Syndrome Differentiation and Treatment of Obesity from "Orchids to Eliminate Stagnant Qi" / 中国实验方剂学杂志

Obesity is a chronic， recurrent， and progressive metabolic disorder characterized by the abnormal or excessive accumulation of body fat caused by multiple factors such as genetics， dietary structure， lifestyle and behavior， psychology， environment， and society， leading to an energy surplus. Obesity is a major risk factor that increases the risk of developing various chronic diseases， including type 2 diabetes， hypertension， cardiovascular diseases， stroke， and certain malignancies. The global incidence of obesity is increasing year by year. With the continuous improvement of people's living standards， more than half of adults in China are now overweight or obese， posing a serious threat to people's health and increasing the social and economic burden. It has become a pressing major public health issue that needs to be addressed urgently. The concept of obesity can be traced back to the Huangdi’s Internal Classic （Huang Di Nei Jing）， which describes it as "the problems in fat and affluent people are caused by excessive taking of rich food"， and suggests that ''frequent intake of rich and greasy foods can produce interior heat. Sweet flavor causes chest fullness. That is why its spleen-Qi flows upwards and changes into consumption-thirst disease. It can be treated by Eupatorii Herba which is used to remove stagnant Qi''. The stagnant qi is caused by the transformation failure of rich and greasy food and wine， so obesity is the disease of stagnant qi. Obesity is caused by indulging in rich and greasy food， wine， spicy and flavorful foods， raw and cold foods， and sweet and greasy foods， or overeating and leading a sedentary lifestyle， staying up late， or experiencing emotional imbalances such as excessive joy， anger， worry， pensiveness， and fear. It can also be caused by congenital abnormalities， leading to improper functioning of the spleen and stomach， dysregulation of the absorption and secretion of the small intestine， and the accumulation of stagnant Qi in the organs and muscles， resulting in a plump physique. The intake of food and drink depends on the functions of the stomach in receiving and decomposing， the small intestine in absorbing and secreting， and the spleen in transforming and transporting. The affected organs in obesity are the spleen， stomach， and small intestine. Orchids， specifically Eupatorii Herba and Lycopi Herba， are aromatic herbs that can regulate the smooth flow of Qi， eliminate stagnation， and cleanse impurities. In a broader sense， any aromatic and pungent substance that can invigorate the spleen， promote clarity， harmonize the stomach， reduce turbidity， and assist in the normal secretion and absorption functions of the small intestine， thereby eliminating excess， is referred to as orchid. Therefore， the treatment principle for obesity is to use ''orchids to eliminate stagnant Qi''， aiming to regulate the functions of the spleen， stomach， and small intestine using aromatic and pungent substances， gradually eliminating excessive dampness， phlegm， turbidity， and heat， and restore the balance of the middle energizer. This way， individuals who are obese can achieve a non-obese state.

A baseline survey on the establishment of myopia follow up cohort among students in Peixian, Xuzhou City / 中国学校卫生

Objective@#This study aimed to find out the myopia rate and related ocular biological parameters of grade 1-3 students in Peixian, Xuzhou City, and to establish a cohort observation population, so as to provide baseline reference for control strategies for myopia and reduce the myopia rate.@*Methods@#A total of 1 952 students from two nine year schools in Peixian were selected by stratified cluster sampling in June 2020. Visual examination was administered by trained personnel using uniformly equipped instruments, including uncorrected visual acuity, diopter, intraocular pressure, axial length.@*Results@#The overall myopia rate of students from grade one to grade three in two schools in Peixian was 21.77%, and the myopia rate of girls (23.81%) was significantly higher than that of boys (20.16%). With the growth of age and grade, the myopia rate increased continuously, and the difference was statistically significant ( χ 2=134.10, 144.30, P <0.05). The myopia rate of 6-year-old group was 8.87 %. The axial length of the left and right eyes of the myopic group was significantly higher than that of the non myopic group ( t = 411.95, 366.85, P <0.01), the intraocular pressure and mean corneal curvature of the left eye of the myopic group were higher than those of the nonmyopic group ( t =5.91, 10.22 , P <0.05).@*Conclusion@#The baseline survey results show that the myopia rate of grade 1-3 in Peixian of Xuzhou City is low, but myopia has occurred in the 6-year-old group. With the growth of age and grade, the myopia rate continues to rise. So it is urgent to explore effective and feasible myopia prevention and control measures.

