ABSTRACT
The theory of generation and restriction among five elements， as one of the basic theories in traditional Chinese medicine （TCM）， reveals that treating disease should focus on the root. Since its first record in Huangdi's Internal Classic （Huang Di Nei Jing）， this theory has been covered in many chapters of Synopsis of the Golden Chamber （Jin Gui Yao Lue） and further developed by physicians of later generations， allowing it to serve as a guide for clinical treatment of various diseases. Diabetic nephropathy （DN） is one of the most common complications of diabetes and also a main risk factor for death and disability by virtue of the long-term disease course and complex symptoms. At present， no specific drug is available in western medicine. Considering the close relationship of its complicated etiology and pathogenesis with the five zang organs， DN treatment should focus not only on the kidney， but also other zang organs. Guided by the theory of generation and restriction among five elements， this article believes that DN mainly results from kidney deficiency combined with spleen deficiency and its dysfunction in regulating the water passage. In addition， the exuberance of heart fire and the failure of liver to govern the free flow of Qi are also responsible for the occurrence of DN. Clinically， the therapeutic methods proposed based on theory of generation and restriction among five elements are recommended for DN treatment after the differentiation of actual manifestations into specific syndromes. Specifically， the method of replenishing Huo to nourish Tu is applicable to DN patients with spleen and kidney yang deficiency， the method of nourishing Shui to moisten Mu to those with liver and kidney yin deficiency， the method of mutual generation between Jin and Shui to those with lung and kidney yin deficiency， the method of banking up Tu to generate Jin to those with lung and spleen Qi deficiency， the method of purging the heart and tonifying the kidney to those with non-interaction between heart and kidney， and the method of banking up Tu to control Shui to those with spleen deficiency and fluid retention. Such timely and effective interventions are conducive to delaying the development of DN to end-stage renal disease （ESRD） and improving the clinical outcomes. This article discusses the application of the theory of generation and restriction among five elements in TCM to DN treatment， aiming to provide a theoretical basis for the future application of such new diagnosis and treatment ideas.
ABSTRACT
Diabetes is one of the most common chronic non-communicable diseases. The incidence rate is on the increase year by year. As the disease progresses, it can cause damages to many tissues and organs, such as eyes, kidneys, nerves, heart and blood vessels, which seriously endangers human health. Traditional Chinese medicine (TCM) has outstanding clinical advantages in the prevention and treatment of diabetes, with distinctive characteristics of diagnosis and treatment. TCM has a long history of understanding diabetes. In recent years, researches on etiology, pathogenesis and treatment have gradually deepened and made certain progress. As early as in the Huangdi Neijing, there is a record of "If people’s lung, spleen viscera (stomach), liver, kidney are weak, they can easily get diabetes". This paper collected and summarized ancient literatures relating to diabetes. According to the basic construction principle of "integration-authenticity-innovation" in the theoretical framework of TCM，the causes of the disease include liver weakness and failure in dredging and regulation，emotional disorder, endogenous heat and dryness, heart weakness, heart Yin depletion, endogenous dryness and heat， spleen deficiency and failure in transportation and transformation， lung injury caused by dryness and heat, dysfunction of body fluid distribution, kidney Yin deficiency, astringent weakness, insufficient Qi transformation for maintaining body fluid metabolism balance. In general, Yin deficiency is the root cause, and dryness and heat are the appearance. A framework for the treatment of diabetes was built with five organs as spatial dimension. This paper summarizes the etiology and pathogenesis of diabetes caused by viscera deficiency, with the treatment of diabetes with the five internal organs as the basic framework. The main methods of treating diabetes are relieving Qi stagnancy in liver, regulating the mood，clearing the heart fire, Yin-enriching and dryness-moistening, reinforcing spleen Yang, invigorating spleen and removing dampness, clearing lung and moistening dryness, nourishing Yin, kidney Yin, warming kidney and promoting Yang. A clear and hierarchical theoretical framework was built as a bridge between the theory of TCM and clinical practice of TCM, in the expectation to provide new ideas for the study of ancient TCM literatures and the treatment of diabetes mellitus with TCM, and contribute to the inheritance and development of TCM theory.
