Gutuo Jiejiu decoction improves survival of patients with severe alcoholic hepatitis: A retrospective cohort study

AIM To verify the value of Gutuo Jiejiu decoction in improving the survival of patients with severe alcoholic hepatitis(SAH).METHODS We performed a retrospective cohort study in consecutive patients diagnosed with SAH at the Teaching Hospital of Chengdu University of Traditional Chinese Medicine and Shuguang Hospital, Shanghai University of Traditional Chinese Medicine. The traditional Chinese medicine formula Gutuo Jiejiu decoction was employed as an exposure factor. Patients from the Teaching Hospital of Chengdu University of Traditional Chinese Medicine who had been treated with Gutuo Jiejiu decoction + prednisone were assigned to an observation group, and patients from Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who had been treated with prednisone alone were selected as a control group. A retrospective analysis was performed by comparing age, alcohol intake, and clinical parameters of liver injury beforeand after treatment. Additionally, the 3-and 12-mo survival rates and the occurrence of complications were analyzed.RESULTS One hundred and twenty-eight eligible patients were selected from 175 cases with SAH, of which 68 were assigned to the observation group and the other 60 to the control group. No significant difference was found in the patients' baseline characteristics(P > 0.05). However, significant improvements of 90-d survival rate [56/68(82.4%) vs 27/60(45.0%), P = 0.0000] and 365-d survival rate [48/68(70.6%) vs 13/60(21.7%), P = 00000] were observed in the observation group after treatment. After the first 3 mo of treatment, more improvements in the clinical parameters and scoring systems related to liver injury occurred in the observation group than in the control group(P < 0.05). After treatment for 12 mo, the differences in the clinical parameters and scoring systems related to liver injury between the two groups were more significant(P < 0.05). No significant differences in complications and adverse effects were found between the two groups.CONCLUSION Gutuo Jiejiu decoction could improve the survival rates and clinical parameters of liver injury in patients with SAH, and may represent a new option for treating SAH.

Prognostic value of Muc5AC in gastric cancer: A meta-analysis

AIM: To assess the correlation between decreased Muc5 AC expression and patients' survival and clinicopathological characteristics by conducting a metaanalysis.METHODS: Literature searches were performed in Pub Med and EMBASE,and 11 studies met our criteria. Summary hazard ratios or odds ratios(ORs) with 95% confidence intervals(CIs) were calculated to estimate the effect. For the pooled analysis of the correlation between decreased Muc5 AC expression and clinicopathological characteristics(tumour invasion depth,lymph node metastasis,tumour-node-metastasis stage,tumour size,venous invasion and lymphatic invasion),ORs and their variance were combined to estimate the effect. RESULTS: Eleven retrospective cohort studies comprising 2135 patients were included to assess the association between Muc5 AC expression and overall survival and/or clinicopathological characteristics. Decreased Muc5 AC expression was significantly correlated with poor overall survival of gastric cancer patients(pooled HR = 1.35,95%CI: 1.08-1.7). Moreover,decreased Muc5 AC expression was also significantly associated with tumour invasion depth(pooled OR =2.12,95%CI: 1.56-2.87) and lymph node metastasis(pooled OR = 1.56,95%CI: 1.00-2.44) in gastric cancer.CONCLUSION: Decreased Muc5 AC expression might be a poor prognostic predictor for gastric cancer.

Advances in the research of high myopia treatmen

高度近视是屈光度超过-6.00D的病症,伴有轴向延伸和眼底变化,如颞弧斑块,色素上皮变薄,豹形眼底,紫红斑,视网膜脉络膜萎缩,视力逐渐下降,以及弱视,青光眼,白内障,玻璃体不透明,视网膜脱离等眼科疾病.高度近视是中国失明的常见原因之一.本文将对高度近视的治疗做-综述,以更好地指导临床和提高患者的视力水平.

