Bushen Huoxue Prescription Regulates PINP and β-CTX in Treatment of Femoral Head Necrosis with Syndrome of Liver and Kidney Deficiency / 中国实验方剂学杂志

ObjectiveTo explore the therapeutic mechanism of Bushen Huoxue prescription from the perspective of bone metabolism by observing the clinical efficacy of this prescription in treating femoral head necrosis （ONFH， syndrome of liver and kidney deficiency） and its influences on bone metabolism indexes： N-terminal propeptide （PINP） and β-collagen degradation product （β-CTX）. MethodSixty-six ONFH patients with the syndrome of liver and kidney deficiency in Zhengzhou Traditional Chinese Medicine Hospital of Orthopedics from December 2021 to September 2022 were selected. The patients were randomized into an experimental group and a control group by the parallel control method， with 33 patients in each group. The experimental group received Bushen Huoxue prescription orally， while the control group received Xianlinggubao Capsules orally， with a treatment cycle of 6 months. The visual analogue scale （VAS） score， Harris score， Association Research Circulation Osseous （ARCO） staging， imaging changes， quantitative scores of TCM symptoms， and serum levels of PINP and β-CTX were determined before and after treatment. The occurrence of adverse events and reactions was recorded. ResultThe total response rate in the experimental group was 83.87% （26/31）， which was higher than that （68.75%， 22/32） in the control group （Z=-2.096， P<0.05）. After treatment， the single and total scores of TCM symptoms， VAS score， and β-CTX level decreased in the two groups （P<0.05）. Moreover， the decreases in the scores of hip pain， lower limb mobility， soreness of waist and knees， and lower limb flaccidity， total score of TCM symptoms， VAS score， and β-CTX level in the experimental were larger than those in the control group （P<0.05）. After treatment， the imaging results showed no significant improvement in the two groups. The Harris score and PINP level in both groups increased after treatment （P<0.05）， and the increases were more obvious in the experimental group than in the control group （P<0.05）. No serious adverse event or adverse reaction appeared during the observation period. ConclusionBushen Huoxue prescription can relieve pain and TCM symptoms and improve the hip joint function in treating ONFH patients with the syndrome of liver and kidney deficiency. It can inhibit the development of ONFH， increase PINP， and decrease β-CTX. No obvious side effect appears during the clinical observation period， which shows that Bushen Huoxue prescription has good safety.

Exploration on the idea of reducing the reproductive toxicity of Tripterygium wilfordii from the theory of "Yi and Gui homology" in TCM / 国际中医中药杂志

Tripterygium wilfordii is widely used in the treatment of autoimmune system diseases, but its obvious reproductive toxicity limits the clinical application and promotion of the drug. At present, there is no clear solution to the reproductive injury of Tripterygium wilfordii. TCM believes that its reproductive toxicity lies in its properties of pungent, bitter, and cold. Long-term use can dry liver and blood, hurt liver and yang, consume kidney essence, damage kidney and yang, destroy the balance of qi and blood, yin and yang in the internal organs, and cause infertility. Based on the relationship between liver and kidney and human reproductive function, this article proposed to understand the reproductive toxicity of Tripterygium wilfordii from the perspective of "Yi and Gui homology", and explored the method of reducing the reproductive toxicity of Tripterygium wilfordii according to the thought of "treating liver and kidney together", in order to expand the theoretical thinking of TCM for the safe clinical application of this drug.

Discussion on the Pathogenesis of Osteonecrosis of the Femoral Head Under the System of Non-uniform Settlement During Bone Resorption and Multidimensional Composite Bowstring Working in Coordination with the Theory of Liver-Kidney and Muscle-Bone Based on the Concept of Liver and Kidney Sharing the Common Source / 广州中医药大学学报

From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.

Study on the Distribution Pattern of Traditional Chinese Medicine Syndromes in Patients with Dry Eye and Its Correlation with Gender and Age / 广州中医药大学学报

