Correlation Between Granulomatous Mastitis and Autoimmune Function and the Immuneregulating Role of Traditional Chinese Medicine

Granulomatous mastitis(GM)is a benign granulomatous condition,and its pathogenesis may be related to autoimmune disorders.Cellular immunity,humoral immunity,immunoglobulins,and complement could all play a role in the disease process,showing certain clinical patterns.Corticosteroids can quickly control disease progression,and immunosuppressants can be used for complex and refractory GM cases.In traditional Chinese medicine(TCM),“healthy qi”is similar to immune system function.For GM with deficient healthy qi,TCM treatments such as internal and external herbal applications can help regulate immune function and shorten disease duration by staged and TCM treatment,regulating viscera,reinforcing healthy qi,and eliminating pathogenic factors.

胡玉荃教授治疗肾虚血热型先兆流产临证经验

先兆流产病因复杂,临床证型多变,是孕早期常见疾病,胡玉荃教授从医多年,在诊治先兆流产方面具有丰富的临床经验和独到见解。胡教授认为,先兆流产的病机核心在于肾虚胎元不固,而血热冲任不宁是动胎常因,故肾虚血热是临床常见证型,以固肾养血、清热安胎为基本治疗原则,自拟验方安胎饮随证加减,配合西药同治,辅以调畅情志,疗效颇佳。

Outcome measures in clinical trials of traditional Chinese medicine for stable angina pectoris

Objective:This work aimed to present a descriptive analysis of the outcome measures used in clinical trials of traditional Chinese medicine(TCM)for patients with stable angina pectoris,and to provide baseline data for the development of core outcome sets(COSs)for relevant clinical trials.Methods:Medical databases were searched to identify randomized trials of the effects of TCM for the treatment of stable angina pectoris.Outcome measures of each trial were extracted.Descriptive statistics were used to analyze the baseline characteristics of outcomes in clinical trials of TCM.Results:94 randomized trials(with 9,111 participants)involving 79 different outcomes were identified.The mean number of outcomes was 5(1-21 per trial).The 5 most commonly reported outcomes were efficacy rate of electrocardiogram,efficacy rate of angina pectoris,efficacy rate of TCM syndrome,fasting lipid indices,and withdrawal rate of nitroglycerin.Several challenges were identified:(1)significant heterogeneity of outcomes and differences in the technique and timing of the measurement of the same outcome;(2)transformation of continuous data into categorical data and presented as such in>90% of trials;(3)few trials on the outcomes associated with the advantages and characteristics of TCM;and(4)selective reporting of outcomes.Conclusions:The outcomes used are excessively heterogenous,and the choice of some outcomes(timing and techniques)for measurement is confusing or inappropriate.Hence,developing and implementing a COS is necessary for greater consistency.

Meta-analysis of TCM in the Treatment of AIDS Diarrhea

Objective The aim of the study is to systematically evaluate the effect of Traditional Chinese medicine(TCM)in the treatment of AIDS diarrhea.Methods The computer system was used to comprehensively search database of Wanfang(WF),VIP,and China National Knowledge Infrastructure(CNKI)for relevant literature on the application effect of Chinese medicine in the treatment of AIDs diarrhea.The retrieval time was set from January 1,2010 to August 15,2021.The documents that did not meet the inclusion criteria were eliminated,and the quality of the qualified literature was evaluated according to the improved Jadad scoring standard.The main outcome indicators were entered into the literature,and Review Manager 5.0 software was used for meta-analysis.Results Eight eligible articles were included,a total of 536 cases of AIDS diarrhea patients were included.All eight eligible articles observed the clinical efficacy of TCM in the treatment of AIDS diarrhea,among which four observed the TCM syndrome changes in the treatment of AIDS diarrhea,and four observed adverse reactions of TCM in the treatment of AIDS diarrhea.All articles were extracted for valid data.After entering all the main observation index data,the results of meta-analysis showed that the effect of TCM in the treatment of AIDS diarrhea was better,the differencewas statistically significant[MD=2.92,95%CI(1.81,4.70),p<0.001];TCM in the treatment of AIDS diarrhea was more conducive to improving the TCM syndrome scores of patients,the difference was statistically significant[MD=-2.55,95%CI(-3.37,-1.73),p<0.001];the adverse effects of TCM in the treatment of AIDS diarrhea were mild,and the difference was statistically significant[MD=1.70,95%Cl(0.48,5.97),p=0.41].Conclusion The effect of TCM in the treatment of AIDS diarrhea patients is remarkable,which can effectively improve the TCM symptom scores of patients without increasing the incidence of adverse reactions.

