Pathological Observation of Blood Stasis Syndrome in Non-diabetic Peripheral Neuropathies: A Retrospective Analysis Based on Nerve Biopsy / 中国结合医学杂志

OBJECTIVE@#To investigate the pathological features of blood stasis syndrome (BSS) in non-diabetic peripheral neuropathy.@*METHODS@#Clinical data of 31 patients with non-diabetic peripheral neuropathy who had undergone nerve biopsy during December 2004 and December 2010 in Xuanwu Hospital Capital Medical University were retrospectively analyzed. According to Chinese medicine (CM) syndrome differentiation and signs, 26 patients were blood stasis type and 5 patients were non-blood stasis type. Clinical and pathological data were compared in detail.@*RESULTS@#Clinically, although both groups shared similar symptoms of limb numbness, weakness and sensory disturbances, the prevalence of neuralgia was much grievous in BSS group (73.1%, 26/31) compared with the non-BSS group (0%, 0/5). As for signs, dermal nutrients disturbance (84.6%, 22/26), dark or purple tongue (100.0%, 26/26), and sublingual varices (80.7%, 21/26) were more common in the BSS group than the non-BSS group (0%, 60%, 20%, respectively). The prevalence of qi deficiency cases (19/26) in the BSS group was significantly higher compared with the non-BSS group (1/5). The unique histological manifestations of BSS were axonal degeneration (16/26 vs 2/5 in non-BSS group), which was the hallmark of ischemia. Cases with BSS had prominent microangiopathy (61.5%, 16/26), manifested as epineurium vasculitis (inflammatory cell infiltrated to the vessel wall, obliteration and recanalization, vascular proliferation, extravascular hemosiderin deposition), angiotelectasis, proliferation and hyaline degeneration of endoneurium capillary. In the BSS group, impaired blood-nerve barrier was indicated by sub-perineurial edema (46.2%, 11/26) and endoneurial edema (15.4%, 4/26). The Renaut body (15.4%, 4/26) and amyloid deposition (3.8%, 1/26) found in the BSS group were absent in the non-BSS group.@*CONCLUSIONS@#BBS was common in non-diabetic peripheral neuropathies. The nerves exhibited ischemic alteration of primary axon degeneration and secondary demyelination. The interstitial tissue revealed microcirculation impairment, blood-nerve barrier disturbance, amyloid deposition and proliferation changes. The high prevalence of qi deficiency also highlights the therapy of promotion of blood circulation and removal of blood stasis.

Distribution laws of Chinese medical syndrome types and analyses of risk factors in senile hypertension patients: a clinical study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the distribution laws of TCM syndrome types and to analyze the distribution of dynamic blood pressure curve, atherosclerosis, and age in senile hypertension patients.</p><p><b>METHODS</b>Totally 1 131 senile hypertension patients were recruited from 7 provinces and municipal cities. Features of TCM syndromes, classification and distribution curves, and syndrome distribution laws were observed. The distribution curves of dynamic blood pressure, carotid atherosclerosis, and age were compared in each TCM syndrome types.</p><p><b>RESULTS</b>There were four main syndrome types in 736 cases (56.15%), i.e., excessive accumulation of phlegm-dampness syndrome (210 cases, 16.02%), yin deficiency and hyperactivity of yang syndrome (177 cases, 13.50%), Gan-Shen yin deficiency syndrome (79 cases, 6.03%), and deficiency of qi and yin syndrome (252 cases, 19.22%). Besides, there were two more sub-types, i.e., collateral obstruction by blood stasis syndrome and collateral obstruction by phlegm and stasis. Circadian blood pressure monitor was completed in 211 cases. Of them, abnormal circadian blood pressure occurred in 152 cases (accounting for 72. 38%); yin deficiency and hyperactivity of yang syndrome, excessive accumulation of phlegm-dampness syndrome, deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome were most often seen. Color ultrasound of carotid artery was performed in 660 patients of main syndromes. The incidence was quite higher in those of excessive accumulation of phlegm-dampness syndrome (182 cases, 27. 58%), deficiency of qi and yin syndrome plus collateral obstruction by blood stasis syndrome or collateral obstruction by phlegm and stasis (322 cases, 48.79%). Yin deficiency and hyperactivity of yang syndrome was dominant in patients 60 -79 years old, while deficiency of qi and yin syndrome and Gan-Shen yin deficiency syndrome were dominant in patients older than 80 years.</p><p><b>CONCLUSIONS</b>Excessive accumulation of phlegm-dampness syndrome, yin deficiency and hyperactivity of yang syndrome, Gan-Shen yin deficiency syndrome, and deficiency of qi and yin syndrome were main syndrome types in senile hypertension patients. There was statistical difference in the distribution curves of blood pressure, atherosclerosis, and age of various TCM syndrome types.</p>

