Yiqi Huoxue Decoction in the treatment of Qi and yin deficiency and stasis type diabetic nephropathy in stageⅢ and its effect on VEGF and TGF-β1

Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β1).Methods:Sixty patients with stage DN of Qi-yin deficiency and stasis type DN who were treated in the Endocrinology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to December 2019 were selected as the research subjects.The remainder method was used to divide them into 30 cases in the observation group and 30 cases in the control group.Patients in both groups were referred to the guidelines and expert consensus for general treatment of DN(hypogl-ycemic,antihypertensive,lipid-lowering,etc.).The control group was given pancreatic kallikrein enteric-coated tablets orally once,120U,3 times a day,and the observation group was given The traditional Chinese medicine Yiqi Huoxue Decoction was taken orally,one dose daily,twice a day in the morning and evening;the two groups intervened continuously for 8 weeks.Detect blood FPG,PBG,HbA1c,β2-MG,BUN,SCr,VEGF,TGF-β1,and urine mALB and UACR levels before and after treatment,and calculate eGFR before and after treatment in both groups;observe changes in TCM syndrome scores in the two groups,Compare its clinical efficacy.Results:After 8 weeks of treatment,the total clinical effective rate of patients in the observation group was 93.3%,which was significantly different from the control group of 76.6%(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those before treatment and in the control group(P<0.05);The levels of FPG,HbA1c,PPG,mALB,β2-MG,UACR,VEGF,and TGF-β1 in the observation group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of SCr and BUN in the observation group were significantly lower.Compared with before treatment,eGFR increased,but there was no signi-ficant difference(P>0.05).Conclusion:Yiqi Huoxue Decoction for the treatment of patients with DN typeⅢqi-yin deficiency and stasis type,not only helps to lower blood sugar levels,improve TCM syndromes,but also can reduce early renal damage,reduce urine albumin,and delay kidney function It may be further worsened and has better safety.The mechanism may be related to reducing the levels of VEGF and TGF-β1,thereby delaying the fibrosis of tubulointerstitial scar and inhibi-ting glomerular capillary sclerosis.

Study on syndrome differentiation based on pharmacology of syndrome management system-a case of Qi and Yin deficiency syndrome

Taking the Qi and Yin deficiency syndrome as an example,the research method of pharmacology of syndrome management system was proposed.By means of text mining,systematic pharmacology and target analysis,to attempt to reveal the essence of the corresponding syndrome by studying the drugs and targets of Qi and Yin deficiency.Fourteen Chinese herbs treating Qi and Yin deficiency were retrieved and used more than 30 times,and 9,317 related targets were predicted.The common targets of action were 85.Topological analysis was carried out by using degree centrality,closeness centrality and betweenness centrality to confirm that estrogen receptor(ESR1),tumor necrosis factor(TNF),D(2)dopamine receptor(DRD2),vitamin D3 receptor(VDR),glucocorticoid receptor(NR3C1),acetylcholinesterase(ACHE)and endothelin-1(EDN1)were highly correlated with Qi and Yin deficiency syndrome.Through the target to find Qi and Yin deficiency syndrome corresponding to 17 categories of diseases.A new idea was provided for studying the biological essence of TCM clinical syndrome differentiation.

Consensus on diagnostic criteria for Yin deficiency syndrome in hypertension:a modified Delphi study

OBJECTIVE:To reach consensus on the diagnostic criteria for Yin deficiency syndrome in hypertension(YDSH)patients by a modified Delphi method.METHODS:Our study was consistent with T/CACM 1032-2017.The methodology of RAND/UCLA appropriateness was used to develop consensus guidance statements.A nationwide panel of experienced clinical experts from 19 provinces was constructed.These experts were all prominent in Traditional Chinese Medicine(TCM)of cardiovascular diseases.This consensus process consisted of two rounds of questionnaires and a final round of consultation to analyze the weight score of each item.Moreover,the data extraction process is carried out independently by third-party researchers(LIANG Junya,SUN Yang,and DU Xiaona).When there is disagreement in all three rounds,the expert panel group(odd number)are invited to vote,and the one with more votes wins.In the questionnaires,participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale.The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement.And then the diagnostic criteria of YDSH were formed according to the weight score in the final round.RESULTS:Twenty-eight experts(84.8%)participated in the first round,and thirty-one(93.9%)finished the second round.After two rounds,the consensus of YDSH was reached on 11 items(25.6%),including symptoms,signs,and pulse condition.Twenty-one experts(63.6%)completed the final round in which they used a grading system for each item.Red tongue with scanty fur had the highest weighting(22.8%),followed by heat in the palms and soles(20.1%).CONCLUSIONS:The consensus-based diagnostic criteria for YDSH,formed by a modified Delphi method,can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

