Traditional Chinese Medicine Syndrome of Primary Sjögren's Syndrome Patients with Interstitial Lung Disease / 中国实验方剂学杂志

ObjectiveTo summarize the characteristics of traditional Chinese medicine （TCM） syndrome in primary Sjögren's syndrome （pSS） patients with interstitial lung disease （ILD） and to explore associated factors. MethodA survey was conducted and pSS patients who were treated in TCM department of rheumatism at China-Japan Friendship Hospital from December 2018 to April 2022 were included. Tongue manifestations and syndromes of patients were recorded. pSS patients with ILD were classified into the pSS-ILD group and those without the ILD were included in the pSS-non-ILD group. The tongue manifestations， syndromes， and laboratory indexes were compared between the two groups， and logistic regression was used to explore the factors associated with pSS-ILD. ResultA total of 200 pSS patients were included， with 186 （93.0%） females， median age of 57 years， and median disease course of 60 months， of which 44 （22%） had pSS-ILD. In terms of tongue manifestations， pSS-ILD patients generally had dark/purple/stasis tongue， fissured tongue， and tongue with little fluid， thick coating， yellow coating， and greasy coating. The proportion patients with yellow coating was higher in pSS-ILD group than in the pSS-non-ILD group （χ2=4.799，P<0.05）. In terms of syndrome， more than 40% of pSS-ILD patients had Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. As for Yin deficiency， liver-kidney Yin deficiency syndrome ranked the first. For Qi deficiency， lung Qi deficiency syndrome was most commonly seen. The proportion of patients with lung Qi deficiency was higher in the pSS-ILD group than in the pSS-non-ILD group （χ2=18.667，P<0.01）. As to laboratory indexes， compared with the pSS-non-ILD group， pSS-ILD group had high proportion of anti-SSA-positive patients （P<0.05） and high levels of C-reactive protein （CRP） （P<0.01）， complement C3 （χ2=4.332，P<0.05）， and complement C4 （P<0.05）. Logistic regression analysis showed that pSS with ILD was positively associated with lung Qi deficiency ［odds ratio （OR）=6.079， 95% confidence interval （CI） 2.585-14.298， P<0.01）］ and yellow coating （OR=5.260， 95% CI 1.337-20.692， P<0.05） and negatively associated with low C4 （OR=0.199， 95% CI 0.070-0.564， P<0.01）. ConclusionAbout 22% of pSS patients had ILD， and patients with pSS-ILD generally have Qi deficiency， Yin deficiency， phlegm-dampness， Qi stagnation， and/or blood stasis syndrome. Yellow coating， lung Qi deficiency and C4 level are factors associated with pSS combined with ILD.

Characteristics of Tongue Manifestations and Syndromes of Patients with Primary Sjögren's Syndrome of Different Time / 中国实验方剂学杂志

ObjectiveTo explore the characteristics of tongue manifestations and traditional Chinese medicine （TCM） syndromes in patients with primary Sjogren's syndrome （pSS） of different time. MethodpSS patients who visited TCM Department of Rheumatism in China-Japan Friendship Hospital from December 2018 to October 2021 were included and grouped according to the disease courses （short<5 years， medium 5-10 years， long > 10 years）. Chi-square test was used for comparison between three groups and Bonferroni method for multiple comparisons. In the pairwise comparison， P<0.017 indicated significant difference. Chi-square test was performed on the syndrome and specific tongue manifestations with inter-group differences to analyze the trend of tongue manifestations and TCM syndromes over time （interval： two years）. ResultA total of 193 pSS patients were enrolled， with 85 （44.0%） of short disease course， 69 （35.8%） of medium disease course， and 39 （20.2%） of long disease course. The common tongue manifestations were crimson tongue， fissured tongue， thin tongue， lack of fluid， and dry coating， which showed no significant difference among the three groups. Higher proportion of patients with light red tongue was observed in the group with short disease course than in group with medium disease course （χ2=6.407， P<0.017）. Higher proportions of patients with thick coating （χ2=6.784， P<0.017） and phlegm-dampness syndrome （χ2=11.545， P<0.017） and lower proportion of patients with Qi deficiency syndrome （χ2=12.706， P<0.017） were found in the group with short disease course than in the group with long disease course. Patients with medium （χ2=6.358， P<0.017） and long （χ2=8.279， P<0.017） disease course tended to have exfoliated coating compared with those with short disease course， and the proportion of patients with exfoliated coating rose and the proportion of patients with thick greasy coating decreased over time （Ptrend<0.05）. In addition， the proportion of patients with phlegm-dampness syndrome decreased and that with Qi deficiency syndrome increased over time （Ptrend<0.05）. ConclusionIn the early stage， patients with pSS often show both dryness and dampness， as manifested by the thick greasy coating and phlegm-dampness syndrome. In the medium and late stage， patients often have Qi-Yin deficiency， as evidenced by exfoliated coating and Qi deficiency. In the clinical practice， medicines should be prescribed based on tongue manifestations and TCM syndrome of patients.

