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Bronchiectasis is characterized by a “vicious cycle” involving compromised host defense， mpaired clearance of airway mucus， bacterial colonization， infections， and inflammation， leading to frequent acute exacerbations and diminished quality of life. Based on the hypothesis of “vicious circle”， this paper explores the treatment of bronchiectasis by traditional Chinese medicine （TCM） from three aspects. Firstly， dissipating excessive “phlegm” secretion and enhancing airway clearance form the foundation of the treatment， aiming to improve the condition of mucus hypersecretion. Secondly， invigorating spleen for strengthening vital energy can improve the function of immune system and reduce recurrent infections and acute attacks. Lastly， clearing heat and purging the lung can alleviate infection and inflammatory damage. By employing these methods， TCM can disrupt the progression of the “vicious circle”， delaying disease advancement， minimizing acute exacerbations， and improving the quality of life for patients.
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@#Objective To evaluate the effect of frailty on postoperative complications in elderly patients with esophageal cancer. Methods We enrolled the patients aged≥65 years and with esophageal cancer who underwent surgical treatment in Shanghai Chest Hospital in 2021. The modified frailty index (mFI) was calculated and the patients were divided into a non-frailty group and a frailty group. The primary outcomes were the incidence of postoperative pulmonary infection, arrhythmia, anastomotic fistula and chylothorax complications. Secondary outcomes were the time of extubation, the rate of unplanned re-intubation, the length of ICU stay, hospital stay, rate of readmission within 30 days after discharge and the mortality within 30 days after operation. Results Finally 607 patients were collected. There were 273 patients in the non-frailty group and 334 patients in the frailty group. The non-frailty group had lower rates of complications including pulmonary infection (5.5% vs. 13.5%), arrhythmia (3.7% vs. 9.3%), anastomotic fistula (2.9% vs. 7.5%), and shorter ICU stay [2.0 (0.0, 4.0) d vs. 4.0 (1.0, 6.0) d] and in-hospital stay [11.5 (9.5, 13.0) d vs. 13.0 (11.0, 18.0) d], lower rates of the readmission within 30 days (2.9% vs. 6.6%) and the mortality within 30 days (0.4% vs. 1.2%) compared with the frailty group (P<0.05). Conclusion Frail elderly patients with esophageal cancer have higher rates of postoperative complications. mFI can be used as an objective index to identify high-risk elderly patients with esophageal cancer.
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@#Objective To investigate the effect of intravenous analgesia with a wireless or traditional analgesia pump system in thoracoscopic lung resection. Methods Patients who used the patient-controlled intravenous analgesia after thoracoscopic lung resection between June 2016 and June 2021 were enrolled in the study. They were allocated into a wireless pump group (a ZigBee-based wireless analgesia pump system collecting data automatically) and a traditional analgesia pump group. Perioperative analgesia management followed the routine standard operation protocol of Shanghai Chest Hospital. The patients’ numeric rating scale (NRS) for pain and postoperative nausea and vomiting (PONV) scores were collected for analysis from the Anesthesia Information Record System. The incidence of postoperative analgesia insufficiency (defined as NRS≥4 points) within 48 h, the incidence of PONV within 24 h, and the 48 h completion rate of analgesia pump infusion were compared. Results A total of 59 431 patients were collected, including 24 855 males and 34 576 females, 17 209 patients in the wireless pump group, and 42 222 patients in the traditional analgesia pump group. The incidence of analgesia insufficiency within 48 h after operation (3.75% vs. 4.98%, P=0.007), the incidence of PONV within 24 h after operation (13.60% vs. 16.70%, P=0.030) in the wireless pump group were lower than those in the traditional analgesia pump group. The 48 h completion rate of analgesia pump infusion in the wireless pump group was higher than that in the traditional analgesia pump group (83.40% vs. 71.90%, P<0.001). The wireless pump group could monitor the pressing times and use of the analgesia pump, while the traditional analgesia pump group could not record the relevant data. Conclusion Compared with the traditional analgesia pump, the wireless analgesia management system may be convenient for timely, accurate and individualized management, and has good analgesic effect and low incidence of adverse reactions, and may be more suitable for perioperative analgesia management.
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Objective: To explore the quality of life and its influencing factors of enhanced recovery after surgery (ERAS) of esophageal cancer patients. Methods: The quality of life of 134 esophageal cancer patients was assessed using the quality of life assessment scale (EORTC QLQ-C30) developed by the European Cancer Research and Treatment Organization. Student's t test, One-way ANOVA and multiple linear regression statistical methods were used to analyze the effects of sociodemographic and clinical characteristics on patients' quality of life. Results: The overall score of quality of life (74.00) was lower than that of the general population (75.30). However, the scores of emotion and cognition in function dimension (93.97 and 95.77) were better than those of the general population (82.80 and 86.50). The results of fatigue, pain, insomnia and constipation in symptom dimension (14.18, 10.94, 11.69 and 5.72) were better than those of the general population (28.80, 20.50, 20.40 and 10.70). The pathological stage, body mass index and dietary were independent influencing factors for the quality of life of patients with esophageal cancer (P<0.05). Conclusions: ERAS can partially improve the quality of life of esophageal cancer patients. More attention should be paid to the esophageal cancer patients after surgery and take targeted measures to improve their quality of life.
