Clinical efficacy and bacterial flora characteristics of Huazhi Rougan granules in the intervention of moderately resistant to damp-heat nonalcoholic fatty liver disease

Background:To explore the clinical efficacy of Huazhi Rougan granules in treating non-alcoholic fatty liver disease(NAFLD)and its effect on the oral and intestinal flora.Methods:48 patients who met the inclusion criteria were intervened with Huazhi Rougan granules,the liver and spleen CT ratio,Traditional Chinese medicine(TCM)syndrome,body mass index(BMI,WC,SMM,body fat percentage,visceral fat area),liver function,and blood lipid levels were compared before and after treatment,and the curative effect was evaluated;6 cases of NAFLD patients whose clinical efficacy after Huazhi Rougan granule intervention was effective were randomly selected,and the patient’s oral and intestinal samples were taken for further analysis.Results:After treatment,the total effective rate of clinical efficacy was 85.14%.The TCM symptoms of NAFLD patients were significantly alleviated compared with before treatment(P<0.05).There were statistically significant differences in ALT,AST,GGT,TC,and TG before and after treatment(P<0.01).After treatment,BW,BMI,WC,body fat percentage,visceral fat area,liver hardness,and fat attenuation index were significantly decreased(P<0.01).Oral-gut flora analysis showed:After treatment,the Shannon index of the gut microbial community increased(P<0.01).Compared with before treatment,the abundance of Firmicutes decreased,while the abundance of Bacteroidetes,Candidatus-Sa,and Tenericutes increased(P<0.05).At the genus level,the abundance of Bacteroides,Lactobacillus,and Bifidobacterium increased,and Streptococcus,Oribacterium,and Peptoanaerobacter decreased(P<0.05).Before and after treatment,the dominant bacterial phyla in the intestine were the same,including Bacteroidetes,Firmicutes,and Proteobacteria.The abundance of Firmicutes and Roseburia decreased after treatment(P<0.05).Conclusions:Huazhi Rougan granules have a significant effect on the treatment of NAFLD,can improve liver function,reduce blood lipids,can effectively reduce body morphological indicators such as body mass,WC,body fat percentage,visceral fat area,liver stiffness measurement(LSM),and fat content,and has the function of protecting the liver and reducing blood pressure,promoting the role of intrahepatic fat metabolism;and significantly relieve the clinical symptoms.NAFLD patients have the gut and oral flora disturbances.Huazhi Rougan granules can restore the diversity of intestinal microbial communities in NAFLD patients and play a therapeutic role by regulating the abundance and composition of oral and Gut flora.

Identification of Cirrhosis Subtypes Through Heterogeneous Medical Information Network

Background:Liver cirrhosis is a complex and heterogeneous disease,with a mortality rate of up to 57%,resulting in 1.03 million deaths per year.The prevalence of liver cirrhosis is on the rise.Patients with liver cirrhosis have a variety of clinical phenotypes and are prone to various complications related to liver cirrhosis.Therefore,there is an urgent need to improve the early prevention and clinical management of cirrhosis and its complications.Methods:We use a precise medical approach to analyze and characterize the complex manifestations of cirrhotic patient populations,and we propose a Heterogeneous Medical Record Network(HEMnet)that includes electronic medical records,molecular interaction networks,and domain knowledge.We train the network embedding vector on HEMnet to obtain the low-dimensional vector representation of each node.With these vectors,we enriched the original medical record and identified six subtypes of cirrhosis.Results:Subtype 1 is characterized by heart disease,and subtype 2 has the strongest association with metabolic-related diseases.Subtype 3 was characterized by Chronic gastritis diseases.Subtype 4 was characterized by Liver cirrhosis-related complications-serous effusion.Subtype 5 had the strongest association with hepatitis-cirrhosis-related complications diseases and gallbladder disease.Subtype 6 was most strongly associated with Liver cirrhosis-related complications and hepatic carcinoma.By assessing the human disease-gene association of each subtype,the rich phenotype and biological functions of each subtype at the gene level were matched to the disease comorbidities and clinical differences we identified through EHR.Conclusion:Our approach demonstrates the utility of applying a precision medicine paradigm to cirrhosis and the prospect of extending this approach to other complexes,multifactorial diseases.

