Effect of gastrointestinal heat retention syndrome on gut microbiota in children with upper respiratory tract infection and lung-heat syndrome

Objective:Gastrointestinal heat retention syndrome(GHRS)is associated with lung-heat syndrome and is related to recurrent respiratory infection.Upper respiratory tract infection(URTI)lung heat syndrome is common in children.The study will explore the effect of GHRS on the structure and function of gut microbiota in children with URTI lung-heat syndrome.Methods:Participants were divided into both groups using the self-developed URTI scale and the“GHRS Diagnostic Scale$Pediatric Part”:GHRS-positive children(LS group)and GHRS-negative children(L group).General information,clinical symptoms,and stool were collected.We used 16S rRNA amplicon sequencing technology to determine the gene sequence of the V3eV4 region in feces and measure the gut microbiota of the both groups at the genus level.Results:A total of 23 children were included in the both groups.There were 12 cases in the LS group and 11 cases in the L group.There was no statistical difference between the both groups in age,gender,height,weight,and body mass index.The effective sequences shared by the both groups accounted for 85.66%of the total.In the gut microbiota,there was no difference in the a diversity and the b diversity between the both groups.Compared with the L group,the LS group had a significant increase in the relative abundance of the Ruminococcus gnavus group,Prevotella-9,Staphylococcus,and Actinomyces(P<.05).The functions of the both groups of microbiota primarily concentrate on metabolism,genetic information processing,and environmental information processing.The relative abundance of signaling molecules and interactions in the LS group were higher than that in the L group(P<.05).The redundancy analysis(RDA)showed that the URTI score had the greatest impact on the distribution of microbiota.Conclusion:GHRS may affect the development of URTI lung-heat syndrome by changing the relative abundances of gut microbiota.

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.

Research progress on modern mechanism of“moxibustion can be used for heat syndrome”

The authors have retrieved the experimental literature on moxibustion in treatment of heat syndrome in recent years, and summarized the mechanism of moxibustion in treatment of heat syndrome from such aspects as ant-ipyretic and anti-infective effect of moxibustion, the effect on peripheral metabolism of humoral factors and the level of central neurotransmitter, and the regulation of immune function through sorting and analysis, thus providing experimental evidences for the feasibility and effectiveness of ＂moxibustion can be used for heat syndrome＂, and providing ideas and direction for future researches.

Effect of New Pulian Ointment (新普连膏) in Treating Psoriasis of Blood-Heat Syndrome:A Randomized Controlled Trial

Objective:To objectively assess the clinical efficacy and safety of a new Pulian Ointment(新普连膏,NPLO) in treating psoriasis of blood-heat syndrome of Chinese medicine.Methods:A total of 108 patients with psoriasis of blood-heat syndrome were equally assigned,using a randomizing digital table,to the test group treated externally with NPLO and the control group treated with placebo;the medication was done using a single-blinded method twice a day.Meanwhile,all patients received by oral intake a conventional Ch...

Theoretical Exploration and Clinical Application of Moxibustion for Heat Syndrome

This article gives a profound exploration on the theoretical origin, prohibitions and mechanisms of moxibustion for heat syndrome. Based upon the ancient and modem literature, this article also gives a classified summarization on diseases of moxibustion for heat syndrome, in order to obtain a thorough understanding about the theory and clinical application of moxibustion for heat syndrome, hence to further perfect the theory of moxibustion and guide the clinical practice.

Structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome differentiated by traditional Chinese medicine

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of subhealthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the“GHRS diagnostic scale”,collected their oropharyngeal swabs,and sequenced the 16 SrDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,Metagenome Seq analysis,and linear discriminant analysis effect size(LEf Se)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundancebased coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while betadistances did not exhibit any significant intergroup differences.There were 9 differently distributed nonpredominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in Metagenome Seq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

A new way to analyze the traditional Chinese medicine syndrome:heat toxin syndrome in cerebral infarction