ABSTRACT
Objective:By the method of network pharmacology， the mechanism of Pinelliae Rhizoma and Citri Exocarpium Rubrum in the treatment of metabolic syndrome was explored. Method:Effective components of Pinelliae Rhizoma and Citri Exocarpium Rubrum were retrieved by TCMSP database，and then selected by ADME parameters. TCMID，BATMAN-TCM，SymMap，TCM-MESH database were used to supplement effective components of TCMSP. TCMSP target prediction model was used to predict potential targets of drugs. DRUGBANK，DisGeNET，CTD，GeneCards，OMIM，PharmGkb，KEGG，DiGSeE databases were retrieved to obtain the targets of metabolic syndrome，and the chips were downloaded and analyzed through GEO database No.GSE98895 to screen out the differential genes of normal people and patients with metabolic syndrome，and supplement the target databases of metabolic syndrome. The intersections of Pinelliae Rhizoma-Citri Exocarpium Rubrum and metabolic syndrome disease targets were obtained by Rstudio 3.6.2. The above intersection targets were imported into the Metascape database for module analysis and overall GO（Biological Process），KEGG and Reactome pathway analysis. The core targets were selected from the intersection targets by using the cytohubba plug-in，the core genes were input into the database of BioGPS，Genecards to analyze the tissue distribution and subcellular distribution，and the core targets were assigned by using the database of DisGeNET. Result:A total of 34 active components and 120 targets of Pinelliae Rhizoma and Citri Exocarpium Rubrum were screened out，and 115 targets were obtained after the intersection of Rstudio 3.6.2. The results of Metascape module analysis and whole analysis were mostly the same，mainly involving the biological processes， such as ligand receptor interaction，calcium ion，cGMP-PKG，cholinergic synapse，thyroid hormone，insulin. The cytohubba plug-in was used to screen out 17 targets，involving 17 key genes， such as VEGFA and NOS3. The tissue and subcellular distribution of the core targets mainly included lymphoblasts，CD33+_myeloid cells，amygdala，pineal and cytoplasmic matrix，mitochondria. The main proteins were signal molecules，kinases and nucleic acids. Conclusion:Pinelliae Rhizoma and Citri Exocarpium Rubrum could treat metabolic syndrome through complex biological processes and pathways，such as blood circulation，ligand receptor interaction of nerve activity，cGMP-PKG，interleukin-related action，calcium ion. This indicates that traditional Chinese medicine（TCM） treated diseases through multi-component，multi-target，multi biological processes，multi-channel and other ways（which is also proved by the distribution of core genes in the tissue，subcellular and protein ascription information），indicating the superiority of the holism concept of TCM. Erchetang and its similar prescriptions are suitable for treating metabolic syndrome，which also indicates that the principle of "treating different diseases with the same therapy" of TCM is not only reflected at the theoretical level； and network pharmacology needs to be further proved in the combination with experimental verification.
ABSTRACT
Objective: To study the effects of modified Buzhong Yiqitang on cardiac function and fat acid binding protein3 (FABP3)and peroxisome proliferator-activated receptor gamma(PPARγ) protein of cardiac myocytes in type 2 diabetic mellitus (T2DM) rats, and to explore the mechanism of this prescription to protect T2DM cardiomyopathy. Method: After 6 weeks of high-glucose and high-fat diet, streptozotocin (STZ) was intraperitoneally injected (50 mg·kg-1) to establish a diabetic rat model, and then randomly divided into normal group, model group, modified Buzhong Yiqitang group (21 g·kg-1) and metformin hydrochloride group (2 g·kg-1). After continuous administration for 6 weeks, echocardiography was used to detect the cardiac structure and function of the rats in each group. Combined with the measured blood glucose level, it was judged that the rat model building of diabetic cardiomyopathy was successful.Rat heart tissue was dissected, and rat myocardial morphology was observed by hematoxylin-eosin(HE)staining. Western blot was used to detect the expression levels of FABP3 and PPARγ proteins in rat myocardium. Result: Compared with normal group, levels of blood sugar, total triglyceride(TC), triglyceride(TG),insulin (INS) in model group rats increased significantly (PPγ protein expression levels were significantly lower (PPPγ protein expression was significantly increased (PConclusion: Modified Buzhong Yiqitang can improve glucose and lipid metabolism disorder in diabetic cardiomyopathy rats, improve cardiac function in diabetic cardiomyopathy rats, increase the expression of PPARγ in cardiomyocytes, and reduce the expression of FABP3 protein.
ABSTRACT
Purpose To assess the frequency of discordances in ER, PR and HER-2 status between primary and recurrent cancer and the impact of the discordance on breast cancer patient survival. Method Immunohistochemistry and/or fluorescent in situ hybridization was used to evaluate ER, PR and HER-2 status of primary and recurrent cancer in 62 breast cancer patients. The correlation between discordances in ER, PR and HER-2 receptors and clinicopathologic characteristics and patient survival was analyzed. Results Among 62 patients with breast recurrent cancer, discordance rate for ER, PR, and HER-2 was found in 6 (9.7％), 9 (14.5％) and 3 (4.8％) patients, respectively. During the follow-up period the ER-discordant cases had a poorer overall survival (median 29 months vs 44 months, P=0.021) and post-recurrence survival (median 6 months vs 15 months, P=0.027), compared with the concordant cases. No impact on overall survival or post-recurrence survival was observed for PR and HER-2 discordance when compared with the respective concordant cases (P> 0.05 for all).Conclusion Our results demonstrate an evident change regarding ER, PR and HER-2 between breast primary and recurrent cancer, and the ER unstable status in breast cancer suggust a worse prognosis.