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Humans , Esophageal Neoplasms/surgery , Fatigue , Quality of Life , Surveys and QuestionnairesABSTRACT
Objective: To observe the effects of electroacupuncture (EA) pretreatment on M1 polarization of alveolar macrophages (AMs) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS), and to explore the potential protective mechanism of EA.Methods: Forty Sprague-Dawley rats were randomly divided into a normal group, a model group, and three groups of EA pretreatment [including a Chize (LU5) group, a Zusanli (ST36) group and a Chize (LU5) plus Zusanli (ST36) group], with eight rats in each group. The model rats of ALI were established by instilling LPS [2 mg/(kg·bw)] into the trachea of rats for 3 h. The rats in each EA pretreatment group were pretreated with EA for 30 min per day at the corresponding bilateral acupoints 6 d before instilling LPS. Three hours after modeling, the pulmonary function of the rats was tested, and the lung tissue was taken to calculate the ratio of lung wet weight to dry weight (W/D). The pathological lung changes and the injury score were observed by hematoxylin-eosin staining. The contents of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and myeloperoxidase (MPO) in rat's bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay. The mRNA and protein expression levels of M1 macrophage markers clusters of differentiation 86 (CD86), inducible nitric oxide synthase (iNOS), and its signaling pathway factor Toll-like receptor (TLR) 4, and nuclear factor-κB (NF-κB) p65 in the alveoli were detected by fluorescence quantitative polymerase chain reaction and Western blot, respectively. Results: After being induced by LPS, the pulmonary function of the model rats showed that the forced expiratory volume in 0.1 s (FEV0.1), forced expiratory volume in 0.3 s (FEV0.3), and their respective ratios of FEV to forced vital capacity (FVC) (including FEV0.1/FVC and FEV0.3/FVC) were significantly decreased (P<0.01), while the W/D of lung tissue was increased (P<0.01). The score of lung injury was significantly higher (P<0.01). The contents of TNF-α, IL-1β, and MPO in the BALF and the mRNA and protein expression levels of CD86, iNOS, TLR4, and NF-κB p65 in the lung tissue were significantly increased (P<0.01). After EA pretreatment, the FEV0.1, FEV0.3, FEV0.1/FVC, and FEV0.3/FVC were significantly increased, the lung injury score decreased significantly, and the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs and proteins in the alveoli decreased significantly (P<0.05 or P<0.01). Compared with the other two single acupoint groups, the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs in the alveoli in the Chize (LU5) plus Zusanli (ST36) group were significantly lower (P<0.01). Conclusion: EA pretreatment at Chize (LU5) and Zusanli (ST36) can inhibit inflammation and reduce pulmonary injury in ALI rats induced by LPS. The effect of the combination of Chize (LU5) and Zusanli (ST36) is better than that of using these two acupoints separately, and its mechanism may be related to the inhibition of AMs' M1 polarization by down-regulation TLR4/NF-κB signaling pathway.
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In this article, we summarize clinical features and management of 3 cases with pathology confirmed granulomatous hypophysitis, to improve knowledge and provide treatment guidance in this regards. Patients presented with headache, blurred vision and central diabetes insipidus, respectively. The imaging manifestations were sellar area or pituitary stalk occupying lesions, and the nature was undetermined. The symptoms were not completely relieved after subtotal resection or biopsy. The symptoms could be controlled by high dose glucocorticoid, but relapsed after reduction. Two patients were treated with glucocorticoid combined with azathioprine. One case had no recurrence after withdrawal of the drug and 1 patient was still in treatment. Therefore, for the patients whose symptoms are still not relieved after operation and recurred after glucocorticoid reduction, the scheme of high-dose glucocorticoid combined with immunosuppressant azathioprine can be considered, which may achieve satisfactory curative effect and prognosis.