Potential Mechanisms of Yanghe Decoction in the Treatment of Soft Tissue Sarcoma and Arteriosclerosis Obliterans Based on Network Pharmacology

Objective The objective of this study was to investigate potential mechanisms of Yanghe Decoction(YHD)in treating soft tissue sarcoma(STS)and arteriosclerosis obliterans(ASO)based on the use of network pharmacology.Methods Candidate compounds and potential targets were identifed through the TCM Systems Pharmacology database and a comprehensive literature search.Related targets of STS and ASO were collected in the GeneCards database,DisGeNET database,and Drugbank database.Furthermore,The STRING 11.0 database was used to determine protein-protein interaction(PPI)networks;common targets were obtained and imported into Cytoscape 3.7.2.Then,a PPI network comprising common targets was drawn,and network topology analysis was performed to screen for key shared targets.Gene ontology functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis of key shared targets were performed by using Metascape software.Subsequently.a compound-target-pathway network was constructed via Cytoscape 3.7.2.Results The following signaling pathways were found to be associated with the mechanisms of YHD in treating STS and ASO:AGE-RAGE signaling pathway,IL-17 signaling pathway;HIF-1 signaling pathway,TNF signaling pathway,interactions between cytokines and cytokine receptors,Th17 cell differentiation,and NOD-like receptor signaling pathway.Among the compounds and targets involved in these pathways,quercetin,luteolin,and kaempferol were found to be core compounds,and TNF,IL-6,and MAPK1 were found to be core targets.Conclusion Taken together,our findings elucidated that potential mechanisms of YHD in treating STS and ASO involved cellular proliferation/differentiation,angiogen-esis,inflammation,immune responses,oxidative stress,and other related signaling pathways.

Clinical Effects of Bushen Culuan Prescription on Infertility Due to Decreased Ovarian Reserve of Kidney Deficiency and Liver Depression Pattern

Objective The objective of this study was to explore the clinical effects of Bushen Culuan prescription on infertility due to decreased ovarian reserve of kidney deficiency and liver depression pattern.Methods Totally 100 infertile patients with ovarian hypofunction treated from October 2019 to January 2022 were selected and divided into the observation group and the control group by a random number table.The control group was treated with estrogen sequential therapy,and the observation group was treated with Bushen Culuan prescription.The clinical efficacy,sex hormone levels including(follicle-stimulating hormone[FSH],luteinizing hormone[LH],and estradiol[E_(2)]),ovarian function,ovarian blood flow status(peak systolic velocity[PSV],antral follicle count[AFC],arterial pulse index[PI],and resistance index[RI]),and pregnancy outcome in the two groups were compared and analyzed.Results The total effective rate of the observation group(96.00%)was significantly higher than that of the control group(80.00%).The difference was statistically significant(p<0.05).Before treatment,there was no significant difference in sex hormone levels(FSH,LH,E_(2),and FSH/LH),ovarian function(number of primary follicles,number of dominant follicles,ovulation number,and endometrial thickness),and ovarian blood flow(PSV,RI,PI,and AFC)between the two groups(p>0.05).After treatment,the levels of serum hormones FSH,LH,E_(2),and FSH/LH decreased significantly in both groups.The number of primary follicles,dominant follicles,and ovulation increased significantly,and the thickness of endometrium decreased significantly;the indexes of PSV,RI,and AFC of ovarian blood flow increased significantly,and the PI index decreased significantly.The levels of each index in the observation group were better than those in the control group(p<0.05).In the control group,32 cases were pregnant within 1 year after treatment,and the pregnancy rate was 64.00%;21 cases in the observation group were pregnant within 1 year after treatment,and the pregnancy rate was 42.00%;the pregnancy rate in the observation group was higher than that in the control group,and the difference was statistically significant(χ^(2)=4.014,p=0.045<0.05).Conclusion Bushen Culuan prescription has a definite effect on infertility due to ovarian hypofunction.The action mechanism may involve multicomponent and multitarget stimulation to improve patients'ovarian function,regulate the level of sex hormones,and improve the pregnancy outcome.

