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Objective:To explore the therapeutic effect and mechanism of Dachengqi decoction on patients with mild acute pancreatitis (MAP).Methods:A parallel randomized controlled trial was conducted. Sixty-eight patients with acute pancreatitis (AP) admitted to Shanghai Traditional Chinese Medicine (TCM)-Integrated Hospital from March 2018 to February 2021 were enrolled. Referring to the condition on admission of the patients and whether they agreed to receive the Dachengqi decoction or not, they were divided into conventional treatment group and Dachengqi decoction group according to the principle of 1∶1 equal randomness. Meanwhile, 20 healthy volunteers were recruited as controls. Both groups of patients were treated with octreotide, fasting, gastrointestinal decompression, antipyretic and analgesic, anti-inflammatory, inhibition of gastric acid and pancreatic juice secretion, maintenance of electrolyte balance and other western conventional medicine. The patients in the Dachengqi decoction group received Dachengqi decoction orally on the basis of routine treatment, 100 mL each time, twice a day, for seven consecutive days. The inflammation parameters [white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6)] before and after treatment and the recovery time of gastrointestinal function (first exhaust time, time to recover bowel sounds, first defecation time) of patients were recorded. 16S rRNA gene sequencing of stool samples was recorded, and normalized data were obtained after quality control and other related processing. The data were subjected to diversity analysis (Alpha diversity and Beta diversity) and linear discriminant analysis effect size analysis (LEfSe analysis) to observe changes in the gut microbiota of MAP patients. Spearman rank correlation coefficient was used to analyze the correlation between inflammatory indexes and microorganisms at the intestinal genus level. Blood, urine, stool samples, renal function, and electrocardiogram (ECG) during treatment of MAP patients were detected to assess the safety of the treatment.Results:Of the 68 patients with AP, 16 were excluded from moderate-severe AP, 4 were not collected or voluntarily abandoned treatment. Finally, 48 patients with MAP were enrolled, 24 in the conventional treatment group and 24 in the Dachengqi decoction group. The inflammation parameters levels at 7 days of treatment in both groups were significantly lower than those before treatment. CRP, PCT and IL-6 levels in the Dachengqi decoction group were significantly lower than those in the conventional treatment group [CRP (mg/L): 8.50 (3.50, 13.00) vs. 16.00 (9.25, 29.75), PCT (μg/L): 0.06 (0.03, 0.08) vs. 0.09 (0.05, 0.11), IL-6 (ng/L): 6.36 (3.96, 10.79) vs. 13.24 (6.69, 18.87), all P < 0.05]. The first exhaust time, time to recover bowel sounds and first defecation time in the Dachengqi decoction group were significantly shorter than those in the conventional treatment group [first exhaust time (days): 1.62±0.65 vs. 2.80±0.65, time to recover bowel sounds (days): 1.13±0.58 vs. 2.31±0.76, first defecation time (days): 3.12±0.75 vs. 4.39±0.76, all P < 0.05]. The analysis of intestinal microflora diversity showed that both the diversity and abundance of microbial communities were the highest in the healthy control group and the lowest in the conventional treatment group. In addition, the coincidence degree of microbial communities in healthy controls and MAP patients was small, while the coincidence degree of MAP patients among different treatment methods was relatively large. LEfSe analysis showed that Dachengqi decoction reduced the relative abundance of Escherichia coli-Shigella and Clostridium erysipelae, and increased the relative abundance of three beneficial bacteria, namely Lactobacillus, Rombutzia and Brutella. In the intestines of MAP patients, Lactobacillus mucilaginus and Lactobacillus conjunctus were significantly enriched. Correlation analysis showed that positive correlations between Escherichia coli- Shigella and the four inflammatory indicators including WBC, CRP, PCT, IL-6 were statistically significant ( r value was 0.31, 0.41, 0.57, 0.43, respectively, all P < 0.05). There was no significant correlation between other bacteria and inflammatory indicators. During the treatment, there was no obvious abnormality in blood, urine and feces, renal function and ECG of MAP patients. Conclusions:Dachengqi decoction could reduce inflammatory responses and promote recovery of intestinal microecological balance and gastrointestinal function in patients with MAP by regulating the composition of intestinal flora. No significant adverse effects were observed during the treatment period.