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This study aims to summarize the clinical research evidence on oral Chinese patent medicines for the treatment of influenza with the method of scoping review， and thus clarify the status quo and problems. Specifically， the target medicines were selected from related drug catalogues and diagnosis and treatment protocols， and the basic information of the medicines on the specifications was collected. Articles on these medicines were retrieved from Chinese and English databases for statistical analysis and visualization. Finally， 36 medicines and 87 articles were included. The main efficacy of the medicines is clearing heat and removing toxin， and the main components of the medicines are Lonicerae Japonicae Flos， Forsythiae Fructus， and Isatidis Radix. A total of 12 medicines can be used for the treatment of mumps and acute bronchitis in addition to influenza. Only 6 medicines have contraindications and adverse reactions labeled on the specifications. Papers on oral Chinese patent medicines in the treatment of influenza show an increasing trend， and the authors are from 25 provinces and cities in China. Among them， papers on Lianhuaqingwen preparations take up the largest proportion. The studies were mostly randomized controlled trials， non-randomized controlled trials， and retrospective research. A total of 13 studies were supported by national funding， and only 9 studies included more than 200 cases. The most frequently used method was the comparison of the intervention effect of Chinese patent medicines with western medicine， and the treatment course was generally 3-14 days. A total of 7 outcome indicators were used in the studies and the frequency was in the order of ① composite effective rate，② antipyretic effect， ③ symptom improvement， ④ safety indicator， ⑤ virological examination， ⑥ serum inflammatory factor， and ⑦ traditional Chinese medicine （TCM） syndrome score. The conclusions in the clinical studies show difference from the information in drug catalogues. The drug specifications are generally not standard. The available clinical studies have the limitations of small quantity， low in quality， and no demonstration of TCM advantages. In the future， it is necessary to optimize the specifications of Chinese patent medicines， enhance clinical research， further standardize the design of clinical research， and highlight the characteristics of Chinese patent medicines， thereby providing evidence to support the comprehensive clinical evaluation of oral Chinese patent medicines for influenza.
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The volatile oil of Chuanxiong Rhizoma(CX) is known as an effective fraction. In order to seek a suitable method for processing CX and its decoction pieces, this study selected 16 volatile components as indices to investigate how different processing methods such as washing/without washing, sun-drying, baking, oven-drying and far-infrared drying at different temperatures affected the quality of CX and its decoction pieces(fresh CX was partially dried, cut into pieces, and then dried) by headspace gas chromatography-mass spectrometry(GC-MS), cluster analysis, principal component analysis and comprehensive weighted scoring. The results showed that the rapid washing before processing did not deteriorate the volatile components of CX. Considering the practical condition of production area, oven-drying was believed to be more suitable than sun-drying, baking, and far-infrared drying. The CX decoction pieces with a thickness of 0.3-0.4 cm were recommended to be oven-dried at 50 ℃. The integrated processing(partial drying, cutting into pieces, and drying) did not cause a significant loss of volatile components. For the fresh CX, the oven-drying at 60 ℃ is preferred. The temperature should not exceed 60 ℃, and drying below 60 ℃ will prolong the processing time, which will produce an unfavorable effect on volatile components. This study has provided the scientific evidence for field processing of CX, which is conducive to realizing the normalization and standardization of CX processing in the production area and stabilizing the quality of CX and its decoction pieces.
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Desiccation , Gas Chromatography-Mass Spectrometry/methods , Oils, Volatile , Principal Component Analysis , Rhizome/chemistry , Volatile Organic Compounds/analysisABSTRACT
Objective:To know the exercise status of asthmatic in school-age, and to identify possible influen-cing factors.Methods:School-age children with a firm diagnosis of asthma were continuously included in Asthma Clinic of Allergy Department, Children′s Hospital Affiliated to Capital Medical University from January 2016 to January 2017.Patients who complain any symptoms during or after exercise with or without exercise limitation were assigned to the abnormal exercise group (ANE), and children who stated no symptoms and exercise limitation were defined as normal exercise group (NE), correspondingly.These data include age, gender, length of recurrent wheezing history, duration of treatment with inhaled corticosteroids (ICS), asthma control status, body mass index (BMI), pulmonary function parameters by spirometry and plethysmography that were collected and analyzed.Results:A total of 194 cases were included: 135 cases (69.6%) were well controlled, 39 cases (20.1%) were partially controlled, and 20 cases (10.3%) were uncontrolled.Totally, 95 cases (49.0%) were distributed in ANE group, while 99 cases (51.0%) were in NE group.Meanwhile, 111 patients (57.2%) had normal BMI, 32 patients (16.5%) were overweight, and 51 patients (26.3%) were obese.In the Logistic regression model of all cases, the worse asthma control level (partially controlled OR=4.77, 95% CI: 2.07-11.00, P<0.001, uncontrolled OR=10.02, 95% CI: 2.70-37.22, P=0.001) and higher BMI ( OR=1.15, 95% CI: 1.06-1.25, P=0.001) were closely associated with the significantly increased risk of exercise abnormality.Among the patients with normal BMI, ANE group had more cases with hyperinflation than normal exercise group (43.8% vs.19.0%, P=0.005). Conclusions:The results suggested that poor asthma control status and overweight/obesity are risk factors for exercise limitation, and excessive lung inflation may also affect exercise in children with asthma.