A Brief Review of Animal Models for COVID-19

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)causes an outbreak of corona virus disease 2019(COVID-19)globally.It is to date one of the biggest public health threat in the world.Although studies on this emerging coronavirus have developed rapidly since the COVID-19 case was confirmed,there is much remains unknown about SARS-CoV-2.To better understand the mechanism of cross-species transmission and search for efficient vaccines and therapeutics for COVID-19,animal models are highly required to evaluate countermeasures against emerging COVID-19.An ideal animal model should respond as similar as human be-ings to SARS-CoV-2 infection and show analogical symptoms,reflecting the human beings clinical sign,viral replication,and pathology that can be applied to identify in human beings.Fortunately,several animal models have been developed to study SARS-CoV-2 and aim to find new vaccines,antiviral agents,and Chinese materia medica very shortly.We aim to review the climical presentations of COVID-19 concerning pathologic features in humans and summarize the current animal models'strengths and limitations of use for SARS-CoV-2.

Rupi Sanjie Xiaotong Plaster in Treating Breast Hyperplasia of Liver Stagnation and Phlegm Coagulation Pattern

Objective:To observe the clinical efcacy and safety of external application of Rupi Sanjie Xiaotong Plaster(乳癖散结消痛膏,RPSJXTP)in treating breast hyperplasia of liver stagnation and phlegm coagulation pattern.Methods:Totally 72 female patients with breast hyperplasia of liver stagnation and phlegm coagulation pattern admitted to the First Hospital Affiliated to Henan University of Chinese Medicine were enrolled by ran-domized,single-blind,placebo-controlled research method,and were divided into the treatment group(36 ca-ses)and the control group(36 cases)according to computer random number method.The treatment group were given RPSJXTP,while the control group were gi ven placebo plaster.The course of treatment in both groups was 8 weeks.The breast pain score,breast color ultrasound score,lump score,depression score,and Chinese medicine syndrome score were compared between the two groups at different times.The levels of estra-diol(E_(2)),progesterone(P)and pituitary prolactin(PRL)were detected and the adverse reactions of two groups were observed during the treatment of both groups.Results:Before treatment,there was no significant difference in total breast pain score,breast color ultrasound score,lump score,depression score and levels of serum P,E_(2)and PRL between the two groups(P>0.05);compared with previous treatment,the total breast pain score,breast color ultrasound score,lump score,and depression score significantly decreased in the treat-ment group(P<0.05),and the total breast pain score and depression score of the control group significantly declined(P<0.05);compared with control group,the total breast pain score,breast color ultrasound score,lump score,and depression score significantly decreased after treatment in the treatment group(P<0.05).The improvement rate of Chinese medicine syndromes and the clinical efective rate in the treatment group were higher than those in the control group(P<0.05).There were no serious systemie adverse reactions during the treatment in both groups.Local pruritus occurred in 3 cases in the treatment group and 1 case in the control group.Conclusion:RPSJXTP is effective in treating breast hyperplasia of liver stagnation and phlegm coagula-tion pattern.It can effectively relieve the breast pain which will not recur after stopping of drug use,which can reduce the color ultrasound score,lump score,and depression score of the patients and improve Chinese medi-cine syndromes without serious adverse reactions.