Objective To explore the etiology and pathogenesis of dry eye by studying the distribution pattern of gender,age and traditional Chinese medicine(TCM)syndrome type in dry eye patients and by analyzing their correlation.Methods A total of 244 patients with dry eye who met the inclusion criteria were selected.The distribution of gender,age and TCM syndrome types was statistically analyzed,and then the correlation of TCM syndrome types with gender and age of dry eye patients was explored.Results(1)Of the 244 dry eye patients,96(39.34%)were male and 148(60.66%)were female,the incidence of the female being higher than that of the male.There were 124(50.82%)patients younger than 45 years old,81(33.20%)patients aged 45-60 years old,and 39(15.98%)patients older than 60 years old.The proportion of the patients younger than 45 years old was higher than that of other age groups.(2)Among the 244 patients with dry eyes,89 cases(36.47%)were differentiated as liver and kidney deficiency syndrome,75 cases(30.74%)were differentiated as qi stagnation and blood stasis syndrome,69 cases(28.28%)were differentiated as spleen and kidney deficiency,and 11 cases(4.51%)were differentiated as yin deficiency and damp-heat syndrome.And the occurrence frequency of the above four syndrome types was in descending order.(3)In the dry eye patients of various age groups,patients aged＜45 years old predominantly suffered from qistagnation and blood stasis syndrome,accounting for 41.94%(52/124);patients aged 45-60 years old and those aged＞60 years old predominantly suffered from liver and kidney deficiency syndrome,accounting for 46.91%(38/81)and 53.85%(21/39),respectively.The distribution of TCM syndrome types varied in the patients with different age groups,and the difference was statistically significant(χ2 = 22.128,P＜0.01).(4)In male dry eye patients,qi stagnation and blood stasis syndrome was predominant,accounting for 39.58%(38/96);among female dry eye patients,liver and kidney deficiency syndrome and spleen and kidney deficiency syndrome were prevalent,accounting for 41.89%(62/148)and 31.08%(46/148),respectively.The distribution of TCM syndrome types varied in the patients with different genders,and the difference was statistically significant(χ2 = 82.610,P＜0.01).Conclusion The TCM syndromes of patients with dry eyes are frequently differentiated as liver and kidney deficiency syndrome,followed by the qi stagnation and blood stasis syndrome.The prevalence of dry eyes is related to the gender and age,and gender and age are correlated with the TCM syndrome types to certain extent.

GUAN Guo-Hua's Experience in Differentiating and Treating Central Serous Chorioretinopathy in Lingnan Area / 广州中医药大学学报

This article summarized Professor GUAN Guo-Hua's clinical experience in treating central serous chorioretinopathy(CSC)in Lingnan area.Based on the theory of"macula due to the spleen dysfunction",and by taking the geographical and climatic characteristics of Lingnan area as well as the body constitutional features of Lingnan residents into account,Professor GUAN Guo-Hua proposed that spleen deficiency leading to damp encumbrance was the fundamental pathogenesis of CSC in Lingnan area,and liver and kidney were gradually affected in the middle and late stages of CSC,which finally resulted into blood stasis and water retention.For the treatment of initial attack of CSC,the focus was on treating the spleen,and Erchen Decoction was adopted as the basic prescription for modified application to strengthen the spleen and drain dampness;for the treatment of CSC in the middle and late stages,the emphasis was on simultaneous treatment of the liver,spleen and kidney as well as blood and water,and Zhujing Pills and Wuling Powder were adopted as the basic prescriptions for nourishing the liver and kidney and for strengthening the spleen,activating blood and promoting urination.The treatment of the spleen is advocated throughout the whole treatment process,and the medication of drugs should be modified based on syndrome differentiation and according to the specific conditions,thus to achieve significant results.

Analysis of HUANG Feng's Medication Rules for Low Back Pain Based on Data Mining / 广州中医药大学学报

Objective To analyze the medication rules of Professor HUANG Feng for the treatment of low back pain using data mining methods.Methods The information of prescriptions for the effective cases of outpatients with low back pain treated by Professor HUANG Feng were collected and screened.Microsoft Excel 2019 was used to analyze the frequency of medication and the distribution of properties,flavors and meridian tropism of the drugs in the included prescription.IBM SPSS Modeler 18.0 was used for association rule analysis,and IBM Statistics 26.0 was used for cluster analysis.Results A total of 239 prescriptions and 75 Chinese medicines were included.There were 23 high-frequency Chinese medicines with the medication frequency being or over 20 times,and the top 10 Chinese medicines were Glycyrrhizae Radix et Rhizoma,vinegar-processed Corydalis Rhizoma,Cibotii Rhizoma,Atractylodis Macrocephalae Rhizoma,Zanthoxyli Radix,salt-processed Achyranthis Bidentatae Radix,Rehmanniae Radix,Dipsaci Radix,Coicis Semen,and Salviae Miltiorrhizae Radix et Rhizoma.The medicines were mainly warm in nature,and were sweet,bitter and pungent in flavor.Most of the drugs had the meridian tropism of liver,stomach and spleen meridians.Among the drug combinations obtained from association rule analysis with the top 20 highest support,vinegar-processed Corydalis Rhizoma,Cibotii Rhizoma,Atractylodis Macrocephalae Rhizoma and Zanthoxyli Radix were the core drugs.Cluster analysis yielded 6 clustering combinations.Conclusion For the treatment of low back pain,Professor HUANG Feng follows the principle of"treatment adapting to the climate,individuality,and environment"and"treating the root cause of the disease",usually adopts the drugs for activating blood,moving qi and relieving pain,nourishing the liver and kidney,and also uses the medicines for replenishing qi and strengthening the spleen.The ideas of HUANG Feng for the treatment of low back pain can be used as a reference for the clinical treatment.

