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High mortality rates from cardiovascular diseases (CVDs) persist worldwide. Older people are at a higher risk of developing these diseases. Given the current high treatment cost for CVDs, there is a need to prevent CVDs and or develop treatment alternatives. Western and Chinese medicines have been used to treat CVDs. However, several factors, such as inaccurate diagnoses, non-standard prescriptions, and poor adherence behavior, lower the benefits of the treatments by Chinese medicine (CM). Artificial intelligence (AI) is increasingly used in clinical diagnosis and treatment, especially in assessing efficacy of CM in clinical decision support systems, health management, new drug research and development, and drug efficacy evaluation. In this study, we explored the role of AI in CM in the diagnosis and treatment of CVDs, and discussed application of AI in assessing the effect of CM on CVDs.
Subject(s)
Humans , Aged , Cardiovascular Diseases/drug therapy , Medicine, Chinese Traditional , Artificial Intelligence , Integrative MedicineABSTRACT
Objective:To explore the effects of Xintongtai （XTT） on traditional Chinese medicine （TCM） syndrome score and collagen fibers in vascular smooth muscle cells（VSMCs） of rabbits with atherosclerosis in the regulation of p38 mitogen-activated protein kinase （p38 MAPK）/activator protien-1 （AP-1）signaling pathway. Method:A total of 120 rabbits of SPF grade were randomly divided into the sham operation group， combined phlegm and blood stasis model group， rosuvastatin group， and low-， middle-， and high-dose XTT groups. The rabbit model of atherosclerosis due to combined phlegm and blood stasis was established by exposing them to high-fat diet and balloon injury. Following modeling， the corresponding drugs were administered by gavage for eight weeks （2.3， 4.6， 9.2 g·kg<sup>-1</sup> for low-， middle-， and high-dose XTT groups and 0.55 mg·kg<sup>-1 </sup>for rosuvastatin group）. At the end of medication， the abdominal aorta was isolated and stained with htoxylin-eosin （HE） for observing the vulnerable plaque. Matrix metalloproteinase-9 （MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1） were detected by immunohistochemistry （IHC）. The collagen fiber decomposition in VSMCs was observed after Masson staining. The protein expression levels of p38 MAPK and AP-1 in aorta was assayed by Western blotting. The combined phlegm and blood stasis syndrome was scored based on TCM syndrome scoring scale. Result:Compared with the model group， XTT at each dose and rosuvastatin significantly decreased MMP-9 content， increased TIMP-1， down-regulated p38 MAPK protein expression， and weakened the nuclear translocation of AP-1 （<italic>P</italic><0.01）. Compared with the low-dose XTT group， the middle- and high-dose XTT groups and rosuvastatin group exhibited obviously lowered MMP-9，elevated TIMP-1， down-regulated p38 MAPK protein expression， and diminished AP-1 nuclear translocation （<italic>P</italic><0.05，<italic>P</italic><0.01）. The TCM syndrome scores of the middle- and high-dose XTT groups and rosuvastatin group were significantly improved as compared with that in the model group （<italic>P</italic><0.05，<italic>P</italic><0.01）. The comparison with the low-dose XTT group revealed a remarkable improvement in TCM syndrome score of the middle- and high-dose XTT groups and rosuvastatin group （<italic>P</italic><0.01）. As demonstrated by Masson staining， the smooth muscle fibers in the model group were arranged in disorder， accompanied by enhanced collagen decomposition， thinned fibrous cap， and increased plaque vulnerability. Compared with the model group， the VSMCs in each XTT group and rosuvastatin group were orderly arranged， manifested as decreased collagen fiber decomposition and increased plaque stability. Conclusion:XTT down-regulates the expression of p38 MAPK and MMP-9， increases the level of TIMP-1， reduces the nuclear translocation of AP-1， diminishes the decomposition of collagen fibers in VSMCs， and improves the score of combined phlegm and blood stasis syndrome. XTT alleviates arteriosclerosis due to combined phlegm and blood stasis by regulating p38 MAPK/AP-1 signaling pathway and downstream cytokines and stabilizing vulnerable plaques.
