Syndrome Differentiation-based Treatment of Diarrhea-predominant Irritable Bowel Syndrome with Chinese Medicine via 5-HT Signaling Pathway： A Review / 中国实验方剂学杂志

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic functional bowel disorder characterized by abdominal pain and diarrhea， with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis. The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders， especially IBS-D. 5-Hydroxytryptamine （5-HT）， as an important brain-gut peptide regulating gastrointestinal function， affects brain activity， gastrointestinal motility， pain perception， mucosal inflammation， and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D. In recent years， traditional Chinese medicine （TCM） has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation. Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway. With a focus on syndrome differentiation in TCM， this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway， aiming to provide a scientific basis for TCM treatment of this disease.

Effects of Cistanches Herba polysaccharides on rats with constipation-predominant irritable bowel syndrome / 中国药房

OBJECTIVE To investigate the effects of Cistanches Herba polysaccharides （abbreviated as CDPS） on rats with constipation-predominant irritable bowel syndrome （IBS-C）. METHODS SD rats were divided into control group （20 rats） and modeling group. The modeling group was given 2 mL of normal saline at 0-4 ℃ intragastrically （once a day， for 14 consecutive days） to induce IBS-C model. After modeling， model rats were grouped into model group， positive control group （mosapride citrate， 1.35 mg/kg）， CDPS low-dose group （50 mg/kg） and CDPS high-dose group （100 mg/kg）， with 20 rats in each group. Administration groups were given corresponding drug solution intragastrically， and control group and model group were given a constant volume of water intragastrically， once a day， for 28 consecutive days. The fecal water content， serum content of 5-hydroxytryptamine （5-HT）， and charcoal powder propulsion rate of rats were determined in each group；the pathological morphology of colon tissue was observed， and mRNA and protein expressions of nerve growth factor （NGF） and tropomyosin receptor kinase A （TrkA） in colon tissue were detected. RESULTS Compared with control group， the fecal water content and carbon powder propulsion rate in the model group were decreased significantly （P＜0.05）； the rupture of mucosal muscle layer in colon tissue， significant infiltration of inflammatory cells and cellular edema were observed； the content of 5-HT in serum， and relative mRNA and protein expressions of NGF and TrkA were increased significantly （P＜0.05）. Compared with model group， the fecal water content and carbon powder propulsion rate of rats were increased significantly in administration groups （P＜0.05）， and pathological changes of colon tissue were relieved significantly， while the content of 5-HT in serum， the mRNA and protein expressions of NGF and TrkA in colon tissue were decreased significantly （P＜0.05）； among them， the above indicators inthe positive control group and CDPS high-dose group were generally close to those in the control group （P＞0.05）. CONCLUSIONS CDPS can alleviate the symptoms of IBS-C rats， which may be related to the inhibition of NGF/TrkA signaling pathway.

Predominant peripheral lesions in patients with diabetic retinopathy and its association with systemic comorbidities

Purpose: To determine the associations of predominant peripheral lesions (PPLs) with systemic comorbidities in individuals with diabetic retinopathy. Methods: This is a multicenter cross-sectional observational study conducted across three tertiary eye care centers in south India between January 2019 and July 2021. Ultra-widefield fundus images of consecutive patients with varying severity of diabetic retinopathy with data on systemic comorbidities were classified based on the presence or absence of PPL. Systemic comorbidities (hypertension, diabetic kidney disease, coronary artery disease, dyslipidemia, and anemia) were compared between the two groups. Results: A total of 879 participants (70.1% males) were included in the study, of which 443 (50.4%) patients had PPL. The mean age of the study participants was 56 ± 10 years, mean age of onset of diabetes was 41.24 ± 11.6 years, and mean duration of diabetes was 15.39 ± 7.6 years. The number of PPL increased with increasing severity of DR. Of all the systemic comorbidities analyzed, we found that coronary artery disease (CAD) had a significant association with PPL (Odds ratio [OR]-1.69; 95% confidence interval [CI], 1.12–2.55; P = 0.013) after adjusting for diabetic retinopathy severity, duration of diabetes, and age of onset of diabetes. Conclusion: The presence of PPL is a marker for coronary artery disease and early referral to cardiology is warranted.

Neuroimagen estructural y polaridad predominante en pacientes con trastorno afectivo bipolar tipo I de Antioquia / Structural Neuroimaging and Predominant Polarity in Patients with Type 1 Bipolar Disorder from Antioquia