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Objective To identify related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus(T2DM)through continuous glucose monitoring(CGM). Methods The included 147 patients with T2DM were those who had undergone CGM for 5 days in our ward of Department of Endocrinology and Metabolism,Huashan Hospital from Dec 2018 to Oct 2019. The general information, laboratory parameters and CGM parameters of the patients were collected. According to whether there wasan episode of hypoglycemia during the monitoring period,the patients were divided into non-hypoglycemia group and hypoglycemic group. A single hypoglycemia episode was defined as a sensor monitoring blood glucose of less than 3.9 mmol/L and lasting for more than 15 minutes.CGM parameters included the mean blood glucose(MBG),standard deviation(SD),coefficient of variation(CV),the differences between maximum and minimum blood glucose (BG) levels (ΔBG),mean amplitude of glycemic excursions (MAGE)and the percentage of time in range(％TIR)of BG at <3.9 mmol/L,3.9-7.8 mmol/L,>7.8 mmol/L,3.9-10.0 mmol/L,and >10.0 mmol/L. Results Logistic regression analysis showed that lower estimated glomerular filtration rate(eGFR)levels,increased use of insulin and its analogs and lower MBG levels were associated with hypoglycemic episodes. Spearman correlation analysis showed that the MBG level and the ％TIR of BG>7.8 mmol/L and BG>10.0 mmol/L were negatively associated while glycemic variability(GV)levels(SD,CV,ΔBG,MAGE)and ％ TIR of BG at 3.9-7.8 mmol/L were positively associated with hypoglycemic episodes. Pearson correlation analysis showed that the duration of hypoglycemic episodes was positively correlated with the use of sulfonylureas and CV levels. Conclusion Lower eGFR levels,increased treatment with insulin and its analogs and lower MBG levels were related factors for hypoglycemic episodes in patients with T2DM.
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Objective:To investigate the effects of early allergen exposure on airway inflammation responses and airway hyper-reactivity in a mouse model of asthma and the possible mechanism.Methods:Neonate BALB/c mice were randomly divided into three groups of normal control group, asthma group and early exposure group with eight in each group. The mice in the early exposure group were subcutaneously injected with 0.1 ml of ovalbumin (OVA) once a day for 10 consecutive days on the third day after birth and the other two groups were treated with 0.1 ml of PBS. Six weeks after birth, the mice in the asthma group and the early exposure group were sensitized with 0.2 ml of OVA allergen once a day for five consecutive days and then challenged with OVA 7 d after sensitization. The normal group was sensitized and challenged with PBS. Pathological changes in 1ung tissues were detected by HE or PAS staining. Flow cytometry was performed to quantify T cell subsets in bronchoalveolar lavage fluid (BALF). Th2-related cytokines (IL-4, IL-5 and IL-13) in BALF and the levels of OVA-specific IgE and IgG in serum were measured by ELISA. The percentages of CD4 + IFN-γ + T(Th1), CD4 + IL-4 + T(Th2) and CD4 + CD25 + Foxp3 + Treg cells in lung tissues were detected by flow cytometry. The airway resistance was detected using a small animal lung function testing system. Results:The pathological changes in lung tissues were less severe in the early exposure group than in the asthma group. However, PAS staining results showed no significant difference in cell metaplasia was found between the two groups. Compared with the asthma group, early exposure to OVA allergen significantly reduced the percentage of Th2 cells [(16.2±2.4)% vs (19.4±3.4)%, P<0.05] and increased the proportion of Treg cells [(3.7±0.4)% vs (2.1±1.4)%, P<0.05]. Moreover, the levels of IL-4 [(65.3±17.1) pg/ml vs (144.4±23.1) pg/ml] and IL-5 [(103.3±21.1) pg/ml vs (198.3±23.1) pg/ml] in BALF were significantly down-regulated in the early exposure group. A reduced production of OVA-specific IgE but not IgG in serum and an inhibited airway hyper-reactivity following OVA challenge were observed in the early exposure group. Conclusions:Early exposure to OVA allergen could offer a protective effect against OVA re-exposure-induced pathological changes, inflammatory responses and airway hyper-reactivity in grown-up mice.
