Integrated Systems Pharmacology, Urinary Metabonomics, and Quantitative Real-Time PCR Analysis to Uncover Targets and Metabolic Pathways of the You-Gui Pill in Treating Kidney-Yang Deficiency Syndrome.

Kidney-yang deficiency syndrome (KYDS) is a metabolic disease caused by a neuro-endocrine disorder. The You-gui pill (YGP) is a classic traditional Chinese medicine (TCM) formula for the treatment of KYDS and has been widely used to warm and recuperate KYDS clinically for hundreds of years in China. However, it is unknown whetherthe corresponding targets and metabolic pathways can also be found via using metabonomics based on one platform (e.g., 1H NMR) to study different biological samples of KYDS. At the same time, relevant reports on further molecular verification (e.g., RT-qPCR analysis) of these targets associated with biomarkers and metabolic pathways have not yet, to our knowledge, been seen in KYDS's research. In the present study, a comprehensive strategy integrating systems pharmacology and 1H NMR-based urinary metabonomics analysis was proposed to identify the target proteins and metabolic pathways that YGP acts on KYDS. Thereafter, further validation of target proteins in kidney tissue was performed through quantitative real-time PCR analysis (RT-qPCR). Furthermore, biochemical parameters and histopathological analysis were studied. As a result, seven target proteins (L-serine dehydratase; phosphoenolpyruvate carboxykinase; spermidine synthase; tyrosyl-tRNA synthetase, glutamine synthetase; 3-hydroxyacyl-CoA dehydrogenase; glycine amidinotransferase) in YGP were discovered to play a therapeutic role in KYDS via affecting eight metabolic pathways (glycine, serine and threonine metabolism; butanoate metabolism; TCA cycle, etc.). Importantly, three target proteins (i.e., 3-hydroxyacyl-CoA dehydrogenase; glutamine synthetase; and glycine amidinotransferase) and two metabolic pathways (butanoate metabolism and dicarboxylate metabolism) related to KYDS, to our knowledge, had been newly discovered in our study. The mechanism of action mainly involved energy metabolism, oxidative stress, ammonia metabolism, amino acid metabolism, and fatty acid metabolism. In short, our study demonstrated that targets and metabolic pathways for the treatment of KYDS by YGP can be effectively found via combining with systems pharmacology and urinary metabonomics. In addition to this, common and specific targets and metabolic pathways of KYDS treated by YGP can be found effectively by integration with the analysis of different biological samples (e.g., serum, urine, feces, and tissue). It is; therefore, important that this laid the foundation for deeper mechanism research and drug-targeted therapy of KYDS in future.

[Correlation between TCM syndrome types and clinical symptoms of benign prostatic hyperplasia with chronic prostatitis].

OBJECTIVE: To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP). METHODS: We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS). RESULTS: Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course. CONCLUSIONS: The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.

[Correlation between Signs of Living Body in Abdominal and Pelvic Cavities and Syndrome Typing of Chinese Medicine in Colorectal Cancer Patients].

OBJECTIVE: To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine (CM) in colorectal cancer patients. METHODS: Totally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five types, i.e., inner-accumulation of damp and heat, blockage of stasis and toxin, Pi-Shen yang deficiency, blood-qi deficiency, Gan-Shen yin deficiency. Signs of living body in abdominal and pelvic cavities were collected. The correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM were analyzed. RESULTS: Red colorectal canals or mass were dominated in colorectal cancer patients with inner-accumulation of damp and heat syndrome. Dark purple colorectal canals or mass were dominated in colorectal cancer patients with blockage of stasis and toxin syndrome. Reddish colorectal canals or mass were dominated in colorectal cancer patients with blood-qi deficiency syndrome. Pale colorectal canals or mass were dominated in colorectal cancer patients with Pi-Shen yang deficiency syndrome. Whitish or red-white stripes were dominated in colorectal cancer patients with Gan-Shen yin deficiency syndrome. Dropsy colorectal canal was associated with Pi-Shen yang deficiency syndrome. Intracavitary effusion was often seen in colorectal cancer patients with inner-accumulation of damp and heat syndrome. The effusion was yellowish in less amount. Intracavitary adhesion was often seen in colorectal cancer patients with blockage of stasis and toxin syndrome. There was no correlation between the maximum diameter of mass or each syndrome type of CM. CONCLUSION: There existed correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM, which could be taken as one of references for syndrome typing of colorectal cancer patients.

[Relationship between Life Habits and Constitution Types of Chinese Medicine in the Senile Living at Home in Beijing Downtown].