Effect of Huashi Runzao Prescription on Primary Sjögren's Syndrome / 中国实验方剂学杂志

ObjectiveTo observe the efficacy and safety of Huashi Runzao prescription for patients with primary Sjögren's syndrome （pSS） of combined dryness and dampness pattern. MethodA total of 105 eligible patients were randomized into the experimental group （65 cases） and control group （40 cases）， and they were respectively treated with Huashi Runzao prescription and hydroxychloroquine for 12 weeks. Visual Analogue Scale （VAS） was employed to assess the symptoms. The symptoms of dryness， fatigue， and pain， European League Against Rheumatism （EULAR） Sjögren's Syndrome Patient Reported Index （ESSPRI）， EULAR Sjögren's syndrome disease activity index （ESSDAI）， and immune inflammatory indicators before and after treatment were compared between the two groups， and adverse reactions were observed. ResultAfter treatment， the ESSPRI score was lower than that before treatment in the experimental groups （P<0.01） and was lower in the experimental group than in the control group （P<0.05）. The VAS scores of dry mouth， dry eyes， overall dryness， fatigue， and pain in the experimental group decreased compared with those before treatment （P<0.01）， and the experimental group had lower VAS scores of dry mouth and overall dryness than the control group （P<0.01）. After treatment， the ESSDAI score of both groups decreased compared with that before treatment （P<0.05， P<0.01）， but there was no significant difference between the groups. After treatment， the level of immunoglobulin M （IgM） decreased （P<0.01） and the level of complement C3 increased （P<0.01） in the experimental group， while the level of complement C3 decreased in the control group （P<0.05）. There was no significant difference in the laboratory indexes between groups. During the treatment， stomachache occurred to one case in the experimental group， which was alleviated after the treatment， and no adverse reaction was observed in the control group. According to the chi-square test， the occurrence of adverse reactions was insignificantly different between the two groups. ConclusionHuashi Runzao prescription can alleviate the symptoms of dryness， fatigue， and pain， and reduce disease activity without associated side effects in pSS patients with combined dampness and dryness pattern.

Effect of Huashi Runzao Prescription on Structure and Function of Submandibular Gland in Sjögren's Syndrome Model Mice / 中国实验方剂学杂志

ObjectiveTo investigate the effects of Huashi Runzao prescription （HRP） on the histopathological injury and function of submandibular gland in naive non-obese diabetic （NOD/Ltj） mouse model of Sjögren's syndrome （SS） and its regulatory effect on aquaporin 5 （AQP5） expression in submandibular gland cells. MethodThe SS model was induced in NOD/Ltj mice. The NOD/Ltj female mice aged nine weeks were selected and randomly assigned into model group，HRP group （7.15 g·kg-1·d-1），and hydroxychloroquine （HCQ） group （1.30 g·kg-1·d-1）， and female BALB/c mice in the same age were selected and assigned into the normal group， with six mice in each group. Drug intervention lasted eight weeks. The water consumption and salivary flow rate （SFR） of each group were recorded. The pathological staining results of the submandibular gland of mice in each group were observed and scored. AQP5 expression was determined by immunohistochemistry （IHC） and Western blot. ResultCompared with the normal group， the model group showed increased water consumption （P<0.05） and reduced SFR （P<0.05）. Compared with the model group， the HRP group showed decreased water consumption （P<0.05） and increased SFR （P<0.05）， and the HCQ group showed increased SFR （P<0.05）. In terms of histopathological results of the submandibular gland，compared with the normal group，the model group showed increased pathological score， number of lymphocyte infiltration foci，and percentage of lymphatic infiltration area （P<0.05）. Compared with the model group， the HRP group showed reduced pathological scores and number of lymphocyte infiltration foci （P<0.05）， and the HRP group and the HCQ group showed reduced percentage of lymphatic infiltration area（P<0.05）. The results of IHC and Western blot showed that compared with the normal group，the model group showed down-regulated expression level of AQP5 protein （P<0.05）， and compared with the model group and the HCQ group，the HRP group showed up-regulated expression level of AQP5 protein （P<0.05）. ConclusionHRP can improve the secretion function of submandibular gland acinous cells and glandular structure injury in SS model mice， and its mechanism may be related to the up-regulation of AQP5 protein expression level in submandibular gland cells.

