment used in the control group. After treatment, the survival rates of the patients were compared by the stage of cancer and evaluation of 24 prognostic factors analyzed by a Cox regressionmodel, and the clinical data were statistically analyzed. RESULTS: The survival rates of all patients were over 90.0% at 1 and 3 months after treatment with no significant differences between the two groups (P>0.05); In the observation group the survival rates at 6 months and 1 year were 93.4% and 42.8%, respectively, being superior to 85.6% and 18.3% in the control group (P<0.05). The median survival time in the observation group was superior to the control group (P<0.05); The effects of 24 prognostic factors were significantly better in the observation group than in the control group (P<0.05). CONCLUSION: Integrated Chinese-western therapy can significantly improve the survival rate in patients with middle-late stage NSCLC and improve prognostic factors compared with western therapy alone.

Observation on Therapeutic Effect in Acupuncture Treatment of Soft Tissue Injuries by Differentiation of Deficient and Excessive Patterns

Objective： To compare the therapeutic effects between the needling method by identification of deficient and excessive patterns and the needling method by routine meridian differentiation in the treatment of soft tissue injuries. Methods. 380 cases of the patients with soft tissue injuries were randomly divided into pattern identification group （200 cases, with the needling method by identification of deficient and excessive patterns） and meridian identification group （180 cases, with the needling method by routine meridian differentiation）, to observe and compare the therapeutic effects in the two groups. Results： The curative effect was 86% in the pattern identification group and 31.11% in the meridian identification group, with a significant difference （P〈 0.01）. In comparison with the total average treatment times in the cured and improved cases, the pattern identification group was 8.8 days and the meridian identification group was 15.6 days, with a remarkable significant difference （P〈 0.01）. The pattern identification group was better than the meridian identification group. Conclusion： In the treatment of soft tissue injuries, the needling method by identification of deficient and excessive patterns was better than the needling method by routine meridian differentiation.

Treatment of Facial Chloasma by Auricular Pressure in41 Cases

According to differentiating syndrome and dividing patter, 41 cases of Facial Chloasma by Auricular Pressure in Shen (MA-AH), Fei (MA-IC 1), Neifenmi (MA-IC 3), Luanchao (MA-AT), Mianjia (MA-L) and Xia’erbei (MA-IC), the total effective rate was 87.8%. Key Words Skin Pigmentation, Chloasma - Auricular Point Sticking - Syndrome Differ Treatment Author: Liu Guang-xia (1954-), female, associate professorTranslator: Xiao Yuan-chun

Treatment of 43 Cases of Enuresis by Acupuncture

By classification with syndrome differentiation into the three patterns of deficient cold in the lower energizer, qi deficiency in the spleen and lung and damp heat in the Liver Meridian, 43 cases of enuresis were treated by puncturing Baihui (GV 20), Guanyuan (CV 4) and Shanyinjiao (SP 6). After two courses of the treatment, the results showed cure in 28 cases, improvement in 13 cases and failure in 2 cases. Key Words Enuresis - Acupuncture Therapy - Syndrome Differ Classification Translator: HUANG Guo-qi

Clinical Study on Treatment of Depression with Combined Acupuncture & Medicine

Purpose To observe and compare the curative effects of combined acupuncture and medicine with simple herbal medicine on treatment of depression.Method Altogether 63 cases were enrolled according to the determination of internationally accepted self-evaluation depression scales (SDS), among tehm 33 cases were treated with combination of acupuncture and herbal medicine (acupuncture-medicine group) and the other 30 cases were in treated with herbal medicine alone (herbal medicine group)Results The total effective rate of acupuncture-medicine group was 90.9% and that of herbal group was 80.0%. And there was significant statistics difference between the curative effects of two groups (P<0.05) without obvious adverse reaction.Conclusion Combination of acupuncture and medicine has better effect in treating depression than herbal medicine group. Key Words Depression - Acupuncture Medication Combined - Syndrome Differ Classification Author: XU Hong (1967-), femake, attending physicianTranslator: HAN Chou-ping

Consideration on diagnosis and treatment based on an overall analysis of symptoms and signs in acupuncture clinic

There is worrying about current clinical situation on diagnosis and treatment based on an overall analysis of symptoms and signs in acupuncture. Japanese specialists in the acupuncture field have pointed out that sufficient attention should be paid to its various malpractices. Responding to their questioning, the author put forward some main problems existing and made certain analysis. Diagnosis and treatment based on an overall analysis of symptoms and signs should be expressed in their application according to successive theories, methods, prescriptions, acupoints and techniques. In order to elevate therapeutic effects of acupuncture, forth effort should be put to various aspects, such as clinical skills, functional regularity, indications and affected factors.