Objective:To establish a diagnostic system for heat toxin syndrome of acute cerebral infarction.Based on this toxin syndrome diagnostic system,the general principles of heat toxin development will be uncovered,and the critical turning point at which the heat toxin syndrome occurs will also be explored.Methods:In this study,a total of 271 hypertension patients with cerebral infarction within 72 h were recruited from the Affiliated Dongfang Hospital of the Beijing University of Chinese Medicine,the Affiliated Dongzhimen Hospital of Beijing University of Chinese Medicine,the Affiliated Renmin Hospital of Peking University,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,the Affiliated Hospital of Hebei University of Traditional Chinese Medicine and China Meitan General Hospital from August,2008,to December,2009.The patients’Chinese medical information was recorded on days 1,3,5,7,and 14 during their hospitalizations.The medical records were recorded according to traditional Chinese medicine(TCM)theory and included the serum marker levels at the beginning and at the end of the trial.The time line was also analyzed.Results:The level of Hs-CRP,PAG,NSE,OX-LDL,and MMP-9 were abnormal and,were higher in CI patients compared to hypertension patients.In the study of the heat toxin diagnosis system,according to the entropy clustering results,30 combinations of the medical information can be sorted into the traditional syndromes,but 13 combinations cannot be sorted.To obtain more precise symptoms related to the heat toxins,a logistic regression equation was set up with the variables from the unsorted medical information;the dependent variables were fever and BP fluctuation.Weighted variables were obtained.MLP analysis demonstrated that the diagnosis model was stable and precise.The accuracy reached 83.82%.The ROC test showed that seven points of the diagnosis system was the best cutting point,with a sensitivity of 0.857 and a specificity of 0.955.Progressing stroke was related to heat toxin syndrome.When the turning point appeared,the combination of symptoms,such as coma,aphasia,gummy eyes,and halitosis,predicted the deterioration or recovery of CI.The heat toxin syndrome existed in every subtype of CI;however,the observed heat toxin levels were highest in PACI and lowest in LACI.Meanwhile,blood and sputum stasis syndromes transformed into heat toxicity were one source of heat toxin syndrome.Conclusion:Heat toxin syndrome,as well as qi/blood/sputum stasis,co-existed in the CI patients,and the transformation frequently appeared during the process.Three to five days after the onset of CI was the turning point,at which time several combinations of medical indicators make it possible to predict the development of CI.

Association between gastrointestinal heat retention syndrome and respiratory tract infections in children:A prospective cohort study

Objective:To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections(RRTIs)in children.Methods:A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital.Children without respiratory tract infections(RTIs)were consecutively recruited according to the selection criteria.A semi-structured questionnaire was used to record traditional Chinese medicine(TCM)symptoms and demographic and physiological characteristics.Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity.The participants were followed up for 12 months.Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months.Episodes of pneumonia and RTIs were recorded in detail.Results:A total of 420 children were included.Of participants,370(88.10%)were followed up for 12 months.The mean number of RTI episodes per participant was 5.37(95%CI:5.14 to 5.60).In total,186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the nongastrointestinal heat retention syndrome group completed the 12-month follow-up period.The baseline of both groups was comparable.The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27(95%CI:1.01 to 1.59)times that in children without gastrointestinal heat retention syndrome.Logistic regression analysis revealed that abnormally increased appetite with frequent hunger,foul breath,dry stools,and dark red or purple fingerprints were positively correlated with the incidence of pneumonia.Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI.Conclusions:Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children.Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.

Exploring the association between gastrointestinal heat retention syndrome and adult chronic eczema: A caseecontrol study

Objective:To investigate the association between gastrointestinal heat retention syndrome(GHRS)and adult chronic eczema.Methods:This caseecontrol study compared GHRS/GHRS accompanied by damp-heat syndrome(GHRSDHS)and other patient characteristics between subjects with(cases)and without chronic eczema(controls)to identify potential factors associated with this condition.Semi-structured questionnaires were used to collect data via face-to-face interviews.Participants were recruited from Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine.A logistic regression analysis was performed on the collected data,and odds ratios(ORs)were calculated.Results:A total of 168 cases and 172 controls were recruited.Among the cases of adult chronic eczema,there were 79 subjects with GHRS and 68 with GHRS-DHS.Sex(P=.02,OR=0.54,95%confidence interval[CI]:0.32-0.91),GHRS(P=.04,OR=1.90,95%CI:1.02-3.51),GHRS-DHS(P<.001,OR=4.89,95%CI:2.36-10.15),high sweet food consumption(P=.04,OR=2.03,95%CI:1.03-3.97),and mental stress(P=.01,OR=2.37,95%CI:1.26-4.47)were each found to be associated with chronic eczema.Furthermore,GHRS had a weak positive correlation with eczema EASI severity as measured by the eczema area and severity index(EASI)(P=003).Conclusion:GHRS/GHRS-DHS may be associated with adult chronic eczema.In the future,prospective cohort studies with larger samples should be conducted to investigate the cause and effect association between GHRS and adult chronic eczema.