Analysis of factors related to hemocytopenia and interstitial lung disease secondary to primary Sj?gren's syndrome / 中华风湿病学杂志

Objective:To detect the factors related to hemocytopenia and interstitial lung disease (ILD) secondary to primary Sj?gren's syndrome (pSS) in in-patients.Methods:Clinical characteristics of patients with pSS hospitalized in China-Japan Friendship Hospital from March 2014 to October 2020 were retrospectively analyzed. Patients were divided into different groups according to hemocytopenia and ILD. Chi-square test and Mann-Whitney U test were used to compare data in subgroups, and logistic regression were used to detect factors related to hemocytopenia and ILD secondary to pSS. Results:Five hundred and seventy-one inpatients with pSS were included in this study and the female: male ratio was 8∶1. Two hundred and seventy five of included patients had hemocytopenia (48.2%) and 180 patients had ILD (31.5%). Compared with patients without hemocytopenia, patients with hemocytopenia had higher ratio in low C3 [ OR=2.326, 95% CI(1.483, 3.650), P<0.01] and elevation of erythrocyte sedimentation rate (ESR) [ OR=1.912, 95% CI(1.233, 2.964), PP<0.01) . Compared with patients without ILD, patients with ILD showed higher ratio in male[ OR=2.509, 95% CI(1.269, 4.959), P<0.01) and fatigue [ OR=5.190, 95% CI(5.190, 13.931), P<0.01) , lower positive rate of anti-SSA antibody [ OR=0.392, 95% CI(0.230, 0.668), P<0.01) and anti-CENPB [ OR=0.337, 95% CI(0.145, 0.782), P<0.01] antibodies, and lower ratio in low C3[ OR=0.332, 95% CI(0.189, 0.582), P<0.01]. Conclusion:Low C3 and high ESR may be risk factors for developing hemocytopenia in patients with pSS. Men with pSS may be susceptible to ILD, while pSS patients with ILD may have lower ratio in positive anti-SSA antibody, positive anti-CENPB antibody and low C3. All of these findings are yet to be validated by future prospective cohort studies.

Difference in clinical characteristics of patients with primary Sj?gren's syndrome by gender and age of disease onset / 中华风湿病学杂志

