Syndrome Differentiation and Treatment of Obesity from "Orchids to Eliminate Stagnant Qi" / 中国实验方剂学杂志

Obesity is a chronic， recurrent， and progressive metabolic disorder characterized by the abnormal or excessive accumulation of body fat caused by multiple factors such as genetics， dietary structure， lifestyle and behavior， psychology， environment， and society， leading to an energy surplus. Obesity is a major risk factor that increases the risk of developing various chronic diseases， including type 2 diabetes， hypertension， cardiovascular diseases， stroke， and certain malignancies. The global incidence of obesity is increasing year by year. With the continuous improvement of people's living standards， more than half of adults in China are now overweight or obese， posing a serious threat to people's health and increasing the social and economic burden. It has become a pressing major public health issue that needs to be addressed urgently. The concept of obesity can be traced back to the Huangdi’s Internal Classic （Huang Di Nei Jing）， which describes it as "the problems in fat and affluent people are caused by excessive taking of rich food"， and suggests that ''frequent intake of rich and greasy foods can produce interior heat. Sweet flavor causes chest fullness. That is why its spleen-Qi flows upwards and changes into consumption-thirst disease. It can be treated by Eupatorii Herba which is used to remove stagnant Qi''. The stagnant qi is caused by the transformation failure of rich and greasy food and wine， so obesity is the disease of stagnant qi. Obesity is caused by indulging in rich and greasy food， wine， spicy and flavorful foods， raw and cold foods， and sweet and greasy foods， or overeating and leading a sedentary lifestyle， staying up late， or experiencing emotional imbalances such as excessive joy， anger， worry， pensiveness， and fear. It can also be caused by congenital abnormalities， leading to improper functioning of the spleen and stomach， dysregulation of the absorption and secretion of the small intestine， and the accumulation of stagnant Qi in the organs and muscles， resulting in a plump physique. The intake of food and drink depends on the functions of the stomach in receiving and decomposing， the small intestine in absorbing and secreting， and the spleen in transforming and transporting. The affected organs in obesity are the spleen， stomach， and small intestine. Orchids， specifically Eupatorii Herba and Lycopi Herba， are aromatic herbs that can regulate the smooth flow of Qi， eliminate stagnation， and cleanse impurities. In a broader sense， any aromatic and pungent substance that can invigorate the spleen， promote clarity， harmonize the stomach， reduce turbidity， and assist in the normal secretion and absorption functions of the small intestine， thereby eliminating excess， is referred to as orchid. Therefore， the treatment principle for obesity is to use ''orchids to eliminate stagnant Qi''， aiming to regulate the functions of the spleen， stomach， and small intestine using aromatic and pungent substances， gradually eliminating excessive dampness， phlegm， turbidity， and heat， and restore the balance of the middle energizer. This way， individuals who are obese can achieve a non-obese state.

Effect of Modified Huangqi Guizhi Wuwutang on Apoptosis-related Bax and Caspase-12 of Sciatic Nerve Cells in Diabetes Rats / 中国实验方剂学杂志

