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ObjectiveTo compare the diagnostic accuracy of five different weighting methods of Chinese medicine syndrome and then analyze their diagnostic efficacy and characteristics， by taking Diagnostic Standard for Type 2 Diabetes Mellitus （T2DM） with Dampeness-heat Syndrome （abbreviated as diagnostic standard） as an example. MethodsData from expert questionnaire on the diagnostic standard and a cross-sectional survey of 1021 patients were collected. The comparative diagnostic test accuracy （CDTA） method was used to calculate the area under the ROC curve （AUC）， area under the PR curve （AUPR）， accuracy （ACC）， sensitivity， and specificity of five commonly used weighting methods in two categories， including knowledge-driven weighting methods （expert scoring synthesis method， analytic hierarchy process， and precedence chart method） and data-driven weighting methods （logistic regression contribution method and entropy weighting method）. ResultsAmong 1021 patients with T2DM， 389 cases were diagnosed as dampness-heat syndrome. The expert scoring synthesis method， analytic hierarchy process method， and precedence chart method were basically consistent in the weight scores of each item. The expert scoring comprehensive method， analytic hierarchy process method， and entropy weighting method have a smaller difference in the weight scores of each item， while there was larger difference in the weight scores of each item of the precedence chart method and the logistic regression contribution method. The AUC （95% CI）， AUPR， ACC， sensitivity， and specifi-city of the expert scoring synthesis method were 0.913 （0.893， 0.932）， 0.851， 0.870， 0.868 and 0.875， respectively； while those of the analytic hierarchy process method were 0.910 （0.890， 0.930）， 0.838， 0.879， 0.848 and 0.896； of the precedence chart method were 0.919 （0.900， 0.937）， 0.858， 0.875， 0.871 and 0.875； of the logistic regression contribution method were 0.867 （0.842， 0.891）， 0.792， 0.853， 0.769 and 0.898； and of the entropy weighting method were 0.895 （0.873， 0.916）， 0.820， 0.869， 0.802 and 0.908. ConclusionThe knowledge-driven weighting methods are better than the data-driven weighting methods in terms of diagnostic efficacy and reflecting expert experience.
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Diseases of glucose and lipid metabolism disorder,presented rather complicated pathological mechanism,often with clinical pattern of multiple concurrent diseases.Therefore,the traditional single-disease based on treatment methods need improving.In view of plenty of clinical practice,theatrical and fundamental researches,the pathological mechanisms of some chronic disorders,such as hyperlipidemia,nonalcoholic fatty liver disease,type 2 diabetes,hypertension,atherosclerosis and severe cardiovascular complications,resulted from the impairment in the metabolism of glucose and lipid were investigated using the method of integrated Chinese and western medicine.Overall,the features of these diseases and their common characteristics were discovered,and accordingly we defined the new concept of glucolipid metabolic disease (GLMD) and put forward the concept of pivot liver of metabolic regulation system.In addition,we developed the therapeutic strategy of modulating liver,starting pivot and cleaning turbidity,for the comprehensive and integrated treatment and prevention of these diseases.The theory of GLMD shared the critical characteristics with precision medicine,taking its own specialty.Finally,the content and approaches for the research of GLMD were proposed,and some essential and core fields in the precision medical research for GLMD were profoundly analyzed and prospected.
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Objective To explore the mechanism of Fudoidan for regulating the disorder of lipid metabolism in rats. Methods Rat hyperlipidemic model was established. The effect of Fudoidan on rats levels of blood lipids, lipid metabolic enzyme, and the lipid contents in the stool, as well as bile metabolismand LDL-R mRNA expression in the liver were observed. Results Fudoidan can notably restrain the concentration of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) of hyperlipidemic rats and increase the concentration of high-density lipoprotein cholesterol (HDL-C) and activities of 1ipoprotein lipase (LPL), hepatic lipoprotein (HL) and lecithin cholesterol acyltransferase (LCAT).Fucoidan can remarkably increase the contents of cholesterol, TG, bile acid , but has no effect on the secretion of bile, the concentration of cholesterol and bile acid in bile. The results of RT-PCR experiment showed that Fudoidan can notably improve the expression level of low-density lipoprotein receptor (LDL-R) mRNA in the liver of hyperlipidemic rats. Conclusion Fucoidan can regulate the disorder of lipid metabolism probably by restraining the absorption of lipids (TC, cholesterol, bile acid) , activating the activities of lipid metabolic enzyme (LPL, HL and LCAT), and promoting the expression of LDL-R mRNA in the liver.