Objective:To compare the clinical characteristics of patients with primary Sj?gren's syndrome (pSS) by gender and age of disease onset.Methods:Clinical data of hospitalized patients with pSS in China-Japan Friendship Hospital from March 2014 to August 2020 were retrospectively analyzed. Patients were divided into different groups according to their genders and ages of disease onset (young grong <30 years, middle-age group 30-59 years, elderly group ≥60 years). Chi-square test and Mann-Whitney U test were used to compare data in subgroups, and logistic regression was performed to analyze data after control covariates. Results:Five hundred and forty one patients with pSS were included in this study and 481 of them were women (88.9%) Women had higher ratio than men in dry mouth [ OR (95% CI) =2.172(1.091, 4.323), P=0.027], dry eyes [ OR(95% CI)=2.179(1.062, 4.469), P=0.034], leukocytopenia [ OR(95% CI)=3.789(1.150, 12.482), P=0.029], ANA titer≥1∶160 [ OR(95% CI)=2.233(1.279, 3.898), P<0.01], positive anti-SSA [ OR(95% CI)=2.919(1.644, 5.183), P<0.01], positive anti-Ro52 [ OR(95% CI)=3.018(1.685, 5.405), P<0.01], while men had higher ratio than women in parotid enlargement [ OR(95% CI)=2.345(1.281, 4.325), P<0.01], and interstitial lung disease (ILD) [ OR(95% CI)=2.593(1.460, 4.606), P<0.01]. Compared with patients in young group, patients in middles age group had higher ratio in dental caries [ OR(95% CI)=5.940(2.230, 15.819), P<0.01], xero-phthalmia [ OR(95% CI)=2.904(1.313, 6.425), P<0.01], arthralgia [ OR(95% CI)=1.959(1.039, 3.694), P=0.038] and ILD [ OR(95% CI)=2.247(1.018, 4.959), P=0.045], but lower ratio in renal involvement [ OR(95% CI)=0.402(0.211, 0.766), P<0.01]; patients in elderly group had higher ratio in dental caries [ OR(95% CI)=7.437(2.441, 22.656), P<0.01], xerophthalmia [ OR(95% CI)=6.084(1.901, 19.468), P<0.01], and ILD [ OR(95% CI)=4.857(2.029,11.627), P<0.01]. Compared with patients in elderly group, patients in young group had higher positive rate in anti-SSA [ OR(95% CI)=2.836(1.245, 6.459), P=0.013], anti-SSB [ OR(95% CI)=3.075(1.413, 6.690), P<0.01], rheumatoid factors (RF) [ OR(95% CI)=3.323(1.620, 6.817), P<0.01] and elevated immunoglobulin G (IgG)[ OR(95% CI)=3.567(1.747, 7.284), P<0.01]; patients in middle age group had higher positive rate in anti-SSB[ OR(95% CI)=2.330(1.315, 4.130), P<0.01], RF [ OR(95% CI)=2.026(1.279, 3.208), P<0.01], and elevated IgG [ OR(95% CI)=2.077(1.297, 3.327), P<0.01]. Conclusion:Women with pSS present a higher ratio in dry mouth, dry eyes, leukocytopenia and positive autoantibodies than men, while parotid enlargement and ILD are more common in men than women. Young patients are prone to renal involvement, middle-aged patients are prone to arthralgia, while elderly patients are prone to dental caries and xerophthalmia. With the growth of age, the positive rates of autoantibodies and elevated IgG are decreased gradually in patients with pSS, but the ratios of dental caries, xerophthalmia and ILD is increased gradually.

Hydrogen attenuates the inhibition of P.g-LPS on osteogenic capacity of huma periodental ligament cells / 实用口腔医学杂志

Objective:To observe the effects of hydrogen on osteogenic capacity of human periodontal ligament cells(hPDLCs)stim-ulated with P.g-LPS.Methods:hPDLCs were cultured and divided into 4 groups:control(C)group,osteogenic induction(OI) group,OI +1 00 ng/ml LPS(OILPS)group and OIPLS +3%H2 (H2 OIPLS)group,and treated respectively.Alizarin red staining (ARS)was carried out 3 weeks after treatment.ALP and OC mRNA expression of the cells was examined by RT-PCR after 7-d treat-ment.Results:LPS decreased A value of ARS(P <0.01 ),ALP mRNA expression(P <0.001 )and OC mRNA expression(P <0.001 )of the cells.H2 increased the A value(P <0.05),ALP mRNA expression(P <0.01 )and OC mRNA(P <0.01 )of the cells treated by LPS.Conclusion:High concentration of P.g-LPS can inhibit osteogenic capacity of hPDLCs,while hydrogen can impair the P.g-LPS induced suppression of hPDLC's osteogenesis.