RESUMEN Introducción: La polaridad predominante (PP) se ha propuesto como un especificador del trastorno afectivo bipolar (TAB) por su relación con variables clínicas y pronósticas. Es posible que esto se deba a una neurobiología subyacente distinta, de tal manera que los cambios encontrados por resonancia magnética estructural (RMe) en el TAB sean diferentes y específicos. Objetivos: Explorar hallazgos de neuroimagen estructural en pacientes con TAB I de acuerdo con la PP. Métodos: Estudio de corte transversal que evaluó a 77 pacientes con TAB I usando la entrevista DIGS. Se estableció la PP utilizando la definición operativa de los 2 tercios de todos los episodios afectivos a lo largo de la vida para clasificar la PP en maniaca (PPM), depresiva (PPD) o indeterminada (PPI). Se les realizó RMe durante la fase de eutimia para medir estructuras intracraneales. Los datos obtenidos se analizaron mediante un modelo de regresión lineal ajustado por variables de confusión (consumo de medicamentos, consumo de alcohol, consumo de sustancias psicoactivas) y se compararon entre los 3 grupos para hallar la diferencia de medias estandarizada (DME). Resultados: Se encontraron diferencias con adecuado tamaño de efecto en 3 estructuras cerebrales tras ajustar por variables de confusión, específicamente en el giro fusiforme derecho y el giro lingual izquierdo, que fueron mayores en el grupo de PPD que en el de PPM (DME = 0,92; IC95%, 0,34-1,49; DME = 0,78; IC95%, 0,21-1,35). Así mismo en el tálamo derecho, que se mostró mayor en el grupo de PPI frente al de PPM (DME = 0,89; IC95%, 0,31-1,46). Conclusiones: Se observó una reducción del espesor del giro fusiforme derecho y el giro lingual izquierdo, así como del volumen talámico derecho en pacientes con TAB I con PPM, lo que respalda la hipótesis de que la PP cuenta con un correlato neurobiológico plausible y podría tener potencial utilidad como especificador del TAB.

ABSTRACT Introduction: Predominant polarity (PP) has been proposed as a specifier of bipolar disorder (BD) due to its relationship with clinical and prognostic variables. It is possible that this is due to a different underlying neurobiology, in such a way that the changes found by structural nuclear magnetic resonance imaging (sMRI) in BD are different and specific. Objectives: To explore findings of structural neuroimaging in patients with BD type I (BD-I) according to PP. Methods: Cross-sectional study that evaluated 77 patients with BD-I using the DIGS interview. PP was established using the operative definition of two-thirds of all affective episodes throughout life to classify PP as manic (MPP), depressive (DPP) or indeterminate (IPP). MRI-was performed during the euthymia phase to measure intracranial structures. The data obtained was analyzed using a linear regression model adjusted for confounding variables (drug use, alcohol use, psychoactive substance use) and were compared between the three groups finding the standardized mean difference (SMD). Results: Differences with adequate effect size were found in three brain structures after adjusting for confounding variables, specifically in the right fusiform gyrus and the left lingual gyrus, which were greater in the DPP group than in the MPP group (SMD = 0.92; 95% CI = 0.34 to 1.49 and SMD = 0.78; 95% CI = 0.21 to 1.35). Likewise, in the right thalamus, it was shown to be greater in the IPP group compared to MPP group (SMD 0.89, 95% CI = 0.31 to 1.46). Conclusions: A reduction in the thickness of the right fusiform gyrus and the left lingual gyrus, as well as the right thalamic volume was observed in patients with BD-I with PPM, which supports the hypothesis that PP has a plausible neurobiological correlate and could have potential utility as a BD specifier.

Preliminary study on the role of glycoprotein A repetitions predominant in regulating tuberculosis pathogenesis through regulatory T cells / 中华传染病杂志

Objective:To investigate the role of glycoprotein A repetitions predominant (GARP) in the pathogenesis of tuberculosis through regulatory T cell (Treg), in order to provide new targets for the treatment of tuberculosis.Methods:Sixty patients with active pulmonary tuberculosis (ATB) admitted to Huashan Hospital, Fudan University and Wuxi Fifth People′s Hospital from January to September 2021 were included. And six individuals with latent tuberculosis infection (LTBI), and 16 healthy controls (HC) were recruited during the same period. Flow cytometry was performed to detect the proportion of Treg in the peripheral blood, and the expressions of GARP and transforming growth factor-β1 (TGF-β1) on Treg in different groups. Mann-Whitney U test was used for statistical analysis. Results:Among the 60 patients with ATB, 23 patients did not receive anti-tuberculosis drug therapy, 17 patients were treated for less than three months, ten patients were treated for three to less than six months, and ten patients were treated for greater than or equal to six months. The percentage of CD4 + CD25 + forkhead box protein 3 (Foxp3) + Treg in untreated ATB patients was 7.50%(5.67%, 9.00%), which was higher than that in HC (5.57%(5.03%, 6.09%)), and the difference was statistically significant ( U=95.00, P=0.010). The percentage of GARP expressing in CD4 + CD25 + Foxp3 + Treg in untreated ATB patients was 10.37%(7.79%, 12.90%), which was higher than that in LTBI (7.02%(5.15%, 8.81%)) and HC (5.33%(4.26%, 6.67%)), respectively, and the differences were both statistically significant ( U=31.00, P=0.040; U=36.00, P<0.001, respectively), while there was no significant difference between LTBI and HC ( U=25.00, P=0.095). The percentage of CD4 + CD25 + Foxp3 + Treg expressing TGF-β1 in untreated ATB patients was 7.13%(4.25%, 8.89%), which was higher than that in HC (3.59%(2.10%, 5.17%)), and the difference was statistically significant ( U=71.00, P=0.001). The expressions of GARP in CD4 + CD8 -CD25 + Foxp3 + Treg in patients with ATB treated for less than three months group, three to less than six months group and greater than or equal to six months group were 7.82%(3.94%, 13.17%), 6.92%(5.61%, 9.47%) and 7.26%(5.82%, 9.64%), respectively. The expressions of TGF-β1 in CD4 + CD8 -CD25 + Foxp3 + Treg in the above three treatment groups were 11.16%(7.91%, 15.23%), 8.66%(5.43%, 12.54%) and 7.82%(6.01%, 9.53%), respectively, and the expression of TGF-β1 in CD4 + CD8 -CD25 + Foxp3 + Treg in the patients with ATB treated for less than three months group was higher than that in the greater than or equal to six months group, the difference was statistically significant ( U=37.50, P=0.024). Conclusions:Foxp3/GARP/TGF-β1 pathway may be involved in the immune mechanism of Treg regulating the pathogenesis of tuberculosis, and GARP may be a new target for anti-tuberculosis therapy.

