Fecal-associated microbiome differences between traditional Chinese medicine qi-deficiency and balanced constitutions

Objective:To explore the structural and functional characteristics of the fecal-associated microbiome(FAM)in a traditional Chinese medicine(TCM)qi-deficiency constitution(QDC)by comparing with balanced constitution(BC)and screen the related biomarkers.Methods:In this cross-sectional study,the TCM constitutions of subjects were determined based on published the Classification and Determination of constitution in TCM and further confirmed by a TCM clinician.Clinical characteristics were recorded,and fecal samples were collected for 16S rDNA sequencing using the Illumina Miseq platform.The FAM structure was described using alpha-diversity indexes,beta-diversity indexes,and the relative abundances of the dominant taxa.Differences in the FAM distribution and function were analyzed with a Wilcoxon rank-sum test,MetagenomeSeq,and LEfSe analysis,after which a receiver operating characteristic curve based on the specific operational taxonomic units(OTUs)was constructed to calculate the area under the curve.Results:Our study population was composed of 22 BCs and 9 QDCs.There were no significant differences between the two groups in the distribution of clinical characteristics or alpha-diversity indexes,except for the sweets preference and blood glucose level.In principal coordinate analysis and partial least squares discriminant analysis,the bacterial communities in the BC group samples and QDC group samples clustered separately.Notably,there were 214 OTUs significantly distributed between groups in the MetagenomeSeq analysis,200 OTUs identified by the Wilcoxon rank-sum test,and 6 OTUs found by the LEfSe analysis.Predicted function analysis revealed that six metabolic pathways were distinctly distributed between the two groups.The area under the curve for the receiver operating characteristic curve based on the four specific OTUs was 0.88.Conclusion:Unique FAM structural and related functional characteristics are displayed in individuals with a QDC,and four specific OTUs could be used as QDC biomarkers to assist in clinical diagnosis.

Transforming growth factor β1 is a differentially expressed candidate protein of congestive heart failure with Qi-deficiency-blood-stasis syndrome

OBJECTIVE: To investigate the role of tongue coating fluid protein in regulation of congestive heart failure(CHF) in Qi-deficiency-blood-stasis syndrome.METHODS: We studied patients with CHF(3 patients with Qi-deficiency-blood-stasis syndrome and 3 without Qi-deficiency-blood-stasis syndrome) to investigate differentially expressed proteins. We also included a control group. A biotin label-based antibody array was used for testing tongue coating fluid samples from patients. Net-work analysis of these differentially expressed proteins was conducted using the STRING database,which can predict the relations between differentially expressed proteins and CHF with Qi-deficiency-blood-stasis syndrome.RESULTS: A total of seven differentially expressed proteins were identified, and among these, transforming growth factor β1(TGF-β1) gets a particular attention for us has drawn specific attention.Network analysis showed a homologous relationship of TGF-β1 with bone morphogenetic protein15, which is associated with myocardial fibrosis.CONCLUSION: Occurrence and development of CHF may result from certain DE-proteins and associated signaling pathways. TGF-β1 protein may be a candidate marker for assessing the risk of CHF in Qideficiency-blood-stasis syndrome.

Randomized Controlled Trial on Treatment of Bronchial Asthma of Qi-deficiency Cold Syndrome Type by Pingchuan Yiqi Granule (平喘益气颗粒)

Objective： To evaluate the effect and safety of Pingchuan Yiqi Granule （平喘益气颗粒, PYG） in treating bronchial asthma of qi-deficiency cold syndrome type （BS-QDC）. Methods： With the randomized, positive agent parallel controlled design adopted, the 80 subjects enrolled were assigned in the ratio of 3：1 to two groups, the 60 patients in the trial group were treated with PYG and the 20 in the control group treated with Ruyi Dingchuan Pill （如意定喘丸,RDP）, with the therapeutic course consisting of 7 days for both groups. The clinical effects, effects on TCM syndrome and the changes of lung function after treatment were observed. Results： The effect of the treatment on asthma in the trial group： clinically controlled rate was 6.67%, markedly effective rate 51.67%, improved rate 33.33% and ineffective rate 8.33%; and the corresponding rates in the control group were 5.00%, 50.00%, 30.00%, and 15.00% respectively. Comparison between the two groups showed insignificant difference （P〉0.05）. The effect on TCM syndrome in the treated group： clinically controlled rate was 11.67%, markedly effective rate 58.33%, effective rate 21.67% and ineffective rate 8.33%; and those in the control group were 10.00%, 50.00%, 30.00% and 10.00% respectively, also showing insignificant difference between the two groups （P〉0.05）. Lung function test showed that the change on forced expiratory volume in 1 second （FEV1） after treatment in the trial group was of statistical significance （P〈0.05）, but no significant difference was shown in the change of peak expiratory flow （PEE P〉0.05）; while the changes in the control group were just the opposite, showing insignificance in FEV1 （P〉0.05） but significance in PEF （P〈0.05）. Comparison of the therapeutic effect on lung function between the two groups showed no significant difference （P〉0.05）. No adverse reaction was found in either group in the course of treatment. Conclusion： PYG used to treat BS-QDC is effective and safe, it＇s effect is similar to that of RDP.

