Investigation of the mechanism of action of Sanwu Huangqin Tang in the treatment of restless leg syndrome based on network pharmacology,molecular docking technology and molecular dynamics simulation

Background:Through the use of network pharmacology and molecular docking approaches,this study will examine the pharmacological effects of Sanwu Huangqin Tang on restless legs syndrome in order to better understand the mechanism of action of Traditional Chinese medicine(TCM)on RLS.Method:Utilise the TCMSP database to collect and select the drug components of Sanwu Huangqin Tang,and the Uniprot database to identify pertinent targets;RLS-related disease targets were obtained from GeneCards,DrugBank,and OMIM databases;and STRING and Cytoscape 3.9.1 software were used to generate an interaction network.KEGG pathway analysis and GO enrichment analysis were performed utilizing the DAVID database.Use Autodock for analyzing the relationships between targets and core components.Result:By using a network pharmacology approach,83 active ingredients and 50 drug-disease intersecting targets were derived for Sanwu Huangqin Tang.The molecular docking results showed that the drug components had strong affinity with the average target targets.Conclusions:This study provides new insights into the mechanism through which Traditional Chinese Medicine(TCM)treats Restless Legs Syndrome(RLS).Furthermore,it lays the foundation for additional research into the mechanism of treatment for RLS through the intervention that addresses various targets and pathways using the active ingredients identified by Sanwu Huangqin Tang.

Management of restless legs syndrome in chronic liver disease:A challenge for the correct diagnosis and therapy

AIM To investigate the association between restless legs syndrome(RLS) and well-defined chronic liver disease, and the possible therapeutic options. METHODS Two hundred and eleven patients with chronic liver disease, complaining of sleep disturbances, painful leg sensation and daily sleepiness, were included. Patients with persistent alcohol intake, recent worsening of clinical conditions, or hepatitis C virus were excluded. Diagnosis of RLS was suggested by the Johns Hopkins questionnaire and verified by fulfilling the diagnostic criteria by Allen. All patients were tested, both at baseline and during follow-up, with the Hamilton rating scale for depression, sleep quality assessment(PSQI), Epworth sleepiness scale(ESS), International Restless Legs Syndrome Study Group evaluation, and international RLS severity(IRLS) scoring system. Ironfree level, ferritin, folate, vitamin B12 and D-OH25 were detected. Neurological examinations and blood testoccurred at the beginning of the therapy, after 2 wk, and at the 28^(th), 75 th, 105 th, 135 th, 165 th and 205 th day. Regarding therapy, pramipexole or gabapentin were used.RESULTS Patients were moderately depressed, with evident nocturnal sleep problems and concomitant daily sleepiness. Sleep problems and involuntary leg movements had been underestimated, and RLS s yndrome had not be e n c ons ide re d be fore t he neurological visit. All(211/211) patients fulfilled the RLS diagnostic criteria. Twenty-two patients considered their symptoms as mild, according to IRSL, but 189 found them moderate to very severe. No correlation was found between ammonium level and ESS or PSQI. Augmentation was rather precocious in our patients(135 th day), and more frequent(35%) than previous data(8.3%-9.1%). The dosage of dopamine agonists was found to be associated with augmentation and appears in range with the literature. Previous intake of alcohol and lower levels of vitamins have been related to the phenomenon in our study.CONCLUSION RLS is a common disorder, requiring rapid diagnosis and treatment. Further research is therefore fundamental.

基于鲁棒Restless Bandits模型的多水下自主航行器任务分配策略

针对水下监测网络中多自主航行器(AUV)协同信息采集任务分配问题进行了研究。首先,为了同时考虑系统中目标传感器的节点状态与声学信道状态对AUV任务分配问题的影响,构建了水声监测网络系统的综合模型;其次,针对水下存在的多未知干扰因素并考虑了模型产生不精确的情况,基于强化学习理论将多AUV任务分配系统建模为鲁棒无休止赌博机问题(RBP)。最后,提出鲁棒Whittle算法求解所建立的RBP,从而求解得出多AUV的任务分配策略。仿真结果表明,在干扰环境下与未考虑干扰因素的分配策略相比,在系统分别选择1、2、3个目标时,鲁棒AUV分配策略对应的系统累计回报值参数的性能分别提升了5.5%、12.3%和9.6%,验证了所提方法的有效性。