Clinical Observation of Dingchuan Decoction(定喘汤)Combined with Omazumab in Treating Acute Attack of Bronchial Asthma(Heat Asthma Syndrome)

Objective:To explore the therapeutic effect of Dingchuan Decoction combined with omazumab on acute attack of bronchial asthma.Methods:From January 2020 to November 2021,90 patients with acute asthma were treated in our hospital,which belonged to heat asthma syndrome according to TCM syndrome differentiation in our hospital.They were divided into control group and observation group with 45 cases in each group.The control group was treated with omazumab,while the observation group was treated with omazumab combined with Dingchuan Decoction.The changes of lung function,exhaled nitric oxide(FeNO),blood gas indexes and hematological indexes were observed before and after treatment,and the adverse reactions and asthma recurrence within 3 months were observed.At the same time,animal experiments were carried out to verify the curative effect of Dingchuan.Results:After treatment,the total effective rate,FeNO,pulmonary function,partial pressure of blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),interleukin-6(IL-6),interleukin-5(IL-5),immunoglobulin E(IgE)and asthma recurrence in 3 months in the observation group were better than those in the control group;There was no significant difference in pulse oxygen saturation(SaO_(2))and the incidence of adverse reactions between the two groups.Animal experiments show that Dingchuan Decoction can effectively improve lung inflammation.Conclusion:The combination of Dingchua Decoction and omazumab has a good curative effect in the treatment of acute attack of bronchial asthma,which can effectively improve the lung function and blood gas index of patients,reduce the levels of inflammatory factors and IgE,and has no obvious increase in adverse reactions,and effectively control the recurrence of asthma within 3 months.It can be used as an auxiliary maintenance treatment for patients with mild and moderate acute attack and clinical remission of asthma,thus reducing the utilization rate of hormones and having high application value.

Multicenter Clinical Randomized Controlled Trial and Network Pharmacology Analysis of Zhenzhu Qingyuan Granules for the Treatment of Gastroesophageal Reflux Disease

Objective To evaluate the clinical efficacy and safety of Zhenzhu Qingyuan Granules through a clinical randomized controlled trial and to analyze the potential action targets and pathways of this formula using network pharmacology.Methods Patients with gastroesophageal reflux disease(GERD)of liver–stomach stagnant heat pattern who met the inclusion and exclusion criteria were randomly divided into the control group and the observation group.The control group received oral rabeprazole,whereas the observation group were given Zhenzhu Qingyuan Granules in addition to the rabeprazole.The treatment duration was 8 weeks.Clinical efficacy was observed in both groups after 8 weeks.Network pharmacology was used to analyze the action targets of ZhenzhuQingyuanGranules and the genes related to GERD,and core targets were inferred.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were conducted to explore the potential mechanisms of this formula.Results The clinical research results showed that the total effective rate in the treatment group was 92.68%,compared with 70.00%in the control group,with a statistically significant difference(p<0.05).After treatment,both Chinese medicine syndrome score and endoscopic score improved in both groups compared with before treatment(p<0.05),and the treatment group showed greater improvement than the control group(p<0.05).Network pharmacology identified effective components of Zhenzhu Qingyuan Granules for treating GERD,including quercetin,luteolin,andβ-sitosterol,with potential action targets such as tumor protein 53(TP53),protein kinase B(AKT1),and tumor necrosis factor.Conclusion Zhenzhu Qingyuan Granules can significantly improve clinical symptoms in patients with GERD of liver–stomach stagnated heat pattern,enhance clinical efficacy,and have high safety.This formula may exert therapeutic effects through multiple targets and pathways.

Formulation Mechanism of Mailuo Shutong Pills in the Treatment of Varicocele

Varicocele is a common disease in male urology clinic,mainly manifested as testicular pendent distension discomfort,scrotal moisture,less weak semen and other symptoms.There is no specific drug in clinical treatment of modern medicine and traditional Chinese medicine.Mailuo Shutong Pills was created by TANG Zuxuan,a Chinese medical master,for the treatment of damp and heat stasis type thrombotic superficial phlebitis and other vascular diseases.In clinical application,it was found to have a good clinical effect on the treatment of symptoms caused by varicose vein.This paper analyzed the formulation mechanism of Mailuo Shutong Pills in the treatment of varicocele from the perspective of traditional Chinese and western medicine,and provides theoretical basis for clinical application.

Jinye Baidu granule for wind-warmth lung-heat disease(heat in the lung-wei)： protocol for a randomized, double-blind, parallel, controlled trial

OBJECTIVE: To observe the curative effect of Jinye Baidu granule in the treatment of fever and swollen and sore throat caused by wind-warmth lung-heat disease(heat in the lung-wei) to further identify the indications.METHODS: This randomized, double-blind, parallel, controlled trial will include patients with acute upper respiratory infection and wind-warmth lung-heat disease(heat in the lung-wei). Patientswith serious bacterial infection(white blood cell count > 12 × 10~9, neutrophils > 80%) will be excluded. Patients will be divided into three categories(blocks) according to their condition: fever only, a swollen and sore throat, and combined fever plus a swollen and sore throat. Patients within each of the three blocks will be further divided into a treatment group and a control group via stratified blocked randomization. The treatment group will be treated with Jinye Baidu granule, and the control group will be treated with Fufang Shuanghua granule. The primary outcome measure will be body temperature recovery time for patients with fever, throat symptom score for patients with a swollen and sore throat, and body temperature recovery time and throat symptom score for patients with combined fever plus a swollen and sore throat. Routine blood testing, urine testing, liver function, kidney function and ECG data of all patients will be collected as safety indices before and after enrollment, and adverse events will be recorded during the whole trial course.CONCLUSION: This study protocol will include stratified block analysis according to patients' symptoms, and identify the accurate clinical indications of Jinye Baidu granule. It will also enable safety evaluation from laboratory indices and adverse events, which will provide reliable evidence for clinical treatment.