Liver metabolomic characteristics in three different rat models of Yin deficiency based on ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry

OBJECTIVE:To investigate the mechanism of Yin deficiency syndrome(YDS) by analyzing the liver metabolomic characteristics of three different Yin deficiency rat models METHODS:Following the TCM etiology,for clinical features and pathological manifestations of modern medicine,three kinds of animal models of Yin deficiency were induced and replicated.Totally 48 Sprague-Dawley(SD) male rats were randomly divided into blank group,irritation induced model group,Fuzi-Ganjiang induced model group,and thyroxine-reserpine induced model group.After successful development of model,the ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry was carried out to detect metabolites in each group.The metabolites of rat liver were analyzed for the characteristics of their biomarkers.The pathway enrichment analysis and metabolic network construction were performed through various online databases including Metabolite Biology Role,Human Metabolome Database,MetaboAnalyst,and Kyoto Encyclopedia of Genes and Genomes.RESULTS:The SD rats in the experimental group showed symptoms like less weight gain,reduced diet and water intake,high body temperature,increased liver and kidney indexes,and abnormal liver and kidney tissue morphology.Moreover,the rats showed high increased levels of serum cyclic adenosine monophosphate,estradiol,alanine transaminase,and aspartate aminotransferase and decreased levels of cyclic guanosinc monophosphate and testosterone.We found four key interrelated metabolic pathways in the liver tissue metabolomics,including the biosynthesis of pantothenic acid and coenzyme A,and metabolism of alpha-linolenic acid metabolism,glycerophospholipid metabolism,and sphingolipid.CONCLUSION:The liver and kidney YDS is closely related to the biosynthesis of pantothenic acid and CoA and abnormal metabolism of α-linolenic acid,glycerophospholipid,and sphingolipid in SD rats.

Liuwei Dihuang Pill(六味地黄丸)Treats Postmenopausal Osteoporosis with Shen(Kidney) Yin Deficiency via Janus Kinase/Signal Transducer and Activator of Transcription Signal Pathway by Up-regulating Cardiotrophin-Like Cytokine Factor 1 Expression

Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group （Group A）, PMOP Shen-yang deficiency group （Group B）, PMOP without Shen deficiency group （Group C）, and control group （Group N）. Real-time polymerase chain reaction （RT-PCR） and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 （CLCF1）, ankyrin repeat and SOCS box containing 1 （ASB1）, and proldneticin 2 （PROK2） genes and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. Results： The mRNA （P〈0.05） and protein （P〈0.01） expression levels of the CLCF1 gone in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gone were obviously up-regulated （P〈0.01）. After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated （both P〈0.01）, and the average bone density of the top femur had significantly increased （P〈0.05）. In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. Conclusions： The CLCF1 gone is an important gone associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gone expression and activation of the JAK/STAT signaling pathway.

Correlation between constitution of Yin deficiency syndrome and polymorphism of HLADQA1 / treatment response of Peg-IFNα therapy in HBeAg positive chronic hepatitis B patients

Objective To observe the correlation between constitution of yin deficiency syndrome(YDS)and polymorphism of HLA-DQA1/treatment response of Peg-IFNαtherapy in HBe Ag positive chronic hepatitis B(CHB)patients,and to explore constitution of Chinese medicine(CM)in response to interferon therapy.Methods Totally 120 HBe Ag positive CHB patients who were

Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

Objective:To establish a rat model of type 2 diabetes(T2DM)manifesting the Chinese medicine syndrome pattern of both qi and yin deficiency for evaluating the efficacy of a Chinese herbal formula(CHF),integrative medicine(IM),and pioglitazone(PIO)on T2DM indicators in the animal model.Methods:The rat model was induced by a high-fat diet(HFD)and streptozotocin(STZ,30 mg/kg).CHF(3.4 g/kg),PIO(2.7 mg/kg),and IM(3.4 g CHF+2.7 mg PIO)were administered to rats once daily for 14 days.Related laboratory parameters were observed.Results:Diabetic rats showed unsmooth fur,alopecia,reduced activity,huddling,somnolence,depression,pale or reddened tongue,damp/dark red tail,and high levels of water and food intake,urine volume,and stool weight,but weakened grip strength.Low levels of serum SOD,Nat-Kt-ATPase,cAMP/cGMP,and a high level of iNOS were observed.Hyperglycemia,hyperinsulinemia,insulin resistance,high levels of serum glucagon/IDE and pancreatic amylin,and low serum and pancreatic SS levels were evident as well.Conclusions:A rat model of T2DM with both qi and yin deficiency was successfully replicated.CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM,though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Dry eye disease due to meibomian gland dysfunction treated with Pinggan Yuyin Qingre formula(平肝育阴清热方):a stratified randomized controlled trial

OBJECTIVE:To observe the clinical efficacy on improving the quality of meibum in patients suffer from dry eye disease(DED)due to meibomian gland dysfunction(MGD)with hyperactivity of Yang due to Yin deficiency pattern after being treated with Pinggan Yuyin Qingre formula(平肝育阴清热方,PGYYQR).METHODS:Totally 120 patients who met the inclusion criteria were included and stratified into three levels according to the level of MGD(1-3),and patients in each level was randomly allocated into the treatment group and control group according to a 1∶1 ratio.Both groups were treated with sodium hyaluronate eye drops,and the treatment group was also given PGYYQR granules.Both groups were treated continuously for eight weeks.The score of the properties of meibomian gland(MG)secretion,the score of the palpebral margins,the average noninvasive tear breakup time(NITBUTav),lipid layer thickness(LLT),and Traditional Chinese Medicine(TCM)syndrome efficacy were compared between the two groups after treatment.RESULTS:A total of 116 cases were included in the statistical analysis.The differences were statistically significant in the score of the properties of MG secretion,the score of the palpebral margins,and NITBUTav between the two groups after treatment,the treatment group was superior to the control group;there was no evidence of a difference in LLT.In terms of TCM syndrome efficacy,the total effective rate was 84.7%in the treatment group and 50.9%in the control group,with the statistically significant difference.None of the included cases had adverse reactions.CONCLUSIONS:PGYYQR is effective in improving the quality of meibum,and the tear film stability which thereby relieving the ocular symptoms in MGD-related DED patients with hyperactivity of Yang due to Yin deficiency pattern.

The Clinical Experience of Prof. Zhang Xiaofeng in the Treatment of Small Follicular, Ovulatory Infertility with Traditional Chinese Medicine

With the popularization of clinical ultrasound technology,small follicular ovulation infertility is gradually being recognized in clinical practice.Low follicle ovulation refers to the phenomenon that the average value of the three diameter lines of the dominant follicle is less than 14mm-18mm under continuous ultrasound monitoring.The dominant follicle ovulates before it develops to maturity,which is a kind of ovulation disorder and one of the leading causes of unexplained infertility[1],accounting for 25%-30%of the total number of patients with infertility[2].At present,Western medicine mostly uses ovulation,stimulating drugs to treat this disease.Still,due to the clinical result of“high ovulation but low pregnancy”,there are certain obstacles in treatment.The purpose of this article is to discuss Zhang Xiaofeng’s understanding of TCM of this disease.The tutor believes that the location of the disease is in the kidney,and the mechanism of the disease is kidney yin deficiency and blood heat.The treatment principle is sequential therapy,nourishing yin and clearing heat,taking into account the protection of the spleen and stomach,and the therapeutic effect is perfect.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

Yangqing Chenfei formula(养清尘肺方)alleviates crystalline silica induced pulmonary inflammation and fibrosis by suppressing macrophage polarization