Effect of transcutaneous electrical acupoint stimulation on labor analgesia / 中国针灸

OBJECTIVE@#To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on labor pain.@*METHODS@#A total of 151 primiparas who were vaginal delivery were randomized into a TEAS group (76 cases) and a peridural group (75 cases). In the peridural group, peridural blockage was applied to analgesia. In the TEAS group, TEAS was applied at Hegu (LI 4)，Neiguan (PC 6), Jiaji T~L (EX-B 2) and Ciliao (BL 32), disperse-dense wave (2 Hz/100 Hz), 15-50 mA in current intensity. The analgesic time was from 3 cm to completely opening of cervix. The visual analogue scale (VAS) scores were observed before analgesia, after 30, 60, 120 min of analgesia in the two groups. The time of different stages of labor, usage rate of oxytocin, incidence rate of adverse reaction and amount of postpartum hemorrhage were recorded. The newborn's 1 and 5 min Apgar scores were evaluated.@*RESULTS@#The VAS scores showed a downward trend in the two groups after analgesia (0.05). The usage rate of oxytocin and incidence rate of adverse reaction in the TEAS group were 9.2% (7/76) and 2.6% (2/76), which were lower than 34.7% (26/75) and 18.7% (14/75) in the peridural group (0.05).@*CONCLUSION@#The analgesic effect of TEAS is inferior to peridural blockage, but TEAS could relieve labor pain to the tolerance, shorten the time of active phase on the first stage and second stage of labor and reduce the use of oxytocin, has mild adverse reaction.

Profiling and identification of chemical components of Shenshao Tablet and its absorbed components in rats by comprehensive HPLC/DAD/ESI-MS analysis / 中国天然药物

Shenshao Tablet (SST), prepared from Paeoniae Radix Alba (PRA) and total ginsenoside of Ginseng Stems and Leaves (GSL), is a traditional Chinese medicine (TCM) preparation prescribed to treat coronary heart disease. However, its chemical composition and the components that can migrate into blood potentially exerting the therapeutic effects have rarely been elucidated. We developed an HPLC/DAD/ESI-MS approach aiming to comprehensively profile and identify both the chemical components of SST and its absorbed ingredients (and metabolites) in rat plasma and urine. Chromatographic separation was performed on an Agilent Eclipse XDB C column using acetonitrile/0.1% formic acid as the mobile phase. MS detection was conducted in both negative and positive ESI modes to yield more structure information. Comparison with reference compounds (t, MS), interpretation of the fragmentation pathways, and searching of in-house database, were utilized for more reliable structure elucidation. A total of 82 components, including 21 monoterpene glycosides, four galloyl glucoses, two phenols from PRA, and 55 ginsenosides from GSL, were identified or tentatively characterized from the 70% ethanolic extract of SST. Amongst them, seven and 24 prototype compounds could be detectable in the plasma and urine samples, respectively, after oral administration of an SST extract (4 g·kg) in rats. No metabolites were observed in the rat samples. The findings of this work first unveiled the chemical complexity of SST and its absorbed components, which would be beneficial to understanding the therapeutic basis and quality control of SST.

Profiling and identification of chemical components of Shenshao Tablet and its absorbed components in rats by comprehensive HPLC/DAD/ESI-MS analysis / 中国天然药物

Shenshao Tablet (SST), prepared from Paeoniae Radix Alba (PRA) and total ginsenoside of Ginseng Stems and Leaves (GSL), is a traditional Chinese medicine (TCM) preparation prescribed to treat coronary heart disease. However, its chemical composition and the components that can migrate into blood potentially exerting the therapeutic effects have rarely been elucidated. We developed an HPLC/DAD/ESI-MS approach aiming to comprehensively profile and identify both the chemical components of SST and its absorbed ingredients (and metabolites) in rat plasma and urine. Chromatographic separation was performed on an Agilent Eclipse XDB C column using acetonitrile/0.1% formic acid as the mobile phase. MS detection was conducted in both negative and positive ESI modes to yield more structure information. Comparison with reference compounds (t, MS), interpretation of the fragmentation pathways, and searching of in-house database, were utilized for more reliable structure elucidation. A total of 82 components, including 21 monoterpene glycosides, four galloyl glucoses, two phenols from PRA, and 55 ginsenosides from GSL, were identified or tentatively characterized from the 70% ethanolic extract of SST. Amongst them, seven and 24 prototype compounds could be detectable in the plasma and urine samples, respectively, after oral administration of an SST extract (4 g·kg) in rats. No metabolites were observed in the rat samples. The findings of this work first unveiled the chemical complexity of SST and its absorbed components, which would be beneficial to understanding the therapeutic basis and quality control of SST.

