July 2019, Volume 22，No.21 Abstracts（B）
Author：尹鹏 Source：CGP Published： [07-05] views： 322
Removing the Pathogenic Factor from Urine on RASS System and Cytokines in a Rat Model of Acrolein-induced Airway Mucus Hypersecretion XU Zongying，SHI Shaohua，YU Han，ZHONG Xianggen*
School of Chinese Medicine，Beijing University of Chinese Medicine，Beijing 100029，China
*Corresponding author：ZHONG Xianggen，Professor，Chief physician；E-mail：email@example.com
【Abstract】 Background In Synopsis of Prescriptions of the Golden Chamber，Shenqi pills are used in a total of 5 prescriptions，mainly for the treatment of urination problems via warming and nourishing the kidney qi，circulating qi and promoting urination.Objective To observe the effect of Shenqi pills on renin-angiotensin-aldosterone（RASS）system and cytokines in a rat model of acrolein-induced airway mucus hypersecretion based on the theory of “Treatment of shortness of breath caused by minor case of Fluid-retention syndrome should following the principle of removing pathogenic factors from urine.Linggui Zhugan Decoction and Shenqi pills can be adopted” proposed in Synopsis of Prescriptions of the Golden Chamber.Methods This study was carried out between April and August 2017.A total of 60 SPF male Sprague-Dawley rats were randomly selected and equally divided into control group，model group，Shenqi pills group，Linggui（poria cocos and cassia twig）group and Shenqi pills without Linggui group.The latter 4 groups were given atomization inhalation of 3 mg/L acrolein，twice daily at an interval of 3 hours for 4 consecutive weeks for establishing the models of acrolein-induced airway mucus hypersecretion，while the control group received atomization inhalation of the same dose of 0.9% sodium chloride solution.From the 5th week of the intervention，Shenqi pills group，Linggui group，and Shenqi pills without Linggui group received 1 ml/100 g Shenqi pills solution for warming the kidney qi and promoting urination，1 ml/100 g Linggui decoction for circulating qi and promoting urination，1 ml/100 g Shenqi pills without Linggui decoction for warming and nourishing the kidney qi，respectively，twice daily for another 4 consecutive weeks，while control and model groups received intragastric administration of the same volume of distilled water.24-hour urine volume，pulmonary function parameters（FEV0.3，FVC，FEV0.3/FVC，PEF），levels of IL-1β，IL-13，TGF-αand TNF-αin bronchoalveolar lavage fluid（BALF），and levels of PRA，plasma angiotensinⅡ and aldosterone（ALD）were collected.Results 24-hour urine volume in the control group was less than that of other groups（P<0.05）．Model group showed less 24-hour urine volume than 3 medicine intervened model groups（P<0.05）．Shenqi pills group had less 24-hour urine volume than Linggui group（P<0.05）．Compared with the control group，model group demonstrated lower average FEV0.3，FVC，FEV0.3/FVC and PEF，and Linggui group showed less average FEV0.3/FVC（P<0.05）．Model group demonstrated lower FEV0.3，FVC，and PEF than Linggui group，and showed lower FEV0.3，FVC，PEF and FEV0.3/FVC ratio than both Shenqi pills and Shenqi pills without Linggui group（P<0.05）．The control group showed lower IL-1β，IL-13，TGF-α and TNF-α in BALF compared with other groups（P<0.05）．The Shenqi pills group showed higher levels of TNF-α in BALF than control group（P<0.05）．And the levels of these 4 parameters were lower in 3 medicine-intervened model groups than those of the model group（P<0.05）．Moreover，Shenqi pills group showed lower levels of IL-1β and TNF-α in BALF than both Linggui and Shenqi pills without Linggui groups（P<0.05）．PRA levels in all groups were similar（P>0.05）．Compared with the control group，model group showed higher plasma angiotensinⅡ and ALD levels（P<0.05），and Linggui and Shenqi pills without Linggui groups showed higher plasma ALD levels（P<0.05）．Model group demonstrated higher plasma angiotensinⅡ and ALD levels than 3 medicine intervened model groups（P<0.05）．Shenqi pills without Linggui group had higher plasma ALD compared with Shenqi pills group（P<0.05）.Conclusion Shenqi pills showed better effect than Linggui and Shenqi pills without Linggui in regulating IL-1β and TGF-α in BALF.Fluid-retention syndrome can be alleviated by warming and nourishing kidney qi or circulating qi and promoting urination，but the combination of the two can yield better efficacy，namely，the retained excessive old fluid and the new-produced excessive fluid can be removed.The mechanism of removing the pathogenic factor from urine might be related to improve pulmonary functions，inhibit RASS system activation and regulate cytokines associated with mucus hypersecretion.