Application of auricular acupoints therapy in relieving the gastrointestinal side effects induced by chemotherapy： an integrative review

Background： It is an urgent matter to relieve the side effects induced by chemotherapy. In recent years, auricular acupoints therapy, which is a nursing technique used in traditional Chinese medicine （TCM）, has been used on many patients who are undergoing chemotherapy without causing any side effects. Furthermore, it has a good efficacy and is inexpensive. Aim： The aim of this study was to provide evidence for the need of further research in the treatment and nursing of patients during chemotherapy. Methods： We conducted an integrated review of the reports in CNK1, WanFang Data, SinoMed, and PubMed databases for journal articles published after 1990. The search terms included auricular acupoints taping and pressing, auricular acupoints therapy, auricular point sticking, ear points, chemotherapy, and side effects and relevant Medical Subject Heading terms. We then analyzed the mechanism, acu- points, and operation method and summarized the application of auricular acupoints therapy in patients suffering from chemotherapy side effects. Results： This review included 102 articles published between 1990 and 2016, and we brought 63 other articles into the study. Eighteen articles focused on auricular acupoints therapy, combined with other therapy, to relieve patient side effects during chemotherapy. Conclusions： Auricular acupoints therapy can prevent and relieve the side effects induced by chemotherapy. It deserves further clinical applications.

New exercises of Health Qigong and patients with type 2 diabetes mellitus:a systematic review and meta-analysis

OBJECTIVE: To systematically assess the effect of new exercise of Health Qigong(NEHQ) on fasting plasma glucose(FPG), 2 hour postprandial plasma glucose(2 hPG), Hemoglobin A1C(HbA1C), triglycerides(TG), total cholesterol(TC), low density lipoprotein(LDL), and high density lipoprotein(HDL)in patients with type 2 diabetes mellitus(T2DM).METHODS: Data were retrieved by searching EMBASE,MEDLINE, The Cochrane Library, China Biology Medicine,China National Knowledge Infrastructure, Wanfang Data and Chongqing VIP Database. The random-ized controlled trials(RCTs) related to NEHQ were searched. The search terms were "fasting plasma glucose","2 hour postprandial plasma glucose","Hemoglobin A1C","TG(triglycerides)","total cholesterol","low density lipoprotein",and "high density lipoprotein". Meta-analysis were conducted with the Collaboration's Revman 5.3.RESULTS: Fourteen RCTs including 999 patients were analyzed. The levels of FPG in the patients with the intervention of NEHQ-Ba Duan Jin in 2, 6, 9 months respectively, and of NEHQ·Mawangdui Daoyin in 12 months were lower than those in the control group(P<0.05); the levels of 2hPG in the patients with the intervention of NEHQ-Ba Duan Jin in 2, 4, 6 months respectively were lower than those in the control group(P<0.05);the levels of HbAlc in the patients with the intervention of NEHQ·Ba Duan Jin in 2, 3, 4, 6, 9 months respectively, and of NEHQ·Mawangdui Daoyin 12 months were lower than those in the control group(P<0.05); the levels of TG in the patients with the intervention of NEHQ·Ba Duan Jin in 4 and 6 months respectively, and of NEHQ·Mawangdui Daoyin in 12 months were lower than those in the control group(P<0.05);the levels of TC in the patients with the intervention of NEHQ·Ba Duan Jin in 2,6, 9 months respectively were lower than those in the control group(P<0.05); the levels of LDL in the patients with the intervention of NEHQ-Ba Duan Jin in 3 and 6 months respectively were lower than those in the control group(P<0.05);the level of HDL in the patients with the intervention of NEHQ·Mawangdui Daoyin in 12 months was higher than those in the control group(P<0.05).CONCLUSION: The outcomes of the patients with T2DM in NEHQ group was better than those in the control group in terms of FPG, 2hPG, HbA1C, TQ LDL, and HDL.