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis：a multicenter,single-blind,randomized,controlled,phase Ⅲ clinical trial

OBJECTIVE:To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis.METHODS:This was a multicenter, single-blind,randomized, controlled trial.From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group.The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules.The treatment course was 1 month for both groups.RESULTS:In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group(87.21%) was significantly higher than that in the control group(80.70%, P < 0.01).After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group(all P < 0.05).In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group(82.07%) was similar to that in the control group(71.21%, P >0.05).After the treatment period in both groups,the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group(P < 0.05).CONCLUSION:The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis,and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.

Comfortable Lifestyle-induced Imbalance of Neuro-endocrine-immunity Network:A Possible Mechanism of Vascular Endothelial Dysfunction

Objective： To observe the changes of vascular endothelial functions and general neuroendocrine-immunity （NEI） network under the state of qi-deficiency syndrome induced by excessive idleness and to approach their internal relevance and illuminate initially the pathophysiological mechanism of vascular lesion induced by excessive idleness. Methods： A total of 100 male Wistar rats were randomly divided into the control group and the qi-deficiency syndrome model group, 50 rats in each group. The qi-deficiency syndrome model was established by feeding the animals with hyper-alimentation diet in combination with restricting movement for 10 weeks. Changes of common chemical signal molecules related to NEI and vascular endothelial functions were measured by the end of the experiment. Furthermore, their internal relevance was analyzed by the method of canonical correlation analysis. Results： The vascular endothelial structure and function were obviously injured in the model group. Compared with the control group, the chemical signal molecules, such as 5-hydroxytryptamine （5-HT）, corticosterone （CORT）, triiodothyronine （T3）, tetraiodothyronine （T4）, angiotensin Ⅱ （Ang Ⅱ）, interleukin-1 （IL-1）, and tumor necrosis factor-α （TNF-α） in peripheral blood of the model group （n=43） were changed significantly （P〈0.05 or P〈0.01）. Canonical correlation analysis showed that vascular endothelial dysfunction was correlated to the changes of these signal molecules in the NEI network. Conclusions： Comfortbased lifestyle induced not only vascular endothelial dysfunction but also an imbalance of the NEI network. Vascular endothelial dysfunction and the imbalanced NEI network interacted with each other, and an imbalance of the NEI network may be the pathophysiologic basis for the genesis and development of vascular endothelial dysfunction, even diseases of the blood vessel.

Effect of supplementing Qi and promoting blood circulation therapy on left ventricular remodeling: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the effectiveness of an adjuvant therapy from Traditional Chinese Medicine for supplementing Qi and promoting blood circulation(CMSQPBC) on left ventricular remodeling in patients after myocardial infarction(MI).METHODS: Randomized controlled trials were identified in the Cochrane Library, Embase, Web of Science, PubMed, China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang databases, reviews, and reference lists of relevant articles. The weighted mean difference(WMD) was calculated for changes in the left ventricular ejection fraction(LVEF), LV end-diastolic volume(LVEDV) and LV end-systolic volume(LVESV) from baseline to follow-up(> 3 months) by using random-effects Meta-analysis. The primary outcome was change in LVEF, and secondary outcomes were changes in LV dimensions including LVEDV and LVESV.RESULTS: A total of 10 trials(enrolling 854 participants, median follow-up six months) evaluated the association between CMSQPBC and changes in LV function and volume. Compared with the control group, CMSQPBC significantly improved LVEF(854 patients;WMD: 4.97%, 95% CI: 3.78-6.15;P < 0.001)and attenuated the enlargement of LVEDV(607 patients;WMD:-7.89 mL, 95% CI:-11.54 to-4.24;P<0.001) and LVESV(364 patients;WMD =-5.80 mL,95% CI,-9.60 to-2.01;P < 0.01).CONCLUSION: CMSQPBC may reverse deleterious pathological remodeling after myocardial infarction. Higher quality and more rigorous randomized trials with larger sample sizes are needed to further confirm the findings.

Clinical and Experimental Study on Huodan Tablet (藿丹片) in Treating Infantile Viral Myocarditis

Objective: To study the effect of Huodan tablet (藿丹片, HDT) in treating infantile viral myocarditis. Methods: Clinical manifestations and physical signs as well as laboratory examinations have been observed. Results: The markedly effective rate was 68%, and total effective rate 91.67% in the treated group, while in the control group, the markedly effective rate was 30.83%, and the total effective rate 70.84%. According to Ridit analysis, significant difference was shown between the two groups. r-treated group=0.5000, r-control group=0.295+2×0.025 respectively. Conclusion: HDT has no toxic side-effect and can be taken safely and conveniently, it conforms to the demands of WHO on new drug for prevention and cure of myocarditis.