OBJECTIVE:To explore the underlying mechanisms of the effects of Yangqing Chenfei formula(养清尘肺方,YCF) on inflammation and fibrosis in silicosis via inhibition of macrophage polarization.METHODS:A silicotic rat model was established via a single intratracheal instillation of silica particles on the first day of week 0.Subsequently,YCF was administered intragastrically to silicotic rats during weeks 0-2 and 5-8 twice daily.The mouse-derived alveolar macrophage cell line was used to investigate the mechanisms of YCF in M1/M2 polarization.RESULTS:YCF treatment effectively inhibited lung pathological changes,including inflammatory cell infiltration and tissue damage,and increased the forced expiratory volume in the first 0.3 s,functional residual capacity,and maximal mid-expiratory flow in weeks 2 and 8.Furthermore,the treatment improved lung functions by upregulating tidal volume,pause increase,and expiratory flow at 50% tidal volume from weeks 5 to 8.Moreover,YCF could significantly suppressed the progression of inflammation and fibrosis,by reducing the levels of inflammatory cytokines,as well as collagen-Ⅰ and Ⅲ.YCF treatment also decreased the numbers of macrophages and M1/M2 macrophages and the level of transforming growth factor-β(TGF-β).Additionally,YCF5,the effective substance in YCF,decreased lipopolysaccharide and interferon-γ-induced M1 macrophage polarization in a concentration-dependent manner.The mechanism of anti-M1 polarization might be related to a decrease in extracellular signal-regulated kinase,c-JUN N-terminal kinase,P38,and P65 phosphorylation.Furthermore,YCF5 inhibited interleukin-4-induced M2 macrophages by decreasing the protein and m RNA expressions of arginase-1 and CD206 as well as the levels of profibrotic factors,such as TGF-β and connective tissue growth factor.The mechanisms underlying the anti-M2 polarization of YCF5 were primarily associated with the inhibition of the nuclear translocation of phosphorylated signal transducer and activator of transcription 6(pSTAT6).CONCLUSION:YCF significantly inhibits inflammation and fibrosis in silicotic rats probably via the suppression of M1/M2 macrophage polarization mediated by the inhibition of mitogen-activated protein kinase and nuclear factor kappa B signaling pathways and Janus kinase/STAT6 pathways.

Mirror-like tongue is an important predictor of acute heart failure:a cohort study of acute heart failure in Chinese patients

OBJECTIVE:To reveal that mirror-like tongue,observed via a noninvasive inspection,is a powerful indicator of the severity and prognosis of patients with acute heart failure(AHF).METHODS:This was an observational,prospective study.A total of 408 patients who met the inclusion criteria and were diagnosed with AHF for the first time at Taicang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from August 2019 to January 2021 were selected as the research subjects.According to their tongue fur,the patients were divided into group A(mirror-like tongue group)and group B(non-mirror-like tongue group).The clinical characteristics and incidence of major adverse cardiovascular events(MACEs)within 1 year of follow-up were systematically compared between the two groups.RESULTS:Sixty-five patients were included in group A,and 343 patients were included in group B.There were 32 males and 33 females in group A and 168 males and 175 females in group B.The average age of the overall population was 64 years old,and the average age of group A was significantly higher than that of group B(74 vs 62 years,P<0.001).Compared with that in group B,the left ventricular ejection fraction(LVEF)in group A was significantly lower(35%vs 42%,P<0.001),and the log N-terminal pro B-type natriuretic peptide(NT-proBNP)level was significantly higher(4.0 vs 3.4,P<0.001).The proportion of the combined application of vasoactive drugs in group A was significantly higher than that in group B(64%vs 38%,P<0.001).Group B had a higher proportion of coronary angiography(29.5%vs 16.9%,P=0.038).Group A was more inclined to require mechanical ventilation than group B(33.9%vs 22.5%,P=0.049).The length of hospital stay in group A was significantly longer than that in group B(13.1 vs 7.6,P<0.001).The incidence of MACEs,such as recurrence of AHF,new myocardial infarction and stroke,in group A within one year was higher than that in group B(P=0.007,0.009,<0.001).The incidence of cumulative MACEs in group A was significantly higher than that in group B[hazard ratio=2.76,95%confidence interval(1.73,4.41),P<0.001].Univariate and multivariate Cox regression analyses showed that mirror-like tongue,age,length of stay,LVEF and log NT-proBNP were independent predictors of MACEs in patients with AHF within one year.CONCLUSIONS:Noninvasive tongue inspection technology can be used as a powerful tool for assessing the severity of illness and predicting prognosis in patients with AHF.A mirror-like tongue is an independent risk factor for MACEs in patients with AHF during the first year and has a combination effect with age,length of hospital stay,ejection fraction and NT-proBNP on the occurrence of MACEs.

