Research progress of apparent mineralocorticoid excess syndrome / 中国基层医药

Apparent mineralocorticoid excess (AME) is an autosomal recessive inheritance caused by 11β－hydroxysteroid dehydrogenase 2 gene mutation.It may occur in newborn and adult.AME was first reported in 1977 by Werder et al.Its clinical features include hyporenin type hypertension , hypoaldosteronemia, metabolic alkalosis, hypernatremia and hypokalemia.In recent years,with the improvement of clinical diagnosis ,especially gene detection , AME has been reported one after another.In this paper,the pathogenesis,clinical manifestation ,diagnosis and therapy of AME were reviewed in order to improve the understanding of this disease and provide reference for its clinical diagnosis and treatment.

Correlation of Disease Activity with Primary Syndromes of Deficiency and Excess Types of Lupus Nephritis / 广州中医药大学学报

Objective To explore the correlation of disease activity with the primary syndromes of deficiency and excess types of lupus nephritis(LN). Methods A retrospective study was carried out in 134 LN patients,and the LN patients were differentiated into deficiency syndrome(deficiency group)and excess syndrome(excess group). The disease activity related indicators of systemic lupus erythematosus disease activity index(SLEDAI)scores, complements, inflammation indexes, and urine indicators were compared between the two groups. Results Of the 134 LN patients,33 cases were differentiated into excess syndrome,and 101 cases were differentiated into deficiency syndrome. According to the SLEDAI scores, 9.09％ of the patients in excess group were inactive, 4.95％ of the patients in deficiency group were inactive, and most of the patients in the two groups were at severe active stage. There was no significant difference of SLEDAI scores between the two groups(P>0.05) . The differences of complement C3 and C4 , inflammation indexes of C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),urine protein,and urine occult blood were also insignificant between the two groups (P>0.05). Conclusion There is no correlation between deficiency-excess syndrome differentiation and disease activity of LN. Most of the LN patients with deficiency syndrome are at active stage,but not at remission stage.

The Clinical Experience of Integrated Traditional Chinese and Western Medicine in Treating Elderly Acute Myeloid Leukemia of SHEN Yiping / 浙江中医药大学学报

[Objective] To summarize Dr. SHEN Yiping's clinical experience of integrated traditional Chinese and western medicine in treating elderly acute myeloid leukemia (AML). [Methods]By examining with cases of illness and warding round,collecting the medical records of elderly AML patients treated by Dr. SHEN, learning the latest diagnosis and treatment guidelines, reading a large number of related papers and a large number of classical books, from the aspects of etiology and pathogenesis, therapeutic principles and methods, the clinical experience of the treatment of elderly AML were analyzed and summarized, and one medical record was provided.[Results]Dr. SHEN believes that the pathogenesis is deficiency syndrome accompanied with excess syndrome. Mostly due to congenital deficiency and poor basic functions, deficiency of spleen and kidney, heat poison intrusion, burning Jin as sputum, forcing blood going in wrong line, phlegm and blood stasis, evil accumulating in bone marrow and then suffered. Dr. SHEN uses heat-clearing, detoxifying and anti-cancer drugs to suppress and eliminate leukemia cells on the basis of chemotherapy and supplements beneficial drugs to achieve the goal of chemotherapy without harming the positive effect, he uses "Kangbai Yannian Tang" combined with decitabine and chemotherapy as a basic solution and changes flexibly by according to the clinical manifestations, changes of syndrome types of the patients, the clinical effect is remarkable, and the case had good results. [Conclusion]Dr. SHEN is good at integrated traditional Chinese and western, combining of syndrome differentiation and disease differentiation, using the combination of heat-clearing method and complement in the treatment of elderly AML, the experience and wonderful methods are worth learning and spreading.

Discussion on nutritional status of patients with chronic obstructive pulmonary disease under mechanical ventilation based on cold-heat/deficiency-excess syndrome differentiation in traditional Chinese medicine / 中国中西医结合急救杂志

Objective To observe the incidence of malnutrition, the therapeutic effect of nutritional support and the prognosis of patients with chronic obstructive pulmonary disease (COPD) under mechanical ventilation (MV) in patients with different traditional Chinese medicine (TCM) syndrome types and discuss the relationships between these indicators and the differentiation of cold-heat/deficiency-excess syndrome. Methods One hundred and three patients with COPD and MV admitted to Zhuji Hospital of TCM from September 2015 and July 2017 were enrolled, according to the different TCM syndromes, they were divided into an excess-heat syndrome group 42 cases and an asthenia-cold syndrome group 61 cases, and the differences in nutrition indexes and prognosis between the two groups were compared. Results The acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, nutritional risk screening 2002 (NRS2002) score and the incidence of malnutrition in excess-heat syndrome group were significantly lower than those in the asthenia-cold syndrome group, while the body mass index (BMI) in excess-heat syndrome group was obviously higher than that in the asthenia cold syndrome group [APACHE Ⅱ score: 20.1±5.4 vs. 22.0±3.4,NRS2002 score: 5.2±0.6 vs. 6.2±0.8, incidence of malnutrition: 61.9% (26/42) vs. 80.3% (49/61), BMI (kg/m2): 22.6±3.8 vs. 19.9±4.8, all P < 0.05]. The levels of albumin (Alb), prealbumin (PA) and transferrin (TF) of the excess-heat syndrome group were higher than those in the asthenia-cold syndrome group, and the differences between the two groups were statistically significant on the 7th day under MV [Alb (g/L): 36.14±2.97 vs. 34.40±3.37, PA (mg/L): 237.67±28.01 vs. 185.34±30.86, TF (g/L): 2.13±0.38 vs. 1.95±0.12, all P < 0.05]. In the excess-heat syndrome group, the percentage of weaning from MV was higher than that of the asthenia-cold syndrome group [85.7% (36/42) vs. 65.6% (40/61)], the 28-day mortality [14.3% (6/42) vs. 31.1% (19/61)] and ICU stay time (days: 9.21±2.96 vs. 11.13±3.96) were lower than those of the asthenia cold syndrome group (all P < 0.05). Conclusion The analysis of TCM differentiation of cold-heat/deficiency-excess syndrome has a certain reference value to realize the changing rules in nutritional status and prognosis of patients with COPD under mechanical ventilation.