3例肺纤维化患者临床抗纤维化治疗的药学监护

目的:分析肺纤维化患者抗纤维化治疗的药学监护重点及其成效。方法:临床药师参与3例肺纤维化患者临床治疗,协助医师个性化地调整治疗方案,并针对不同药物针对性开展药学监护。结果与结论:临床药师通过药学监护的开展,及时发现并解决了肺纤维化患者在治疗过程中潜在或实际存在的用药问题,保障了临床用药的安全性和合理性。

腕踝针治疗中风后肩手综合征Ⅰ期临床疗效观察

目的:比较腕踝针与常规针刺治疗中风后肩手综合征Ⅰ期的临床疗效。方法:将64例中风后肩手综合征Ⅰ期患者随机分为腕踝针组和常规针刺组,各32例。在内科和常规康复治疗基础上,腕踝针组予腕踝针治疗,穴取患侧上4区、上5区、上6区;常规针刺组予针刺患侧肩髃、曲池、手三里等,两组均每次30 min,每天治疗1次,每周5次,共治疗3周。分别于治疗前后观察两组患者视觉模拟量表(VAS)评分、手部肿胀程度、肩手综合征评估量表(SHSS)评分、Fugl-Meyer上肢运动功能评定(FMA-UE)评分、改良Barthel指数(MBI)评分,并评定两组临床疗效。结果:治疗后,两组患者VAS评分、手部肿胀程度、SHSS评分均较治疗前降低(P<0.05),FMA-UE、MBI评分均较治疗前提高(P<0.05);腕踝针组VAS评分、手部肿胀程度、SHSS评分低于常规针刺组(P<0.05),FMA-UE、MBI评分高于常规针刺组(P<0.05)。腕踝针组总有效率为96.9%(31/32),高于常规针刺组的90.6%(29/32,P<0.05)。结论:腕踝针可有效减轻中风后肩手综合征Ⅰ期患者疼痛及手部肿胀程度,提高患者上肢运动功能及日常生活自理能力,疗效优于常规针刺。

Electroacupuncture for post-stroke anxiety disorder on the base of the heart-brain theory:A randomized controlled trial

Objective:To evaluate the differences in the clinical effect and the safety in the treatment of post-stroke anxiety disorder(PSAD)between electroacupuncture(EA)and paroxetine on the base of the heart-brain theory.Methods:A total of 70 patients of PSAD were randomized into an EA group and a medication group,35 cases in each one.In the EA group,four acupoints were selected and divided into two pairs.In the Pair A,there were Baihui(百会GV20)and Fengfu(风府GV16).In the Pair B,there were Xinshu(心俞BL15)and Shenmen(神门HT7).After acupuncture,the electroacupuncture apparatus was applied.The duration of needle retention was 20 min.EA was given three times a week,totally for 4 weeks.In the medication group,paroxetine tablets were administered orally,10 mg daily in the first 4 days and 20 mg afterwards,totally for 4 weeks.Before and after treatment,as well as in the follow-up period,Hamilton anxiety scale(HAMA),Barthel index(BI)for daily life ability,and clinical global impression(CGI)were observed and the clinical therapeutic effect was evaluated separately.Results:A total of 3 cases were dropped-out in the medication group.Finally,35 cases in the EA group and 32 cases in the medication group were included in the analysis.Compared with the scores before treatment,the scores of HAMA and CGI-SI(severity of illness)were lower and the scores of BI were higher after treatment and during the follow-up in either the EA group or the medication group(all P<0.05).Compared with the scores after treatment,the differences were not significant in HAMA and CGISI scores during the follow-up in either the EA group or the medication group(all P>0.05).Compared with the medication group,BI score in the EA group was higher in the follow-up,indicating the statistical significance(P<0.05).After treatment,CGI-SI score was different statistically between the EA group and the medication group(P<0.05).There were 5 cases with adverse reactions in the EA group and 9 cases in the medication group.Conclusions:The therapeutic effect of electroacupuncture on the base of heart-brain theory is similar to the oral administration of paroxetine in the treatment of post-stroke anxiety disorder.This therapy relieves anxious emotions,promotes the recovery of limb function and has less adverse reactions in the patients.