Clinical Efficacy of Tongxie Yaofang on Diarrhea-predominant Irritable Bowel Syndrome （IBS-D） Patients with Liver Depression and Spleen Deficiency / 中国实验方剂学杂志

ObjectiveTo explore the clinical efficacy and mechanism of Tongxie Yaofang in treating diarrhea-predominant irritable bowel syndrome（IBS-D） patients with liver depression and spleen deficiency. MethodA total of 168 IBS-D patients with liver depression and spleen deficiency who were treated from August 2017 to June 2021 were divided into observation group and control group by random number table，84 in each group. The observation group was administrated with Tongxie Yaofang decoction-free granules orally，and the control group received oral treatment of pinaverium bromide，both for 4 weeks. The main symptoms of IBS were compared before and after treatment，such as the degree of abdominal pain，stool changes，traditional Chinese medicine pattern curative effect scoring system（TCM-PES），IBS quality of life questionnaire （IBS-QOL），IBS symptom severity scale（IBS-SSS），self-rating anxiety scale （SAS），and self-rating depression scale（SDS）. Nimodipine was used to evaluate the efficacy based on TCM syndrome score of liver depression and Qi stagnation. Enzyme-linked immunosorbent assay（ELISA） was conducted to detect the plasma interleukin-10（IL-10）and IL-12 before and after treatment. ResultAfter 4 weeks of treatment， the response rate of abdominal pain in observation group was 92.86% （78/84）， higher than that in control group （82.14%， 69/84）（χ2=6.254，P<0.05）. The response rates of diarrhea in observation group and control group were 91.67% （77/84）and 77.38% （65/84）， respectively（χ2=8.214，P<0.01）. TCM-PES and IBS-QOL scores of observation group after treatment were higher and IBS-SSS score was lower than those of control group （P<0.05）. The efficacy rate of TCM syndromes in observation group was higher than that of control group （P<0.05）. Additionally， after treatment， the observation group had lower SAS and SDS scores （P<0.05）and IL-12 level（P<0.05）and higher plasma IL-10 level than the control group （P<0.05）. ConclusionTongxie Yaofang can relieve abdominal pain and diarrhea in IBS-D patients with liver depression and spleen deficiency，reduce negative emotion，and improve the quality of life of patients，which may be related to alleviating the visceral hypersensitivity.