The preventive effect of garlicin on a porcine model of myocardial infarction reperfusion no-reflow / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate whether garlicin can prevent reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction (AMI).</p><p><b>METHODS</b>Twenty-two male Chinese mini swines were randomized into 3 groups: sham-operation group (n=6), control group (n=8), and garlicin group (n=8). The distal part of left anterior descending coronary artery (LAD) in swines of the latter two groups was completely occluded by dilated balloon for 2 h and a successful AMI model was confirmed by coronary angiography (CAG) and electrocardiograph (ECG), which was then reperfused for 3 h. In the sham-operation group, balloon was placed in LAD without dilatation. Garlicin at a dosage of 1.88 mg/kg was injected 10 min before LAD occlusion until reperfusion for 1 h in the garlicin group. To assess serial cardiac function, hemodynamic data were examined by catheter method before AMI, 2 h after occlusion and 1, 2, and 3 h after reperfusion. Myocardial contrast echocardiography (MCE) and double staining with Evans blue and thioflavin-S were performed to evaluate myocardial no-reflow area (NRA) and risk area (RA).</p><p><b>RESULTS</b>Left ventricular systolic pressure and left ventricular end-diastolic pressure significantly improved in the garlicin group after reperfusion compared with the control group P<0.05) and 2 h after AMI (P<0.05). MCE showed garlicin decreased reperfusion NRA after AMI compared with the control group (P <0.05). In double staining, NRA/RA in the garlicin group was 18.78%, significantly lower than that of the control group (49.84%, P<0.01).</p><p><b>CONCLUSIONS</b>Garlicin has a preventive effect on the porcine model of myocardial infarction reperfusion no-reflow by improving hemodynamics and decreasing NRA.</p>

Combined use of non-biological artificial liver treatments for patients with acute liver failure complicated by multiple organ dysfunction syndrome / 世界急诊医学杂志（英文）

BACKGROUND: Acute liver failure (ALF) caused by viral and non-viral hepatitis is often accompanied with severe metabolic disorders, the accumulation of toxic substances and continuous release and accumulation of a large number of endogenous toxins and inflammatory mediators. The present study aimed to investigate the effects of various combined non-biological artificial liver treatments for patients with acute liver failure (ALF) complicated by multiple organ dysfunction syndrome (MODS). METHODS: Thirty-one patients with mid- or late-stage liver failure complicated by MODS (score 4) were randomly divided into three treatment groups: plasmapheresis (PE) combined with hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF), PE+CVVHDF, and HP+CVVHDF, respectively. Heart rate (HR) before and after treatment, mean arterial pressure (MAP), respiratory index (PaO2/FiO2), hepatic function, platelet count, and blood coagulation were determined. RESULTS: Signifi cant improvement was observed in HR, MAP, PaO2/FiO2, total bilirubin (TBIL) and alanine aminotransferase (ALT) levels after treatment (P<0.05). TBIL and ALT decreased more signifi cantly after treatment in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.01). Prothrombin time (PT) and albumin were signifi cantly improved only in the PE+CVVHDF and PE+HP+CVVHDF groups (P<0.05). TBIL decreased more significantly in the PE+HP+CVVHDF group than in the HP+CVVHDF and PE+CVVHDF groups (P<0.05). The survival rate of the patients was 58.1％ (18/31), viral survival rate 36.4％ (4/11), and non-viral survival rate 70％ (14/20). CONCLUSION: Liver function was relatively improved after treatment, but PE+HP+CVVHDF was more efficient for the removal of toxic metabolites, especially bilirubin. The survival rate was significantly higher in the patients with non-viral liver failure than in those with viral liver failure.