Springtime migratory restlessness and departure orientation of Great Knots(Calidris tenuirostris)in the south compared to the north Yellow Sea

Background: The motivation of birds to proceed with migration is associated with both endogenous and exogenous factors. According to their migratory situation and to the characteristics of stopover sites, birds might exhibit migratory motivation differently among sites. Although migratory motivation of migrating birds has been well studied in many species, the investigation of the same species in different migratory situations and at different stopover sites is still limited. We predicted that birds at different stopover sites could differ in migratory disposition, including expression of migratory restlessness and responses to environmental cues.Methods: Here we compared migration motivation and orientation of Great Knots(Calidris tenuirostris) at two stopo ver sites, Chongming Dongtan in the south Yellow Sea, which is a temporary rest site, and Yalujiang Estuary Wetland in the north Yellow Sea, which is a critical refuelling site, during northward migration. Modified Emlen funnels, with thermal paper inside to record scratches of the birds, were used to detect activity(intensity and direction) of birds. Environmental conditions, including wind direction and speed, cloud cover, tide condition, times of the day(before and after sunset) were recorded during experiments. Generalized linear models were used to detect the effects of endogenous and exogenous factors on the migratory motivation of the birds.Results: In the south Yellow Sea, the migratory activity intensity of Great Knots was positively related to wind assistance. In the north Yellow Sea, where birds exhibited higher intensity of migratory activity than in the south, the intensity increased and the motivation to initiate migration grew stronger as the season advanced. The Great Knots exhibited wind-related orientation behaviour in the funnels at both sites.Conclusions: The results suggest that the intensity of migratory motivation differed between the two sites. Departure decisions of Great Knots appear to be affected mainly by external factors at the temporary rest site in the south Yellow Sea but possibly by endogenous factors at the final pre-breeding refuelling site in the north Yellow Sea.

CLINICAL STUDY OF 108 RESTLESS LEGS CASES BY ACUPUNCTURE OR EAR ACUPUNCTURE

108 cases of restless legs syndrome were treated , out of which, 56 cases withacupuncture, 52 cases with ear acupuncture. The therapeutical effects of acupuncture are superior tothat of ear acupuncture.

A clinical investigation of the relationship between different sedation depths and the restlessness after using midazolam as an adjuvant during regional anesthesia

Objective： To investigate the relationship between different sedation depth and the restlessness after using midazolam as an adjuvant during regional anesthesia. Methods ： One hundred and fifty patients undergoing regional anesthesia were randomly divided into three groups. In group A, the patients were sedated at the level of OAA/S IV with midazolam during regional anesthesia. In group B and C, the sedation depths were kept at the levels of Ⅲ and Ⅱrespectively. The changes of BP, HR and SpO2 were recorded before and after midazolam. The rate of restlessness was also evaluated. Results： Blood pressures decreased in certain degree at 5 and 10 min after midazolam compared with those before in all three groups. BP decreased over 20% of the baseline in 4 cases in group A, in 5 cases in group B, and in 5 cases in group C. There was no significant difference in BP dropping among three groups. Compared with group B and C SpO2 dropped significantly at 3 and 5 rain after midazolam in group C, in which SpO2 was less than 93% in 8 cases. The restlessness rate in group C was 22%, which was significantly higher than those in group A （2% ,P〈0.01） and group B（4% ,P〈0.05）. Conclusion： The sedation depth is related to the rate of restlessness when midazolam is used as an adjuvant during regional anesthesia. It is suggested that the appropriate sedation depth for the patients under regional anesthesia is OAA/S Ⅲ.

Prevalence of Restless Legs Syndrome in Patients Treated with Peritoneal Dialysis: Clinical and Biochemical Characteristics among Patients with and without Restless Legs Syndrome