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Objective:To investigate the effect of Banxia Xiexintang on the epithelial-mesenchymal transition （EMT） of human peritoneal mesothelial cell line （HMrSV5） induced by gastric cancer-derived exosomes （Exo）. Method:Banxia Xiexintang-containing serum was prepared and the human gastric cancer NCI-N87-derived exosomes （NCI-N87-Exo） were extracted， followed by their identification by transmission electron microscopy and Western blotting and labeling with 1，1-dioctadecyl-3，3，3，3- tetramethylindocarbocyanine perchlorate （Dil）. The cells were divided into the blank group， model group， and low-， medium-， and high-dose （13.5，27，54 g·kg<sup>-1</sup>） Banxia Xiexintang groups. HMrSV5 cells in the blank group were cultured alone， the ones in the model group with 100 mg·L<sup>-1</sup> NCI-N87-Exo， and those in the low-， medium-， and high-dose Banxia Xiexintang groups with 100 mg·L<sup>-1</sup> NCI-N87-Exo plus low-， medium-， and high-dose 10% Banxia Xiexintang-containing serum， respectively. Confocal laser microscope was used to observe the uptake of NCI-N87-Exo by HMrSV5 cells at 24 h， 48 h and 72 h. Seventy-two hours later， the morphological changes in HMrSV5 cells were observed. The protein expression levels of E-cadherin， cytokeratin 19 （CK19）， <italic>α</italic>-smooth muscle actin （<italic>α</italic>-SMA）， elastin， and transforming growth factor-<italic>β</italic><sub>1</sub> （TGF-<italic>β</italic><sub>1</sub>）， Smad2/3， and p-Smad2/3 were assayed by Western blot. Result:It was observed under the transmission electron microscope that NCI-N87-Exo showed an oval or dish-shaped vesicle structure with a particle size ranging from 40 to 80 nm. Exo marker proteins CD9 and CD63 were highly expressed while calreticulin was not expressed， implying that the NCI-N87-Exo was confirmed. After 24 h， 48 h， 72 h of co-culture， it was observed under the fluorescence microscope that NCI-N87-Exo were taken up by HMrSV5 cells， which was positively correlated with time. Compared with the blank group， Banxia Xiexintang significantly inhibited the uptake of NCI-N87-Exo by HMrSV5 cells， with better effect noticed in the middle- and high-dose Banxia Xiexintang groups（<italic>P</italic><0.05，<italic>P</italic><0.01）. After intervention with Banxia Xiexintang-containing serum， the HMrSV5 cells were arranged densely， and the intercellular space was significantly reduced， with the most obvious changes present in the high-dose Banxia Xiexintang group. Western blot revealed that the protein expression levels of E-cadherin and CK19 in HMrSV5 cells after being intervened with the medium- and high-dose Banxia Xiexintang-containing serum were increased significantly as compared with those in the blank group， whereas the levels of <italic>α</italic>-SMA and Elastin were decreased significantly （<italic>P</italic><0.01）. Banxia Xiexintang-containing serum at the low， medium， and high doses remarkably down-regulated TGF-<italic>β</italic><sub>1</sub> and p-Smad2/3 protein expression（<italic>P</italic><0.05，<italic>P</italic><0.01）. However， there was no significant change in Smad2/3. Conclusion:NCI-N87-Exo can be taken up by HMrSV5 cells to induce EMT. Banxia Xiexintang can inhibit the uptake of NCI-N87-Exo by HMrSV5 cells and the resulting EMT induced by NCI-N87-Exo， which is related to the regulation of TGF-<italic>β</italic><sub>1</sub>/Smads signaling pathway.
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Objective:To evaluate the clinical efficacy of Bupi Qingfei decoction in the treatment of bronchiectasis colonized by<italic> Pseudomonas aeruginosa</italic> （PA） （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）. Method:A total of 72 bronchiectasis patients colonized with PA （ lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome ） were randomly divided into the observation group （36 cases， two cases were lost to follow-up and three dropped out） and control group （36 cases， three cases were lost to follow-up and four dropped out）. There were 31 cases in the observation group and 29 cases in the control group completing the trial. Patients in the observation group were treated with Bupi Qingfei decoction orally，once in the morning and again in the evening， one bag every other day， and simulated azithromycin tablet at the dose of 0.5 g，once every other day， while those in the control group with azithromycin tablet at 0.5 g，once every other day， and simulated Bupi Qingfei decoction， once in the morning and again in the evening， one bag every other day. Patients in both groups received health education and postural expectoration. The treatment lasted for 24 weeks，followed by a 24-week follow-up. The frequency of acute exacerbation，quality of life （St. George's Respiratory Questionnaire） score，traditional Chinese medicine （TCM） syndrome score，lung function ［forced expiratory volume in one second percentage of predicted（FEV<sub>1</sub>%pred） and FEV<sub>1</sub>/forced vital capacity（FVC）］， and serum immunoglobulin （Ig）A，IgE，IgG，and IgM levels of the two groups were evaluated after treatment. Result:The frequencies of acute exacerbation after 24 weeks of treatment and during the 24-week follow-up in the observation group were lower than those in the control group （<italic>P</italic><0.05）. The total quality of life （St. George's Respiratory Questionnaire） score and symptom scores in the observation group after 24 weeks of treatment were significantly decreased as compared with those before treatment （<italic>P</italic><0.05）. There was no significant improvement in the quality of life in the control group either after 24 weeks of treatment or during the 24-week follow-up. The effective rate against TCM syndrome in the observation group was 64.52%（20/31） after 12 weeks of treatment，which was obviously higher than 31.03%（9/29） in the control group （<italic>χ</italic><sup>2</sup>=6.726，<italic>P</italic><0.05）. After 24 weeks of treatment，the effective rate in the observation group was 83.87%， slightly higher than 68.97% in the control group. After 12 and 24 weeks of treatment，the scores of cough，expectoration，fatigue，anorexia，spontaneous sweating，abdominal distension， and loose stool in the observation group were better than those in the control group （<italic>P</italic><0.05）. There were no significant changes in lung function and serum immunoglobulin classes in the two groups. Conclusion:Bupi Qingfei decoction is effective in reducing the frequency of acute exacerbation， alleviating the symptoms， and improving the quality of life of bronchiectasis patients colonized by PA （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）.