Curative effect of assisted reproduction technology by Traditional Chinese Medicine multi-channel interventional therapy on 95 cases of in vitro fertilization and embryo transfer failure

OBJECTIVE: To evaluate the curative effect of Traditional Chinese Medicine(TCM) multi-channel interventional therapy on women with Assisted Reproductive Technology(ART) failure, to compare the curative effect of the dual therapy and triple therapy on women with ART Failure, and to choose the best TCM interventional therapeutic plan.METHODS: The 95 cases with ART Failure from West China second University Hospital of Sichuan University meeting the inclusion criteria were randomly divided into three groups:dual therapy group(31 cases), triple therapy group(33 cases)and control group(31 cases). According to the intervene treatment of in vitro Fertilization and Embryo Transfer(IVF-ET) long cycle scheme, the control group wait naturally for 3 months before IVFET. The dual therapy group take TCM prescriptionⅡ of cultivating emotion and assisting reproduction and auricular acupoint therapy for 3 months before IVF-ET, then Western Medicine treatment progestin supporting as well as auricular application and Antai Recipe after IVF-ET transplantation.The triple therapy group take TCM prescription Ⅱof cultivated emotion and assisted reproduction,auricular acupoint therapy and retention enema of TCM, and combination treatment the same as dual therapy group after transplantation. The natural pregnancy number, the period condition of secondary IVF-ET and the improvement of the kidney deficiency, liver depression and blood stasis syndrome among those three groups were compared.RESULTS: It was showed from analysis in 95 cases with ART failure that the number of natural preg-nancy was as followings: 3 patients from the dual therapy group, 10 patients from the triple therapy group, and no patient from the control group. The comparison among three groups have statistical significance(P < 0.05). The treatment group is superior to the control group, while the triple therapy is superior to the dual therapy. The comparison of the condition of the fertility rate, clinical pregnancy rate, biochemical pregnancy rate and early abortion rate during the period of secondary IVF-ET between pre-therapy and post-treatment of both the dual therapy group and the triple therapy group have statistical significance(P < 0.05). The comparison of the improvement of the kidney deficiency,liver depression and blood stasis syndrome between pre-therapy and post-treatment of both the dual therapy group and the triple therapy group have statistical significance(P < 0.05). The comparison between three groups after treatment have statistical significance(P < 0.05).CONCLUSION: TCM multi-channel interventional therapy can increase the natural pregnancy rate of patients with ART Failure(the triple therapy is superior to the dual therapy); it can increase the fertility rate, clinical pregnancy rate, and decrease the early abortion rate during the period of secondary IVF-ET; it can improve syndromes of kidney deficiency, liver depression and blood stasis.

Efficacy and safety of Shenyankangfu Tablet,a Chinese patent medicine,for primary glomerulonephritis:A multicenter randomized controlled trial

Background:Shenyankangfu Tablet(SYKFT)is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.Objective:This trial compared the efficacy and safety of SYKFT,for the control of proteinuria in primary glomerulonephritis patients,against the standard drug,losartan potassium.Design,setting,participants and intervention:This was a multicenter,double-blind,randomized,controlled clinical trial.Primary glomerulonephritis patients,aged 18-70 years,with blood pressure≤140/90 mmHg,estimated glomerular filtration rate(eGFR)>45 mL/min per 1.73 ㎡,and 24-hour proteinuria level of 0.5-3.0 g,were recruited in 41 hospitals across 19 provinces in China and were randomly divided into five groups:SYKFT,losartan potassium 50 mg or 100 mg,SYKFT plus losartan potassium 50 mg or 100 mg.Main outcome measu res:The primary outcome was change in the 24-hour proteinuria level,after 48 weeks of treatment.Results:A total of 735 participants were enrolled.The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78%±2.56%(P=0.006)more than that in the losartan 50 mg group,which was 0.51%±2.54%(P=1.000)less than that in the losartan 100 mg group.Compared with the losartan potassium 50 mg group,the SYKFT plus losartan potassium 50 mg group had a 13.39%±2.49%(P<0.001)greater reduction in urine protein level.Compared with the losartan potassium 100 mg group,the SYKFT plus losartan potassium 100 mg group had a 9.77%±2.52%(P=0.001)greater reduction in urine protein.With a superiority threshold of 15%,neither was statistically significant.eGFR,serum creatinine and serum albumin from the baseline did not change statistically significant.The average change in TCM syndrome score between the patients who took SYKFT(-3.00[-6.00,-2.00])and who did not take SYKFT(-2.00[-5.00,0])was statistically significant(P=0.003).No obvious adverse reactions were observed in any group.Conclusion:SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients,with no change in the rate of decrease in the eGFR.SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.Trial registration number:NCT02063100 on ClinicalTrials.gov.