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Objective:To observe the clinical efficacy of Dachengqi decoction combined with octreotide in the treatment of patients with acute pancreatitis (AP).Methods:From March 2018 to February 2021, a total of 68 patients with mild acute pancreatitis (MAP) and moderately severe acute pancreatitis (MSAP) admitted to Shanghai Traditional Chinese Medicine-Integrated Hospital were included, and they were randomly divided into western medicine treatment group and Dachengqi decoction group. The patients in the western medicine treatment group received conventional western medicine (octreotide+symptomatic treatment); in the Dachengqi decoction group, 100 mL of Dachengqi decoction was taken orally on the basis of conventional western medicine, twice a day; the observation time for both groups was 7 days. The levels of inflammation parameters [white blood cell count (WBC), interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP)] and serum amylase (Amy) before and after treatment of patients between the two groups, as well as the occurrence of clinical efficacy indicators and adverse reactions were compared.Results:Among the 68 included patients, 4 were excluded because the specimen was not obtained or the patient gave up the treatment. A total of 64 patients were finally enrolled in the analysis, including 32 cases in the Dachengqi decoction group and 32 cases in the western medicine treatment group respectively. There was no statistically significant difference in inflammation parameters or serum Amy levels before treatment between the two groups. At 7 days of treatment, the inflammatory parameters and serum Amy levels of the two groups were significantly lower than those before treatment [western medicine treatment group: WBC (×10 9/L) was 5.94±2.08 vs. 11.81±3.66, IL-6 (ng/L) was 7.22 (5.72, 14.23) vs. 30.13 (15.77, 85.37), PCT (μg/L) was 0.068 (0.052, 0.128) vs. 0.290 (0.231, 0.428), CRP (mg/L) was 26.0 (18.3, 35.8) vs. 112.0 (62.0, 126.0), Amy (U/L) was 77 (57, 116) vs. 352 (162, 1 576); Dachengqi decoction group: WBC (×10 9/L) was 5.56±2.04 vs. 12.22±2.85, IL-6 (ng/L) was 5.70 (3.26, 11.06) was 50.30 (23.99, 88.32), PCT (μg/L) was 0.038 (0.028, 0.808) vs. 0.308 (0.129, 0.462), CRP (mg/L) was 11.0 (3.5, 24.0) vs. 150.0 (75.0. 193.0), Amy (U/L) was 78 (57, 104) vs. 447 (336, 718); all P < 0.05], and the levels of IL-6, PCT, and CRP decreased more significantly after treatment in the Dachengqi decoction group (all P < 0.05). The total clinical effective rate of patients in the Dachengqi decoction group was significantly higher than that of the western medicine treatment group [93.75% (30/32) vs. 71.88% (23/32), P < 0.05]. There was no obvious adverse event during the treatment and observation period in the two groups. Conclusion:Dachengqi decoction combined with octreotide therapy could improve the clinical efficacy of AP patients, and its mechanism might be related to reducing the level of inflammatory factors, thereby inhibiting the inflammatory response, and regulating the level of serum Amy.