Discussion on the Medication Rules of ZHONG Guang-Ling in Treating Lumbar Disc Herniation / 广州中医药大学学报

Objective To explore the medication rules of Professor ZHONG Guang-Ling's prescriptions for the treatment of lumbar disc herniation(LDH)based on data mining method,so as to provide reference for the treatment of LDH with Chinese medicine.Methods The prescriptions for the effective cases of outpatients of LDH treated by Professor ZHONG Guang-Ling in the recent 5 years were collected.The medication frequency of Chinese medicines in the included prescriptions and the distribution of their properties,flavors and meridian tropism were investigated.Moreover,the association rule analysis and cluster analysis of the high-frequency drugs were carried out.Results A total of 164 prescriptions were included and 168 Chinese medicines were used.The top 10 high-frequency drugs in descending order were Achyranthis Bidentatae Radix,Chuanxiong Rhizoma,Pheretima,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Gentianae Macrophyllae Radix,Angelicae Sinensis Radix,Rehmanniae Radix Praeparata,Persicae Semen,Cyperi Rhizoma,and Carthami Flos.The properties of the prescribed drug were mainly warm and mild in nature,and bitter and pungent in flavor,and mainly had the meridian tropism of the liver,kidney and spleen meridians.According to the therapeutic actions,the drugs were mainly categorized as deficiency-supplementing drugs,dampness-removing and collateral-unblocking drugs,and blood-activating and stasis-removing drugs.The results of association rule analysis yielded 10 drug pairs,and cluster analysis yielded 6 core drug combinations.Conclusion For the treatment of LDH,Professor ZHONG Guang-Ling usually adopts the Chinese medicine for supplementing the deficiency and supporting healthy-qi,together with the medicines for nourishing the liver and kidney and regulating the spleen and stomach from the perspective of liver,kidney and spleen.Moreover,therapy of activating blood and removing stasis is also stressed,pathogen-eliminating medicines for removing dampness,unblocking collaterals and clearing heat are used based on syndrome differentiation,and then simultaneous application of purging and nourishing therapeutics is achieved through the utilization of purging method after supplementing method.

Effects of polystyrene microplastics on growth and development and hepatic lipid metabolism in mice / 中国组织工程研究

BACKGROUND:Plastic as a durable,inexpensive,easy to manufacture organic synthetic polymer materials are widely used.At the same time,plastic resistance to high temperatures,acid and alkali resistance,corrosion-resistant properties make it difficult to degrade in nature,and ultimately forming a huge number of microplastic pollution threatening human health. OBJECTIVE:To investigate the effects of microplastic exposure on growth and development and hepatic lipid metabolism in mice. METHODS:Twenty C57BL/6J male mice were adaptively fed for one week,and then randomly divided into normal and microplastic groups(n=10 per group).Mice in the normal group were given a normal diet and water,for 4 weeks.Mice in the microplastic group were given a normal diet and free drinking of microplastic(polystyrene)water with a concentration of 1 000 μg/L,for 4 weeks.At 2 and 4 weeks of drinking,body mass and grip strength,blood lipids and liver and kidney function,ultrasonic morphology and pathological morphology of liver and lipid deposition were detected. RESULTS AND CONCLUSION:(1)With the extension of time,the body mass of mice in the two groups gradually increased,and the body mass of mice in the microplastic group was greater than that in the normal group after 2,4 weeks of drinking water(P<0.05).With the extension of time,the grip strength of mice in the normal group gradually increased,and the grip strength of mice in the microplastic group first decreased and then increased,and the grip strength of mice in the microplastic group was lower than that in the normal group after drinking water for 4 weeks(P<0.05).(2)Liver ultrasound examination showed that compared with the normal group,the ultrasonic echo signal of the liver in the microplastic group was enhanced after 2 and 4 weeks of drinking water.(3)Hematoxylin-eosin staining showed that the morphology of liver cells in the microplastic group did not change significantly after 2 and 4 weeks of drinking water,but inflammatory cell infiltration could be seen.Oil red O staining showed that obvious lipid deposition was observed in the liver of microplastic group after 2 and 4 weeks of drinking water.(4)Compared with the normal group,the levels of serum high density lipoprotein cholesterol,triacylglycerol,and aspartate aminotransferase in the microplastic group were decreased after 2 weeks of drinking water(P<0.05),and the serum triacylglycerol concentration was decreased after 4 weeks of drinking water(P<0.05).(5)These findings confirm that microplastics may cause weight gain,loss of physical strength,and abnormal hepatic lipid metabolism in mice.