Detection of the calcium and phosphorus in the hard tissue of permanent teeth：spectrophotometry and ethylene diamine tetraacetie acid titration / 中国组织工程研究

BACKGROUND: Currently, acid etching and bonding technology have been widely used in clinical stomatology. Data have indicated that the main content of inorganic elements (calcium and phosphorus) has a certain difference between the dental enamel and dentin of the young and adult permanent teeth. OBJECTIVE:To measure the content of main inorganic elements, calcium and phosphorus, in the dental enamel and dentin from young and adult permanent teeth with spectrophotometry and ethylene diamine tetraacetie acid titration method. METHODS:Each 20 adult and young permanent teethin vitrowere selected. Plaster stone and water was mixed; when it was nearly dried, the teeth were verticaly cast in the mixture and the tooth surface was exposed. The models were cut into the slices using syj-200 precision cutting machine, and then the slices were put into nitric acid and dissolved through heater to prepare standard solution. At last, the concentrations of calcium and phosphorus in the hard tissue of both young and adult permanent teeth were measured with spectrophotometric method and titration method. RESULTS AND CONCLUSION:The content of calcium and phosphorus and calcium/phosphorus ratio in the hard tissue of young permanent teeth were less than those of adult permanent teeth (P < 0.05), reflecting that the organic matter content was more than that in adult permanent teeth, but their mineralized degree was inferior to that of adult permanent teeth (P < 0.05). These findings indicate that the young permanent teeth are more acid proof than the adult permanent teeth; therefore, the acid etching time can be properly prolonged for young permanent teeth in clinical treatment, in order to achieve better effects.

Preliminary study on the biological characters of Ornidazole Slow-Release Membrane / 中国海洋药物

Objective To evaluate the biocompatibility and antibacterial activities of the Ornidazole Slow-Release Membrane.Methods 1.The lower lips of 12 rats were sewed into 12 pockets and the pockets were immited with extracting solution of the ornidazole membrane, formaldehyde and normal saline respectively once per day.The specimens were examined histologically 7 days later.2.The dorsal muscles of 16 rats were implanted with the membranes or silk threads,and examined histologically 1 week and 2,4,6 weeks later respectively.3. The antibacterial activity against Streptococcus mutans and Fusobacterium nucleatum was observed on solid culture medium in vitro.Results The animal experiments showed the membranes were not irritative to the oral mucosa.It was found that the tissue reaction of the membranes was similar to that of the silk threads after implanted into dorsal muscles and the membranes had been degraded in the second week.And the membranes had effective antibacterial action against Streptococcus mutans and Fusobacterium nucleatum.Conclusion The Ornidazole Slow-Release Membrane possesses favorable biocompatibility and antibacterial activities.

The effect of Nd:YAG laser irradiation combined with acidulated phosphate fluorid treatment on the acid resistance of human enamel / 实用口腔医学杂志

Objective: To study the effect of pulsed Nd:YAG laser irradiation combined with acidulated phosphate fluorid (APF) on the acid resistance of human dental enamel. Methods: Enamel samples were prepared from 192 caries-free extracted teeth. The smooth surface and pits and fissures were treated with 12 3 g/L APF for 4 minutes after 100,150 or 200 mJ pulsed Nd:YAG laser irradiation. Then the teeth were put into 12.3 g/L of artificial caries inducing solution (acid solution) for 1,5,10 or 24 h respectively. The control teeth were treated with APF only. The amount of calcium dissolved in the solution was determined with an atomic absorption spectrophotometer and the depth of artificial caries was measured with polarized microscope. Results: The amount of calcium dissolved in the acid solution was significantly less in the groups with laser treatment than that in those without laser treatment (P

Antibacterial activities of dental alginate impression materials impregnated with carboxymethyl chitosan / 中国海洋药物

Objective To determine the antibacterial activities of the alginate impression materials impregnated with carboxymethyl chitosan.Methods Carboxymethyl chitosan with different replace positions,replace degrees,relative molecular masses and deacetyl degrees were added into the dental alginate impression materials by different ratios.Their antibacterial activities were determined using a method according to the Chinese and Japanese standards for testing antibacterial efficacy of antibacterial materials.Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC6538 were used in this test.Results O-carboxymethyl chitosan showed best antibacterial activity.O-carboxymethyl chitosan added into the alginate impression materials had the best antimicrobial activity on Escherichia coli and Staphylococcus aureus in the ratios of 1% and 1.4%,respectively.Its inhibitory bacteria rate could reach 99.99% along with the increase of deacetyl degree.Conclusion The alginate impression materials impregnated with carboxymethyl chitosan have a favorable antimicrobial activity.