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Objective:To seed for stable time window of the integrated disease-syndrome animal model based on the counterevidence from Chinese medicinal prescriptions， and to verify syndrome stability and reliability. Method:A model of depression was established by exposing rats to chronic unpredictable mild stress （CUMS）， followed by body weight measurement， sugar water test， behavioral test， and brain 5-hydroxytryptamine（5-HT） detection. The identification of liver depression and spleen deficiency syndrome was conducted after the equivalent transformation of human clinical symptoms into macroscopic representations of rats. Based on the dynamically collected macroscopic representation scale， Xiaoyaosan was used to reversely verify the stability and reliability of the integrated disease-syndrome animal model of depression due to liver depression and spleen deficiency. Result:The sugar water consumption and the number of crossings and the total movement distance in the open field test of 16-week-old rats in the CUMS （eight weeks of CUMS） group were significantly lower than those in the normal group （<italic>P</italic><0.05）. According to the immunohistochemical results， the 5-HT content in hippocampal area CA2 of rats in the CUMS group was also significantly lowered as compared with that in the normal group（<italic>P</italic><0.05），which indicated that depression was successfully modeled. The liver depression and spleen deficiency syndrome was present in 14-week-old rats （six weeks after CUMS）of the CUMS group， and the number of rats experiencing the liver depression and spleen deficiency syndrome reached the peak in the 16th week （eight weeks after CUMS），accounting for 70% of the total number. Thereafter， the number decreased gradually. The syndrome scores of the 14-， 16-， 18-， 20-， and 22-week-old rats in the Xiaoyaosan group were reduced by 66.6%， 70.7%， 54.8%， 50.4%， and 44.8%， which were graded as effective， marked effective， effective， effective， and effective， respectively. Conclusion:The age of 14-16 weeks（six to eight weeks after CUMS） is considered the stable and reliable time window for depression due to liver depression and spleen deficiency.
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Objective To analyze the dynamic changes in the expression and function of peripher-al typeⅡinnate lymphoid cell (ILC2) subpopulation and the activity of signal transducers and activators of transcription (STAT6) in children with hay fever during pollen season. Methods A total of 10 patients with hay fever, 10 patients with house dust mite ( HDM)-sensitized asthma and 12 healthy controls ( HC) were enrolled in this study. Changes in peripheral ILC2 and the intracellular expression of Th2-related cyto-kines were detected by flow cytometry during and outside the pollen season. Peripheral Lin- cell population was isolated from each group and cultured with the presence of IL-25 or IL-33 for 7 d. The concentrations of IL-5 and IL-13 in culture supernatants were measured by ELISA. Expression of phospho-STAT6 at protein level was quantified by Western blot. Results Within the pollen season, the percentage of peripheral ILC2 cells was significantly higher in children with hay fever [(23. 09±7. 86)％] than in children with HDM-sen-sitized asthma [(6. 84±3. 85)％, P<0. 05] and healthy children[(1. 69±0. 87)％, P<0. 05]. In the non-pollen season, the peripheral ILC2 cells in children with hay fever presented a decreasing trend [(11. 30±2. 45)％], but was still higher than that in HDM-sensitized asthmatics [(3. 76±1. 96)％, P<0. 05] and HC [(1. 32±0. 91)％, P<0. 05] at the same time point. Moreover, peripheral IL-13+ILC2 cells in children with hay fever [(6. 94±3. 16)％ vs(4. 17±1. 98)％, P<0. 05] and in HDM-sensitized asthmatics [(1. 89 ±0. 70)％ vs(1. 44±0. 55)％, P<0. 05] during the pollen season were significantly higher than those in the non-pollen season. After the in vitro stimulation with IL25 or IL-33, the levels of IL-5 and IL-13 in culture supernatants were both increased in children with hay fever and HDM-sensitized asthmatics, and a synergis-tic action was observed when IL25 and IL-33 were used in combination. Meanwhile, the protein level of phospho-STAT4 in Lin-cells was significantly up-regulated in the hay fever group after stimulation with IL25 and IL-33. Conclusions During the pollen season, the abnormal number and function of ILC2 subpopula-tion in children with hay fever might be another cause of the occurrence of clinical symptoms in a short period of time or acute exacerbation.