ObjectiveTo investigate the effect of modified Huangqi Guizhi Wuwutang （MHGW） on the protein and mRNA expression of B-cell lymphoma-2-associated X protein （Bax） and cysteinyl aspartate specific proteinase-12 （Caspase-12） related to the apoptosis of sciatic nerve cells in diabetes rats to explore the mechanism of MHGW in the treatment of peripheral neuropathy in diabetes. MethodAnimal experiments were conducted. A diabetes model was induced in sixty male sprague-dawley （SD） rats by feeding on a high-sugar and high-fat diet combined with streptozotocin （STZ） intraperitoneal injection. Rats with random blood glucose levels ≥ 16.7 mmol·L-1 for three consecutive days were considered to have successfully developed diabetes. Forty-eight rats that successfully developed diabetes were randomly divided into a model group， an α-lipoic acid group （0.026 8 g·kg-1·d-1）， a high-dose MHGW group （2.5 g·kg-1·d-1）， and a low-dose MHGW group （1.25 g·kg-1·d-1）， with 12 rats in each group. Another 10 rats were assigned to the normal group. Body weight and random blood glucose levels of the rats were monitored. At the end of a 16-week intervention period， the sciatic nerve conduction velocity of the rats was measured using the Key point electromyography collection system. The protein and mRNA expression of Bax and Caspase-12 in the sciatic nerve cells was detected by Western blot analysis and real-time quantitative polymerase chain reaction （Real-time PCR）， respectively. ResultCompared with the normal group， the model group showed a significant decrease in body weight （P<0.01） and a significant increase in random blood glucose levels （P<0.01）. After a 16-week intervention， compared with the model group， the high-dose MHGW group exhibited a significant increase in body weight （P<0.05）， while there were no statistically significant differences in body weight changes among the other treatment groups. Random blood glucose levels significantly decreased in all treatment groups （P<0.01）. After 16 weeks of intervention， compared with the normal group， the model group had significantly reduced motor and sensory nerve conduction velocities （P<0.01）. Compared with the model group， all treatment groups showed significant increases in motor and sensory nerve conduction velocities （P<0.05， P<0.01）. The expression of Bax and Caspase-12 proteins in the sciatic nerve cells was significantly elevated in the model group compared with that in the normal group （P<0.01）. In contrast， all treatment groups showed significant reductions in the expression of Bax and Caspase-12 proteins in the sciatic nerve cells as compared with that in the model group （P<0.01）. The expression of Bax and Caspase-12 mRNA in the sciatic nerve cells significantly increased in the model group compared with that in the normal group （P<0.01）. Compared with the model group， the α-lipoic acid group and the high-dose MHGW group showed significant reductions in the expression of Bax mRNA in the sciatic nerve cells （P<0.05， P<0.01）， while the low-dose MHGW group showed a decreasing trend in the expression of Bax mRNA. The expression of Caspase-12 mRNA in the sciatic nerve cells significantly decreased in all treatment groups （P<0.01）. ConclusionMHGW may improve and repair sciatic nerve damage in diabetes rats by inhibiting sciatic nerve cell apoptosis.

Effect of Modified Huangqi Guizhi Wuwutang on Stress-related IRE1α/CHOP Pathway of Sciatic Nerve Endoplasmic Reticulum in Diabetes Rats / 中国实验方剂学杂志

ObjectiveTo investigate the protective effect of modified Huangqi Guizhi Wuwutang （MHGW） on endoplasmic reticulum stress in the sciatic nerve of diabetes rats based on the pathways of inositol-requiring enzyme 1α （IRE1α） and CCAAT/enhancer-binding protein homologous protein （CHOP）. MethodSixty rats were fed on a high-sugar and high-fat diet for six weeks， followed by intraperitoneal injection of streptozotocin at a dose of 35 mg·kg-1. Random blood glucose levels were measured three days later and rats with a sustained blood glucose level ≥ 16.7 mmol·L-1 were included in study （n=48）. The rats were randomly divided into a model group， an α-lipoic acid group （0.026 8 g·kg-1·d-1）， a high-dose MHGW group （2.5 g·kg-1·d-1）， and a low-dose MHGW group （1.25 g·kg-1·d-1）. Another 10 rats were assigned to the normal group. The intervention lasted for 16 weeks. After 16 weeks， the sciatic nerve structure of the rats in each group was observed under light microscopy using Luxol fast blue （LFB） staining. Transmission electron microscopy was used to observe the ultrastructure of the sciatic nerve. Chemiluminescence method was employed to measure the serum reactive oxygen species （ROS） levels. Western blot and real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were used to evaluate the expression of p-IRE1α protein， IRE1α mRNA， CHOP protein， and CHOP mRNA in the sciatic nerve of the rats. ResultCompared with the normal group， the model group showed elevated serum ROS levels （P<0.01）. In contrast， the serum ROS levels were significantly reduced in the treatment groups compared with those in the model group （P<0.01）. The sciatic nerve of the model group showed pathological changes compared with that in the normal group， while the treatment groups exhibited improvement in sciatic nerve pathology compared with the model group. The protein expression of p-IRE1α and CHOP in the sciatic nerve significantly increased in the model group as compared with that in the normal group （P<0.01）. However， the treatment groups showed a significant decrease in the protein expression of p-IRE1α and CHOP in the sciatic nerve compared with the model group （P<0.05， P<0.01）. Furthermore， compared with the normal group， the model group showed upregulated mRNA expression of IRE1α and CHOP in the sciatic nerve （P<0.01）， while the treatment groups exhibited a significant decrease in the mRNA expression of IRE1α and CHOP compared with the model group （P<0.01）. ConclusionMHGW can alleviate endoplasmic reticulum stress-induced cell apoptosis and improve the structure and function of the sciatic nerve in diabetes rats by inhibiting the expression of IRE1α/CHOP pathway-related proteins and mRNA， thereby preventing and treating peripheral neuropathy in diabetes.