针灸与克龄蒙治疗更年期潮热比较研究

Objective:To compare the therapeutic effect on menopausal hot flashes between acupuncture and Climen so as to provide a new approach to the treatment of this disease.Methods:A total of 80 cases in line with inclusion criteria were randomized into a treatment group(treated with acupuncture) and a control group(oral administration with climen),40 cases in each one.The treatment for 1 month was as 1 course and lasted consecutively for 2 courses.Before and after treatment,the contents of serum estrogen(estradiol,E_(2)) and 5-hydroxytryptamine(HT) and the scores of the attack frequency and severity scale of hot flashes and sweating,domestic modified Kupperman scale and traditional Chinese medicine(TCM) symptom scale were observed,and the clinical therapeutic effect was evaluated in the two groups separately.Results:Before treatment,there was no difference in the content of E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the patients between two groups,indicating the comparability(all P>0.05).Compared with the data before treatment,the contents of serum E_(2)(treatment group vs control group:22.24±11.02 vs 33.12±1.01;22.11±10.19 vs 25.29±2.23) and5-HT(treatment group vs control group:96.12±8.21 vs 131.21±30.21;96.98±7.99 vs 108.29±22.08),the score of hot flashes and sweating(treatment group vs control group:8.24±1.02 vs 3.12±1.01;8.11±1.19 vs 5.29±2.23),Kupperman score(treatment group vs control group:26.12±2.21 vs11.21±0.21;26.98±1.99 vs 18.29±2.08) and TCM symptom score(treatment group vs control group:18.97±3.87 vs 10.12±0.16;19.01±2.29 vs 15.61±2.89) were statistically different after treatment in the two groups(all P<0.05).After treatment,the contents of serum E_(2) and 5-HT,the score of hot flashes and sweating,Kupperman score and TCM symptom score in the treatment group were all different statistically compared with the control group(all P<0.05).There was statistical difference in clinical therapeutic effect in the patients between two group,in which,the therapeutic effect in the treatment group was better than that in the control group(90% vs 77.5%,P<0.05).Conclusion:Acupuncture effectively reduces Kupperman score and TCM symptom score in the patients and its therapeutic effect is better than climen.Regarding relieving hot flashes symptoms in menopausal patients of kidney yin deficiency and improving in attack frequency and severity of hot flashes and sweating,the effects of acupuncture are superior to Climen.Acupuncture obviously increases the contents of serum E_(2) and 5-HT.

Protective effect of Yiguanjian decoction against DNA damage on concanavalin A-induced liver injury mice model

OBJECTIVE:To investigate the inhibitory effect of Yiguanjian decoction(YD) on DNA damage in Concanavalin A(Con A)-induced liver injury mice model and to explain the possible mechanism.METHODS:Totally 120 male BALB/c mice were randomly divided into 6 groups,20 mice each:normal group,model group,Bifendate group,YD low dose group,YD middle dose group and YD high dose group.Except normal group,liver injury model induced by Con A was established.While modeling,each mouse in YD group was given YD(0.4 m L/20 g per day) by intragastric administration(0.13 g YD for YD low dose group;0.26 g for YD middle dose group;0.52 g for YD high dose group).Bifendate group was given Bifendate(0.2 gnd model·kg-1 grou·d-1) by gavage.Normal group ap were fed with same volume of physiological saline daily.After 8 weeks,the serum alanine transaminase(ALT)and aspartate transaminase(AST) were tested.The hematoxylin-eosin staining was used to evaluate the grade of liver inflammation and liver fibrosis stage.Hepatocellular DNA damage was detected by single cell gel electrophoresis technology.The protein expression of tumor necrosis factor-α(TNF-α),Bax and Mut T Homolog 1(MTH1) was detected by western blotting and enzyme linked immunosorbent assay.Bax m RNA and MTH1 m RNA were detected by Real-time Polymerase Chain Reaction(PCR).RESULTS:YD can improve the degree of liver inflammation and fibrosis in the liver of chronic hepatitis mice,the dose effect relationship is remarkable(P < 0.05).YD can reduce liver cell DNA damage.The difference between YD middle dose group and model group was statistically significant(P < 0.05).YD middle dose group had decreased the protein expression of TNF-α in the mice liver of immunological liver injury(P < 0.05).YD can increase the protein expression of Bax(P < 0.05).Compared with normal group,the protein expression of MTH1 was decreased(P < 0.05),but there was no statistical significance between YD group and model group(P >0.05).YD can increase the m RNA expression of Bax and MTH1(both P < 0.05).CONCLUSION:YD can effectively inhibit the DNA damage in immunological liver injury mice,the mechanism may be that it can decrease the TNF-αand increase the Bax and MTH1 expression.