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Objective@#To analyze the dynamic changes in the expression and function of peripheral type Ⅱ innate lymphoid cell (ILC2) subpopulation and the activity of signal transducers and activators of transcription (STAT6) in children with hay fever during pollen season.@*Methods@#A total of 10 patients with hay fever, 10 patients with house dust mite (HDM)-sensitized asthma and 12 healthy controls (HC) were enrolled in this study. Changes in peripheral ILC2 and the intracellular expression of Th2-related cytokines were detected by flow cytometry during and outside the pollen season. Peripheral Lin- cell population was isolated from each group and cultured with the presence of IL-25 or IL-33 for 7 d. The concentrations of IL-5 and IL-13 in culture supernatants were measured by ELISA. Expression of phospho-STAT6 at protein level was quantified by Western blot.@*Results@#Within the pollen season, the percentage of peripheral ILC2 cells was significantly higher in children with hay fever [(23.09±7.86)%] than in children with HDM-sensitized asthma [(6.84±3.85)%, P<0.05] and healthy children[(1.69±0.87)%, P<0.05]. In the non-pollen season, the peripheral ILC2 cells in children with hay fever presented a decreasing trend [(11.30±2.45)%], but was still higher than that in HDM-sensitized asthmatics [(3.76±1.96)%, P<0.05] and HC [(1.32±0.91)%, P<0.05] at the same time point. Moreover, peripheral IL-13+ ILC2 cells in children with hay fever [(6.94±3.16)% vs(4.17±1.98)%, P<0.05] and in HDM-sensitized asthmatics [(1.89±0.70)% vs(1.44±0.55)%, P<0.05] during the pollen season were significantly higher than those in the non-pollen season. After the in vitro stimulation with IL25 or IL-33, the levels of IL-5 and IL-13 in culture supernatants were both increased in children with hay fever and HDM-sensitized asthmatics, and a synergistic action was observed when IL25 and IL-33 were used in combination. Meanwhile, the protein level of phospho-STAT4 in Lin- cells was significantly up-regulated in the hay fever group after stimulation with IL25 and IL-33.@*Conclusions@#During the pollen season, the abnormal number and function of ILC2 subpopulation in children with hay fever might be another cause of the occurrence of clinical symptoms in a short period of time or acute exacerbation.
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Coronavirus disease-2019 (COVID-19) is highly contagious. In the early stages of the disease, the symptoms of coldness, dampness and depression in the lungs often appear, including fever, fatigue, soreness, dry cough, poor appetite, and white greasy tongue coating. During the development of the disease, the damp toxin epidemic often enters the inner and generates heat, and the damp heat epidemic toxin blocks pleurodiaphragmatic sites, the triple energizer and lungs, with manifestations of chest tightness, shortness of breath, exacerbation after exercise, or high fever without bringing down, poor appetite, bitterness in mouth, fatigue, diarrhea, loose stools, and yellow and thick tongue fur. As the pathogen can go outward or enter more deeply inside to cause death at the moment, it is the crucial time to treat the disease. In this study, Haoqin Qingdantang was used to clear dampness and heat, reconcile Shaoyang channel and recover the triple energizer, detoxify the dampness fever epidemic toxin, and block the toxin inside, with a good efficacy. This prescription focuses on smoothing the Shaoyang gallbladder channel and the triple energizer, and regards the spleen and stomach as the acquired essence. In the prescription, Erchentang reconciles the spleen and stomach, elevates clear Qi and lower turbid Qi. Bupleuri Radix is added to increase its detoxification function, and Paeoniae Rubra Radix is added to circulate the blood and prevent pathogen from the blood. When the condition improves, Sweet Wormwood Herb and talc are often withdrawn, and Codonopsis is added to nourish the spleen and stomach, to strengthening vital qi to eliminate pathogenic factor. Based on the cases of COVID-19 treated in Wuhan Jinyintan Hospital, this paper summarized some experience of applying Haoqin Qingdantang.