Analysis of status and influencing factors of parents' discharge preparation for preterm infants in intensive care unit / 中国实用护理杂志

Objective:To understand the level of discharge preparation of parents of premature infants in intensive care unit, and investigate the status of discharge preparation of parents of premature infants and its influencing factors.Methods:Convenient sampling was used to recruit the 202 parents of preterm infants who stayed in the neonatal intensive care unit in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May to December 2018. The characteristics questionnaire and the Chinese version of Readiness for Hospital Discharge Scale-Parent Form were used to collect data.Results:The total score of parents' readiness for discharge of premature infants ranged from 111 to 290 (222.28±34.81). Multiple linear stepwise regression analysis showed that birth gestational age, birth weight, parity, parents' gender, annual family income were the influencing factors of premature parents' discharge readiness( P<0.05). Conclusions:The parents of premature infants in NICU are not well prepared for discharge. Medical staff should pay more attention to premature infants with low birth age and weight, first-born parents and low-income parents, so as to improve the discharge guidance content, help them prepare for discharge in all aspects and improve their care ability after discharge.

The Role of Intestinal Fungi and Its Metabolites in Chronic Liver Diseases

Current studies have confirmed that liver diseases are closely related to intestinal microorganisms; however, those studies have mainly concentrated on bacteria. Although the proportion of intestinal microorganisms accounted for by colonizing fungi is very small, these fungi do have a significant effect on the homeostasis of the intestinal microecosystem. In this paper, the characteristics of intestinal fungi in patients with chronic liver diseases such as alcoholic liver disease, nonalcoholic fatty liver disease and cirrhosis are summarized, and the effects of intestinal fungi and their metabolites are analyzed and discussed. It is important to realize that not only bacteria but also intestinal fungi play important roles in liver diseases.

Effects of different adding time of human milk fortifier on the incidence of complication and catch-up growth of low birth weight premature infants / 中国实用护理杂志

Objective:To investigate the effects of different adding time of human milk fortifier on the incidence of complication and catch-up growth of low birth weight premature infants.Methods:A total of 150 low birth weight premature infants were assigned to early fortification group, middle fortification group and delayed fortification group, each 50 cases. In early fortification group, adding human milk firtifier in the enteral intake of 70-85 ml/kg·d, 70-85 ml/kg·d and 86-100 ml/kg·d in the middle fortification group and delayed fortification group, respectively. The incidence of complication and growth development during hospitalization were compared between three groups. Meanwhile, the catch-up growth of low birth weight premature infants were follow-up in three groups.Results:The weight growth rate in the early fortification group was (15.45±2.54) g kg -1·d -1, and middle fortification group was (15.13±2.21) g kg -1·d -1, and the delayed fortification group was (13.50±2.02) g kg -1·d -1, the difference was statistically significant ( F value was 10.676, P<0.01). The incidence of feeding intolerance in the early fortification group was 20.0% (10/50), he middle fortification group was 6.0% (3/50), and delayed fortification group was 4.0% (2/50), the difference was statistically significant ( χ2 value was 8.444, P<0.05). However, there was no significant difference in the incidence of complication and growth development during hospitalization between the three groups ( P>0.05). Repeated measures ANOVA showed that, the differences of body weight, body length and head circumference were statistically significant for the time main effect and group main effect ( F values were 6.291-965.062, P<0.01). In addition, the differences of body length were statistically significant for the group by time interaction ( F value was 5.752, P<0.01). The body weight in the corrected postnatal age 2 months in the early fortification group, middle fortification group and delayed fortification group were (3 017.83±347.40), (2 897.27±315.35), (2 761.22±319.23)g, and the body weight in the corrected postnatal age 3 months were (3 947.67±461.99), (3 844.85±434.68), (3 647.78±418.62)g; the body length in the corrected postnatal age 3 months of the early fortification group, middle fortification group, and the delayed fortification group were (57.87±3.97), (57.19±2.98), (54.27±2.94) cm) and head circumference were (38.13±3.75), (37.13±4.28), (35.42±2.82)cm, the difference was statistically significant ( F values were 6.987, 5.479, 15.035, 6.473, P<0.01). Conclusion:Human milk firtifier with enteral intake of 70-85 ml/kg·d contributes to catch-up growth in low birth weight premature infants, as well as not to the increases in the incidence of feeding intolerance.