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Objective To assess scoliosis in adolescence and adults by three-dimensional ( 3-D ) ultrasound imaging . Methods A commercial available ultrasound instrument with a magnetic sensor system was used for long distance 3-D ultrasound imaging .Specific phantoms were imaged to evaluate the precision of this imaging system . Twenty healthy adults and 20 patients with scoliosis were imaged by 3-D ultrasonography and radiography . The deformity angle of the patients with scoliosis was measured on the reconstructed coronal plane ( C plane) of 3-D ultrasound imaging . The relevance between the curvature measured by ultrasound and the Cobb angles originated by radiography were evaluated . Results There was no significant difference between the angles of the phantom measured by the 3-D ultrasound imaging system and that measured by an angle gauge ( P = 0 .479) . The transverse process ,vertebral arch and acoustic shadow of the central spinous process of spines in healthy adults can be displayed on the reconstructed C plane by 3-D ultrasound imaging . The morphology of scoliosis in all the twenty patients can be observed on the reconstructed C planes ( multi-layers) by 3-D ultrasound imaging ,which accorded well with that observed on radiograph . In 9 patients ,part of the spinal segment could not be totally displayed on one single coronal plane and no additional measurement was carried out . In 11 patients ,all the segments of the spine could be clearly displayed on a single coronal plane and the curvature of scoliosis was then measured . There were no significant differences between the angle measured on 3-D ultrasound imaging and the Cobb angle measured on radiograph( P =0 .974) and the two measurement methods have high correlation( r =0 .991 , P <0 .0001) . Conclusions The commercial available 3-D ultrasound imaging system applied in this study offers a viable method to assess scoliosis in adolescence and adults in a reliable and radiation-free manner .
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Objective:To compare the effectiveness and safety of Dengzhanhuasu and Danshen Injection in the treatment of the patients with angina pectoris of coronary heart disease with Meta-analysis, and to provide basis for their application in clinic.Methods:Computer search was performed using Cochrane Central Register of Controlled Trial,Ovid-medline,EMBASE,PubMed,CNKI,Wanfang,VIP and CBM,and the literatures about the effectiveness and safety of Dengzhanhuasu and Dansheng Injection in the treatment of the patients with angina pectonis of coronary heart disease were obtained.According to the principle of selection and elimination, the literatures were selected, and the qualities of literatures were evaluated.The related data were extracted from the literatures.RevMan 5.3 software was used to extract the data for Meta-analysis.Results:A total of 167 literatures were retrieved, and 8 randomlized-controlled studies were selected according to the selection criteria.The evaluation results of the effectiveness of angina pectoris according to symptom showed that χ2=2.62,df=7,P=0.92,Z=6.85 (P<0.000 01), 95%CI:2.73-6.10. The evaluation of the effectiveness of angina pectoris according to electrocardiogram,χ2=6.37,df=7,P=0.50,Z=6.37(P=0.000 01),95%CI:1.94-3.49.The results of Meta-analysis showed that there were significant differences in the relief of symptoms and improvement of the electrocardiogram efficacy between Dengzhanhuasu and Danshen Injection in the treatment of angina pectoris of coronary heart disease (P<0.05).Conclusion:Dengzhanhuasu has better effectiveness in the treatment of the patients with unstable angina than Dansheng Injection and they have the same safety.
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<p><b>OBJECTIVE</b>To evaluate the reliability and validity of SF-36 scale in urban residents, and provide reference for the selection of suitable health measure tools for urban residents.</p><p><b>METHODS</b>Multi-stage cluster stratified sampling was conducted to select the residents aged ≥18 years in three urbanized communities of Hangzhou. SF-36 scale was used for the measurement of the quality of life and Spearman-Brown and Cronbach' s α coefficients were used for the evaluation of split-half reliability and internal consistency reliability. The convergent and discriminative validity were evaluated by using the success rate of experiments and the criterion-related validity was evaluated with correlation analysis and non-parameter test. Structural equation modeling was used in the evaluation of contract validity.</p><p><b>RESULTS</b>SF-36 scale had good split-half reliability (R=0.94) and internal-consistency reliability (except for bodily pain and vitality, Cronbach's α range: 0.70-0.91). The convergent validity (88.57%), discriminate validity (successful rates 90.61%) and the criterion-related validity (γs=0.56, the score was consistent with the self-reported health status) were good. Second-order confirmatory factor analysis model was not well-fitted (GFI= 0.721, AGFI= 0.682, CFI= 0.731, RMR= 0.084, RMSEA= 0.098), indicating that the construct validity was poor.</p><p><b>CONCLUSION</b>The reliability, consolidation validity, discrimination validity and criterion-related validity of SF-36 scale were good, while the construct validity was poor. Improvement is needed when the scale is used for urban residents.</p>