【Key words】 Mucus；Acrolein-induced airway mucus hypersecretion；Models，animal；Shenqi pill；Removing the pathogenic factor from urine；Renin-angiotensin-aldosterone system；Cytokines
TCM Syndrome-based Analysis of Musculoskeletal Ultrasound Findings of 28 Joints in Rheumatoid Arthritis Patients CHEN Guangyao1，HU Qi1，XU Yuan2，ZHENG Sisi1，MA Xiao2，LUO jing2，TAO Qingwen2*
1.Beijing University of Chinese Medicine，Beijing 100029，China
2.Department of TCM Rheumatology，China-Japan Friendship Hospital/Beijing Key Lab for Immune-Mediated Inflammatory Diseases，Beijing 100029，China
*Corresponding author：TAO Qingwen，Chief physician，Professor，Doctoral supervisor；E-mail：firstname.lastname@example.org
【Abstract】 Background Previous studies have shown that laboratory，imaging and clinical parameters differ significantly in rheumatoid arthritis（RA）patients by traditional Chinese medicine（TCM）syndrome，and studying these parameters can provide evidence for TCM syndrome differentiation.TCM syndrome-based analysis of musculoskeletal ultrasound findings of 28 joints in RA patients provide evidence for the treatment of this disease according to syndrome differentiation.Objective To perform a TCM syndrome-based analysis of musculoskeletal ultrasound findings of 28 joints in RA patients，so as to provide a basis for incorporating musculoskeletal ultrasonography into TCM syndrome differentiation system of RA.Methods From April 2017 to April 2018，120 inpatients and outpatients were selected from Department of TCM Rheumatology，China-Japan Friendship Hospital，and were divided into 4 commonly seen syndromes defined in Guidelines for Clinical Research of New TCM Drugs.Clinical and laboratory data were collected，including age，sex，course of RA，C-reactive protein（CRP），erythrocyte sedimentation rate（ESR），anti-cyclic citrullinated peptide（ACPA），rheumatoid factor（RF）（since anti-ACPA and RF were exponentially increased，it is convenient to process data using ln（ACPA+1）and ln（RF+1）for data statistics），28-tender joint count（TJC28），28-swollen joint count（SJC28），self-rated general health（GH）score，and Disease Activity Score 28（DAS28）．Findings of musculoskeletal ultrasound of 28 joints were also obtained，including synovitis joint count，synovitis score，Power Doppler（PD）joint count，PD score，and bone erosion count.Results For the TCM syndromes of 120 patients，there were 42 cases of dampness-heat obstruction syndrome，32 cases of deficiency of liver and kidney syndrome，25 cases of cold-dampness obstruction syndrome，and 21 cases of phlegm-stasis obstruction syndrome.The average RA course of patients with deficiency of liver and kidney syndrome was longer than that of those with dampness-heat obstruction syndrome or phlegm-stasis obstruction syndrome（P<0.05）．The average levels of CRP，ESR，ln（RF+1），SJC28，self-rated GH score，DAS28 of patients with dampness-heat obstruction were higher than those of other three groups（P<0.05）．The average TJC28 of patients with dampness-heat obstruction was more than that of those with cold-dampness obstruction or phlegm-stasis obstruction（P<0.05）．Both average synovitis joint count and synovitis score of patients with dampness-heat obstruction and those with deficiency of liver and kidney were larger than those of patients with cold-dampness obstruction and those with phlegm-stasis obstruction（P<0.05）．Patients with dampness-heat obstruction showed greater average PD joint count and PD score compared with other three groups（P<0.05）．The average bone erosion count of patients with dampness-heat obstruction was less than that of those with deficiency of liver and kidney，but greater than that of those with cold-dampness obstruction（P<0.05）．The average bone erosion count of patients with deficiency of liver and kidney was greater than that of those with cold-dampness obstruction or phlegm-stasis obstruction（P<0.05）．Conclusion Laboratory and clinical parameters are closely related to the TCM syndrome in RA patients.In particular，dampness-heat obstruction syndrome is associated with high RA disease activity.Moreover，TCM syndrome has a certain correlation with the musculoskeletal ultrasound findings of 28 joints in RA patients.The dampness-heat obstruction syndrome is closely related to synovitis and PD，while the deficiency of liver and kidney syndrome is accompanied by more bone erosion joints.