ABSTRACT
<p><b>OBJECTIVE</b>To determine the preoperative serum VEGF, IL-6, and CRP levels in colorectal carcinoma, and to explore their correlation with disease status and prognosis.</p><p><b>METHODS</b>Serum VEGF and IL-6 levels were assessed using ELISA, and CRP was measured by immunoturbidimetry. They were compared between the colorectal carcinoma group and the control group. The five-year survival rate and poor prognostic factors were analyzed by Kaplan-Meier and Log-rank method, respectively.</p><p><b>RESULTS</b>The serum VEGF, IL-6, and CRP levels in colorectal carcinoma were (591 ± 312) pg/ml, (13.2 ± 3.7) pg/ml, and (1.14 ± 0.87) mg/dl, respectively, higher than that in the control group. The two groups showed significant difference in VEGF and CRP (P < 0.001, P = 0.002). VEGF expression was higher in male than that in female [(638 ± 387) pg/ml vs. (552 ± 271) pg/ml, P = 0.042]. The cases with tumor size smaller than 5 cm had lower VEGF expression compared with that in cases with tumor size ≥ 5 cm [(538 ± 275) pg/ml vs. (647 ± 331) pg/ml, P = 0.009]. IL-6 expression showed significant difference in males (11.7 ± 3.2) and females (15.2 ± 4.0) pg/ml, (P = 0.011). The five-year survival rate in the group with VEGF < 591 pg/ml was 86.8% (33/38), higher than that in the ≥ 591 pg/m group. High VEGF level tended to reduce survival (χ(2) = 0.933, P = 0.344). VEGF ≥ 591 pg/ml was a factor of poor prognosis in colorectal carcinoma, assessed by Log-rank methods (P < 0.05). Tumor size and VEGF concentration were risk factors of prognosis (P = 0.032, OR = 0.985; P = 0.011, OR = 0.976).</p><p><b>CONCLUSIONS</b>Serum VEGF and IL-6 expressions have gender differences. Serum VEGF can be used as a biomaker of clinical diagnosis of colorectal cancer, and has an important significance on the prognosis of patients.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Biomarkers, Tumor , C-Reactive Protein , Metabolism , Colorectal Neoplasms , Blood , Pathology , Follow-Up Studies , Interleukin-6 , Blood , Logistic Models , Preoperative Period , Risk Factors , Sex Factors , Survival Rate , Tumor Burden , Vascular Endothelial Growth Factor A , BloodABSTRACT
Objective To investigate the thermal effects on tissue structures during microwave endometrial ablation(MEA)and seek a feasible method of endometrial thinning and a fitting mode of applicator radiating microwaves.Methods Operations were performed between the group of thorough uterine curettage and the group of early follicular phase in in vitro or in vivo uterus.The former was treated with MEA after thorough uterine curettage;while the latter was treated with MEA in the early follicular phase directly.The applicator radiating microwaves were moved in "Z" or "Z+W" shape inside uterine cavity.At the same time the serosal temperature was measured in the uterine fundus,tael cornua uteri,the posterior wall and the lower part of anterior wall.After operations the uterine specimens were stained by hematoxylin- eosin,and respiratory enzyme dehydronicotinamide adenine dinucleotide phosphate diaphorase(NADH-d) methods.The morphologic changes and the depth of tissue thermal damage were evaluated using an optical microscope and electron microscope.Results(1)Under the optical microscope the endometrial glands became distorted,the cell boundaries disappeared,the nucleoli turned condensed and were stained darker. A large number of acute inflammatory cells appeared in fibrous tissue.In the shallow muscle layer cells were arrayed thickly,nucleoli were solidified and condensed,and cellular plasm were concentrated.The endometrial and the superficial muscle layers were damaged and colorless with NADH-d staining.The scope of the tissue thermal damage was clearly seen.Under an electron microscope,some smooth muscle ceils, chromatin,karyotheca and cellular membranes were destroyed.The mitochondria were swollen,membranes were ruptured,and the crista disappeared.Many organelles were destroyed.The chromatin was lightly wrecked in the transitional area between putrescence and the normal smooth muscle tissue.Karyotheca and cellular plasm still existed,the mitochondria were highly edematous and the crista were disappeared,and the granular endoplasmic reticula were slightly expanded and degranulated.(2)The serosal temperature in in vitro uterus was significantly higher than that in in vivo uterus(P0.05).The injury depth of the "Z+ W" radiation group increased significantly than that of the " Z" radiation group(P