Introduction and Aims:This is a prospective study identifying prevalence of Restless Legs Syndrome (RLS) in patients ongoing peritoneal dialysis (PD) due to end stage renal disease (ESRD) and comparing clinical and biochemical characteristics among patients with and without RLS. Methods: Two hundred ESRD patients who received PD at least six months assessed by neurologist and nephrologist with regards to presence of RLS. Also, clinical and biochemical features of these patients are determined. One hundred and forty four patients were excluded from study because they had other secondary causes of RLS except for ESRD. Results: Thirteen of 56 patients (23.2%) had RLS. The use of vitamin B + folic acid supplements was significantly lower in patients with RLS than in those without RLS (69.2% vs 97.7%;p = 0.008). There was no significant difference between patient groups with and without RLS in terms of age, gender, body mass index, cause of ESRD, peritoneal membrane transport characteristic, smoking, consuming alcohol, use of erythropoietin, duration of PD, hemoglobin, serum calcium, serum phosphorus, serum albumin, levels of serum iron, total iron binding capacity, ferritin, folic acid and vitamin B12, transferrin saturation, weekly Kt/V urea value, and amount of residual urine volume (p > 0.05). Conclusion: RLS is more common among PD patients than general population. Although essential cause is not exactly known, use of folic acid and vitamin B complex decrease the RLS prevalence in this particular patient group.

Restless Legs Syndrome in Liver Transplant Recipients

Background: The prevalence of restless legs syndrome (RLS) is approximately 10% in general population. This condition is more prevalent in certain diseases and we previously reported the prevalence of RLS in chronic liver disease population to be 62%. Objectives: Our aim was to assess the self-reported prevalence of RLS using an RLS symptom specific questionnaire in liver transplant patients. Methods: Subjects were a convenience sample in transplant clinic. They completed a validated survey for core RLS symptoms and if positive went on to completed a telephone survey using the validated International RLS Severity Scale Questionnaire (IRLS) and the Johns Hopkins RLS QoL survey to measure the effect of RLS symptoms on daily activities. Results: 40 patients surveyed, RLS was found in 16 subjects (40%) with moderate severity {17 (SD + 7.2, high score 31)}. Hepatitis C as indication for liver transplant was more likely associated with RLS (p = 0.05). Calcium channel blockers were protective (p = 0.032) while antidopaminergic agent use was statistically significant for RLS symptom (p = 0.005). On multiple linear regression analysis, diabetes (p = 0.024) and use of antidepressants/antihistamines (p = 0.049) were associated with RLS. Quality of Life (QoL) surveys specific to RLS suggested RLS symptoms resulted in significantly diminished QoL, with an average QoL score of 80 (SD + 11.7). Conclusion: There was a very high prevalence of RLS in our liver transplant patients with majority experiencing moderate or severe symptoms. The explanation for this higher prevalence is likely due to combination of comorbidites as well as medications that can trigger RLS.

That Restless Feeling

Mrs.Feldmeyer found her inher bedroom crying.She stood inthe doorway and said seriously,“Icame over to borrow your vacuumcleaner,Carolyn. Mine’s broken.The door was open,so I just walkedin.What on earth is the matter?”Carolyn sat up and dried

An Analysis of Medication Rules of Chinese Medicine for Restless Legs Syndrome Based on Data Mining

Objective: Based on data mining, to explore the medication rules of Chinese medicine for the treatment of restless legs syndrome(RLS). Methods: The CNKI, WANFANG, and VIP were taken as data sources, and "restless legs syndrome, RLS" as the key words, and "Chinese medicine, Chinese materia medica, traditional Chinese medicine(TCM), traditional Chinese and Western medicine" as sub key words, the data was extracted from the journals and literature related to the treatment of RLS by TCM from the establishment of the database to 2020, and data mining techniques(frequency analysis, cluster analysis, association rules) were used to analyze the core drugs and drug pair(group) rules. Results: A total of 87 prescriptions met the requirements of this study, involving 142 Chinese herbal medicines. The top 5 Chinese herbal medicines with a higher frequency of use were Radix Paeoniae Alba, Radix Glycyrrhizae, Radix Angelicae Sinensis, Fructus Chaenomelis and Radix Astragali seu Hedysari. The four Qi(气) of the medicine were mainly warm and neutral, the five flavors were mainly sweet, bitter, and pungent. The main channels of the meridian were mainly the liver meridian, spleen meridian and heart meridian. The medication categories were mainly tonifying deficiency herbs, blood activating and removing blood stasis herbs, and eliminating wind and dampness herbs. The association rule analysis yielded 24 Chinese medicine combinations with high support, and the hierarchical cluster analysis yielded a total of 5 clusters. Conclusion: TCM treatment of RLS is based on tonifying deficiency herbs, especially to replenish Qi and blood throughout the course of the disease, supplemented by herbs for promoting blood circulation and removing blood stasis, and herbs for eliminating wind and dampness, as well as combined with herbs for reliving superficies and herbs for calming the liver to stop the wind.