Effect of Sancaijiangtang on plasma nitric oxide and endothelin-1 levels in patients with type 2 diabetes mellitus and vascular dementia:a single-blind randomized controlled trial

OBJECTIVE: To observe the effect of Sancaijiangtang powders on plasma nitric oxide and endothelin-1 levels. We sought to identify the common pathological link and mechanism of action for Traditional Chinese medicine in type 2 diabetes mellitus and vascular dementia,and to explicate the material basis for treating the different diseases with the same method in Traditional Chinese Medicine.METHODS: In total,168 patients with type 2 diabetes mellitus and vascular dementia were enrolled in the study,and randomly divided into two groups by simple randomization. Patients in the treatment group received oral Sancaijiangtang powders with pioglitazone hydrochloride three times daily,while patients in the control group received pioglitazone hydrochloride alone. The treatment course was for12 weeks. Mini-mental state examinations(Chinese version) and Montreal Cognitive Assessments(Beijing version) were performed,and fasting plasma glucose,fasting insulin,hemoglobin A1 c,homeostasis model assessment of insulin resistance,plasma nitric oxide and endothelin-1 levels were measured before and after the treatment.RESULTS: The post-treatment levels for all measurements in both groups were better than pre-treatment levels(P < 0.05). The post-treatment levels for all measurements in the treatment group were better than the levels measured in the control group(P < 0.05).CONCLUSION: Type 2 diabetes mellitus and vascular dementia have common pathological mechanisms for insulin resistance and endothelium dysfunction. Sancaijiangtang powders could improve the release of nitric oxide and inhibit the secretion of endothelin-1. Therefore,the material basis exists for treating the different diseases with the same method in Traditional Chinese Medicine.

不同饮片形式对菊花饮片煎煮质量的影响

目的:通过比较菊花传统饮片、压制饮片和煮散颗粒的煎煮质量,为筛选新型中药饮片提供数据支撑和科学依据。方法:以不同饮片形式在不同煎煮时间点的绿原酸、异绿原酸A、3,5-O-双咖啡酰基奎宁酸含量和干膏收率为评价指标,考察菊花传统饮片、压制饮片及菊花煮散颗粒的煎煮情况。结果:同等条件下,煮散颗粒的煎出效果略优于其他两种饮片,但差异无统计学意义。结论:不同形式的饮片不影响菊花的煎煮溶出效果,3种饮片形式均可以保证菊花煎煮质量。除传统饮片外,其他饮片形式可进一步研究和应用推广。

Two Sets of Acupoint Combination of Similar Functions Engage Shared Neural Representation:A Functional Magnetic Resonance Imaging Study