Clinical efficacy and safety of intra-arterial chemotherapy for the treatment of young infants with retinoblastoma / 眼科新进展

Objective To assess the safety and efficacy of intra-arterial chemotherapy (IAC) for the treatment of young infants (≤ 6 months) with retinoblastoma (RB).Methods Together 21 (24 eyes) young infants (≤6 months) with RB who received IAC were included from January 2013 to February 2017 in this study and the clinical data were retrospectively analyzed.According to the international stages for intraocular retinoblastoma,stage B appeared in 4 eyes,stage D in 13 eyes,and stage E in 7 eyes.And there were two kinds of administration for chemotherapy,including perfusion chemotherapy of melphalan (≤ 0.5 mg · kg-1) combined carboplatin (20 mg) on the first and third IAC procedures,and melphalan (≤ 0.5 mg · kg-1) combined with topotecan (0.5-1.0 mg) on the second and fourth IAC procedures,and the dose of melphalan was appropriately adjusted according to the tumor changes and the response of the child after the previous IAC.Then main outcome measures include successful rate for procedures,ocular preservation rate,local and systemic complications and the time and dose of radiation exposure during IAC were evaluated.Results Of the 70 IAC procedures performed on 24 eyes,69 procedures (98.6％) were successful,and 1 was failed due to ophthalmic spasm.IAC ranged from 2 to 4 cycles with mean 3.3 cycles.After IAC procedures,17 eyes presented fish-like changes or calcification or scar formation,and the overall ocular preservation rate was 70.8％,and the other 7 eyes (29.2％) underwent enucleation of the eyeballs due to fundus hemorrhage in 3 eyes and extensive vitreous implantation in 4 eyes.Postoperative adverse reactions included eyelid oedema in 8 patients,fundus hemorrhage in 3 eyes,ocular arteriospasm in 1 patients and bone marrow suppression in 9 patients.The mean irradiation time was 3.2-32.4 (6.3 ± 1.2) min for one IAC procedure and the mean irradiation dose was 5-153 (51.9 ±9.2)mGy.The cumulative irradiation time was 6.6-53.1 (19.2 ±0.9)min for each patient of IAC cycles and the cumulative irradiation dose was 41-281 (157.3 ± 13.1) mGy.Conclusion IAC is safe and effective for the treatment of young infants (≤≤ 6 months) with RB,and the irradiation dose in IAC is lower than the threshold dose that can cruise lens tissue reactions.

Clinical research on eye complications of acute chlorine poisoning / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM:To observe the eye complications in the cases of acute chlorine gas poisoning. ?METHODS:A retrospective review of 121 cases of acute chlorine gas poising with eye irritation, dry eye and other eye complications in Linyi People’s Hospital from February 2009 to February 2013 was performed. ?RESULTS: Among 121 patients, 117 cases ( about 96. 7%) had complications of eye irritation and conjunctival and corneal epithelial damage, and the ocular surface damage was aggravated with the increasing level of chlorine gas poisoning. After 3, 6mo being discharged, 32 and 7 patients respectively occurred dry eye among 115 patients followed up. One mild chlorine poisoning patient, during the hormonotherapy of pulmonary complication, complicated with bullous retinal detachment, of which symptoms and physical signs had been improved after stopping hormonotherapy and adding drugs facilitating fluid absorption. One severe chlorine poisoning patient with loss of consciousness during the treatment, had corneal ulcer and after ulcer being healed with drug and conjunctival flap covering surgery, was left permanent leukoma cornea. ?CONCLUSlON: Acute chlorine poisoning can cause corneal and conjunctival epithelial damage and dry eye. Ocular complications like bullous retinal detachment associated with hormone application should be paid more attention to in the hormonotherapy. For some patients with severe poisoning, the therapy of corneal and conjunctival epitheliums should be taken seriously in case of irreparable damage in rescuing patient’s life.

Diagnosis and treatment of 3 cases with cystic lymphangiomas of adrenal gland / 中华内分泌代谢杂志

Objective To investigate the clinical features, diagnosis, differential diagnosis, treatment, and prognosis of adrenal lymphangioma. Methods Three cases of adrenal lymphangioma were reported, and the clinical features, treatment and prognosis were analyzed. Results Three cases were incidentally discovered, laboratory tests and endocrine hormone examinations were normal, CT or MRI showed lesions with low density, no reinforced or mild enhancement. All 3 cases underwent laparoscopic adrenalectomy, postoperative pathology supported the diagnosis of adrenal lymphangioma. They were followed up for 8-months, 1-year, and 4-years respectively, with no recurrence. Conclusions Adrenal lymphangioma is a rare benign adrenal leison, with no typical clinical manifestations. Preoperative diagnosis depends on imaging examinations. Histopathological examination is essential in making final diagnosis. Surgery is the preferred treatment option. The prognosis is relatively good.