Effectiveness and safety of acupuncture in treatment of pregnancyrelated symptoms:a systematic review and Meta-analysis

OBJECTIVE:To systematically evaluate the efficacy and safety of acupuncture(AM)in the treatment of pregnancyrelated symptoms such as acute vomiting during pregnancy.METHODS:We comprehensively searched the available literature up to November 2021,including Pub Med,Embase,Cochrane Library,Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database,for randomized controlled trials(RCTs)on AM for the treatment of severe vomiting,insomnia,pharyngeal and pelvic pain,mood abnormalities,and dyspepsia during pregnancy.RESULTS:Sixteen RCTs with a cumulative sample size of 1178 cases were included.Of these,964 patients were included in the Meta-analysis.The Meta-analysis results showed that AM was more efficient than Western medicine in treating discomfort during pregnancy[odds ratio(OR)=1.19,95%confidence interval(CI)(1.11,1.28),P<0.01].AM was better than the control group in improving the visual analog scale scores[standard mean difference(SMD)=0.62,95%CI(0.53,0.71),P<0.01].AM was superior to the control group in improving Numerical Rating Scale(NRS)symptom scores[OR=7.31,95%CI(3.36,15.94),P<0.01].There was no significant difference in adverse effects between the AM and sham-AM groups and the analgesic drug group[OR=0.70,95%CI(0.39,1.28),P=0.25],but the treatment and control groups had mild adverse effects with a low incidence.CONCLUSIONS:AM is more effective than other treatments or pharmacotherapy alone in the treatment of pregnancy-related symptoms,and is relatively safe.However,the quality of the included trials was rather poor,and high-quality studies are required to confirm our findings.

Clinical Observation on the Treatment of Chronic Urticaria with Total Glucosides of Paeony Capsule Combined with Citirizine

Objective： To assess the effect and adverse reaction of total glucosides of paeony capsule （TGPC） in combining with citirizine for the treatment of chronic urticaria. Methods： A total of 120 patients were assigned to two groups by lottery, 65 in the treated group and 55 in the control group. They all were orally treated with citirizine tablet 10 mg per day, but to the treated group, additional 0.2 g TGPC was given three times per day, the therapeutic course for both groups was 4 weeks. The effectiveness of treatment was observed, and the changes of total symptom score, serum levels of interleukin-4 （IL-4）, and immunoglobulin E （IgE） were measured before and after treatment. Moreover, a follow- up was carded out one month after ending the treatment. Results： The dropped cases were two in the treated group and seven in the control group; so, the study was accomplished on 63 patients in the treated group and 48 patients in the control group. The total effective rate was assessed at 73.02% （46/63） in the treated group, which was significantly higher than 47.92% （23/48） in the control group （P〈0.01）. After treatment, the total symptom score decreased in both groups, but the decrement in the treated group was more significant （P〈0.05）. Serum levels of IL-4 and IgE in the treated group lowered significantly, while the changes in the control group were insignificant, so statistical significant differences were shown between groups （P〈0.01）. A follow-up study showed that the relapse rate in the treated group was 30.00% （6/20）, while that in the control group was 90.00% （9/10）, and the former was lower than the latter （P〈0.01）. Adverse reactions, revealed as drowsiness, dizziness, and weakness, were seen in eight cases and seven cases in the two groups, respectively. Besides, mild diarrhea occurred in two cases of the treated group. Conclusions： The treatment of TGPC combining citirizine shows definite curative effect in treating chronic urticaria, with low relapse rate and without evident adverse reaction. Its therapeutic effect might be realized by means of regulating patients＇ immune function. Besides, the medication should be continued for a rather long peried to achieve the full effect.