Need of integrated dietary therapy for persons with diabetes mellitus and “unhealthy” body constitution presentations

From a perspective of Chinese medicine （CM）, persons with unregulated ＂unhealthy＂ body constitution （BC） will further develop chronic diseases, such as diabetes mellitus （DM）. Conventional dietary therapy with nutrition component has its limitations in the regulation of ＂unhealthy＂ BC. However, empirical evidence supports that ＂unhealthy＂ BC can be regulated with food natures and flavors from a perspective of CM. Presentations of ＂unhealthy＂ BC types, such as Yin-deficiency, Yang-deficiency and Yin-Yangdeficiency were found in persons with DM. It would be necessary to regulate the ＂unhealthy＂ BC presentations with integration of conventional dietary therapy and Chinese food therapy. The ultimate goal is to either stabilize glycaemic control or prevent the development of other chronic diseases leading to reduction of disease burden, such as disease-related poor quality of life, stress of healthcare professionals and the rising of healthcare cost.

激光针灸治疗气阴两虚型2型糖尿病32例

Objective To observe the clinical therapeutic effect of laser acupuncture on type 2 diabetes mellitus(T2DM)of qi and yin deficiency type.Methods Laser acupuncture was used to treat 32 patients of T2DM.Acupoint selection:Fèishū(肺俞BL13),Píshū(脾俞BL20),Shènshū(肾俞BL23),Wǎnxiàshū(胃脘下俞EX-B3),Sānyīnjiāo(三阴交SP6)and Zúsānlĭ足三里(ST36).It took 20 min in each treatment,five treatments a week.There were 2 days of interval in 2 weeks of treatment.Before and after treatment,the changes in fasting plasma glucose(FPG),postprandial 2 h glucose(2hPG),fasting insulin(FINS),glycosylated albumin(GA),insulin resistance index(HOMA-IR)and the symptom score of traditional Chinese medicine(TCM)were observed in the patients.The therapeutic effect was evaluated.Results Of 32 cases,8 cases were remarkably effective,18 cases effective and 6 cases failed.The total effective rate was 81.3%.At the end of treatment course,the level of every indicator after treatment was significantly lower than that before treatment(all P<0.01).Conclusion Laser acupuncture achieves the significant therapeutic effect on T2DM of qi and yin deficiency and this therapy deserves to be promoted in clinical application.

Exploration of Syndrome Differentiation Patterns in Coronary Heart Disease Patients during Peri-Operative Stage of Coronary Artery Bypass Graft

Objective: To explore the patterns of Syndrome Differentiation (SD) of coronary heart disease (CHD) patients in peri-operative stage of coronary artery bypass graft (CABG).Methods: One week after operation, thirty-seven CHD patients, who received CABG of internal mammary artery or great saphena vein under conventional general anesthesia with low or middle temperature extracorporeal circulation were differentiated as various syndromes, with the pre- or post-operational EKG, color Doppler echocardiography were done during and after operation. The hemodynamic parameters were monitored.Results: In the CHD patients, 64.9% were differentiated as Qi-Yin deficiency, 67.6% were complicated with phlegm syndrome and 62.2% with blood stasis, suggesting that Qi-deficiency, phlegm and stasis are the basic pathogenetic factors in patients with CABG. Moreover, the peri-operative syndrome was correlated with the condition of coronary artery lesion, heart and lung functions before operation, and the extracorporeal circulation time during the operation.Conclusion: TCM SD conducting in peri-operative stage might be useful in exploring the patterns of syndrome alteration which provided a basis for preventing peri-operative complications and elevating success rate of operation.