Objective： To investigate whether the neural representations underlying alternating two acupoint combinations （ACs） are the same or not. Methods： In this functional magnetic resonance imaging study, two sets of analgesia ACs were utilized, including Waiguan （TE5） and Qiuxu （GB40） for Group A, and Neiguan （PC6） and Taichong （LR3） for Group B, which are the most commonly adopted in clinical treatment. Each group had 20 healthy subjects. An experinlental design was proposed, which consisted of a pre-needling resting phase, a needling phase and a post-needling resting phase. This paradigm optimally mimics the clinical protocol as well as focuses on both the stimulation and the resting periods. The results were subjected to general linear model analysis, conjunction analysis and the functional connectivity analysis. Results： The rostral anterior cingulated cortex was engaged in the initiative period of the acupuncture effect in both groups, and it was chosen as the seed region for the functional connectivity analysis for the following resting period. The results showed that several shared brain regions were involved in both groups, in particular the insula, amygdala and hypothalamus. Moreover, significant differences were located at the posterior cingulated cortex as revealed by a two sample t-test （P〈0.05, corrected）. Other regions showed no significant differences. This finding was further supported by the spatial correlation analysis that the two groups were significantly correlated （r=0.51, P〈0.01）. Conclusion： This preliminary research helps us understand the neurophysiological mechanisms of acupuncture when following clinical guidelines on ACs, as well as provides an important opportunity to develop better treatment strategies for reducing, or even preventing pain.

Effect on multifocal electroretinogram in persistently elevated intraocular pressure by erigeron breviscapus extract

AIM: To observe the effect on multifocal electroretinogram (mfERG) in persistently elevated intraocular pressure (TOP) by erigeron breviscapus extract (also named Dengzhanhua in Chinese) in rat models. METHODS: The rat models with persistently elevated TOP were established by the method of Akira. Then, erigeron breviscapus extract was given for one month to observe the effect on mfERG in persistently elevated TOP in rats. RESULTS: As elevated TOP went on, the mfERG changes were mainly in weaken of reaction density with progressive development. After intervention of erigeron breviscapus extract, the total peak latency of 131 wave had recovered to some extent and the difference was significant when compared with control group (P <0.05); the total response density and P1 wave response density in second circle had risen noticeably, which had significant differences than those of control group (P <0.05). CONCLUSION: Erigeron breviscapus extract can improve the impaired visual function of persistently elevated TOP in rats, suggesting that this extract is the effective part of erigeron breviscapus for optic neuroprotection.

Efficacy and safety of Sancai powder in patients with type 2 diabetes mellitus: a randomized controlled trial

OBJECTIVE: To assess the efficacy and safety of Sancai powder in patients with type 2 diabetes mellitus(T2DM) inadequately controlled with single oral metformin in a randomized controlled trial(RCT).METHODS: A total of 132 patients with T2 DM were enrolled in the study, who only took metformin(500-1000 mg/day) for at least three months and with inadequate glycemic control(7.0% ≤ hemoglobin A1 c ≤ 9.0%) in the past three months.The patients stopped taking metformin with lifestyle interventions for three weeks, and 105 patients qualified for the program. They were randomly divided into the Sancai powder group and the metformin group(1500 mg/day). The follow-up period was for 12 weeks. Comparisons of several variables were analyzed.RESULTS: No significant differences were found between the two groups in hemoglobin A1c(Hb A1c),fasting plasma glucose(FPG) and 2 h post-meal glucose(2h PG), although they had decreased significantly(P < 0.01). Homeostasis model assessment of beta cell function index was significantly improved in Sancai powder group(P < 0.01), and there were significant differences in the changes of homeostasis model assessment of insulin resistance and insulin sensitivity index in the two groups(P < 0.05). Sancai powder significantly reduced triglyceride level(P < 0.05), although there was no significant difference in the body weight and body mass index in the two groups.CONCLUSION: In this 12-week study, Sancai powder could significantly reduce hemoglobin A1 c,FPG and 2h PG levels, improved beta-cell function and insulin resistance of the T2 DM inadequately controlled with metformin.