Clinical Observation on Rongjin Tongbi Decoction in Treating Sciatica Caused by Lumbar Intervertebral Disc Herniation with Liver and Kidney Deficiency Type / 中国实验方剂学杂志

ObjectiveTo evaluate the efficacy and safety of Rongjin Tongbi decoction on sciatica caused by lumbar intervertebral disc herniation with liver and kidney deficiency type based on a randomized controlled study. MethodFrom January 2019 to July 2022， 90 patients in the department of Traditional Chinese medicine（TCM） of Beijing Jishuitan Hospital who met the inclusion criteria were selected and divided into two groups according to the random number table， with 45 patients in each group. During the study， 19 cases dropped out， with 41 cases included in the final observation group and 30 cases in the control group. The observation group was given Rongjin Tongbi decoction orally， and the control group was given Loxoprofen Sodium Tablets orally for 28 days. The differences in the visual analog scale （VAS） scores， the Japanese Orthopaedic Association （JOA） scores， activities of daily living （ADL） assessments， TCM clinical symptoms， subjective symptoms， and clinical signs scores between two groups before and after treatment were observed. Liver and kidney functions and gastrointestinal adverse reactions were detected for safety evaluation. ResultBefore treatment， there was no statistically significant difference in scores between the observation group and the control group. After treatment， the absolute values of the differences in VAS and ADL scores in the observation group were higher than those in the control group （P<0.05）. There was no statistically significant difference in the absolute value of the difference in JOA scores between two groups. The absolute value of the difference in TCM clinical symptom scores in the observation group was higher than that in the control group （P<0.01）. There was no statistically significant difference in the absolute values of the differences in subjective symptom and clinical sign scores between two groups. The levels of liver and kidney function indicators in both groups before and after the experiment were normal， and there was no significant difference in gastrointestinal reactions. ConclusionRongjin Tongbi decoction can significantly improve the symptoms of sciatica patients caused by lumbar intervertebral disc herniation with liver and kidney deficiency type. After treatment， the patients exhibited significant improvements in pain， activity and other aspects， and it is proven to be safe and reliable， which is conducive to the recovery of physical function.

Guidelines for clinical diagnosis and treatment of combined liver and kidney transplantation / 器官移植

Combined liver and kidney transplantation has been steadily applied in major transplantation centers, saving the lives of many patients with end-stage liver and renal failure. However, there are still multiple unresolved problems in the clinical diagnosis, treatment and long-term prognosis of combined liver and kidney transplantation. By referring to "Technical Operating Standards for Combined Liver and Kidney Transplantation (2019 Edition)" and the latest published literature and guidelines at home and abroad, "Guidelines for Clinical Diagnosis and Treatment of Combined Liver and Kidney Transplantation" was formulated. Recommendations and suggestions were delivered regarding the surgical indications and contraindications, preoperative preparation and evaluation, the timing of transplantation for end-stage liver and kidney diseases, the selection of surgical approaches and postoperative follow-up, specific pathophysiology, surgical techniques, complication management and immunosuppressive treatment of combined live and kidney transplantation, aiming to enhance the utilization rate of grafts and improve the survival and prognosis of combined liver and kidney transplant recipients.

Effects of astragalus polysaccharides on improvement of liver and kidney injury and regulation of intestinal flora structure in cadmium-exposed rats / 中国药理学通报