【Key words】 Arthritis，rheumatoid；Symptom complex；Ultrasonography；Musculoskeletal system
Effect of Anticancer，Antiemesis，Toxicity Attenuation and Synergism of Semen Nelumbinis and Gingerol Composition LONG Tengteng1，ZHAO Chengjian2，JIANG Haiyang1，LI Xiaoling2*，YUE Wang1
1.Qingdao Huanghai University，Qingdao 266427，China
2.Qingdao Municipal Hospital，Qingdao 266011，China
*Corresponding author：LI Xiaoling，Associate chief physician ；E-mail：email@example.com
【Abstract】 Background Vomiting is the most commonly experienced symptom of various diseases in the clinic which can cause water and electrolyte disorders.It is also the most commonly experienced side effects in patients receiving chemotherapy.For managing vomiting induced by chemotherapy and radiotherapy，traditional anti-vomiting treatments have poor efficacies，and combination therapies are often needed.Although chemical preparations such as 5-HT3 receptor antagonist and neurokinin 1（NK1） receptor antagonists are suitable for managing vomiting，their scopes of action are too narrow，and adverse reactions are often severe.Thus，the development of natural，low-toxic，broad-spectrum antiemetic drugs is urgently required. Objective To study the anticancer and anti-emesis efficacy of semen nelumbinis and gingerol composition （lotus-ginger composition）．Methods This study was conducted in 2017.Ninty-six SPF male Kunming mice and 72 healthy CL black adult male minks were selected.Each mouse was inoculated subcutaneously 0.2 ml （containing 2×106 tumor cells） tumorigenic cell suspension （S180 sarcoma，EAC） in the right axilla.The day after inoculation，the mice were randomly and equally divided into the blank control group，cyclophosphamide group，ginerol group and lotus-ginger composition group，receiving intragastric administration of distilled water 0.5 ml，intraperitoneal injection of cyclophosphamide （20 g/kg），intragastric administration of gingerol （10 g/kg，equivalent to crude drug dosage），intragastric administration of lotus-ginger composition（10 g/kg，equivalent to crude drug dosage），respectively，for consecutive 10 days.The tumor mass of mice in each group was compared，and the inhibition rates of tumor were also calculated.Meanwhile，the minks were randomly and equally divided into cisplatin，apomorphine and copper sulphate induced vomiting groups.Cisplatin induced vomiting group was equally divided into four subgroups，the blank control，positive control，gingerol，and lotus-ginger composition subgroups，treated with intragastric administration of 0.9% sodium chloride solution （5 ml），intraperitoneal injection of ondansetron （2 mg/kg），intragastric administration of gingerol （10 g/kg，equivalent to crude drug dosage），intragastric administration of lotus-ginger composition （10 g/kg，equivalent to crude drug dosage），respectively.Cisplatin was administered 30 minutes after treatment with the antiemetic agent or its vehicle，except for the blank control subgroup．The same experimental procedure was performed on apomorphine and copper sulphate induced vomiting groups，receptively，except that apomorphine and copper sulphate were administered to the corresponding subgroups（blank control subgroup was not included） at 30 minutes after treatment with the antiemetic agent or its vehicle.Subgroups of cisplatin，apomorphine and copper sulphate induced vomiting groups were observed the emetic responses and the latency，the number of both retching and vomiting at 6 hours following the administration of cisplatin，apomorphine，copper sulphate，respectively.Results Compared with the blank control group，the tumor of S180 sarcoma and EAC was lighter in cyclophosphamide group，gingerol group and lotus-ginger composition group（P<0.05）．The inhibition rate of S180 sarcoma in cyclophosphamide group，gingerol group and lotus-ginger composition group was 65.5%，31.9%，and 53.4%，respectively.The inhibition rate of EAC was 64.7%，26.7%，and 54.5%，respectively.Cisplatin evoked emetic response in minks，pretreatment with ondansetron，gingerol，lotus-ginger composition prolonged the latency，reduced the number of retches and vomits induced by cisplatin （P<0.05）．