Garlicin ameliorated pressure overload induced myocardial fibrosis in rats through partial inhibiting TGF-beta1 mediated Smads signal / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe whether garlicin could ameliorate pressure overload induced myocardial fibrosis in rats through partial inhibiting transforming growth factor beta1 (TGF-beta1) mediated Smads signal.</p><p><b>METHODS</b>Forty male SD rats were randomly divided into 4 groups, i. e., the sham-operation group, the model group, the garlicin group, and the Tetramethylpyrazine (TMP) group, 10 in each group. The pressure overload induced myocardial fibrosis rat model was prepared using coarctation of aorta. Three days after modeling 5.0 mg/kg garlicin injection was administered to rats in the garlicin group, 20 mg/kg TMP injection to rats in the TMP group by peritoneal injection, while normal saline was peritoneally injected to rats in the sham-operation group and the model group. Four weeks after medication, the changes of myocardial collagen were observed by picrosirius red staining. The myocardial collagen volume fraction (CVF) and perivascular collagen areas (PVCA) were calculated. The serum transforming growth factor beta1 (TGF-beta1) expression was detected using ELISA. The TGF-beta1 protein expression in the myocardial tissue was observed using immunohistochemical assay. The changes of myocardial Smad2 and Smad7 mRNA expressions were detected using Real-time RT-PCR. The effects of garlicin on TGF-beta1 mediated Smad Signaling through luciferase assay were further verified using Mv1 Lu-(CAGA) 12-Luc cell line response to TGF-beta1.</p><p><b>RESULTS</b>Compared with the sham-operation group, the myocardial levels of CVF and PVCA, the serum TGF-beta1 level, and the TGF-beta1 protein expression in the myocardial tissue obviously increased in the model group (P < 0.05, P < 0.01). Compared with the model group, the PVCA level, the serum TGF-beta1 level, and the TGF-beta1 protein expression in the myocardial tissue of the garlicin group and the TMP group obviously decreased (P < 0.05, P 0O 01). The Smad2 mRNA expression was up-regulated while Smad7 mRNA expression down-regulated in the model group. The Smad2 mRNA expression was obviously down-regulated in the garlicin group and the TMP group (P < 0.05). The Smad7 mRNA expression was obviously up-regulated in the TMP group (P > 0.05). One to 2 microg/mL garlicin could obviously inhibit the luciferase activities of corresponding TGF-beta1, under the stimulation of 2 ng/mL TGF-beta1 (P < 0.05).</p><p><b>CONCLUSION</b>Garlicin ameliorated pressure overload induced myocardial fibrosis in rats through partial inhibiting TGF-beta-Smads signal pathway.</p>

Key points in treating hypertension by integrative medicine / 中国中西医结合杂志

In China there exist "three high", "three low" and "three no" phenomena in hypertension, so the task of prevention and treatment of hypertension is urgent and difficult. Practices show that treatment by integrative medicine is the best way to prevent and treat hypertension. In clinics several key points should be noticed: holding the difference of therapy philosophy between Chinese medicine and Western medicine, objectively evaluating the curative efficacy of Chinese medicine and Western medicine, insisting on compatible application of Chinese herbs and Western drugs, stressing the combination of disease identification and syndrome typing, preventing and treating target organs' damage in a scientific way, and paying attention to non-drug treatment of hypertension.

Exploration of TCM syndrome differentiation of coronary heart disease and coronary arteriography / 中国中西医结合杂志

Coronary arteriography (CAG) examination is the widely accepted gold standard for diagnosis of coronary heart disease (CHD) nowadays. In order to explore the situation and value of CAG applied in TCM syndrome differentiation of CHD, and to facilitate the research on disease-syndrome diagnosis of CHD in integrated traditional Chinese and Western medicine (ICWM), the relationship between coronary arterial pathological changes and the TCM syndrome types was probed through reviewing literatures concerning the application of CAG in studying syndrome differentiation of CHD since 2000. The results showed that syndrome types are correlated to the severity and number affected of coronary artery branches. Along with the aggravation of CHD, TCM syndrome typing become even more complicated. There is a gap between the previous detectable index for CHD as well as the TCM syndrome typing and clinical practice. CAG is of vital importance in exploring rules of integrated syndrome differentiation and disease diagnosis of CHD. Therefore, to launch a nationwide multi-centric study on large sample of syndrome differentiation with ICWM is necessary, which should be based on the evidence-based medicine and by dint of the modern medical detecting technique to conduct the study comprehensively in combining differentiation of syndrome and disease, and in both macroscopic and microscopic views.