Case-control study on transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after distal radius fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of open reduction by palm side for the distal radius fracture and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection for the prevention of delayed carpal tunnel syndrome after operation.</p><p><b>METHODS</b>From March 2000 to March 2007, 32 patients (8 males and 24 females, ranging in age from 46 to 66 years) with distal radius fracture were treated with open reduction by palm side and T shape plate internal fixation with simultaneous anterior transverse carpal ligament resection; while 30 patients (7 males and 23 females,ranging in age from 45 to 65 years) only with open reduction by palm side and T shape plate internal fixation. The incidences of delayed carpal tunnel syndrome between the two groups were compared.</p><p><b>RESULTS</b>Among 32 patients treated with open reduction by palm side and T shape plate internal fixation with anterior transverse carpal ligament resection, 3 patients had delayed carpal tunnel syndrome; while in 30 patients treated with open reduction by palm side and T shape plate internal fixation, 10 patients had delayed carpal tunnel syndrome. There was significant statistically difference (P < 0.05%).</p><p><b>CONCLUSION</b>Simultaneous anterior transverse carpal ligament resection can effectively prevent the delayed carpal tunnel syndrome occurrence for the distal radius fracture with open reduction by palm side.</p>

Clinical study of heparin-induced thrombocytopenia / 中华血液学杂志

<p><b>OBJECTIVE</b>To observe the incidence of heparin-induced thrombocytopenia (HIT) in patients received unfractionated heparin (UFH) treatment, and explore the feasibility of monitoring HIT by platelet counts, as well as the significance of HIT-antibody test in HIT diagnosis.</p><p><b>METHODS</b>145 patients received UFH treatment in Vascular Surgery Department were studied. Before and after the UFH treatment, platelet counts, HIT-antibody ELISA test and heparin-induced platelet aggregation (HIPA) were tested.</p><p><b>RESULTS</b>Among the 145 patients, thrombocytopenia occurred in 40 (27.6%) cases, HIT-antibody ELISA test positive in 59 (40.7%) cases, HIPA test positive in 26 (17.9%) cases. The HIT was diagnosed in 24 (16.5%) cases, and heparin-induced thrombocytopenia and thrombosis (HITTS) occurred in 5 (3.4% in all cases, and 20.8% in HIT patients). In HIT patients, 15 patients (62.5%) were thrombocytopenia, HIT-antibody positive and HIPA test positive. Platelet counts in all of the 24 patients recovered to normal or level before UFH treatment in 3-6 days after heparin withdrawal therapy.</p><p><b>CONCLUSION</b>HIT can be early diagnosed by monitoring platelet counts, HIT-antibody ELISA test and HIPA test. Withdrawal of heparin therapy in time and use of alternative anticoagulant, HITTS rate might be expected to decline further.</p>

Inhibitory effect of dexamethasone on TGF-beta1 expression of rabbit ciliary pigment epithelia cultured in vitro / 华中科技大学学报（医学）（英德文版）

In order to elucidate the effect of dexamethasone on the expression of transforming growth factor-beta1 (TGF-beta1) in ciliary pigment epithelial (CPE) cells cultured in vitro, rabbit CPE cells were cultured in vitro, treated with DMEM medium containing 0, 1 x 10(-8), 5 x 10(-8), 10 x 10(-8) and 50 x 10(-8) mol/L dexamethasone respectively for 5 days. The TGF-beta1 expression was detected by immunohistochemistry Supervision methods and analyzed semi-quantitatively by HMIAS-2000 image system. As opposed to in vivo, rabbit CPE cells expressed TGF-beta1 under cultured circumstance in vitro. The gray scales of the positive yellow staining in the groups of 1 x 10(-8), 5 x 10(-8), 10 x 10(-8) and 50 x 10(-8) mol/L dexamethasone were 136.57 +/- 4.43, 140.20 +/- 6.10, 142.98 +/- 2.99, 146.80 +/- 1.68 and 150.05 +/- 1.94 respectively. When the concentrations of dexamethasone were equal to or higher than 5 x 10(-8) mol/L and, the expression of TGF-beta1 was inhibited. 10(-7) mol/L dexamethasone showed a significant inhibition. It was suggested that CPE cells possess the potential ability of synthesizing and expressing TGF-beta1. The inhibition of TGF-beta1 expression by dexamethasone may be beneficial to the treatment of proliferative vitroretinopathy, also exert some influence on the secretion of aqueous humor and ciliary inflammation.