Anti-inflammation effect of moxibustion for rats with diarrhea-predominant irritable bowel syndrome based on multiple miRNAs regulating NF-κB signal pathway / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion on the regulation of nuclear factor-kappa B (NF-κB) and inflammatory factors by multiple microRNAs (miRNAs) in rats with diarrhea-predominant irritable bowel syndrome (IBS-D), and to explore the anti-inflammatory mechanism of moxibustion on IBS-D.@*METHODS@#Twelve of 52 newborn rats were randomly selected into a normal group. The remaining rats were made into IBS-D model. A total of 36 rats with successful model were randomly divided into a model group, a medication group and a moxibustion group, 12 rats in each group. The rats in the medication group were intraperitoneally injected with pyrrolidine dithiocarbamate (PDTC). The rats in the moxibustion group were treated with moxibustion at "Tianshu" (ST 25) and "Shangjuxu" (ST 37) for 20 min each time. All the intervention was given once a day for 7 days. Before and after modeling as well as after intervention, the body mass, loose stool rate and the minimum volume threshold of abdominal withdrawal reflex (AWR) were measured. After intervention, the contents of serum tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-8 were detected by ELISA method; the morphology of colon tissues was observed by HE staining, and the expressions of miR-155, miR-125b, miR-29b, miR-31, miR-18a and NF-κB p65 mRNA in colon tissues were detected by real-time PCR. The expressions of NF-κB p65, TNF-α, IL-1β and IL-8 protein in colon tissues were detected by immunofluorescence.@*RESULTS@#After modeling, the body mass and the minimum volume threshold of AWR in the model group were lower than those in the normal group (P<0.01); the rates of loose stool in the model group were higher than those in the normal group (P<0.01); after intervention, in the model group, the inflammatory infiltration of colon tissues was obvious, and the serum levels of TNF-α, IL-1 β, IL-8 were higher than those in the normal group (P<0.05); the expression of miR-155, miR-125b, miR-29b, miR-31, miR-18a and NF-κB p65 mRNA in colon tissues was higher than that in the normal group (P<0.05); the protein expression of NF-κB p65, TNF-α, IL-1β, IL-8 was also higher than that in the normal group (P<0.01). After intervention, the body mass and the minimum volume threshold of AWR in the medication group and the moxibustion group were both higher than those in the model group (P<0.05); the loose stool rate in the medication group and the moxibustion group were lower than those in model group (P<0.05); the inflammatory cells infiltration in the colon tissues was less, the serum levels of TNF-α, IL-1β and IL-8 as well as the protein expression of NF-κB p65, TNF-α, IL-1β and IL-8 in the colon tissues in the medication group and the moxibustion group were lower than those in the model group (P<0.05, P<0.01). The expression of miR-125b, miR-31, miR-18a and NF-κB p65 mRNA in the medication group were lower than those in the model group (P<0.05). The expression of miR-155, miR-125b, miR-29b, miR-31, miR-18a and NF-κB p65 mRNA in the moxibustion group were lower than those in the model group (P<0.05). The miR-155, miR-125b, miR-29b, miR-31, miR-18a were positively correlated with NF-κB p65 mRNA (0<r<1, P<0.01).@*CONCLUSION@#The anti-inflammatory mechanism of moxibustion at "Tianshu" (ST 25) and "Shangjuxu" (ST 37) for IBS-D rats may be related to regulating multiple miRNAs to inhibit NF-κB signal pathway and reduce the expression of inflammatory factors.

CHU Hao-ran's experience in treatment of diarrhea-predominant irritable bowel syndrome with acupuncture and moxibustion / 中国针灸

Professor CHU Hao-ran believes that the clinical diagnosis and treatment of diarrhea-predominant irritable bowel syndrome with acupuncture and moxibustion should concentrate on the integration of disease and syndrome differentiation. According to the evolution of pathogenesis, this disease is divided into 4 stages, i.e. invasion of exogenous pathogens, liver stagnation and spleen deficiency, spleen and kidney yang deficiency and interaction of cold and heat. Hence, the treatment should be provided by stages. Focusing on regulating the spleen and stomach, a specific acupuncture-moxibustion prescription is proposed, including Tianshu (ST 25), Zhongwan (CV 12), Zusanli (ST 36) and Shangjuxu (ST 37). Additionally, the combination of distal and nearby acupoints is considered and an unique needling manipulation, named the fight between dragon and tiger, is exerted. On the base of syndrome and meridian differentiation, the modern medicine is combined, stressing on the mind regulation and the mutual application of acupuncture and moxibustion in treatment. Eventually, a distinctive treatment system with acupuncture and moxibustion is formed for "regulating the spleen and stomach and differentiating meridians".

Correlation between curative effect and 5-HTTLPR polymorphism in treatment of diarrhea-predominant irritable bowel syndrome with acupuncture for regulating / 中国针灸

OBJECTIVE@#To compare the curative effect on diarrhea-predominant irritable bowel syndrome (IBS-D) between acupuncture for regulating @*METHODS@#A total of 231 patients with IBS-D were randomized into an acupuncture group (154 cases) and a western medication group (77 cases) at the ratio of 2 to 1. In the acupuncture group, acupuncture was applied to acupoint regimen for regulating @*RESULTS@#After treatment and in follow-up, the total scores of IBS-SSS in the patients of the two groups were all reduced as compared with those before treatment (@*CONCLUSION@#Acupuncture for regulating

Mechanism Analysis of Bianketong Tablet in Treatment of Constipation-predominant Irritable Bowel Syndrome Based on Network Pharmacology and Bioinformatics / 中国实验方剂学杂志