Aim To investigate the effects of astragalus polysaccharides on the improvement of liver and kidney injury and the regulation of intestinal flora structure in cadmium exposed rats. Methods Rats exposed to cadmium were established by intraperitoneal injection of CdCl2. After continuous intragastric administration of astragalus polysaccharides for five weeks, urine, liver, kidney and feces were collected. The cadmium residues in urine, liver and kidney were detected by Graphite Furnace Atomic absorption spectrometry, the pathological changes of liver and kidney were observed by HE staining, and Illumina PE250 sequencing and bioinformatics software were used to analyze the structure of intestinal flora. Results After intraperitoneal injection of CdCl2, the accumulation of cadmium in urine, liver and kidney increased significantly, some liver and kidney cells showed pathological damage such as swelling, necrosis and inflammatory cell infiltration. Chao, ace and shannon indexes decreased significantly, while simpson index increased significantly. The number of OTU decreased. And the abundance of Ruminococcus, Bacteroides, Flavonifractor, Roseburia and Elusmicrobium decreased significantly, but Lactobacillus, that of Lachnospiracea_incertae_sedis, Parasutterella, Clostridium XlVb, Clostridium XI, Integinimonas and Fusobacterium increased significantly. Compared with the normal control group, the differences was statistically significant(P<0.05 or P<0.01). After intragastric administration of astragalus polysaccharides, cadmium accumulation in urine, liver and kidney decreased significantly, liver and kidney cell damage alleviated, and inflammatory cell infiltration reduced. Chao, ace and shannon index increased markedly, and simpson index decreased significantly. OTU number increased. And the bundance of Prevotella, Bacteroides, Parasutterella, Elismicrobium and Barnesiella raised significantly, that of Ruminococcus, Oscillibacter, Flavonifractor, Clostridium XlVa, Roseburia, Lactobacillus, Ruminococcus2, Lachnospiracea_incertae_sedis, Clostridium IV, Clostridium XlVb, Clostridium XI and integinimonas decreased significantly, which was statistically significant compared with the group exposed to cadmium alone(P<0.05 or P<0.01). Conclusions Astragalus polysaccharides may improve liver and kidney injury by reducing cadmium accumulation and regulating the structure of intestinal flora in cadmium exposed rats.

Observation of the therapeutic effect of Liuwei Dihuang decoction on thrombocytopenia of liver and kidney yin deficiency in hemodialysis patients / 药物流行病学杂志

Objective To explore the clinical effect of Liuwei Dihuang decoction on thrombocytopenia(HIT)of liver and kidney yin deficiency in hemodialysis patients.Methods 84 hemodialysis patients with liver and kidney yin deficiency HIT were randomly divided into observation group and control group,with 42 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with Liuwei Dihuang decoction on the basis of the control group.The scores of liver and kidney yin deficiency syndrome before and after treatment and the curative effect of traditional Chinese medicine syndrome were compared between the two groups,and the platelet count(Plt),P-selectin level,HIT antibody before and after treatment,the platelet recovery time and clinical efficacy and adverse reactions of the two groups were also compared.Results After 1 month of treatment,the scores of liver and kidney yin deficiency syndrome in the two groups were both lower than those before treatment(P<0.05),which in the observation group was lower than that of the control group(P<0.05).The total effective rate of traditional Chinese medicine syndromes in the observation group(97.62%)was higher than that in the control group(P<0.05).After 14 d of treatment,the Plt of the two groups were both higher than those before treatment,while the levels of P-selectin and the positive rate of HIT antibody of the two groups were lower than those before treatment(P<0.05),and the Plt in the observation group was higher than that of the control group,the levels of P-selectin and the positive rate of HIT antibody in the observation group were lower than those in the control group(P<0.05).The platelet recovery time in the observation group was shorter than that in the control group(P<0.05),the total effective rate of clinical treatment in the observation group(95.24%)was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion On the basis of conventional western medicine treatment,the addition of Liuwei Dihuang decoction to treat HIT of liver and kidney yin deficiency in hemodialysis patients can improve the clinical efficacy,reduce the clinical symptoms of patients,improve the level of Plt,shorten the recovery time of platelet,and reduce the level of P-selectin and the positive rate of HIT antibody,with good safety,which is worthy of clinical promotion.

Primary hyperoxaluria type II and organ transplantation / 器官移植

Primary hyperoxaluria type Ⅱ (PH2) is an inherited disorder of the glyoxylate metabolism caused by the gene mutation of glyoxylate reductase/hydroxypyruvate reductase (GRHPR). PH2 is characterized by recurrent nephrolithiasis and nephrocalcinosis, which may even progress into end-stage renal disease. Currently, organ transplantation is the only treatment option for PH2, which mainly includes two strategies: kidney transplantation and combined liver and kidney transplantation. Kidney transplantation yields a high risk of recurrence of oxalate nephropathy, which may cause early graft dysfunction. Combined liver and kidney transplantation could mitigate the deficiency of oxalate metabolism, whereas it yields a high risk of graft complications. PH2 is an extremely rare disorder. No consensus has been reached on the indications, surgical selection and perioperative management of organ transplantation for PH2 patients. In this article, the pathogenesis, diagnosis, monitoring and organ transplantation experience of PH2 were reviewed, aiming to divert clinicians' attention to PH2 and provide reference for determining diagnosis and treatment regimens, especially transplantation strategy for PH2 patients.