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Humans , Factor Analysis, Statistical , Health Status , Quality of Life , Reproducibility of Results , Self Report , Surveys and Questionnaires , Urban PopulationABSTRACT
Objective To explore the clinical characteristics and diagnosis of autoimmune pancreatitis(AIP) with the aim to raise awareness of AIP.Methods Clinical data of 32 patients with AIP were retrospectively analyzed,including clinical manifestations,imaging features,laboratory examination,histopathology and treatment from November 2009 to April 2013 in the First Affiliated Hospital of Medical School,Zhejiang University.Results All 32 AIP patients including 25 males and 7 females had a median age of (62.5 ± 12.6) years (27-84 years).The initial symptoms included obstructive jaundice in 50.0％patients (16/32),abdominal pain in 43.8％ (14/32),fatigue and weight loss in 12.5％ (4/32),and bloody stool in 6.3％ (2/32).Laboratory findings revealed abnormal liver function in 6.3％ (2/32)patients,increased immunoglobulins in 71.9％ (23/32)patients and elevated IgG4 in 8/10 patients.Computerized tomography(CT) scan and ultrasonography were performed in all patients.Diffusely enlarged pancreas were found in 62.5％ (20/32) patients and focally enlarged in 37.5％ (12/32),additionally main pancreatic duct stenosis in 62.5％ (20/32) patients.Nineteen patients obtained histopathological examination,indicating pancreatic interstitial fibrosis,and infiltration of lymphocytes and plasma cells.Conclusions Autoimmune pancreatitis is an autoimmune disease which may be misdiagnosed as pancreatic cancer.The clinical features,laboratory findings,imaging characteristics,and typical histopathologic presentation,as well as good response to glucocorticoids provide supportive evidence for the diagnosis of AIP.
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Objective To investigate the relationship between the Reelin protein and schizophrenia .Methods 89 patients with schizophrenia were served as schizophrenic group and 89 healthy people as control group .Western blot was employed to detect their peripheral blood Reelin protein expression .Results The expression level of peripheral blood Reelin protein of patients in schizo-phrenic group(0 .66 ± 0 .27) was significantly lower than that in the control group(1 .01 ± 0 .23)(P0 .05) .Reelin protein expression levels of male and female subjects in the control group were 1 .01 ± 0 .25 and 1 .02 ± 0 .26 ,respectively ,with also no statistically significant difference (t=0 .201 ,P>0 .05) .Conclusion The low expression level of Reelin protein is related to schizophrenia .
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To investigate the effects of three classical anti-jaundice formulas Yinchenhao Decoction (YCHD). Yinchen Wuling San (YCWLS) and Zhizi Baipi Decoction (ZZBPD) on liver fibrosis induced by dimethylnitrosamine (DMN) in rats and explore the formula-syndrome relationship.
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Objective To investigate the application of the multiple locus variable numbers of tandem repeats(MLVA) in genotype Mycobacterium tuberculosis(MTB) strains isolated from Uygur in south of Xinjiang, and to understand the characteristics of genotype and distribution. Methods One hundred and fifty-one Mycobacterium tuberculosis strains were collected from Uygur in south of Xinjiang which contains three regions, Kashgar, Hotan and Kizilsu kirghiz. Twenty-four tandem repeats loci in the total genome of MTB were analyzed by PCR and agarose gel electrophoresis method. The characteristics on polymorphism of DNA fingerprinting of 151 MTB strains were analyzed with BioNumerics 5.0 software. Results Twenty-four MLVA loci of 151 MTB strains were analyzed respectively. The results showed that there were obvious polymorphisms of VNTRs. The clustering of genotype showed that these strains could be categorized into 8 gene groups( Ⅰ , Ⅱ , Ⅲ ,Ⅳ, Ⅴ ,Ⅵ,Ⅶ ,Ⅷ) and 151 genotypes. Sixty-seven isolates(44.4% ) belonged to group Ⅵ. 23.2% were group Ⅷ including 35 genotypes, 20. 5% were group Ⅳ including 31 genotypes. The group Ⅵ prevailed mostly in the Kashgar. The group Ⅲ prevailed mostly in the HOTAN. Conclusion The results showed there were obvious polymorphisms of VNTRs of Mycobacterium tuberculosis clinical strains preliminarily. Group Ⅵ was the predominant prevalent strain in south of Xinjiang.