Objective:To explore the potential mechanism of Bianketong tablet （BKT） in the treatment of constipation-predominant irritable bowel syndrome （C-IBS） based on network pharmacology and bioinformatics. Method:The BKT-meridian network was constructed for analyzing the combined effect of the nine Chinese herbs in BKT. The active components and targets of BKT were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and then screened according to the oral bioavailability （OB） and drug likeness （DL） criteria. Following the acquisition of C-IBS target set from GeneCards， Online Mendelian Inheritance in Man （OMIM）， Drugbank and DisGeNet， the protein-protein interaction （PPI） network was constructed. Cytoscape 3.7.2 was utilized for network visualization. The screened key targets were subjected to gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis using DAVID platform. The C-IBS mouse model was established via intragastric administration of ice water， and the key targets of BKT against C-IBS were verified by enzyme linked immunosorbent assay （ELISA） and immunohistochemistry. Result:The large intestinal meridian was the main site where BKT acted. There were 70 potential active components in BKT， which acted on 227 intersection targets. Through T helper cell 17（Th17） differentiation， Toll-like receptor （TLR）， tumor necrosis factor and other signaling pathways， BKT participated in inflammatory response， immune regulation， intestinal nerve regulation， hormonal regulation， and oxidative stress response， thus exerting the therapeutic effects against C-IBS. As reveled by <italic>in vivo</italic> experiments， BKT significantly improved the small intestinal propulsion rate， up-regulated the expression of vasoactive intestinal peptide （VIP） in serum and colon tissue of C-IBS mice， and down-regulated the expression of nuclear transcription factor-<italic>κ</italic>B （NF-<italic>κ</italic>B）， interleukin（IL）-6， and TLR2 in serum and colon tissue， which confirmed the reliability of integration analysis. Conclusion:BKT inhibits C-IBS via multiple components， multiple targets， and multiple pathways. This study has provided ideas for further clinical research and experimental verification of BKT in the treatment of C-IBS.

Diarrhea-predominant irritable bowel syndrome of spleen deficiency and damp excess treated with fire needling therapy with filiform needle and acupoint application therapy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect on diarrhea-predominant irritable bowel syndrome (IBS-D) of spleen deficiency and damp excess among fire needling therapy with filiform needle combined with acupoint application therapy, simple acupoint application therapy and pinaverium bromide tablets, and explore the mechanism on the improvements in IBS-D.@*METHODS@#A total of 150 patients with IBS-D of spleen deficiency and damp excess were randomized into a combined treatment group (50 cases, 14 cases dropped off), an acupoint application group (50 cases, 16 cases dropped off ) and a western medication group (50 cases, 13 cases dropped off ). In the western medication group, pinaverium bromide tablets were prescribed for oral administration, 50 mg per time, three times a day. In the acupoint application group, the herbal plaster of @*RESULTS@#Except the score for abdominal pain in the acupoint application group and the scores for abdominal pain and abdominal distention in the western medication group after 7 days of treatment, the scores for abdominal pain, abdominal distention, defecation frequency, stool form and incomplete bowel movement after 7 and 28 days of treatment were all reduced as compared with those before treatment in each group separately (@*CONCLUSION@#The combined treatment with the fire needling therapy with filiform needle and the acupoint application therapy effectively relieves the clinical symptoms, improves the quality of life and strengthens the immunity in the patients with IBS-D. The therapeutic effect of this combined regimen is better than either simple acupoint application therapy or the oral medication of pinaverium bromide. The mechanism may be related to the regulation of the levels of T lymphocyte subsets and the modulation of the expressions of 5-HT3R and 5-HT4R mRNA in colon tissue.

T cell/histiocyte rich large B cell lymphoma of ascending colon: a rare entity

Colonic T cell/histiocyte rich large B cell lymphoma (THRLBCL) is a very unusual occurrence never described before. A 41-year anaemic male presented with loss of weight and appetite for 7 months and fever with Malena for 1 month. Abdominal examination revealed a 4×6 cm retroperitoneal lump in the right iliac fossa. Radiological investigations (USG and CECT whole abdomen) reported an asymmetrical ill-defined growth in ascending colon and caecum with loco-regional lymphadenopathy. Surgical exploration revealed an ascending colon mass with retroperitoneal lymphadenopathy. Right hemi-colectomy with end ileostomy was done and specimen was sent for histopathology which diagnosed it to be a case of THRLBCL of colon. Patient was followed up after 2 weeks and was planned for chemotherapy.

A Retrospective Comparative Study of Del Nido Versus Intermittent St Thomas Hospital Blood Cardioplegia Solutions in Aortic-Mitral Double Valve Replacement

Introduction: It is not uncommon in patients, havingrheumatic mitral and aortic valve disease, to undergo mitralvalve replacement with aortic valve replacement that is,double valve replacement (DVR) operation who oftenhave severe cardiac dysfunction optimized with medicalmanagement before surgery. In this retrospective studywe investigated 60 such patients, who underwent DVRoperation with either conventional cold blood cardioplegiawith St Thomas 2 solution (STH), or del Nido cardioplegia(DN) over five years and compared the effects of the twotypes of cardioplegia during perioperative and postoperativeperiod with simultaneous comparative study betweenchanges of cardiac performances in the patients with largerleft ventricle as compared to those with less enlargedones.Material and methods: For this retrospective study, the dataof 60 patients of DVR over five years, in Medical College,Kolkata, India, were retrieved for study. The cases wereplaced into 2 groups: STH and DN according to cardioplegiaused during DVR. Demographic, echocardiographic, andseveral perioperative and postoperative data of the two groupsof patients, were collected. Differences between perioperativebehaviour between STH and DN groups and post operativechanges in the echocardiographic parameters betweenpredominantly mitral stenosis (MS) and mitral regurgitation(MR) patients, were analyzed.Results: The aortic cross clamp (CC) and cardiopulmonarybypass (CPB) time in both predominant MS and MR patientswas shorter in the DN than the STH groups. There was lessarrhythmia, less inotropic and ventilator support in the DNgroup. There was 10% mortality in the series with majoritybeing in the STH and MR predominant patients. Postoperativeimprovement of LVEF, reduction of LVIDS and LVIDDwere also observed in MS predominant in comparison toMR predominant patients after DVR in both STH and DNgroups.Conclusion: Use of DN has been found to have a betteroutcome and survival when compared to STH cardioplegiasolution. DVR could reversely remodel depressed heartswith relatively smaller LV volume and restore LV functionof relatively smaller LV of predominant MS patients betterin comparison to MR predominant patients with relativelydilated hearts.