Apomorphine also evoked emetic response in minks，pretreatment with ondansetron，gingerol，lotus-ginger composition prolonged the latency，reduced the number of retches and vomits induced by apomorphine （P<0.05）．Copper sulphate evoked emetic response in minks，too，pretreatment with ondansetron，gingerol，lotus ginger composition prolonged the latency，reduced the number of retches and vomits induced by apomorphine （P<0.05）．Conclusion The composition can inhibit S180 sarcoma and EAC tumor in mice，it also can inhibit vomitings induced by cisplatin，apomorphine and copper sulphate ，and have synergistic effect and toxicity attenuation in the treatment of cancer．
【Key words】 Antineoplastic combined chemotherapy protocols；Semen nelumbinis；Gingerol；Mink；Vomiting
Satisfaction with TCM-based Body Constitution Identification for Community-dwelling Elderly People：a Survey from the Perspective of Primary Providers LI Shuting，REN Jianping*，YANG Lei，ZHU Yiying，WANG Dahui，SHAO Ping
Hangzhou Normal University，Hangzhou 310036，China
*Corresponding author：REN Jianping，Professor；E-mail：firstname.lastname@example.org
【Abstract】 Background The aging population is increasing in China.The prevention and treatment of geriatric diseases in this growing population have become an important duty of healthcare institutions.TCM-based body constitution identification becomes a part of health management for the elderly in primary care with ever-growing importance.Therefore，exploring the main factors associated with primary providers' satisfaction with TCM-based body constitution identification for community-dwelling elderly people，is conducive to further development of such services.Objective To investigate primary providers' satisfaction with TCM-based body constitution identification for community-dwelling elderly people and associated factors，putting forward the corresponding strategies for further development of such services.Methods By use of stratified random sampling，from September to October 2017，6 community health centers were selected from each city of Hangzhou，Shangyu and Huzhou（totaled 18），and from which，258 health workers with an experience of delivering TCM-based body constitution identification were sampled.They were surveyed with a self-developed questionnaire consisting of demographic information，implementation status of TCM-based body constitution identification（technical standards for TCM health management，available equipments for the delivery of TCM-based body constitution identification，impact of the delivery of TCM-based body constitution identification on oneself），and level of satisfaction with the delivery of TCM-based body constitution identification.Multiple linear regression was used to analyze the influencing factors of primary providers' level of satisfaction with the delivery of such services.Results Altogether，248 returned responsive questionnaires，achieving a response rate of 96.0%.Most of the respondents aged 30-39 years old（42.3%），had a college degree（61.7%），1-10 working years（37.1%），and an annual income of 50 000-100 000 yuan（70.2%），worked either in general practice or other departments（35.9%），worked as a clinician（32.3%），had a junior professional and technical title（44.8%），and had never participated in a on-the-job training（30.7%）．The 3 dimensions of TCM-based body constitution identification services presented in descending order of score evaluated by the respondents were：technical standards for TCM health management，available equipments for the delivery of TCM-based body constitution identification，and impact of the delivery of TCM-based body constitution identification on oneself.The score of level of satisfaction with the delivery of such services evaluated by the respondents ranged from 20 to 100，with an average of（75.6±14.6）．