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Objective:To analyze the traditional Chinese medicine（TCM） syndromes of 46 patients with coronavirus disease-2019 (COVID-19) by cluster analysis method. Method:The 46 COVID-19 patients with TCM symptoms, signs, tongue and pulse were analyzed by frequency analysis and clustering analysis, and the TCM syndrome types of COVID-19 patients were classified and summarized by combining clinical expertise, and the evolution law was analyzed by combining the median days of the syndrome collection. Result:The major signs and symptoms of the 46 patients with COVID-19: fever (frequency of 39, accounted for 84.8%), poor appetite (frequency of 44, 95.7%), fatigue (frequency of 42, 91.3%), wheezing breath (frequency of 35, 76.1%), dry mouth (frequency of 21, 45.7%), lung condition short (frequency of 20, 43.5%), defecate pond (frequency of 15, 32.6%), red tongue (frequency 30, accounting for 65.2%), yellowish moss (frequency 27, accounting for 58.7%), and slimy pulse (frequency 30, accounting for 62.5%). TCM syndromes were divided into seven types, i.e. dampness and heat syndrome (13 cases), dampness and toxin syndrome (10 cases), heat stasis syndrome (7 cases), dampness and heat syndrome (5 cases), cold dampness internal invasion syndrome (4 cases), dampness poison blood stasis syndrome (2 cases).According to the time of onset, there were cold and dampness syndrome (median days 6.5 days), dampness was heavier than heat syndrome (10 days), dampness and heat syndrome (10 days), dampness and heat syndrome (11.5 days), heat stagnation of liver and gallbladder syndrome (13 days), dampness and blood stasis syndrome (15 days), and Yin injury syndrome (16 days). Conclusion:Among the 46 cases of COVID -19, damp-heat syndrome was the most common, followed by heat stagnation of liver and gallbladder syndrome, Yin injury and gas consumption syndrome, cold and damp internal invasion syndrome, and dampness and blood stasis syndrome. The pathogenesis of the disease evolved into heat and poison, and later appeared to consume Qi Yin performance.
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Coronavirus disease-2019 (COVID-19) outbreaks were spreading rapidly around the world in early 2020. This disease is within the category of "damp epidemic" and "damp toxin epidemic" in traditional Chinese medicine, with lung and spleen as the lesion focuses, while dampness and toxin as especially prominent properties. Through clinical observation, we found that dampness would often transform into damp heat during the development and evolution of the disease, and the "triple energizer" treatment was an important therapeutic method, eliminating pathogens through purgation and diuresis: for those with damp-heat accumulation toxin diffused to the triple energizer, we could use Ganlu Xiaodudan as primary prescription, which can spread the upper part, smooth the middle part and infiltrate the lower part, so as to provide a way out for the pathogenic factors and regulate Qi movement. For those with damp-heat in Shaoyang channel, we could use Haoqin Qingdantang to clear heat and promote diuresis, harmonize Shaoyang, eliminate damp-heat and epidemic pathogenic factor. For those with pathogen hidden in membrane source dampness trapping and hidden heat, we could use Dayuanyin to eliminate pathogens between interior and exterior parts, and regulate Qi movement. At the same time we shared three typical cases treated in Wuhan, and conducted an in-depth analysis in this study. Clinically, the method of elimination of pathogens through purgation and diuresis is mainly used in the early and middle stage of this disease. When the disease is still located in Qi system, it also can be applied to mild, ordinary patients and severe patients that have accurate syndrome differentiation. In such cases, it can effectively improve symptoms, reduce pathogenic toxin, truncate and reverse the course of disease, give way to pathogen, and avoid disease aggravating.
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This article analyze acupoint selection and characteristics of plaster therapy for stable chronic obstructive pulmonary di-sease(COPD) by data mining. The CNKI, VIP, CBM, WanFang, PubMed, EMbase, Cochrane Library were retrieved for collecting clinical studies of plaster therapy for stable COPD. After literature screening, a total of 46 systematic reviews were included. Frequency statistics, cluster analysis, and Apriori correlation analysis were used to analyze the pattern and characteristics of plaster therapy for stable COPD. The result showed that the main acupoints for stable COPD were BL13, Dingchuan, CV22, BL23 and BL20. The acupoints used are mainly concentrated on the chest and back. The most frequently used meridian is the bladder meridian. Analysis of the acupoints yielded 27 correlation rules. And cluster analysis grouped the high frequency acupoints into 5 categories. The results of the study showed that the current choice of acupoints is rather concentrated. "Local acupuncture points" and "matching points with front and back" were the main acupoint selection rules. The choice of acupuncture points reflected the traditional Chinese medicine treatment principle of strengthening healthy Qi to eliminate pathogenic factor, treating both manifestation and root cause of disease, and preventing measure taken after the occurrence of disease.