Effect of electroacupuncture on intestinal epithelial mucosal barrier function in rats with diarrhea-predominant irritable bowel syndrome / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) on intestinal epithelial mucosal barrier function in diarrhea-predominant irritable bowel syndrome(IBS-D) rats, so as to explore its mechanisms underlying improvement of IBS-D. METHODS: Forty SD rats (half male and half female) were randomly divided into control, model, EA and medication (Pinaverium Bromide, PB) groups, with 10 rats in each group. The IBS-D model was established by chronic unpredictable mild stress combined with gavage of Senna-leaf solution. EA (2 Hz/15 Hz，0.1-1 mA) was applied to unilateral "Zusanli"(ST36),"Tianshu" (ST25), "Sanyinjiao"(SP6) and "Taichong"(LR3) alternatively for 15 min, once daily for 14 days. Rats of the medication group was treated by gavage of PB (10 mL·kg-1·d-1) for 14 days. The visceral sensitivity (pain) was assessed by using the pressure threshold which the inserted rectal balloon catheter air-inflation (connected to a blood pressure gauge) induced stronger abdominal muscular contraction to force the rat's abdomen to lift the experimental stand surface. The diarrhea index was used to evaluate loose stool grade. The expression of Claudin-1 and Occludin (intestinal epithelial tight junction proteins) of colon tissue was detected by immunohistochemistry. The activity of plasma diamine oxidase (DAO) was assayed by using spectrophotometry. RESULTS: Compared with the control group, the diarrhea index and plasma DAO activity in the model group were significantly increased (P0.05). CONCLUSION: Electroacupuncture can significantly improve abdominal pain and diarrhea in IBS-D model rats, which may be closely associated with its effects in up-regulating the expression of intestinal epithelial tight junction proteins Claudin-1 and Occludin to restore the function of intestinal epithelial mucosal barrier.

Effect of Addition and Subtraction Therapy of Xiaoyaosan Combined with Simotang to Gut-brain Axis of Patients with Irritable Bowel Syndrome with Predominant Constipation and Syndrome of Stagnation of Liver Qi / 中国实验方剂学杂志

Objective:To observe clinical effect of addition and subtraction therapy of Xiaoyaosan combined with Simotang to irritable bowel syndrome with predominant constipation （IBS-C） and syndrome of stagnation of liver Qi and to study influence to gut-brain axis. Method:One hundred and forty-four patients were randomly divided into control group （72 cases） and observation group （72 cases） by random number table. The 66 patients in control group completed the therapy （2 patients were falling off or missing visit， 5 patients were eliminate）， 65 patients in observation group completed the therapy （4 patients were falling off or missing visit， 2 patients were eliminate）. Patients in control group got Simotang， 20 mL/time， 3 times/day. In control group， patients in observation group added addition and subtraction therapy of Xiaoyaosan combined with Simotang， 1 dose/day. And courses of treatment in two groups were 4 weeks. Before and after treatment， degree of abdominal pain， irritable bowel syndrome （IBS） symptom severity scale （IBS-SSS）， quality of life in irritable bowel syndrome （IBS-QOL）， syndrome of stagnation of liver Qi， scores of Hamilton anxiety scale-14（HAMA-14）， Hamilton depression scale-17（HAMD-17）， complete spontaneous bowel movement （CSBM）， response rate of abdominal pain and defecation， remission rate of IBS-SSS were all recorded. And levels of vasoactive intestinal peptide （VIP）， substance P （SP）， neuropeptide Y （NPY）， 5-hydroxytryptamine （5-HT）， somatostatin （SS） and calcitonin related gene peptide were detected， and safety was evaluated. Result:Degree of abdominal pain， scores of IBS-SSS， syndrome of stagnation of liver Qi ， HAMA-14， HAMD-17 and levels of VIP， NPY， 5-HT， SS and CGRP in observation group were all lower than those in control group （P<0.01）. And times of CSBM， score of IBS-QOL and level of SP were all higher than those in control group （P<0.01）. Besides， response rate of abdominal pain and defecation and remission rate of IBS-SSS in observation group 95.38%（62/65）， 93.85%（61/65） and 90.77%（59/65）were higher than 83.33%（55/66），78.79%（52/66）and 75.76%（50/66） in control group （P<0.05）. And curative effect of traditional Chinese medicine （TCM） syndromes in was better than that in control group （Z=2.1034， P<0.05）. No serious adverse events happened and no adverse reaction caused by TCM. Conclusion:Addition and subtraction therapy of Xiaoyaosan combined with Simotang can significantly ameliorate IBS-C symptoms， reduce bad mood， improve patients' quality of life， regulate a variety of brain gut peptide factors， and improve brain gut axis disorder. It has good clinical efficacy and safety.