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Objective To analyze sonographic imagings of traumatic neuromas of peripheral nerves,and to investigate the applied values of uhrasonography in the traumatic neuroma of peripheral nerve. Methods The sonographic imagings of 38 patients who had evidences of traumatic neuromas in peripheral nerves were retrospectively reviewed by the last diagnostic results of operations. Results Among 38 cases, 2 incomplete traumatic neuromas were not detected, and 1 incomplete traumatic neuroma was misdiagnosised as neurilemoma by ultrasonography. The coincidence of uitrasonography in incomplete traumatic neuroma and complete severed neuroma was 82.4% and 100%. With regard to the echogenicity of 38 traumatic neuromas of peripheral nerves, the sonographic characteristics of neuromas were all hypoechoic. Thirty-three neuromas appearanced like shuttles and 5 neuromas appearaneed like humps. Conclusions The traumatic neuroma has distinctive ultrasonic appearance. Ultrasonography is useful to direct the diagnosis and treatment of traumatic neuroma.
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<p><b>BACKGROUND</b>It has been proven that clusterin is a newly apoptosis-related factor and upregulates in many tumors. It plays important roles in carcinogenesis and tumor progression. The antiapoptosis of clusterin seems to be relative to other antiapoptosis factors. The aim of this study is to investigate the expression and significance of clusterin in non-small cell lung cancer (NSCLC) tissue.</p><p><b>METHODS</b>The expression of clusterin, p53 and Bax in NSCLC were detected by immunohistochemical SP method and Western blot assay.</p><p><b>RESULTS</b>Positive expression rate of clusterin was 79.25% (42/53) in NSCLC tissues which was much higher than that in normal lung tissue (2/16, 12.50%) (Chi-square=23.68, P < 0.05). The expression of clusterin was closely related to pathological differentiation (rs=0.464, P < 0.01), clinical stage (rs =0.320, P < 0.01) and lymph node metastasis (rs=0.255, P < 0.05), but not correlated to the sex (Chi-square=0.007, P > 0.05), age (Chi-square=0.707, P > 0.05) and histological type (Chi-square=0.702, P > 0.05). The expression of clusterin in NSCLC was positively correlated to the expression of p53 (rs=0.589, P < 0.01), but was negatively related to the expression of Bax (rs =-0.346, P < 0.01). The relative expression level of clusterin protein in NSCLC was significantly higher than that in normal lung tissue (0.541±0.010 vs 0.201±0.020) (P < 0.05).</p><p><b>CONCLUSIONS</b>Clusterin may play an important role in the biological characteristics of NSCLC by the antiapoptosis pathway.</p>
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Objective To explore the role of the autoantibodies against ?_1 and ?_1-adrenergic receptor(?_1-receptor)in the development of hypertension with renal failure.Methods The epitopes of the second extracellular loop of ?_1-receptor(197-222) and ?_1-receptor(192-218) were synthesized and used respectively to screen sera autoantibodies in patients with hypertension and renal failure(n=61),hypertension without renal failure(n=60) and healthy blood donors(n=40,control) by ELISA.Results The positive rates of the autoantibodies against ?_1-receptor(62.3%)and ?_1 receptor(50.8%) in patients with hypertension with renal failure were higher than those of patients with hypertension without renal failure(13.3% and10.0%)(P