Observations on the Efficacy of Thumbtack Needle Therapy for Senile Recurrent Oral Ulcer of Yin Deficiency and Fire ;Excess Type / 上海针灸杂志

Objective To investigate the clinical efficacy of thumb-tack needle therapy for senile recurrent oral ulcer of yin deficiency and fire excess type. Method Sixty patients cancer pain were allocated, using a random number table, to observation and control groups,30 cases each. The control group gargled with 10 mL compound chlorhexidine mouthwash 5 min twice daily and the observation group received thumbtack needle therapy 6 hrs once daily, on the left and right sides alternately, in addition to treatment given to the control group. The course of treatment was five days in both groups. The clinical therapeutic effects were evaluated after the completion of treatment. The TCM symptom score and the VAS score were recorded before and after treatment. A comparative analysis was carried out. Result The total efficacy rate was 96.7%in the observation group and 83.3%in the control group. It was higher in the treatment group than in the control group (P<0.05). The TCM symptom score and the VAS score decreased in the observation and control groups after treatment compared with before (P<0.05, P<0.01). They decreased more in the treatment group than in the control group (P<0.05). Conclusion Thumbtack needle therapy has a definite effect on senile recurrent oral ulcer of yin deficiency and fire excess type. It can relieve TCM clinical symptoms and pains in the patients.

Meta Analysis of Acupuncture Treatment for Vertigo with Excess Syndrome / 上海针灸杂志

Objective To systematically assess the clinical efficacy and safety of acupuncture treatment for vertigo with excess syndrome. Methods Chinese and English literature about acupuncture treatment of vertigo with excess syndrome published in recent years was comprehensively searched. The quality of the retrieved literature meeting the inclusion criteria of randomized controlled trial was assessed and its data was collected. A Meta analysis of the included studies was carried out.Results Finally, 10 articles with randomized controlled trials containing a total of 688 patients were included in the analysis. The included literature was assessed at lower quality using Cochrane evaluation member manual 5.1. A Meta analysis showed that the efficacy rate of acupuncture treatment for vertigo with excess syndrome was higher than that of Western drugs alone [M-H OR 4.84, 95%CI (2.39, 9.81),P<0.0001]. Combined acupuncture and Chinese herbal medicine was superior to Chinese herbal medicine alone [M-H OR 3.82, 95%CI (2.06, 7.10),P<0.0001]. Vertigo symptom and function scoring showed day 3 of treatment [MD 4.66, 95%CI (2.97, 6.35)], day 7 of treatment [MD 0.95, 95%CI (0.03, 1.86)] and day 14 of treatment [MD 0.89, 95%CI (0.71, 2.49)]. There were statistically significant differences in the vertigo symptom and function scores between the two groups of patients at day 3 and 7 of treatment. There were no statistically significant differences in the scores between the two groups of patients at day 14 of treatment. Conclusions Acupuncture or combined acupuncture and Chinese herbal medicine are effective and highly safe in treating vertigo with excess syndrome, but high-quality, multi-center and large-sample RCT studies still need to be conducted for validation and support.

Aromatase excess syndrome presenting with prepubertal gynecomastia in an Egyptian child with type 1 neurofibromatosis.

A romatase excess syndrome (AEXS) is a rare autosomal dominant disorder characterized by prepubertal gynecomastia, it responds well to medical treatment. In the absence of prompt suspicion, it can expose the patient to the risk of unnecessary surgical intervention. Up to our best knowledge, the association between AEXS and neurofibromatosis type 1 (NF1) was not reported before. Here, we describe a AEXS presenting with prepubertal gynecomastia in an Egyptian child with NF1 that improved with aromatase inhibitors.

Licorice-nduced Hypokalemia and Myopathy / 대한신장학회잡지

Chronic ingestion of licorice or licorice-like compounds induces a syndrome with typical findings of mineralocorticoid excess such as hypertension, hypokalemia, metabolic alkalosis, low plasma renin activity. The only unique feature is that plasma aldosterone concentration is decreased. We described a 79-year-old woman who, with a plasma K+ 1.75 mEq/L, showed a paralysis and severe rhabdomyolysis after the habitual comsumption of licorice in the form of a herbal medication. Following potassium replacement therapy and discontinuation of licorice ingestion, complete clinical recovery was observed within ten days. It is important for physicians to keep licorice consumption in mind as a cause for hypokalemic paralysis and rhabdomyolysis.

Clinical Observation on Herbal Plaster at Acupoints for 31 Cases of Primary Dysmenorrhea with Excess Syndrome / 中医杂志

Objective To observe the effect of herbal plaster at acupoints for the excess syndrome of primary dysmenorrhea and its influence on prostaglandins.Methods The patients with of primary dysmenorrhea excess syndrome were randomized into treatment group(33 cases) and control group(31 cases).The former was treated by herbal plaster at acupoints while the latter treated by orally taking Tianqi Tongjing Capsule(Radix Notoginseng for Capsule Dysmenorrhea).Before and after the treatment,the pain scores and the accompanied symptoms were observed;and PGF2? and PGE2 of peripheral blood and renal and hepatic functions were detected.Results After treatment,the pain scores of both groups were significantly decreased(P