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To assess the outcomes of partial cricotracheal resection (CTR) and extended cricotracheal resection (ECTR) for severe laryngotracheal stenosis. From November 2009 to September 2017, 18 patients underwent CTR and ECTR at the Department of Otorhinolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University for severe laryngotracheal stenosis were reviewed retrospectively. There were 12-male and 6-female patients, with the age ranged from 4 to 56 years (median 25 years). The causes were postintubation in 11 cases, cervical trauma in 4, idiopathic in 3. The stenosis located in subglottic and tracheal (12), glottic and subglottic and tracheal (3), subglottic (2), and glottic and subglottic (1). Two patients had concurrent unilateral vocal cord palsy.One patient had undergone previous endoscopic balloon dilation and 8 patients had previous laryngotracheal reconstruction. The stenosis was graded according to modified Myer-Cotton classification as follows: Ⅲb (1), Ⅲc(1), Ⅳa (2), Ⅳb (12), Ⅳc (2). The surgical outcomes and complications were recorded. Among 18 patients,11 of the 12 patients undergoing CTR were decannulated. Five of the 6 patients undergoing ECTR were decannulated. Resected airway length ranged from 1.5 to 4.0 cm (median 2.8 cm). Surgical complications included infection of incision wound in 2 cases, anastomotic granulation in 2, cervical subcutaneous emphysema in 1, aspiration in 1, and unilateral arytenoid prolapse in 1. No recurrent laryngeal nerve injury or tracheoesophageal fistula occurred. The median follow up was 11 months. CTR is efficient for severe subglottic and upper tracheal stenosis while ECTR is efficient for subglottic stenosis extended to the glottis. Both procedures also provide a salvage therapy for patients with previous failed treatments.
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Objective::To explore the effect of modified Qingyitang combined with continuous blood purification in the adjuvant treatment of severe acute pancreatitis (SAP) complicated with multiple organ dysfunction (MODS) caused by heat accumulation of viscera. Method::Totally 100 cases of patients of SAP complicated with MODS, who were diagnosed as heat accumulation of viscera by traditional Chinese medicine(TCM) and treated in ICU of the First Affiliated Hospital of Hunan University of Chinese Medicine during May 2015 and May 2019, were randomly divided into two groups, namely control group and observation group, with 50 cases in each group. The patients in control group were treated with fasting and abstinence, gastrointestinal decompression, inhibition of trypsin secretion, gastric mucosal protection, early jejunal nutrition, reduction of inflammatory reaction, continuous blood purification (CBP), mechanical ventilation and circulatory support. The patients in observation group were treated by nasojejunal tube according to syndrome differentiation in addition to routine comprehensive therapy. Modified Qingyitang was injected for 7 days. The remission time of abdominal pain and distention, the time of first exhaust and defecation, the time of ICU residence, the number of samples falling off, the cause of death and the number of cases were recorded. Relevant indexes were measured before treatment, on the 3rd and 7th day of treatment, including the evaluation indexes of pancreatitis: blood amylase (AMS), blood lipase (LPS), and modified computed tomography severity index (MCTSI), inflammatory response indexes were interleukin-6 (IL-6) and hypersensitive C-reactive protein (hs-CRP). Organ function indexes included APACHE-Ⅱ, arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyltransferase (γ-GGT), urine volume, creatinine (CREA), urea nitrogen (UREA), glomerular filtration rate (GFR), creatine kinase (CK), creatine kinase isoenzymes (CKMB), lactate dehydrogenase (LDH), myoglobin (Mb). Tissue perfusion evaluation indexes included acute physiology and chronic health score, serum lactic acid (Lac) and central venous pressure (CVP). TCM treatment score was based on the syndrome score of acute pancreatitis with heat accumulation of viscera syndrome. Result::The total effective rate of TCM syndromes was 86.67%(39/45) in observation group and 73.91%(34/46) in control group (χ2 =13.524, P<0.01). On the 7th day of treatment, the symptoms and indicators of the two groups were improved. Compared with before treatment, AMS, LPS, IL-6, hs-CRP, MCTSI, APACHE-Ⅱ, Lac, CVP, PaO2, PaO2/FiO2, ALT and AST were improved on the 3rd and 7th day after treatment in observation group and control group. The levels of AMS, LPS, IL-6, hs-CRP, MCTSI, APACHE-Ⅱ, Lac, CVP, PaO2, PaO2/FiO2, ALT, AST, ALP, γ-GGT, urine volume were significantly improved (P<0.05). Compared with control group on the 3rd and 7th day, the levels of AMS, LPS, IL-6, hs-CRP, MCTSI, APACHE-Ⅱ, Lac, CVP, PaO2, PaO2/FiO2, ALT, AST, ALP, γ-GGT, urine volume were significantly improved (P<0.05). CREA, UREA, GFR, CK, CKMB, LDH and Mb were significantly improved (P<0.05). Compared with control group, the abdominal pain, abdominal distension relief time, first exhaust/defecation time, ICU stay time in observation group were significantly shortened (P<0.05), and the mortality rate in observation group was significantly reduced (P<0.05). Conclusion::Patients of SAP accompanied with MODS can be treated with blood purification combined with modified Qingyitang by promoting pancreas repair, inhibiting inflammation and improving organ function. It plays an important role in improving symptoms, alleviating TCM syndromes, delaying progression of disease, reducing hospital stay and reducing mortality.