Differentiation and Characterization of Mycobacterium tuberculosis Complex Causing Pulmonary Tuberculosis across North Central Nigeria

Aims: To differentiate and CharacterizeMycobacterium tuberculosiscomplex causing pulmonary tuberculosis across North Central NigeriaStudy Design:This was a simple descriptive health-based study that involved clinically suspected tuberculosis patients who were referred to two selected General Hospitals for diagnosis in each of the states across North Central Nigeria.Place and Duration of Study:This study was carried out in the North Central zone of Nigeria and it included all the seven States across North Central Nigeria using two General Hospitals Methodology:A total of 371 GeneXpert positive sputa for TB were decontaminated using N Acetyl Cysteine and Sodium Hydroxide under a level 3 Bio-safety cabinet and the resulting sediment was cultured on Lowestein-Jensen (LJ) media containing glycerol and pyruvate at 37ºC in a slanted position, SD-Bioline (TB Ag MPT 64) for the differentiation of MTBC from NTM was carried out using the isolatesfrom LJ culture. Evaluation of speciation was done using Line Probe Assay to determine the predominant species of MTBC. All the protocols used in this study followed the manufacturer’s manual strictly.Results:A total of 371 decontaminated positive GeneXpert sputa derived from 2800 suspected PTB participants were cultured on Lowestein-Jensen (LJ) medium and 302(81.40%) was found positive while 69(18.60%) were found negative. Out of the culture positive isolates, 288 (95.36%) isolates were detected on SD-BIOLINE TB Ag MPT 64 ® assay for MTBC and 14 (4.64%) as NTM. Of the 288 MTBC, three different species were identified; 272 (94.64%) were M. tuberculosis/M.Canetti,7 (2.43%) were M. africanumand 9(3.13) showed a no MTBC reaction band on all the samples that were analysed.Conclusion: Differentiations of MTBC from NTM has help to re-confirm that not all symptoms of pulmonary infection are caused by MTBC but NTM are implicated due to their distribution in the environment, however, molecular characterisation method has narrow our findingsdown to M.tuberculosis/M.canettiias the predominant specie of MTBC circulating in the region, although, M.africaumwas also detected and these two species of MTBC are the leading cause of pulmonary tuberculosis across all the North Central state of Nigeria.per state. The study included 371 positive sputum samples drawn from 2800 suspected pulmonary TB patients between 2017 and 2018.Original ResearchArticle

Application of positive psychological nursing model combined with dietary regulation in the treatment of constipative irritable bowel syndrome / 中国实用护理杂志

Objective@#To explore the application of positive psychological nursing model combined with dietary regulation in the treatment of constipative irritable bowel syndrome.@*Methods@#A total of 100 cases of constipation-predominant irritable bowel syndrome treated from August 2017 to May 2018 were randomly divided into control group and observation group, 50 cases in each group. The control group was given routine nursing intervention, while the observation group was given active psychological nursing intervention and dietary adjustment on the basis of routine nursing. After intervention, the clinical efficacy, psychological status and quality of life of the two groups were compared.@*Results@#The total effective rate of the observation group was 92.00%(46/50), which was significantly higher than that of the control group (72.00%,36/50). The difference was statistically significant (χ2=7.862, P<0.05). The scores of Symptom Checklist-90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group (12.97±2.65, 10.38±1.86, 13.86±1.63, 10.02±1.11, 13.03±1.18, 5.19±0.32, 7.94±1.26, 7.34±0.88, 6.29±1.02, 9.43±1.00, 50.64±5.21, 50.14±5.26) were significantly lower than those in the control group (21.88±3.65, 18.72±1.05, 17.21±1.99, 14.43±1.29, 19.46±1.45, 6.79±0.41, 9.15±1.37, 9.22±1.16, 8.90±1.92, 14.02±1.98, 40.42±3.89, 42.77±3.85) (t=-11.114-27.610, P<0.05). The scores of anxiety, pickiness, health anxiety and social reaction in the Irritable Bowel Syndrome-Quality of Life Scale (IBS-QOL) in the observation group (92.90±12.67, 89.55±14.11, 89.09±15.25, 86.22±16.36) were significantly better than those in the control group (80.04±16.58, 80.09±15.44, 78.25±16.53, 77.79±16.23) (t=-4.358--2.587, P<0.05).@*Conclusion@#Positive psychology combined with dietary regulation intervention can improve the therapeutic effect of patients with constipation-predominant irritable bowel syndrome, improve their mental and psychological symptoms, alleviate anxiety and depression, and improve the quality of life, which is worthy of wide clinical promotion.