Value of Traditional Chinese Medicine syndrome differentiation in predicting the survival time of patients with advanced cancer

OBJECTIVE:To prospectively study the accuracy of the palliative prognostic index(PPI)survival prediction model combined with Traditional Chinese Medicine(TCM)syndrome differentiation.METHODS:The PPI survival prediction model was used to predict survival time.Patients'real survival time was recorded.The survival time was calculated using the Kaplan-Meier method,and the logrank method was used to test the difference.RESULTS:The average PPI survival prediction score of 227 patients was 5.83(95%CI:5.29-6.37).There was a significant difference in the real-life period between the different PPI groups(P<0.05).PPI group Ⅰ(predicted survival of >6 weeks)showed the highest predictive sensitivity and PPI group Ⅱ(predicted survival of 3-6 weeks)showed the highest predictive specificity.According to TCM syndrome differentiation,82 cases(36%)were diagnosed with liver and kidney Yin deficiency(type Ⅳ).The actual survival time of type Ⅳ patients was significantly shorter than that of other types of patients(mean:21.85 vs 28.70,P=0.007).In group Ⅰ,the median survival time of type Ⅳ patients and other types was 25 and 34 d,respectively(P<0.001).The sensitivity and specificity of PPI prediction were improved in group Ⅱ by TCM syndrome differentiation.For patients in group Ⅲ whose predicted survival time was<3 weeks,the specificity of PPI survival prediction was higher in type Ⅳ patients.CONCLUSION:This study shows that the PPI predictive tool for survival rate has important value.TCM syndrome differentiation and typing has certain significance for further classification and survival prediction.

Study on Molecular Mechanism of Liver Yang Ascending Syndrome in Hypertension

Objective: To investigate the molecular mechanism of Liver Yang Ascending Syndrome (LYAS) in hypertension. Methods: The plasma norepinephrine (NE), epinephrine (E) contents in patients with LYAS or Liver and Kidney Yin Deficiency Syndrome (LKYDS) of hypertension and normal controls were determined by high performance liquid chromatography-electrochemical detector (HPLC-ECD). The polymorphism of tyrosine hydroxylase (TH) gene in the three groups were analysed by Southern Blot assay. The polymorphism of TH and monoamine oxidation A(MAO-A), monoamine oxidation B(MAO-B) gene microsatellite in these groups were analysed by polymerase chain reaction (PCR)-SSCP. At the same time, the LYAS model was established by administering Aconitum preparation (AP) to spontaneous hypertension rats (SHR). The adrenal gland medulla of the experimental animal was examined for their TH expression at the protein level after ABC immuno-histochemical staining with the TH monoclonal antibody (McAb). The adrenal TH gene mRNA expression was demonstrated by in situ hybridization with the synthetized TH oligonucleic acid probe. The results of immuno-histochemistry and in situ hybridization were analyzed with the image analysis system (IAS). Results: The plasma NE and E contents in patients with LYAS were more obviously increased than those in LKYDS and normal controls. The TH gene amplified and the type A1 TH microsatellite D11S4046 was markedly higher in the LYAS group than those in the other groups. The TH mRNA protein expression in the adrenal tissue of the AP induced LYAS model in SHR elevated. Conclusion: The LYAS of hypertension has the characters as amplified TH gene and increased TH mRNA and protein expression, which suggested that the overexpression of TH is probably the mechanism of LYAS in hypertension.

情感区三角和印堂治疗失眠:个案报道

Insomnia prevalence may reach up to 30%of the population considering at least one of the following criteria:difficulty in falling asleep,difficulty in remaining asleep,waking up too early,not repairing sleep or bad sleep quality,followed by daily consequences of lack of sleep such as lack of attention or stress.Several studies have reported the use of acupuncture as a therapeutic alternative for insomnia treatment showing important results such as anxiety decrease,improvement of sleep quality,decrease of daily consequences of insomnia,among others.The aim of this project was to use acupuncture as treatment for insomnia using the points Shenmen(神门HT7),Taiyuan(太渊LU9),Neiguan(内关PC6)and Yintang(印堂EX-HN3).After the signing of the TCLE,the patient answered a questionnaire during sessions 1,5 and10.The patient received insomnia treatment through puncture of the following points:HT7,LU9,PC6 and EX-HN3.The patient reported a significant improve in the sleep quality after the first sessions and absence of the symptoms after the tenth session.Therefore we conclude that the stimulation of these acupoints is useful in the insomnia treatment.