Haematological and Hepatorenal Alterations Induced by Potash (Akanwu) on Male Wistar Rats

Introduction: Potash refers to the various naturally occurring water-soluble compounds of potassium used as a traditional food additive in Nigeria. Several health warnings have highlighted the deleterious effect of their consumption. Aim: The present study is aimed at evaluating the effects of graded doses of potash consumption on haematological and hepatorenal indices using Wistar rat models. Materials and Methods: Potash was locally sourced and the elemental composition was determined by X-Ray diffraction (XRD). Twenty (20) male Wistar rats (170 –200g) were used for the study and were divided into four (4) groups of five (5) animals each. Group 1 served as the control while Groups 2 –4 served as the experimental group and received an aqueous mixture of potash via oral gavage at 200, 400 and 800mg/kg respectively for thirty (30) days. Results:XRD elemental analysis of potash revealed the presence of potassium (27.44%), phosphorus (14.27%), antimony (5.18%), barium (4.27%), fluorine (2.78%), cadmium (2.06%), yttrium (1.63%), tellurium (1.32%), caesium (1.12%), niobium (1.04%), sodium (0.42%) and germanium (0.06%). Results from haematological and hepatorenal parameters show a significant reduction in mean values of red blood cell count, haemoglobin concentration and packed cell volume among the experimental groups compared to control (p<0.05) and significantly increased mean corpuscular volume, mean corpuscular haemoglobin, white blood cell count, lymphocytes, neutrophils, MID cell percentage, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, urea, creatine, sodium, potassium and chloride ions among the experimental group compared to thecontrol(P<0.05). Conclusion: The data presented has shown that the chronic consumption of potash at 800mg/kg can negatively alter the haematological and hepatorenal profiles of Wistar rats. Therefore, this study considers potash, a possible toxicant to the blood, liver and kidney

Clinical Efficacy of Gandou Fumu Granules on Wilson Disease with Liver-kidney Deficiency and Phlegm-blood Stasis / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Gandou Fumu granules （GDFM） in the treatment of Wilson disease （WD） with liver-kidney deficiency and phlegm-blood stasis. MethodNinety WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into a control group （45 cases） and a treatment group （45 cases）. All patients were treated with sodium 2，3-dimercaptopropane-1-sulfonate （DMPS）， while those in the treatment group received additional GDFM. All patients were treated for four courses （32 days）. The traditional Chinese medicine （TCM） syndrome scores，clinical effective rate，24 h urinary copper，ceruloplasmin （CER），tumor necrosis factor-α（TNF-α），interleukin-1β（IL-1β），interleukin-6 （IL-6），superoxide dismutase （SOD），glutathione peroxidase （GSH-Px） and malondialdehyde （MDA） levels of the two groups before and after treatment were observed. ResultAfter treatment， the TCM syndrome scores of the two groups decreased （P<0.01），and the score of TCM syndrome in the treatment group was lower than that of the control group （P<0.01）. The total effective rate of the treatment group was 82.22% （37/45）， higher than 57.78% （26/45） of the control group （χ2=6.402，P<0.05）. There was no significant difference in CER before and after treatment in both groups. The post-treatment 24 hour urinary copper increased （P<0.01）， which was higher in the treatment group than that in the control group （P<0.05）. The TNF-α，IL-1β， and IL-6 levels were significantly reduced in both groups after treatment（P<0.01），and the above indicators in the treatment group were significantly lower than those in the control group （P<0.01）. After treatment，the SOD level increased and the MDA level decreased in the control group （P<0.01）， while no significant difference in GSH-Px level was observed. The SOD and GSH-Px levels increased and the MDA level decreased in the treatment group （P<0.01）. After treatment， SOD and GSH-Px levels of the treatment group were higher than those in the control group， while the MDA level was lower than that in the control group（P<0.05，P<0.01）. ConclusionGDFM can improve the TCM syndrome score and clinical efficacy，enhance the copper removing effect，and inhibit the inflammatory response and antioxidative stress in the treatment of WD with liver and kidney deficiency and phlegm-blood stasis.

Clinical observation of Tiaoshen acpuncture for dry eye syndrome with yin deficiency of liver and kidney / 中国针灸