Changed ACC-DMN functional connectivity after acupuncture with deqi for functional dyspepsia treatment

Objective:To clarify altered whole brain functional connectivity of the anterior cingulate cortex(ACC)in functional dyspepsia(FD)patients,and then to explore cerebral influence of acupuncture with deqi treating for FD.Methods:Thirty-two FD patients and 35 healthy subjects(HS)were firstly scanned by the resting-state blood oxygenation level-dependent functional magnetic resonance imaging(BOLD-fMRI)to compare differences of ACC-based functional connectivity(FC).Then 32 FD patients were randomized to receive 20 sessions’acupuncture treatment with(n=16)and without deqi(n=16),as well as underwent functional magnetic resonance imaging(fMRI)scans after treatment.After group re-division according to deqi response,changes of ACC subregions-based resting-state FC(rsFC)were compared between the actual with and without deqi group.Two seeds with bilateral of each were selected as regions of interest(ROIs)of the ACC,including two from the dorsal ACC:S2(BA24)(x=±5,y=2,z=46,r=3.5 mm)and two from the pregenual ACC:17(BA24)(x=±5,y=38,z=6,r=3.5 mm).The clinical changes of the Nepean Dyspepsia Index(NDI)that measuring symptoms and quality of life(QOL)were also used to further assess the correlation with ACC subregions rsFC in FD patients.Results:Compared to HS,FD patients showed significantly increased ACC subregions rsFC with left fusiform gyrus,temporal cortex,hippocampus(HIPP)/amygdala,temporal pole,and right INS,superior occipital gyrus,and bilateral precuneus,superior parietal lobule(SPL),and decreased rsFC with left postcentral/precentral gyrus(PoG/PrG),supplementary motor area(SMA)and right cerebellum.32 FD patients which were then re-divided into the actual deqi group(n=16)and actual without deqi group(n=16).The decrease of the NDI symptom score(pre-pos)in the actual deqi group was significantly greater than that in the actual without deqi group(P<0.05).Among the two groups,the actual deqi group showed increased ACC subregions rsFC with right SMA and bilateral PrG/PoG,and decreased rsFC with right precuneus,middle occipital gyrus,bilateral posterior cingulate cortex(PCC),HIPP/paraHIPP,angular gyrus and SPL after treatment.In addition,the changed NDI QOL scores(pre-post)of the actual deqi group was significantly positively correlated with their Fisher’s transformed Z value of the altered ACC subregion(left I7)rsFC with right SPL(r=-0.597,P=0.04<0.05,FDR corrected P>0.05).Conclusion:The results tested the hypothesis that the advantage of deqi on efficacy is related to affecting the ACC subregions rsFC.It suggested that deqi might participate in the adaptive modulation of disrupted relationship between the ACC subregions and the default mode network(DMN).

The meridian distribution on the lacquer figure unearthed in the Han dynasty tomb in Chengdu Laoguan mountain

In 2012,a lacquer figure was unearthed from the Han dynasty tomb(188 BC-87 BC) at Chengdu Laoguanshan.The lines intaglioed on the Laoguan mountain lacquer figure were similar to the meridians.Objective:To investigate the relationship between the lines on this Laoguanshan lacquer figure and the regular meridians so as to explore the development of meridian system in ancient China.Methods:Based on collecting the photos of the Laoguan mountain lacquer figure and the representative acupuncture classics,the double evidence method(combining the unearthed relics/literature and extant literature) was performed to investigate the relationship between the lines on this Laoguanshan lacquer figure and the regular meridians.Furthermore,the development of regular meridians theory was analyzed from the number,distribution,direction and branches.Results:The routes of the 28 longitudinal white lines on the Laoguan mountain lacquer figure are similar to the regular meridians in the ancient literature including Huángdì Nèijīng 《黄帝内经》 Yellow Emperor’s Inner Classic).The number,distribution and branches of the meridians intaglioed on the Laoguanshan lacquer figure suggested the evolution of the regular-meridian system from the eleven-meridian system to the twelve-meridian system.Conclusions:The meridian system of Laoguanshan lacquer figure was a link connecting the preceding and the following.The Laoguanshan lacquer figure played an important role in the development of the early meridian theory.