Multiple linear regression analysis showed that annual income，participating in the on-the-job training，the score of technical standards for TCM health management，the score of available equipments for the delivery of TCM-based body constitution identification were the influencing factors of primary providers' level of satisfaction with the delivery of TCM-based body constitution identification.Conclusion The 3 dimensions of TCM-based body constitution identification services in descending order of score evaluated by the respondents were：technical standards for TCM health management，available equipments for the delivery of such services，and impact of the delivery of such services on oneself.The average score of level of satisfaction with the delivery of such services evaluated by them was（75.6±14.6），indicating that they had an above-average level of satisfaction with such services.In view of this，the equipments for the implementation of TCM-based body constitution identification should be improved，and the technical approaches should be standardized，and the operation of such services should be enhanced.Moreover，health management talents should be appropriately introduced，on-the-job trainings should be carried out reasonably in relevant health workers，in order to improve primary providers' satisfaction with the delivery of such services and the medical experience of patients.
【Key words】 Body constitution；TCM theories；Community health centers；Health services needs and demand；Patient satisfaction；Root cause analysis；Supplier perspective
Changes in the Quality of Life in Patients with Chronic Kidney Disease Stage 5D Following TCM Treatment：a Single-center Survey CHE Yueni，YIN Ling，ZHU Yilin，ZHAO Junyi，JIANG Yan，SHENG Meixiao*
Department of Nephrology，Affiliated Hospital of Nanjing University of Chinese Medicine，Nanjing 210029，China
*Corresponding author：SHENG Meixiao，Chief TCM physician，Professor；E-mail：email@example.com
【Abstract】 Background Patients with chronic kidney disease（CKD） stage 5D often suffer from different levels of functional disability，which causes physical and mental stresses，seriously impairing the prognosis and quality of life（QOL）．Most of treatments for such patients focus on improving their QOL and promoting clinical rehabilitation，by which they can return to normal daily activities.TCM treatment has great potential for improving the QOL of dialysis patients.Objective To investigate the impact of TCM treatment on the QOL of patients with CKD stage 5D.Methods Participants with CKD stage 5D were recruited from Department of Nephrology，Affiliated Hospital of Nanjing University of Chinese Medicine from January 2017 to January 2018 in accordance with the inclusion and exclusion criteria of the study.General data were collected，such as dialysis mode，essential information（gender，age，marital status，education level，employment status，primary disease，dialysis duration，comorbidity），laboratory inspection indicators，TCM treatment in the past half year，and types of TCM treatment（herbal decoction，Chinese patent medicine Baoshen Tablets，lavipeditum with herbs，acupoint plaster therapy，auriculotherapy with ear seeds，or moxibustion）．KDQOL-SFTM 1.3 was used in a survey to assess the QOL of patients.Results Of the 140 participants，132 responded to the survey effectively，achieving a response rate of 94.29%.Among the 132 respondents，80 underwent hemodialysis（HD） and 52 underwent peritoneal dialysis（PD）；86（65.15%） received TCM treatment within six months，including 40 with HD and 46 with PD；60 received Chinese patent medicine，20 received Chinese herbal decoction，15 received lavipeditum with herbs，17 received auriculotherapy with ear seeds，15 received acupoint plaster therapy，and 9 received moxibustion.At least 2 types of TCM treatments were simultaneously administered to 12 HD patients，and 20 PD patients.The percentage of taking Baoshen Tablets was highest in HD patients，followed by that of receiving acupoint plaster therapy.The percentage of taking Baoshen Tablets was also highest in PD patients，followed by that of receiving herbal decoction.HD patients had lower KDTA dimension score than PD patients （P<0.05）．