OBJECTIVE@#To compare the curative effect of Tiaoshen acupuncture combined with artificial tears and artificial tears alone for dry eye syndrome with yin deficiency of liver and kidney.@*METHODS@#A total of 70 patients of dry eye syndrome with yin deficiency of liver and kidney were randomized into an acupuncture combined with medication group (35 cases, 2 cases dropped off) and a medication group (35 cases, 3 cases dropped off). In the medication group, 0.1% sodium hyaluronate eye drop was applied, 3 times a day, 1 drop each time. On the basis of the treatment as the medication group, Tiaoshen acupuncture was applied at Shenting (GV 24), Shenmen (HT 7), Benshen (GB 13), Taixi (KI 3), Taichong (LR 3), Guangming (GB 37), Fengchi (GB 20), Tongziliao (GB 1), Yuyao (EX-HN 4) in the acupuncture combined with medication group, Tongziliao (GB 1) and Yuyao (EX-HN 4) were connect with electroacupuncture, the needles were retained for 30 min, once a day, 6 times a week. Both groups were treated for 2 weeks. Before and after treatment, the clinical symptom score, SchirmerⅠtest (SⅠT), break-up time (BUT), corneal fluorescein staining (FL) score and Hamilton anxiety scale (HAMA) score were observed in the two groups, and the clinical efficacy was compared in the two groups.@*RESULTS@#Compared before treatment, the clinical symptom scores, corneal FL and HAMA scores were decreased (P<0.05), the levels of SⅠT and BUT were increased after treatment in the two groups (P<0.05). After the treatment, the clinical symptom score, FL and HAMA scores in the acupuncture combined with medication group were lower than the medication group (P<0.05), the levels of SⅠT and BUT in the acupuncture combined with medication group were higher than the medication group (P<0.05). The total effective rate in the acupuncture combined with medication group was 90.9% (30/33), which was higher than 71.9% (23/32) in the medication group (P<0.05).@*CONCLUSION@#Tiaoshen acupuncture combined with artificial tears could promote the secretion of tears for patients of dry eye syndrome with yin deficiency of liver and kidney, repair corneal defect and prolong tear film break-up time, and alleviate anxiety state, its curative effect is better than simple artificial tears.

Clinical study on thermal moxibustion combined with Duhuo Jisheng Decoction for the patients with knee osteoarthritis and liver and kidney deficiency syndrome / 国际中医中药杂志

Objective:To explore the clinical efficacy of thermal moxibustion combined with Duhuo Jisheng Decoction in the treatment of liver and kidney deficiency syndrome of knee osteoarthritis (KOA).Methods:From January 2020 to January 2021, 124 KOA patients with liver and kidney deficiency syndrome, who met the inclusion criteria, were divided into 2 groups according to the random number table method, with 62 in each group. The control group was treated with Duhuo Jisheng Decoction, and the observation group was treated with thermal moxibustion on the basis of the control group. Both groups were treated for 28 days. TCM symptom scores were performed before and after treatment, the Osteoarthritis Index of Western Ontario and McMaster University (WOMAC) was used to evaluate joint function. ELISA was used to detect serum insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2), transforming growth factor-β1 (TGF-β1), IL-1β, IL-6, TNF-α levels, and the clinical efficacy was evaluated.Results:The total effective rate was 91.9% (57/62) in the observation group and 77.4% (48/62) in the control group, and there was significant difference between two groups ( χ2=5.04, P=0.025). After treatment, the TCM symptom score and WOMAC score of the observation group were significantly lower than those of the control group ( t values were 11.33 and 12.23, respectively, all Ps<0.01). After treatment, the serum levels of IGF-1 [(15.63±2.03) ng/L vs. (12.78±1.57) ng/L, t=8.75], FGF-2 [(30.26±5.37) ng/L vs. (26.31±1.94) ng/L, t=5.45] and TGF-β1[(30.39±6.71)μg/L vs. (24.31±5.12) μg/L, t=5.67] in the observation group were significantly higher than those in the control group ( P<0.01), while the levels of IL-1β [(12.50±3.36) ng/L vs. (16.09±4.90) ng/L, t=4.76], IL-6 [(10.59±3.28) ng/L vs. (21.75 ± 4.09) ng/L, t=16.76] and TNF-α [(4.04±1.92) ng/L vs. (6.48±1.43) ng/L, t=8.03] in the observation group were significantly lower than those in the control group ( P<0.01). There was no adverse events from both groups during treatment. Conclusion:Thermal moxibustion combined with Duhuo Jisheng Ddecoction can alleviate the joint pain of KOA patients with liver and kidney deficiency syndrome, promote cartilage repair and improve the clinical curative effect.