Restless Hot Money Inflows May Worsen China's Inflation Risk

A Chinese political advisor on Saturday warned a continued over- expectation for the appreciation of the Chinese currency Yuan would bring in more inflows of hot money and worsen the already excessive liquidity.

Prevalence of restless legs syndrome in patients with irritable bowel syndrome

AIM:To determine the prevalence of restless legs syndrome(RLS)in patients with irritable bowel syndrome(IBS).METHODS:Patients with diarrhea-predominant IBS(n=30),constipation-predominant IBS(n=30),or mixed-symptom IBS(n=30)were recruited from the community between March 2008 and February 2009.Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel over-growth in all patients.The presence of RLS was assessed via an RLS questionnaire and polysomnography.RESULTS:Twentysix patients with IBS(29%)were diagnosed with RLS using the RLS questionnaire.Twenty-four of the 26 patients(92%)underwent polysomnog-raphy,and all had confirmation of RLS.A greater percentage of patients with RLS had diarrhea-predominant IBS(62%)compared with patients with constipation-predominant IBS(4%)or mixed-symptom IBS(33%).CONCLUSION:Restless legs syndrome is prevalent in patients with IBS,especially those with diarrheal symptoms.Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients

AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD patients participated in this study. According to their RLS status, the patients were dividedinto the RLS group(n = 23) and the non-RLS group(n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS The HD patients with RLS scored worse in all the questionnaires used in the study(P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality(P < 0.05). CONCLUSION HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers.

Acupuncture Treatment of Restless Leg Syndrome

Case HistoryMr. Michael Fischer, aged 55 years, a German electrical engineer, paid his first visit on Dec. 7th, 1997, with the chief complaint of pain in the right lower limb for two months.

《内经》“关刺”联合“合谷刺”治疗不宁腿综合征疗效观察

目的 观察《内经》“关刺”联合“合谷刺”治疗不宁腿综合征(restless legs syndrome, RLS)的临床疗效。方法 将100例RLS患者随机分为治疗组(50例,脱落1例)和对照组(50例,脱落2例)。治疗组给予“关刺”联合“合谷刺”治疗,阳陵泉、膝关、丘墟采用关刺法,伏兔、丰隆、漏谷采用合谷刺法;对照组给予假针刺治疗。治疗前后采用国际RLS评定量表(international restless leg syndrome scale, IRLSS)评价患者不宁腿严重程度,采用RLS生活质量量表(RLS quality of Life, RLSQoL)评价患者生活质量,采用失眠严重指数量表(insomnia severity index, ISI)评价患者的睡眠情况,并比较两组临床疗效。结果 治疗组总有效率为91.8%,显著高于对照组的41.7%(P<0.01)。治疗后,治疗组IRLSS评分低于治疗前和对照组(P<0.01),治疗组RLSQoL评分高于治疗前和对照组(P<0.01),治疗组ISI评分低于治疗前和对照组(P<0.01)。对照组治疗前后各项评分比较,差异无统计学意义(P>0.05)。结论 《内经》“关刺”联合“合谷刺”可显著改善RLS患者临床症状,在中医学理论的指导下拓展了《内经》五刺法的临床应用。

基于“胃不和则卧不安”理论探讨肠道菌群对失眠的作用机制

《素问·逆调论》中记载“胃不和则卧不安”。然而由饮食不节引起的失眠,此病症的发病机制尚不清楚。现代研究发现,肠道菌群作为肠和脑的中间纽带,将胃肠道系统与中枢神经系统联系起来,这与中医论述的“胃不和则卧不安”的观点不谋而合。本文以肠道菌群为出发点,探讨胃肠不舒与失眠发生的内在联系,将现代发病机制与中医理论结合起来,以明确“胃不和则卧不安”的发病机制,为治疗失眠提供新思路。