Effect of Intestinal Microbiota in Regulating Visceral Hypersensitivity of IBS-D Based on Brain-gut Interacting Mechanism / 中国实验方剂学杂志

Diarrhea-predominant irritable bowel syndrome (IBS-D) is not only a biological mental disorder, but also a kind of chronic functional bowel disease induced by many factors. The pathogenesis of IBS-D is related to visceral sensory abnormalities, intestinal dynamics abnormalities, intestinal mucosal micro-inflammatory reactions, heredity, dietary intolerance and other factors. The visceral hypersensitivity is one of the main pathophysiology, and refers to an unknown cause of intestinal hypersensitivity to cold, bad mood and other stimuli. However, its mechanism remains unclear. The pathogenesis of IBS-D is closely related to the disturbance of brain and intestinal interaction. IBS-D patients often suffer from anxiety, depression and other psychiatric symptoms due to repeated illness, but long-term chronic mental stress can induce and aggravate IBS-D visceral hypersensitivity. Brain-derived neurotrophic factor (BDNF) and its high-affinity receptor tyrosine kinase B (TrkB) are hotspots in studies about brain-gut axis. BDNF is a highly expressed cytokine in the central nervous system and gastrointestinal tract, and can promote the development of the nervous system, maintain the normal function of mature nerve cells and regulate the gastrointestinal motility and visceral sensitivity. Intestinal microbiota is the key link of brain-gut interaction. Mental disorders are closely related to intestinal symptoms caused by changes in intestinal microbial environment. Repeated mental stimulation can lead to changes in intestinal flora; on the other hand, changes in intestinal flora structure are closely related to the development of the nervous system and the function of the brain. With intestinal microbiota as the study object, this article mainly discusses the effect of intestinal microbiota in regulating visceral hypersensitivity of IBS-D based on brain-gut axis (BDNF/TrkB signaling pathway).

Effect of Changji'an Prescription on Intestinal Permeability of IBS-D Rats / 中国实验方剂学杂志

Objective:To observe the effect of Changji'an prescription on intestinal permeability in diarrhea-predominant irritable bowel syndrome (IBS-D) rats and explore its mechanism for treatment of IBS-D. Method:Male SD neonatal rats were randomly divided into five groups:normal group, model group, pinaverium bromide group(0.018 g·kg-1), high-dose(33.48 g·kg-1) and low-dose (16.74 g·kg-1)Changji'an prescription groups. Except for the normal group, the IBS-D model was established by the combination of maternal and infant separation+acetic acid stimulation+restraint stress. After drug treatment, the ultrastructure of rat intestinal mucosa was observed by using transmission electron microscopy and the plasma D-lactate level was detected by enzyme-linked immunosorbent assay (ELISA). The expression levels of tight junction proteins Occludin and Claudin-1 were detected by Western blot. The mRNA expression levels of Occludin,Claudin-1 and zonula occluden(ZO)-1 were detected by real time polymerase chain reaction (Real-time PCR). Result:As compared with the normal group, the intestinal mucosal epithelial cells were damaged in IBS-D model group, and the microvilli arrangement was sparse and tight junction was widened, and some were not obvious,and the plasma D-lactate level in IBS-D rats was increased significantly (PPD-lactate level in pinaverium bromide group and high-dose Changji'an prescription group was significantly decreased (PD-lactate level in the low-dose group Changji'an prescription group had a tendency to decrease with no statistical difference. The mRNA and protein expression levels of Occludin and Claudin-1 and the mRNA expression of ZO-1 in the colon of rats in each administration group were higher than those in the model group (PConclusion:The therapeutic effect of Changji'an prescription on IBS-D may be achieved by improving the intestinal permeability.

Effects of fatigue-predominant subhealth on mechanical and thermal pain sensitivity in mice / 中国药理学通报

Aim: To study the effects of the fatigue-predominant subhealth on mechanical and thermal pain sensitivity in mice. Methods: Kunming mice were randomly divided into two groups (n = 10); normal control group (control), fatigue-predominant subhealth model group (fatigue). The physiological behavior, rota-rod test and blood routine indexes were examined. The paw withdrawal mechanical threshold (PWMT) and the paw withdrawal thermal latency (PWTL) were measured in order to reflect the change of the mechanical and thermal pain sensitivity. Results: Compared to control group, the fur of model group was markedly pale, the time of rota-rod test was significantly lower (P < 0. 01), the data of blood cells was nearly the same, the outcome of PWMT was increased (P < 0. 01), and PWTL was decreased (P < 0. 01). Conclusions The fatigue-predominant subhealth reduces the mechanical pain sensitivity and increases the thermal pain sensitivity in mice.