Value of hydrogen proton magnetic resonance spectroscopy in the determination of liver triglyceride in patients with fatty liver disease and its influencing factors / 中华肝脏病杂志

Objective@#To investigate the value of 1H-magnetic resonance spectroscopy (1H-MRS) in determining the content of liver triglyceride in patients with fatty liver disease (FLD), as well as its influencing factors.@*Methods@#A total of 124 patients with nonalcoholic fatty liver disease (NAFLD), chronic hepatitis B (CHB), or hepatitis B complicated by FLD who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were enrolled, and the clinical data, serological markers, FibroScan results, and 1H-MRS results were collected. A correlation analysis was performed with the results of liver biopsy as the gold standard, and the influence of factors including hepatitic B virus (HBV) infection and obesity on accuracy was analyzed. A one-way analysis of variance was used for comparison of means between the three groups, and the LSD or SNK test (for homogeneity of variance) or the Tamhane’s or Dunnett’s test (heterogeneity of variance) was used for comparison between any two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. The MRS-PDFF receiver operating characteristic (ROC) curve was plotted, the area under the ROC curve (AUC) was calculated, the optimal cut-off points for the diagnosis of NAFLD were estimated, and sensitivity and specificity were calculated.@*Results@#The NAFLD group (42 patients) and the CHB + NAFLD group (40 patients) had a significantly higher proton density fat fraction (PDFF, the content of triglyceride in the liver) than the CHB group (42 patients) (16.84±9.76/9.39 ± 5.50 vs 3.45 ± 1.63, P < 0.001). The results were significantly correlated with the degree of steatosis confirmed by liver biopsy (P < 0.001), but it was not significantly correlated with inflammation or fibrosis grade. The correlation analysis showed that the MRS-PDFF value measured by 1H-MRS was significantly correlated with body mass index (BMI), blood lipids, alkaline phosphatase, and blood glucose, while it was not significantly correlated with age, sex, or the presence or absence of hepatitis B. The ROC curve analysis showed that the AUCs of PDFF measured by 1H-MRS were 0.93, 0.974, and 0.976, respectively, for the diagnosis of steatosis S1(≥5%), S2(≥34%), and S3(≥66%), and the corresponding optimal thresholds were 5.14%, 11.16%, and 16.7%, respectively.@*Conclusion@#1H-MRS has a high diagnostic value in quantitative evaluation of the degree of liver steatosis in patients with FLD and is not affected by the factors such as HBV infection, age, and sex, while it is correlated with BMI and lipid metabolism.

Effect ofQiwei Granules on Renal Podocyte Injury in Diabetic Nephropathy Mice / 世界科学技术-中医药现代化

This article was aimed to study the effect ofQiwei granules on the podocyte in KK-Ay mice kidney. The 28 8-week-old male KK-Ay mice were randomly divided into the model group, low-dosage, middle-dosage and high-dosageQiwei granule group. Eight C57BL/6J mice were used as the normal control. The general conditions, blood glucose and 24 h albuminuria were recorded in the experiment. After 10-week treatment, renal indexes including serum creatinine and urea nitrogen were measured. The kidneys of mice were collected and measured. The hematoxylin and eosin (HE), Masson’s Trichrome, and periodic acid-Schiff (PAS) were used on renal tissues of mice. The immunohistochemical staining for WT-1 was made. Software analysis was combined in the calculation of renal podocyte amount. Western blot was used in the detection of nephrin protein expressions in the kidney of mice. RT-PCR was used in the detection of nephrin mRNA expression. The results showed that compared with the model group, the body weight, blood glucose, 24 h albuminuria and the serum creatinine were obviously decreased after 10-week treatment ofQiwei granules. It can effectively improve the glomerular mesangial proliferation and preserve the podocyte number. Meanwhile, after the treatment ofQiwei granules, the nephrin protein expression and mRNA expression were obviously higher than the model group. It was concluded thatQiwei granules probably managed nephrin expression to improve the podocyte injury in the diabetic nephropathy of KK-Ay mice.

Practice on the data normalization of medical device adverse event reporting and exploration on improving the quality of the reports / 中国医疗器械杂志

On the basis of real working practices in data normalization, the case reports from the monitoring system were studied, non-standard reports were summarized and the reasons were analyzed, the methods of data normalization and improving the reporting quality were discussed. The standard databases and the rule databases were created, they were capable of automatic completion of the standardization work of new cases.