Inhibitory Effect of Dexamethasone on TGF-β1 Expression of Rabbit Ciliary Pigment Epithelia Cultured in Vitro / 华中科技大学学报（医学）（英德文版）

In order to elucidate the effect of dexamethasone on the expression of transforming growth factor-beta1 (TGF-β1) in ciliary pigment epithelial (CPE) cells cultured in vitro, rabbit CPE cells were cultured in vitro, treated with DMEM medium containing 0,1×10-8 , 5×10-8 , 10 × 10-8 and 50×10-8 mol/L dexamethasone respectively for 5 days. The TGF-β1 expression was detected by immunohistochemistry Supervision methods and analyzed semi-quantitatively by HMIAS-2000 image system. As opposed to in vivo, rabbit CPE cells expressed TGF-β1 under cultured circumstance in vitro. The gray scales of the positive yellow staining in the groups of 1×10-8, 5×10-8, 10×10-8 and 50× 10-8 mol/L dexamethasone were 136. 57±4.43, 140. 20±6.10, 142.98±2. 99, 146. 80± 1.68 and 150. 05± 1.94 respectively. When the concentrations of dexamethasone were equal to or higher than 5×10-8 mol/L and, the expression of TGF-β1 was inhibited. 10-7 mol/L dexamethasone showed a significant inhibition. It was suggested that CPE cells possess the potential ability of synthesizing and expressing TGF-β1. The inhibition of TGF-β1 expression by dexamethasone may be beneficial to the treatment of proliferative vitroretinopathy, also exert some influence on the secretion of aqueous humor and ciliary inflammation.

Regulatory effect of dexamethasone on aquaporin-1 expression in cultured bovine trabecular meshwork cells / 华中科技大学学报（医学）（英德文版）

To evaluate the effect of dexamethasone on the expression of aquaporin-1 (AQP-1) in cultured bovine trabecular meshwork cells, bovine trabecular meshwork cells were cultured in vitro and reproduced to the third and the fourth generation, then treated with dexamethasone at the concentrations of 5, 25, 50, 250 microg/L respectively for 7 days. Immunohistochemical technique-supervision method was employed to measure, and image analysis system to analyze the expression of AQP-1 in normal cultured bovine trabecular meshwork cells and those treated with dexamethasone. In normal bovine trabecular meshwork cells, the grayscale of AQP-1 positive staining was 167.94 +/- 1.18, while it was 168.92 +/- 0.91, 176.72 +/- 1.80, 180.64 +/- 1.31, 185.64 +/- 1.58 in cells treated with 5, 25, 50, 250 microg/L concentrations of dexamethasone. When the concentration of dexamethasone was higher than 25 microg/L, the expression of AQP-1 was significantly inhibited (P < 0.05). The regulation of AQP-1 expression by dexamethasone in cultured bovine trabecular meshwork cells in vitro may be one of causes that retard the aqueous outflow in glucocorticoid- induced glaucoma.

Regulatory Effect of Dexamethasone on Aquaporin-1 Expression in Cultured Bovine Trabecular Meshwork Cells / 华中科技大学学报（医学）（英德文版）

To evaluate the effect of dexamethasone on the expression of aquaporin-1 (AQP-1) in cultured bovine trabecular meshwork cells, bovine trabecular meshwork cells were cultured in vitro and reproduced to the third and the fourth generation, then treated with dexamethasone at the concentrations of 5, 25, 50, 250 μg/L respectively for 7 days. Immunohistochemical technique-supervision method was employed to measure, and image analysis system to analyze the expression of AQP-1 in normal cultured bovine trabecular meshwork cells and those treated with dexamethasone.In normal bovine trabecular meshwork cells, the grayscale of AQP-1 positive staining was 167.94±1.18, while it was 168.92±0.91, 176.72±1.80, 180.64±1.31, 185.64±1.58 in cells treated with 5, 25, 50, 250 tg/L concentrations of dexamethasone. When the concentration of dexamethasone was higher than 25 μg/L, the expression of AQP-1 was significantly inhibited (P＜0.05).The regulation of AQP-1 expression by dexamethasone in cultured bovine trabecular meshwork cells in vitro may be one of causes that retard the aqueous outflow in glucocorticoid induced glaucoma.