Anti-Inflammatory Effect of Qingwen Baidu Decoction (清瘟败毒饮) in Sepsis Rats

Objective：To explore the pharmacological anti-inflammatory mechanism of Chinese formula Qingwen Baidu Decoction（清瘟败毒饮,QBD） from the view of holistic biology.Methods：The rats were randomly divided into a normal conrol group,a lipopolysaccharide（LPS） group,the low- and high-dose QBD groups,and a dexamethasone（DXM） group.NR8383 cells were treated with culture fluid containing 6%serum from rats of each group respectively.Inflammatory mediators were detected by reverse transcription polymerase chain reaction（RT-PCR）,Western blotting hybridization,enzyme linked immunosorbent assay（ELISA）,polymerase chain reaction（PCR） gene array and antibody array.Results：It is showed that the levels of interleukin（IL）-1 α,IL-4 and IL-12 were enhanced in the low-dose QBD group;levels of IL-1 α,IL-12 and IL-18 were augmented in the high-dose QBD group,compared with the LPS group after ELISA detection.Western blot showed that IL-1β and tumor necrosis factor（TNF）-α expression of the control group were lower than other groups.IL-1 βlevel of the low-dose and high-dose QBD groups detected by RT-PCR was higher in early stage but lower after24 h than that of the control group（P〈0.01）.Expression of 84 main inflammatory cytokines and receptors was detected by rat inflammatory cytokines and receptors PCR array.Up-regulation genes were 22 in both the LPS group and the low-dose QBD group,among which 16 up-regulating genes were the same.In these 16 genes,the up-regulating amplitude of 9 genes in the low-dose QBD group was less than that in the LPS group,4 were similar to and 3 were more.Twenty-nine main cytokines were inspected by rat cytokine antibody array.Intergroup gray value differences were found in 7 expressed cytokines.The levels of these 7 cytokines in the lowdose QBD group were all lower than those in the the LPS group.Conclusions：QBD has anti-inflammatory effect on sepsis by changing the level of inflammatory mediators.

Effect of Huanglianjiedu Tang on fever in rats induced by 2, 4-dinitrophenol

OBJECTIVE: To study metabolic characteristics of fever in rats induced by 2, 4-dinitrophenol (DNP) and the effect of Huanglianjiedu Tang (HLJDT) on the fever. METHODS: The urine samples were analyzed by ultra-performance liquid chromatography/electrospray ionization quadruple time-of-flight mass spectrometry (UPLC/ESI-Q-TOF-MS) at the positive ion mode scanning, and experimental data were analyzed by the principal component analysis. RESULTS: Eight potential biomarkers indicating the occurrence and evolvement of fever were determined according to ions in urine samples. Five of them were found increased, while the other three decreased. After HLJDD intervention, the increased five were reduced significantly in high dose group, compared with model group, while the decreased three had no obvious change. Five of the eight biomakers were identified with formyl-5-hy-droxykynurenamine, gentisic acid, aminoadipic acid, phenylacetic acid, L-phenylalanyl-L-hydroxyproline on the basis of MS/MS.These biomarkers are associated with the metabolism of 5-hydroxytryptamine, tyrosine, lysine, phenylalanine and collagen protein, respectively. CONCLUSION: HLJDT had significant effect on DNP-induced fever in rats. The effect was performed possibly by acting on 5-hydroxytryptamine in hypothalamus and some amino acid metabolism. These results suggested that HLJDT relieved fever by acting on multi-targets.

Comparative Study on the Protective Effects of Yinchenhao Decoction(茵陈蒿汤) against Liver Injury Induced byα-Naphthylisothiocyanate and Carbon Tetrachloride

Objective:To optimize the animal model of liver injury that can properly represent the pathological characteristics of dampness-heat jaundice syndrome of traditional Chinese medicine.Methods:The liver injury in the model rat was induced byα-naphthylisothiocyanate(ANIT) and carbon tetrachloride(CCl_4) respectively,and the effects of Yinchenhao Decoction(茵陈蒿汤,YCHD),a proved effective Chinese medical formula for treating the dampness-heat jaundice syndrome in clinic,on the two liver injury models were evaluate...