The Diagnosis Performance of the TCM Syndromes of Irritable Bowel Syndrome by Gastroenterologists Based on Modified Simple Criteria Compared to TCM Practitioners: A Prospective, Multicenter Preliminary Study.

PURPOSE: Traditional Chinese medicine (TCM) including Chinese patent medicine has been widely used to treat irritable bowel syndrome (IBS). Syndrome differentiation is the essence of TCM. However, the diagnostic ability of gastroenterologists to detect TCM syndromes in IBS in China remains unknown. The aim of this study was to investigate the ability of gastroenterologists to diagnose the TCM syndromes of IBS based on modified simple criteria compared with TCM practitioners. METHODS: Patients meeting the Rome III criteria for IBS-D or IBS-C were recruited from six tertiary referral centers between January 2016 and December 2017. After learning the diagnosis criteria of the TCM syndromes in IBS, gastroenterologists first diagnosed the syndromes of the enrolled patients. Subsequently, the patients were diagnosed by TCM practitioners. The rate of agreement between the gastroenterologists and TCM practitioners was analyzed. In addition, demographic data and the distribution of TCM syndrome types in IBS were also analyzed. RESULTS: A total of 178 patients (93 males and 85 females), including 131 patients with IBS-D and 47 patients with IBS-C, were enrolled in this study. The rate of agreement of the syndrome diagnosis between the gastroenterologists and TCM practitioners was 84.3%. The diagnosis consistency rates among IBS-D patients and IBS-C patients were 87.0% and 76.5%, respectively. The most common TCM syndrome type in IBS-D patients was liver depression and spleen deficiency syndrome (27.5%), followed by spleen-yang deficiency syndrome (19.8%). Dryness and heat in intestine syndrome was the most common TCM syndrome in IBS-C patients (57.4%). CONCLUSIONS: Gastroenterologists had good diagnostic agreement with TCM practitioners for diagnosing TCM syndrome types in IBS after learning the diagnostic criteria. This knowledge can aid gastroenterologists in selecting suitable Chinese patent medicine to treat IBS.

Agreement of gastroenterologists in traditional Chinese medical differential diagnosis of functional dyspepsia compared with traditional Chinese medical practitioners: A prospective, multicenter study.

OBJECTIVE: To compare the performance of gastroenterologists major in western medicine in diagnosing traditional Chinese medicine (TCM) syndrome types of functional dyspepsia (FD), postprandial distress (PDS) and epigastric pain syndromes (EPS) based on the main symptoms, with that of traditional TCM practitioners in outpatient services. METHODS: Patients with PDS or EPS were enrolled in the study from six tertiary referral centers between January 2016 and December 2017. Their symptoms were first diagnosed by medical doctors, and then by the TCM practitioners. The diagnostic agreement between the gastroenterologists and the TCM practitioners was calculated. The patients' data and their types of FD syndrome were collected and analyzed. RESULTS: In total 160 patients, including 81 with PDS and 79 with EPS were enrolled. The total diagnostic consistency rate between the gastroenterologists and TCM practitioners was 86.3%, while that of PDS and EPS was 85.2% and 87.3%, respectively. The most common type of PDS diagnosed by TCM practitioners was liver-stomach disharmony syndrome (33.3%), spleen deficiency and qi-stagnation syndrome (33.3%), while that for EPS was liver-stomach disharmony syndrome (36.7%). CONCLUSIONS: Gastroenterologists had a high diagnostic agreement about the types of FD syndromes based on differential diagnosis of the main symptoms, compared with TCM practitioners. This may aid gastroenterologists in selecting Chinese medicine for FD-based on syndrome differentiation.

Comparative Transcriptome Analysis Reveals Stem Secondary Growth of Grafted Rosa rugosa 'Rosea' Scion and R. multiflora 'Innermis' Rootstock.

Grafted plant is a chimeric organism formed by the connection of scion and rootstock through stems, so stem growth and development become one of the important factors to affect grafted plant state. However, information regarding the molecular responses of stems secondary growth after grafting is limited. A grafted Rosa plant, with R. rugosa 'Rosea' as the scion (Rr_scion) grafted onto R. multiflora 'Innermis' as the stock (Rm_stock), has been shown to significantly improve stem thickness. To elucidate the molecular mechanisms of stem secondary growth in grafted plant, a genome-wide transcription analysis was performed using an RNA sequence (RNA-seq) method between the scion and rootstock. Comparing ungrafted R. rugosa 'Rosea' (Rr) and R. multiflora 'Innermis' (Rm) plants, there were much more differentially expressed genes (DEGs) identified in Rr_scion (6887) than Rm_stock (229). Functional annotations revealed that DEGs in Rr_scion are involved in two Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways: the phenylpropanoid biosynthesis metabolism and plant hormone signal transduction, whereas DEGs in Rm_stock were associated with starch and sucrose metabolism pathway. Moreover, different kinds of signal transduction-related DEGs, e.g., receptor-like serine/threonine protein kinases (RLKs), transcription factor (TF), and transporters, were identified and could affect the stem secondary growth of both the scion and rootstock. This work provided new information regarding the underlying molecular mechanism between scion and rootstock after grafting.

[Clinical observation on effect of xuefu zhuyu decoction in treating patients with liver fibrosis caused by chronic hepatitis B].

OBJECTIVE: To observe the effect of Xuefu Zhuyu decoction (XZD) on the chronic hepatitis B caused liver fibrosis (CHBLF) and the portal hemodynamics. METHODS: Sixty patients with CHBLF were randomly divided into two groups, the 28 patients in the treated group were treated with oral intake of XZD and conventional liver protective treatment, the 32 patients in the control group were treated with conventional liver protective treatment alone, the therapeutic course for both groups was 3 months. Serum liver fibrosis criteria and portal dynamical criteria were observed before and after treatment. RESULTS: Comparison of the remarkable effective rate between the two groups showed significant difference. After treatment, in the treated group, all the serum criteria for liver fibrosis (HA, PCIII, LN) and criteria for portal trunk hemodynamics, such as mean velocity and quantity of blood flow were significantly improved (P < 0.05 or P < 0.01), as compared with those in the control group, the difference was also significant (P < 0.05 or P < 0.01). CONCLUSION: XZD has definite therapeutic effect on chronic hepatitis B caused liver fibrosis.

[Screening 20 Chinese herbs often used for clearing heat and dissipating toxin with nude mice model of hepatitis C viral infection].

OBJECTIVE: To seek effective drugs for anti-hepatitis C virus by screening 20 Chinese herbs often used for clearing heat and dissipating toxin with nude mice model of hepatitis C viral (HCV) infection. METHODS: After the model mice had been treated with selected drug for 3 months, transmission electron microscope was used to observe whether the HCV-like particles in human fetal hepatocytes (HFH) transplanted into mice spleen still existed, and quantitative RT-PRC technique was used to detect the serum content of HCV-RNA before and after treatment. RESULTS: (1)HCV-like particles existed in all the model mice after treatment. (2) Serum content of HCV-RNA decreased after treated with Radix Gentianae, Radix Scutellariae, Radix Sophorae tonkinensis, Fructus Gardeniae and Fructus Sophorae flavoscentis, but unchanged after treatment with other drugs. CONCLUSION: All the 20 herbs screened has not effect in directly eradicating HCV, but Radix Gentianae, Radix Scutellariae, Radix Sophorae tonkinensis, Fructus Gardeniae and Fructus Sophorae flavoscentis could significantly inhibit the replication of HCV-RNA.