Prevention and treatment strategy of hypertension based on etiology and pathogenesis of "lower deficiency and upper excess" / 国际中医中药杂志

The etiology and pathogenesis of patients with hypertension are lower deficiency and upper excess. The deficiency below the etiology comes first, and then leads to upper excess. Lower deficiency is manifested by the yin deficiency of liver and kidney. The clinical symptoms are lumbar and knee weakness, or low back pain, or lower limb weakness, or systemic fatigue, or dry throat. In fact, it is mostly manifested as excess of liver yang, manifesting Qi inversion symptoms of high blood pressure, dizziness, dry throat, or bitter mouth, or headache, or tinnitus and deafness, or palpitations, or chest pain, or gastroesophageal reflux, or heartburn acid reflux, which are also named like hyperactivity of liver yang, liver yang heat, liver defencing spleen, or spleen deficiency leading to phlegm. Deficiency of liver and kidney leads to yin failing to restrain yang, resulting in hyperactivity of liver yang, spleen deficiency generating phlegm, and phlegm blocking orifices. Hypertension is due to deficiency of liver and kidney, and its sign is hyperactivity of liver yang. Therefore, lower deficiency and upper excess process and guides the treatment and prevention of hypertension. In the treatment, with the principle of lower deficiency and upper excess, we can nourish liver and kidney Yin to defence liver Yang for hypertension.

Effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with liver-kidney yin deficiency syndrome / 国际中医中药杂志

Objective:To investigate the effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with kidney-qi deficiency and cold syndrome.Methods:A total of 64 patients with rheumatoid arthritis in our hospital from March 2019 to March 2020 who met the inclusion criteria were divided into 2 groups, according to the random number table method, with 32 in each group. The control group was given conventional western medicine therapy, and the observation group was given Duhuo Jisheng decoction on the basis of the control group. Both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum CRP, IL-6, cartilage oligosaccharide protein (COMP) and β-catenin were detected by ELISA method, and adverse eventns during treatment were observed and compared. The clinical efficacy was evaluated.Results:The total effective rate was 87.5% (28/32) in the observation group and 65.6% (21/32) in the control group, and the difference between the two groups was statistically significant ( χ2=4.27, P=0.039). After treatment, the main symptoms, secondary symptoms and tongue and pulse scores of the observation group were significantly lower than those in the control group ( t=7.11, 3.11, 2.41, P<0.01 or P<0.05); serum CRP and IL-6 levels were significantly lower than those in the control group ( t=3.04, 4.56, P<0.01); serum COMP [(12.37±1.68) μg/L vs. (14.24±1.88) μg/L, t=4.20], β-catenin [(1.35±0.24) μg/L vs. (1.68±0.31) μg/L, t=4.76] levels were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse events was 25.0% (8/32) in the observation group and 18.8% (6/32) in the control group, and there was no significant difference between the two groups ( χ2=0.37, P=0.546). Conclusion:The Duhuo Jisheng Decoction can help to reduce the levels of inflammatory cytokines and early cartilage destruction markers in patients with rheumatoid arthritis, and improve the clinical efficacy safely.

Toxicity of Chemotherapeutics Based on Viscera-state doctrine / 中国实验方剂学杂志

Malignant tumors are important diseases that threaten human health. Although targeting and immunotherapy have been gradually applied in the treatment of malignant tumors in recent years， which can alleviate the suffering of patients to a certain extent， there are still problems of large adverse reactions and easy drug resistance. At present， chemotherapy is still the main method for the treatment of malignant tumors. While killing tumor cells， chemotherapy also damages normal cells， which often leads to drug toxicity， such as bone marrow suppression， gastrointestinal adverse reactions， liver and kidney function damage， and oral mucosal reactions. Although modern medicines have a certain effect on the toxicity of chemotherapy drugs， there are still limitations. Traditional Chinese medicine（TCM） has a long history of treating malignant tumors， and considers that chemotherapy is a drug with toxin invading the body， exacerbating the "deficiency"， "toxin" and "stasis" of the body， causing damage to Qi， blood and organs， especially in spleen， stomach， liver and kidney， and leading to bone marrow suppression， liver and kidney function injury and other adverse reactions. Studies have confirmed that the use of TCM treatment has a better clinical efficacy. Therefore， new therapies shall be explored based on the basic theory of traditional Chinese medicine. As the core part of the theoretical system of TCM， Viscera-state doctrine is closely related to looking， listening， questioning and feeling the pulse of TCM， and has constantly developed and improved. It has important significance in guiding diagnosis and treatment of diseases. This study is guided by viscera-state doctrine of TCM and based on the etiology and pathogenesis of TCM. It starts with the clinical manifestations of common drug toxicity of chemotherapy drugs， such as bone marrow suppression， gastrointestinal adverse reactions， liver and kidney function damage， oral mucosal reactions， which are external signs of the toxicity of chemotherapeutic drugs， and associates pathological manifestations of viscera to physiological functions. From elephants and Tibetans， it systematically summarizes the viscera characteristics of various common chemotherapeutic drugs and provides new ideas and methods for clinical use of TCM in treating the toxicity of chemotherapeutic drugs， so as to promote the application of viscera-state doctrine in diagnosis and treatment of diseases.