老年帕金森病与不宁腿综合征的相关性及研究进展

老年帕金森(PD)是临床上常见的一种神经系统变性疾病,其与不宁腿综合征(RLS)的相关性一直以来都是临床研究的重点。老年PD、RLS临床表现不完全相同,且RLS也是老年PD的一种临床并发症,二者均存在多巴胺能系统功能异常,在病理学机制、临床症状学、生理学等方面也存在一定的关联。RLS的临床症状及双下肢无自主活动欲望很可能对老年PD患者睡眠及精神状况产生负面影响,进而加重老年PD患者病情,目前尚无治疗RLS的特效药,了解其发病机理、临床发病率及与老年PD相关症状的关联性有助于为RLS的个体化治疗提供帮助。本综述围绕近年来的相关研究文献,分别从发病机制、流行病学调查、临床表现及治疗方面探究老年PD与RLS的相关性。

基于胃不和则卧不安探讨Hp相关慢性胃炎对患者睡眠的影响

目的探讨幽门螺杆菌(Hp)相关慢性胃炎对患者睡眠的影响及具体表现形式。方法通过问卷调查,对比分析Hp相关慢性胃炎及非Hp相关慢性胃炎患者睡眠的具体特点。结果Hp相关慢性胃炎男性患者总体睡眠显著优于非Hp相关慢性胃炎男性患者及Hp相关慢性胃炎女性患者,明显较非Hp相关慢性胃炎男性患者睡眠质量好、睡眠时间长、睡眠效率高,明显较Hp相关慢性胃炎女性患者睡眠质量好、入睡时间短、睡眠效率高、睡眠障碍少、催眠药物使用少(P<0.05);Hp相关慢性胃炎男性患者较Hp相关慢性胃炎女性患者明显更少出现夜间易醒或早醒、呼吸不畅、感觉冷、做噩梦及其他影响睡眠的事情,更易咳嗽或鼾声高(P<0.05);Hp相关慢性胃炎女性患者催眠药物使用显著多于非Hp相关慢性胃炎女性患者,咳嗽或鼾声高显著多于非Hp相关慢性胃炎女性患者(P<0.05)。结论Hp相关慢性胃炎患者常有睡眠异常且具有一定的性别差异。

身痛逐瘀汤加味联合盐酸普拉克索片治疗痰瘀痹阻型不宁腿综合征的临床观察

目的观察身痛逐瘀汤加味联合盐酸普拉克索片治疗痰瘀痹阻型不宁腿综合征(RLS)患者的临床疗效。方法将50名痰瘀痹阻型RLS患者按照随机数字表法分为2组,对照组25例予盐酸普拉克索片治疗,治疗组25例在对照组基础上联合身痛逐瘀汤加味治疗。2组均治疗1周为1个疗程,治疗2个疗程后统计疗效,比较2组治疗前后国际RLS严重程度评分量表(IRLS)评分、匹兹堡睡眠质量指数量表(PSQI)评分及中医症状评分变化情况。结果治疗组总有效率92.00%(23/25),对照组总有效率60.00%(15/25),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后IRLS评分、PSQI评分及中医症状评分均降低(P<0.05),且治疗组治疗后IRLS评分、PSQI评分及中医症状评分均低于对照组(P<0.05)。结论身痛逐瘀汤加味联合盐酸普拉克索片治疗痰瘀痹阻型RLS疗效确切,可有效改善患者临床症状及中医症状,改善患者睡眠质量,操作简便,临床疗效显著,安全性良好。

黄芪桂枝五物汤联合加巴喷丁治疗尿毒症不宁腿综合征患者的效果

目的:探讨黄芪桂枝五物汤联合加巴喷丁治疗尿毒症不宁腿综合征(RLS)的效果。方法:选取2022年6月—2023年6月湖南中医药大学第一附属医院肾脏内科尿毒症RLS患者60例为研究对象,随机分为对照组和观察组,各30例。对照组使用加巴喷丁治疗,观察组在对照组基础上加用黄芪桂枝五物汤治疗。比较两组临床疗效、睡眠质量、症状指标及情绪状态。结果:观察组总有效率高于对照组,差异有统计学意义(P=0.006);治疗后,两组睡眠质量、睡眠效率、入睡时间、睡眠时间、睡眠障碍、催眠药物、日间功能障碍评分均降低,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组国际下肢不宁腿综合征等级评估量表、汉密尔顿焦虑量表、汉密尔顿抑郁量表评分降低,观察组低于对照组,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤联合加巴喷丁治疗尿毒症RLS的效果确切,能有效缓解症状,改善睡眠及心理状况。