Efficacy of Moxa-burning heat stimulating Zusanli(ST36) and Shenshu(BL23) on expressions of macrophage migration inhibitory factor and macrophage apoptosis in rabbits with adjuvant-induced arthritis

OBJECTIVE: To evaluate the effects of moxa-burning heat stimulating acupoints Zusanli(ST36) and Shenshu(BL23) on macrophage migration inhibitory factor(MIF) and its related molecules which can provide scientific experimental basis for the clinical application of moxibustion treatment of rheumatoid arthritis(RA). METHODS: Thirty rabbits were randomly assigned to control group, RA model(established by injecting Freund’s Complete Adjuvant) group(RA group) and RA model with moxibustion group [Moxa group, Zusanli(ST36) and Shenshu(BL23), 5 moxa pillars/day, 6 d × 3]. The expressions of MIF m RNA were evaluated with reverse transcription polymerase chain reaction;the apoptosis rates of macrophages were detected by erminal deoxynucleotidyl transferase-mediated d TUP nick end labeling;the expressions of related signal molecules were detected with immunohistochemical S-P method and the levels of IL-2 were detected with enzymelinked immunosorbent assay. RESULTS: The expressions of MIF m RNA, extracellular regulated protein kinases 2, p38 mitogen-activated protein kinase and nuclear factor-κ-gene binding p65 in synovial tissue of RA group were significantly increased when compared with control group, which were lower remarkably in moxa group than those in RA group. The apoptosis rates of macrophages in RA group were significantly down-regulated as compared with the control group, which were up-regulated in moxa group compared with the RA group. The levels of IL-2 in synovial fluid from the RA group were elevated significantly as compared with that from control group, but those of the moxa group were reduced when compared with those from RA group. CONCLUSIONS: Moxibustion may simultaneously regulate the expressions of MIF and its related signaling pathways molecules, the apoptosis rate of macrophages in synovial tissue, as well as the level of inflammatory factors in synovial fluid. The results suggest that the antiinflammatory effect of moxibustion on RA may be related to inhibit the expression of MIF in synovial tissue, the molecules of some related signaling pathways and promote the apoptosis of macrophage.

情志护理对脑梗死急性期患者焦虑和睡眠障碍的影响

目的:探讨情志护理方法对脑梗死患者焦虑、睡眠障碍以及一年以后复发率的影响。方法:将2008年5月到2010年5月在我科住院的143例脑梗死急性期患者随机分为两组,对照组采用脑梗死常规护理方法,观察组在此基础上给予中医情志护理。分别在患者入院1周以内、第4周、3个月时运用焦虑指数和匹兹堡睡眠质量指数表(Pitts-burgh Sleep Quality Index,PSQI)对两组进行效果评价,并且观察脑梗死1年以后的复发率。结果:在脑梗死第4周和3个月以后,观察组患者焦虑指数和睡眠障碍的改善程度优于对照组(P<0.05),1年以后,观察组的复发率明显低于对照组,差异有统计学意义(P<0.05)。结论:情志护理可以明显改善脑梗死患者的焦虑和睡眠障碍,降低1年后的复发率,减轻患者及家属的疾病经济负担。

Catgut Implantation at Acupoints for Allergic Rhinitis:A Systematic Review

Objective： To assess the effectiveness and the possible adverse effects of catgut implantation at acupoints for allergic rhinitis （AR）. Methods： This systematic review was carried out in accordance with the Cochrane Handbook version 5.1.0 and the Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement. Extensive literature searches were conducted in PubMed, Excerpta Medical Databases, the Cochrane Library, the China National Infrastructure, Wanfang Chinese Digital Periodical and Conference Database, and the Weipu Chinese Science and Technique Journals Database. The Chinese Clinical Trial Registry Center was also searched for ongoing trials up to September 2012. Randomized controlled trials （RCTs） or quasi-RCTs were included. Risk of bias assessment was performed using the Cochrane tool for assessing risk of bias. Results： Five RCTs with 285 participants were found from 49 relevant studies, but there was just one RCT which met the inclusion criteria for this review. The study showed that treatment of catgut implantation at acupoints could lead to a better alleviation of the signs and symptoms of AR than the crude herb moxibustion. No adverse events were reported in this study. Conclusions： Because of the methodological shortcoming and the risk of bias of the included trial catgut implantation was proved with only limited evidence for the treatment of AR. Robust RCTs with high quality and larger sample size in this field are hoped to be carried out in the future.