Effects of garlicin on NIH3T3 cell proliferation and collagen synthesis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effects of garlicin on fibroblasts proliferation and type I collagen synthesis and explore its anti-fibrosis mechanism.</p><p><b>METHODS</b>Garlicin was added into the culture fluid of NIH3T3 cell, taking Radix Salviae miltiorrhizae as the control medicine. The spiking of H3-thymidine DNA was detected, also the hydroxyproline (HOP) concentration in the culture fluid by alkali digestion method and the protein expression of type I collagen in NIH3T3 cells by immunofluorescent staining.</p><p><b>RESULTS</b>The NIH3T3 cell growth and proliferation rate were obviously reduced after garlicin treatment concentration-dependently in range of 0.2 - 5 microg/mL; HOP level and protein expression of type I collagen also lowered.</p><p><b>CONCLUSION</b>Garlicin could inhibit NIH3T3 cell proliferation, reduce the synthesis and protein expression of type I collagen so as to exert the anti-fibrosis effect.</p>

Study on the therapeutic status of 1242 hospitalized acute myocardial infarction patients in Beijing / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate and analyze the therapeutic level and the existing problems on acute myocardial infarction (AMI) management in Beijing.</p><p><b>METHODS</b>We collected clinic data of 1242 AMI patients from 12 hospitals in Beijing, from January 2000 to March 2001, using a uniformed questionnaire, and evaluated the status of the diagnosis and treatment of AMI according to the Chinese guidelines issued on Decmeber 2001. Corresponding factors which influencing the mortality were also analyzed by one-way factor and multiple factors analysis methodologies.</p><p><b>RESULTS</b>The mean age of the 1242 AMI patients was 63.0 years old and about one third of them were under 55 years old. In hospitals, the total mortality was 9.10%. 37.9% of the patients had received therapy of the intravenous thrombolysis and emergency PCI with a total rate of reperfusion therapy as 56.0%. The in-hospital rates of drug use were as follows: Nitrates 90.0%, Aspirin 87.8%, heparin 88.7%, beta-blockers 73.4%, angiotensin converting enzyme inhibitors(ACEI) 77.6%, lipid regulating agents 43.6%. The rate of intravenous therapy of TCM by promoting the blood circulation and supplementing the vital energy was 30.5%. Results from multiple factors analysis showed that the compositive factors which could lower the mortality were reperfusion therapy,lipid regulating agents, intravenous therapy of TCM, beta-blockers, ACEI, lower molecule heparin and digitalis.</p><p><b>CONCLUSION</b>Data from this study showed that there still existed a gap between clinical management on AMI and the guideline in Beijing. To set up a straightway passage of reperfusion therapy, to become more standardized to follow the guideline in undertaking the medical treatment practice, and to go deep into discuss the status of TCM on AMI management seemed the important tasks we are facing.</p>

Clinical study on effect of Garlicin in stabilizing the carotid artery atherosclerotic plaque in patients with primary hypertension and coronary artery disease / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of garlicin in treating carotid artery atherosclerotic plaque (CAAP) in patients with primary hypertension and coronary heart disease (PHT-CHD).</p><p><b>METHODS</b>Seventy-nine patients with PHT-CHD were randomly divided into the treated group (39 patients) treated with garlicin and fosinopril and the control group (40 patients) treated with fosinopril alone. The change of CAAP was evaluated by high frequency ultrasonic examination every six months, and the changes of intercellular adhesion molecule-1 (ICAM-1) and high sensitive C-reactive protein (hs-CRP) were measured by ELISA, with the observation proceeding for 52 weeks totally.</p><p><b>RESULTS</b>By the end of the experiment, the number of complex plaques, Crouse integrals, intima-media thickness, serum ICAM-1 and hs-CRP were significantly lower in the treated group than those in the control group with significant difference (P < 0.05).</p><p><b>CONCLUSION</b>Garlicin could stabilize CAAP to a certain extent and shows a definite vascular protective effect in patients with PHT-CHD.</p>

Progress in integrative Chinese and Western medicine study on prevention and treatment of myocardial fibrosis / 中国中西医结合杂志

Myocardial fibrosis is an inevitable process of many heart diseases, such as coronary heart disease, myocardial infarction, hypertension, cardiomyopathy, etc. in development from earlier period to terminal stage. To prevent or reverse the process of fibrosis is one of the most important approaches to retard the occurrence of heart failure and reduce the accidence of arrhythmia. In traditional Chinese medicine myocardial fibrosis belongs to the category of "Xinbi". Studies on the occurrence and regulation of myocardial fibrosis, and its treatment by using integrative Chinese and Western medicine or by Chinese drugs singly and their components were reviewed in this paper.