Effect of Tang-Nai-Kang on Trans-differentiation of Renal Tubular Epithelial Cell in KKAy Mice / 世界科学技术-中医药现代化

This study was aimed to explore the effect of Tang-Nai-Kang (TNK) on trans-differentiation of renal tubular epithelial cell in KKAy mice in order to discuss the possible mechanism. Fifty 12-week-old male KKAy mice were randomly divided into the model group, valsartan group, TNK high-dose, middle-dose and low-dose group, with 10 rats in each group. Ten C57BL/6J mice were used in the normal group. Rats in the model group and normal group were given 0.9% sodium chloride solution. Rats in other groups were given the corresponding drugs. After 8 weeks of gavage administration, kidneys of all mice were sampled and given Mosson and PAS dyeing. Expression distribution of α-smooth muscle actin (α-SMA) and E-cadherin in kidney tissues were observed under immunohistochemical staining. Expression of transforming growth factor-β1 (TGF-β1) was measured by western blot. The results showed that compared with the normal group, the area of renal fibrosis in the model group was significantly increased (P < 0.01); the expression of α-SMA was stronger; and the expression of E-cadherin was weaker. Compared with the model group, the area of renal fibrosis in the valsartan group, TNK high-dose, middle-dose and low-dose groups were significantly decreased (P< 0.01); the expression of α-SMA was weaker (P< 0.01);and the expression of E-cadherin was obviously increased (P < 0.05). The TGF-β1 expression in the model group was significantly higher than that in the normal group (P < 0.01). Compared with the model group, the TGF-β1 expression in the valsartan group, TNK low-dose, middle-dose and high-dose groups were significantly lowered (P<0.01). And the TGF-β1 expression in the TNK high-dose group was even lower than that in the valsartan group. It was concluded that TNK was able to suppress the epithelial-mesenchymal transition (EMT) of renal tubular epithelial cell, and lessen the renal tubule interstitial fibrosis, in order to protect the kidney.

Study on Anti-diabetic Effect of Traditional South African Herb Sutherlandia Aqueous Extract / 世界科学技术-中医药现代化

This study was aimed to observe the effects on glucolipid metabolism of aqueous extract of traditional South African herb Sutherlandia. Intraperitoneal injection of streptozotocin (STZ) combined with high fat feed method was used in the establishment of type 2 diabetes rat model. Then, rats were randomly divided into the normal group, model group, pioglitazone group, and the Sutherlandia group. Observation was made on changes of body weight, oral glucose tolerance test (OGTT), blood triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). Western blot method was used to detect IRS-1 expression of skeletal muscle in rats of each group. The results showed that compared with the normal group, body weight in the model group was decreased, and indicators of OGTT, TG, TC, LDL-C were significantly increased (P< 0.05). Symptoms such as increased drink-ing, eating and urine were obvious; and the IRS-1 expression was obviously decreased (P< 0.05). After treatment, compared with the model group, there was no significant body weight increase in the Sutherlandia group or the pi-oglitazone group. Indicators of blood glucose, TG, TC in the Sutherlandia group and the pioglitazone group were ob-viously decreased with no statistical difference (P< 0.05 or P< 0.01). In the Sutherlandia group and the pioglitazone group, IRS-1 expression of skeletal muscle in rats was obviously increased with no statistical difference (P< 0.05). It was concluded that type 2 diabetes rats induced by intraperitoneal injection of STZ combined with high fat feed method can induce glucolipid metabolism disorders. Traditional South African herb Sutherlandia can obviously reduce the blood sugar level, improve blood lipid metabolism, and improve the level of insulin. Sutherlandia can improve the IRS-1 expression of skeletal muscle in rats, relief the insulin resistance, and lower blood sugar. However, the effect of its exact ways required further in-depth study.

Effect of genistein on lipid accumulation in H4Ⅱ E cell induced by oleic acid / 国际中医中药杂志

Objective To observe the effects of genistein(GEN)on oleic acid(OA)induced lipid accumulationin in H4 ⅡE cells and to discuss the possible mechanism of GEN in the pointof AMPK.Methods H4ⅡE cells were cultured in vitro.The control group(NOR),OA treatment group(MOD group)and GEN treatment group were established according to the experimental requirements.The effects of GEN on the proliferation of H4 Ⅱ E cells were measured with MTT assay.The intraeellular TG mass was quantified spectrophotometrically using TG test kit.Cell protein was determined by DCTM Protein Assay kit.The intracellular TG concentration which was used to evaluate lipid accumulation was corrected using protein content as an internal standard.Western blotting was applied to determine the expression of AMPK and P-AMPK (Thr172).Accordingly the phosphorylation levels of AMPK was by means of P-AMPK(Thr172)/AMPK.Results OA treatment can induce lipid accumulation in H4 Ⅱ E cells while GEN treatment can decrease the intracellular TG concentration through up-regulate the phosphorylation levels of AMPK,though the effect was blocked by Compound C that is the inhibitor of AMPK.Conclusion GEN has anti-accumulation of lipid effect in H4ⅡE cell.The mechanism of GEN protective effect is partially due to AMPK.