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OBJECTIVE: To reach consensus on the diagnostic criteria for deficiency syndrome in hypertension (YDSH) patients by a modified Delphi method. METHODS: Our study was consistent with T/CACM 1032-2017. The methodology of RAND/UCLA appr-opriateness was used to develop consensus guidance statements. A nationwide panel of experienced clinical experts from 19 provinces was constructed. These experts were all prominent in Traditional Chinese Medicine (TCM) of cardiovascular diseases. This con-sensus process consisted of two rounds of ques-tionnaires and a final round of consultation to analyze the weight score of each item. Moreover, the data extraction process is carried out independently by third-party researchers (LIANG Junya, SUN Yang, and DU Xiaona). When there is disagreement in all three rounds, the expert panel group (odd number) are invited to vote, and the one with more votes wins. In the questionnaires, participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert scale. The consensus was defined as a panel median rating 1-3 or 7-9 without disagreement. And then the diagnostic criteria of YDSH were formed according to the weight score in the final round. RESULTS: Twenty-eight experts (84.8%) participated in the first round, and thirty-one (93.9%) finished the second round. After two rounds, the consensus of YDSH was reached on 11 items (25.6%), including symptoms, signs, and pulse condition. Twenty-one experts (63.6%) com-pleted the final round in which they used a grading system for each item. Red tongue with scanty fur had the highest weighting (22.8%), followed by heat in the palms and soles (20.1%). CONCLUSIONS: The consensus-based diagnostic criteria for YDSH, formed by a modified Delphi method, can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.
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Hypertension , Medicine, Chinese Traditional , Humans , Consensus , Delphi Technique , Surveys and Questionnaires , Hypertension/diagnosisABSTRACT
Institute of Pediatric,Suzhou University Affiliated Children's Hospital,Suzhou 215003,China Objective To explore the long-term effects of physical exercise on neonatal seizure-induced learning,memory deficit and the expression of zinc transporter-3(ZnT3)in rat hippocampus.Methods Sprague Dawlev rats aged 6 days were randomly divided into a recurrent-seizure group(RS)and a control group. At postnatal dav 6(P6),the recurrent seizures were induced by inhalation of the volatile agent flurothyl once a day for consecu tive 6 davs.The rats in the control group were placed in the container for an equal period of time as those in the RS group without exposure to flurothyl. Y-maze test was performed to evaluate learning and memory capacity at postnatal day 29 to 35 and 61 to 67,respectively.During the period of postnatal day 51 to 56,all the animals in the RS andcontrol groups were subject to a 30-minute daily aerobic exercise program for consecutive 6 days.All the animals weresacrificed at postnatal day 78,and the in situ hybridization method was used to detect the expression of ZnT3 mRNA in hippocampus. Results ①The number of trials needed for getting correct response to the electric stimulation in the first Y-maze test was(60±14.1)and(37.5±17.2)for the RS and control groups,respectively(P＜0.05),while that in the second Y-maze test carried out 24 hours later was(27.5±14.1)and(21±11.01)for the RS and the control groups,respectively(P＞0.05).②Memory test revealed no significant difference between the RS and thecontrol groups(P＞0.05).③In situ hybridization detection showed that the expression of ZnT3 mRNA in hippocam pus was not significantly different between the two groups.However,there showed a significant difference between the dentate gyrus and CA3 in the RS group with regard to the expression of ZnT3 mRNA(P＜0.05). Conclusions Physical exercise improves the learning capacity of neonatal seizure-induced cognitive deficit and might have effects on the regulation of zinc transporter gene expressions in hippocampus.
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Objective To comprehend the current difference of sequence variation of p24 coding region in gag gene and subtype distribution of HIV 1 in Henan province and Shanghai in China. Methods Plasma specimens were collected from 37 HIV 1 patients, of which 25 were from Henan province and 12 were from Shanghai. Most patients in Henan were infected by illegally donating blood while in Shanghai the major transmission routes were blood or blood product transfusion and sexuality. RNAs from plasma specimens were extracted and target gene were amplified by the method of RT PCR and Nested PCR. The sequences of p24 region, 693 nucleotides were determined, then phylogenetic analyses were performed. Results Subtyping showed that 83.8% (31/37) were B subtype. Of 25 Henan specimens, 23(92%)were B subtype and 2 were A subtype. Of 12 Shanghai specimens, 8(66.7%)were B subtype, 1 was A subtype, 2 were CRF01 -AE and 1 was CRF02 -AG. Comparing with the Consensus sequence (Consensus -B, from HIV database), nucleotide variation in B subtype of Henan was 1.6%～4.2%, with an average of 3.2%, while that of Shanghai was 2.0%～3.8%, with an average of 3.4%. No G to A hypermutation was observed in all variations. The median intrasubtype distance for B subtype in Henan and Shanghai was 2.9% and 3.5%, and the intersubtype distance between B subtype and other subtypes was 11.1%～12.5%. The two Consensus sequences of Henan and Shanghai B subtype obtained by CLUSTAL X were aligned to Consensus -B, both the substitution for predicted amino acid were 2.2%(5/231). Of all the variations,they shared the same three mutations: A14P、I91V and E180D. However, the disparity between the two Consensus sequences was not significant (0.9%). Phylogenetic analyses implied that many specimens were B subtype, and all the B subtype specimens from Henan and most of Shanghai B subtype specimens were close to the isolates in Thailand. Conclusion B subtype was the dominant HIV 1 isolate in Henan and Shanghai of China.The HIV 1 B subtype in Henan and Shanghai had coincident homology and shared some identical variations of amino acid.
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Objective: Effect of Zhengjian Granule(ZJ)(Radix Berberidis, Ramulus Euonymi, Radix Scorphulariae Rhizoma Alismatis) on blood pressure(BP) and insulin resistance(IR) in spontaneously hypertensive rats(SHR) was observed. Methods: Twenty four SHR aged 13 weeks were divided into three groups treated with large and small dosage of ZJ and nothing as compared with age matched six Wister Kyoto rats(WKY). BP, glucose(G) and insulin(I) of fasting, G/I and blood lipid were measured before and after treated 8 weeks and compared among groups. Results: While G of fasting had no difference in respective SHR groups compared with WKY, insulin of fasting was markedly higher and G/I were notably lower than WKY( P