Gaseous signaling molecule and study on activating blood circulation and removing stasis / 中国中西医结合杂志

The finding of gaseous signaling molecule NO, CO and H2S, and the advocacy of "gas biology" concept have provided a novel thinking for the study of Huoxue Huayu (HXHY, a traditional Chinese medicine method of promoting blood circulation to remove blood stasis). The concept "Qi" in TCM and gaseous signaling molecule are correlated in respects of their source and mesomeric function. Study of HXHY could only be deepened through an overall cognition on blood stasis syndrome with the view of Qi-blood correlation.

Effect of garlicin on adhesion molecules expression and deformability of peripheral neutrophils in patients with acute cerebral infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of garlicin on adhension molecules CD11a and deformability of peripheral neutrophil in patients with acute cerebral infarction (ACI).</p><p><b>METHODS</b>Neutrophils were separated from peripheral blood of healthy subjects and ACI patients, and incubated in 37 degrees C in vitro. The CD11a expression was detected by antibody fluorescence labeling method and the time of neutrophils passing millipore membrane were measured for calculation of the filter index.</p><p><b>RESULTS</b>CD11a expression rate in healthy subjects was 34.64 +/- 25.34%, while in patients was 55.35 +/- 30.54%, difference between them was significant (P < 0.05). After garlicin treatment, it lowered to 49.16 +/- 31.68%, as compared with untreated group, P < 0.05. The neutrophil filter index in healthy group, untreated group, garlicin treated group and Nimodipine treated group was 0.87 +/- 0.46, 6.42 +/- 6.40, 3.47 +/- 3.67 and 5.03 +/- 3.72 respectively, comparison between that in the garlicin treated group and in untreated group showed significant difference (P < 0.05).</p><p><b>CONCLUSION</b>Garlicin could effectively inhibit the CD11a expression in peripheral blood neutrophils and improve the deformability of the neutrophils in ACI patients.</p>

Experimental study on effect of jiangya maijing liquid on spontaneous hypertension rats fed with high lipid diet / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe and identify the effect of Jiangya Maijing Liquid (JYMJL) on spontaneous hypertension rats (SHR) fed with high lipid diet in antagonizing hypertension and hyperlipidemia and improving pathological changes of kidney.</p><p><b>METHODS</b>Forty-two SHR were divided into 5 groups, except Group A, the Groups B-E were fed with high lipid diet, and Group C, D and E was treated with JYMJL, western drug and Niuhuang Jiangya pill respectively. Besides, Group F was set up for control with normal rats fed by normal diet. The changes of blood pressure (BP), biological indices and renal pathology were observed in the 14 weeks' period of observation.</p><p><b>RESULTS</b>(1) BP raised significantly in Group A and B, it became stable in Group C from the 5th week on and was lower than the BP in other groups (P < 0.01). BP in Group F was not changed; (2) The highest level of nitric oxide (NO) was shown in Group F, and that in Group B and E was lower than that in Group C and D; (3) Level of cholesterol was lower in Group A and F than that in Group C, D and E (P < 0.01), and that in Group C was lower than that in Group B and E (P < 0.01 and P < 0.05 respectively); (4) Pathologic examination on kidney showed that no change was found in Group F, the most severe change was shown in Group B among Group B-E, and the improvement after treatment in Group C was better than that in group B (P < 0.01).</p><p><b>CONCLUSION</b>(1) Condition of disease in rats with hypertension complicated with hyperlipidemia was more severe than that with simple hypertension; (2) JYMJL could restrain the developing of hypertension in SHR, the mechanism may be related with the raising of NO; (3) JYMJL has effect of lowering blood lipid; (4) JYMJL has kidney protective effect, it could alleviate the pathological changes in kidney by way of lowering BP and blood lipid.</p>