In KDTA dimension，HD patients had lower average item scores in terms of dialysis staff encouragement，and patient satisfaction compared with PD patients （P<0.05）．The KDTA dimension score achieved by those younger than 45 years was higher than that achieved by those aged 60-75，or aged greater than 75 years（P<0.05）．The KDTA dimension score achieved by those without comorbidity was higher than that achieved by those with 1，2 or 3 comorbidities（P<0.05）．Those with TCM treatment had higher KDTA dimension score than those without（P<0.05）．In KDTA dimension，those with TCM treatment had higher average item scores in terms of symptom/problems，effects of kidney disease on daily life，cognitive function，sexual function，sleep，support and encouragement of dialysis staff than those without（P<0.05）．HD patients had lower SF-36 dimension score than PD patients（P<0.05）．In SF-36 dimension，HD patients had lower item scores in terms of physical functioning（P<0.05）．The SF-36 dimension score achieved by those younger than 45 years was higher than that achieved by those aged 60-75，or aged greater than 75 years（P<0.05）．Those with primary education had lower SF-36 dimension score than those with secondary or tertiary education（P<0.05）．The SF-36 dimension score achieved by those without comorbidity was higher than that achieved by those with 1，2 or 3 comorbidities（P<0.05）．Those with TCM treatment had higher SF-36 dimension score than those without（P<0.05）．In SF-36 dimension，those with TCM treatment had higher item scores in terms of physical functioning，pain，general health perceptions，emotional well-being，role limitations caused by emotional health problems，and social functioning than those without（P<0.05）．Conclusion Dialysis mode，age，education level，and comorbidity were associated with the QOL of patients with CKD stage 5D.TCM treatment has a positive effect on the improvement of the QOL of such patients.
【Key words】 Nephrosis；Quality of life；Dialysis；Therapeutics；Data collection
Brucellosis with Cervical Spinal Cord Injury：a Case Report LUO Zhun，WANG Wen，CUI Wei*
Department of Infectious Diseases，the First Hospital of China Medical University，Shenyang 110000，China
*Corresponding author：CUI Wei，Professor，Chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Brucellosis is a zoonosis caused by brucella infection，and cervical spine involvement is rarely seen in clinical settings.This article introduced a rare case of paraplegia induced by brucellosis with severe cervical spinal cord injury，and described his clinical manifestations，imaging findings and treatment.Then we discussed the epidemiological characteristics，ideas for diagnosis and treatment of brucellosis with reference to related literature，pointed out that early active standardized medications can completely control the progression of the disease，and reduce the incidence of sequelae and surgery.
【Key words】 Brucellosis；Myelitis；Case reports
Ohtahara Syndrome Caused by a Novel c.581C>T Mutation in the KCNQ2 Gene：a Case Report and Literature Review LI Guangxu，YU Shufeng，LU Jun*，CHEN Minghui，WANG Danhong，CHEN Xiuling
Haikou Hospital Affiliated to Xiangya School of Medicine，Central South University，Haikou 570208，China
*Corresponding author：LU Jun，Professor，Doctoral supervisor；E-mail：email@example.com
【Abstract】 Ohtahara syndrome （OS） is a rare epileptic encephalopathy，which is also known as early infantile epileptic encephalopathy.It is characterized by neonatal onset，typically frequent and uncontrollable tonic clonic seizure，characteristic suppression-burst patterns on electroencephalography （EEG），and severe psychomotor retardation.In this paper，we summarized the clinical features and gene mutation characteristics of one case with ohtahara syndrome caused by a novel c.581C>T mutation in the KCNQ2 gene.And relevant literature was reviewed to improve the awareness of this rare disease.Identification of gene mutations will be beneficial to early diagnosis，intervention，prognosis evaluation and genetic counseling for ohtahara syndrome.
【Key words】 Brain diseases；Ohtahara syndrome；KCNQ2 gene；c.581C>T；Novel mutation