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<p><b>OBJECTIVE</b>To explore the effect of Yixintai Granule (YG) on mRNA and protein expression levels of AQP2 in renal medulla of chronic heart failure (CHF) rabbits.</p><p><b>METHODS</b>CHF rat model was established by ear marginal vein injection of adriamycin. Successfully modeled rabbits were divided into the model group, the high (8.4 g/kg), middle (4.2 g/kg), and low dose (2.1 g/kg) YG group, and the Furosemide group (2 mg/kg). Besides, a normal control group was set up. Equal volume of physiological saline was administered to rabbits of the model group and the normal control group by gastrogavage. YG at different doses was administered to rabbits of the 3 YG groups by gastrogavage. The intervention lasted for 4 weeks, once per day. After treatment the urine volume and pathomorphological changes of renal medulla tissue were observed. mRNA and its protein expression levels of AQP2 were detected.</p><p><b>RESULTS</b>Compared with the normal control group, the urine volume decreased significantly, mRNA and protein expression levels of renal medulla AQP2 increased significantly in the model group (all P < 0.01). Compared with the model group, the urine volume increased significantly, and mRNA and protein expression levels of renal medulla AQP2 decreased significantly in all medicated groups (all P < 0.01). Compared with the low dose YG group, the urine volume significantly increased and the mRNA expression level of renal medulla AQP2 significantly decreased in the middle and high dose YG groups (all P < 0.01). The expression level of AQP2 protein significantly decreased in the high dose YG group (P < 0.01). Pathological changes of the renal medulla was the most obviously seen in the model group. But they were alleviated to various degrees in all medicated groups. They were more obviously attenuated in the middle and high dose YG groups.</p><p><b>CONCLUSION</b>YG could improve CHF possibly through down-regulating mRNA and protein expression levels of AQP2 in renal medulla, and elevating the urine volume.</p>
Subject(s)
Animals , Rabbits , Aquaporin 2 , Genetics , Metabolism , Chronic Disease , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Heart Failure , Drug Therapy , Metabolism , RNA, Messenger , Metabolism , Rats, Sprague-DawleyABSTRACT
<p><b>AIM</b>To investigate the effect of musk soluble components on the growth, the differentiation and the transfection efficiency of rat neural stem cell (NSC) in vitro.</p><p><b>METHODS</b>The growth and the differentiation of rat NSC were observed when musk soluble components were added into the culture medium of NSC. Meanwhile, the pEGFP-C1, which expressed the enhanced GFP protein, was transfected into the NSC by method of electro- transfection.</p><p><b>RESULTS</b>When NSC was treated with musk soluble components, the neurites were outgrowth around NSC and attached to the plate, and the neural spheres were disassociated. The glia-like cells appeared at the concentration of 0.3 per thousand. When the concentration of musk soluble components was lower than 3 per thousand, the transformative cells could recover. Furthermore, the efficiency of transfection pEGFP into NSC was remarkably increased after the treatment with musk.</p><p><b>CONCLUSION</b>After the treatment of NSC with musk soluble components, the neural spheres were disassociated, and then attached to the plate. Musk soluble components could induce NSC differentiation into glia-like cells and improve the transfection efficiency of pEGFP-C1 in vitro.</p>
Subject(s)
Animals , Female , Male , Rats , Brain , Cell Biology , Cell Differentiation , Cell Proliferation , Cells, Cultured , Culture Media , Fatty Acids, Monounsaturated , Chemistry , Fetus , Materia Medica , Pharmacology , Neural Stem Cells , Cell Biology , Rats, Sprague-Dawley , TransfectionABSTRACT
Objective To establish a real time reverse transcription polymerase chain reaction method for detecting WT1 and to understand the expression levels of WT1 in acute lymphocytic leukemia(ALL) of children through examining peripheral blood of leukemia children.Methods Thirty ALL patients, 13 non-leukemia Children and 18 normal children were included in this study. The method of real time RT-PCR detecting the expression of WT1 was established. The expression levels of WT1 gene were tested by this method.Results The expression levels of WT1 in 13 ALL with newly diagnosed patients were (105-106)copies/?g RNA, 12 with partial remission were (102-104)copies/?g RNA and 12 with complete remission were (0-102)copies/?g RNA.Conclusions Significant expression levels of WT1 in ALL are higher than those in non-leukemias and normal children.WT1 could be a marker for detecting minimal residual disease and evaluating therapy efficacy in ALL.