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Objective To study the protective effects of aqueous extract and alcohol-soluble extract of Isodon lophanthoides var.gerardianus (Benth.)Hara (ILVG) on immunity hepatic injury induced by concanavalin A (Con A) in mice.Methods One hundred and eight NIH mice were allocated into normal control group,model group,ILVG groups of aqueous extract and alcohol-soluble extract (low-,middle-and high-dosage),and bifendate group randomly.In the experimental groups,mice received either ILVG aqueous extract or alcohol-soluble extract (18.20 g?kg-1,9.10 g?kg-1,4.55 g?kg-1 respectively) or Bifendate (45 mg?kg-1) by gastric perfusion daily for consecutive 5 days.In the 5th day,Con A (20 mg?kg-1) was injected into mice via the tail vein 4h after administration.And then the blood was obtained by picking out the eyeball and the serum was separated after 8-hour fasting.The serum levels of ALT and AST were analyzed,the body weight as well as the weight of liver,spleen and thymus were measured,and pathological features of hepatic tissue were observed.Results ILVG can decrease the ALT and AST,restrain the enlargement of liver and the shrinkage of thymus and reduce the necrosis of hepatic tissue.Conclusion Aqueous extract and alcohol-soluble extract of ILVG possess the effects of protecting liver from immunity injury induced by Con A in NIH mice.
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Objective To explore the mechanism of Borneolum combined with Rhizoma Chuanxiong in counteracting cerebral ischemia with reperfusion injury.Methods Rat Model of cerebral ischemia with reperfusion injury was set up by occlusion of bilateral carotid arteries.The effect of Borneolum combined with Rhizoma Chuanxiong on the content of nitric oxide(NO)and free radicals of model rat brain tissue was observed.Results Borneolum combined with Rhizoma Chuanxiong decreased the lipid peroxide(LPO)content and increased the activity of superoxidase(SOD)in model rat brain tissue(P
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Objective To observe the effect of Weichangshu Capsule (WCSC) in inhibiting experimental gastric ulcer and the damage of gastric mucosa in SD rats. Methods The experimental gastric ulcer rat models were established by ligation of pylorus, water immersing method and subcutaneous injection of indometacin, and rat models with acute damage of gastric mucosa were induced by hydrochloric acid- ethanol (HAE).Then the effect of WCSC in inhibiting experimental gastric ulcer and the damage of gastric mucosa in SD rats were observed. Results WCSC had obviously inhibitory effects on stress gastric ulcer, indometacin- induced gastric ulcer and HAE- induced acute damage of gastric mucosa. WCSC also inhibited the secretion of gastric juice and increased pepsase activity. Conclusion WCSC has counteraction on experimental gastric ulcer.
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Experimental studies showed that the water extract of rhubarb had low content of anthraquinone and a strong purgative while the alcohol extract a high content of anthraquinone and was free of purgative action,even tannin was eliminated.The purgative action of the water extract was also last when mixed with alcohol extract. The experimental results coincide with the traditional experience in Chinese medicinal theory:"the fresh Rhubarb has a purgative action while rhubarb prepared with wine can promote blood circulation and remove blood stasis."However, from the angle of anthraquinone and tannin, the explanation is unreasonable. It is indicated that the purgative action of rhubarb is greatly influenced, even disappears when prepared with alcohol. So, attention should be paid in the preparation process of Chinese patent drugs containing rhubarb.