OBJECTIVE: To investigate the distribution of constitution types of Chinese medicine (CM) in the elderly living at home in Beijing downtown, and to explore its relationship with life habits. METHODS: A total of 3894 senile more than 60 years old were enrolled in this study. Their constitution types of CM were typed using CM constitution questionnaire. Meanwhile, their demographic features, disease condition, diet habits, exercise habits, sleep habits, and so on were investigated. Multivariate Logistic regression analysis was used to evaluate the relationship between life habits and constitution types of CM. RESULTS: The number of mild type constitution senile was 1111 (28.53%) and the number of biased constitutions 2783 (71.47%). Biased constitutions of the top three were qi deficiency constitution (662, 17.00%), yang deficiency constitution (445, 11.43%), and blood stasis constitution (363, 9.32%). Univariate analysis showed that different habits of diet, exercise, and sleep exist among the senile of different constitutions (P < 0.05). By taking mild type constitution, multivariate Logistic regression analysis (except demographic indices and chronic history) showed that significantly positive correlation existed between qi deficiency constitution and favor for hot food (OR = 1.349, P = 0.015), yang deficiency constitution and favor for hot food (OR = 2.448, P < 0.01), phlegm-wetness constitution and favor for barbecue food (OR = 2.144, P = 0.003), wet-heat constitution and favor for sweet food (OR = 1.355, P = 0.032), wet-heat constitution and favor for tea (OR = 1.359, P = 0.047), blood stasis constitution and favor for hot food (OR = 1.422, P = 0.017), and qi depression constitution and favor for hot food (OR = 1.446, P = 0.031). Regular exercise had negative correlation with qi deficiency constitution (OR = 0.397, P < 0.01), yang deficiency constitution (OR = 0.522, P < 0.01) , phlegm-wetness constitution (OR = 0.475, P < 0.01), wet-heat constitution (OR = 0.647, P = 0.015), blood stasis constitution (OR = 0.608, P = 0.001), qi depression constitution (OR = 0.541, P = 0.001), and special diathesis constitution (OR = 0.466, P < 0.01). Early sleep and rise habit had negative with phlegm-wetness constitution (OR = 0.414, P < 0.01), wet-heat constitution (OR = 0.536, P = 0.015), blood stasis constitution (OR = 0.515, P = 0.004), and special diathesis constitution (OR = 0.526, P = 0.039). CONCLUSIONS: Different constitution types of CM might be highly related to specific life habits. Cultivating better life habits can improve biased constitutions of CM.

[Analysis of associated rules between Chinese medical syndrome typing features of epigastric pain and endoscopic features].

OBJECTIVE: To explore Chinese medical syndrome typing features of epigastric pain and its association with gastroscopic manifestations. METHODS: Using associated rules data mining method, an analysis study was performed in 234 patients with epigastric pain by combining holistic Chinese medical syndrome typing and results of gastroscopic examinations. RESULTS: Pi-Wei deficiency cold syndrome (PWDCS) was associated with pale gastric mucosa, or superficial ulcers accompained with unobvious redness and swelling. Inversed Gan-qi invading Wei syndrome (IGIWS) was associated with bile regurgitation. Damp-heat stagnating in the middle jiao syndrome (DSMJS) was associated with obvious redness and swollen mucosa, or ulcers accompanied with yellow and white fur. Wei-yin exhaustion syndrome (WYES) was associated with coarse mucosa and exposed blood vessels, or rare mucus. Retention of blood stasis in Wei syndrome was associated with bulged swelling and erosion. Indigestion impairing Wei syndrome (IIWS) was associated with retention of water and food, or more mucus attached. The endoscopic manifestations of PWDCS and DSMJS occurred most frequently, while PWDCS and IGIWS ranked the first place in macroscopic Chinese medical syndrome typing. CONCLUSIONS: The manifestations of endoscopic features were closely associated with Chinese medical syndrome typing. The syndrome typing features of epigastric pain could be objectively and further grasped by summarizing syndrome typing laws using modern devices such as gastroscopic examinations, thus improving the accuracy of clinical syndrome typing.

[Exploring the pathogenesis and therapy of liver cancer from "damp-heat insidious pathogen" to "cancer toxin"].

From a macro-level analysis of the attributes and pathogenic features of HBV, the main pathogenic factor for chronic liver diseases including viral hepatitis, cirrhosis, and liver cancer, the concept of damp-heat insidious pathogen was obtained, according to which, in-depth discussions were undertaken. Adopting syndrome typing of Wei (defense), qi (vital energy), Ying (nutrients), and blood, the pathogens leading to different syndromes as well as new products such as pathological "sputum", "stasis" in the disease process were understood, and then, the pathological "sputum" and "stasis", as the hub, playing a role in chronic lesions of the liver collateral were explained. Finally the pathological "sputum" and "stasis" blend and form cancer toxin. Through a comprehensive understanding of the development of chronic liver diseases, it is clear that damp-heat insidious pathogen, as its initiating factor, always exists in the whole process. We summed up heat clearing, dampness resolving, and detoxification was the principle for treating chronic liver disease.

[Observation of serum protein fingerprinting in primary liver cancer patients of different Chinese medical syndromes before and after interventional treatment].

OBJECTIVE: To explore changes of serum protein fingerprinting in primary liver cancer (PLC) patients of different Chinese medical syndromes before and after interventional treatment detected by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS). METHODS: Totally 154 PLC patients were assigned to 5 groups, i.e., Gan depression syndrome (GDS, 37 cases), Pi deficiency syndrome (PDS, 45 cases), dampness heat syndrome (DHS, 18 cases), blood stasis syndrome (BSS, 28 cases), yin deficiency syndrome (YDS, 26 cases). The mass spectra of serum proteins was analyzed by using SELDI-TOF-MS. Then the correlation between Chinese medical syndrome types and the mass spectra of serum proteins was explored before and after interventional treatment. RESULTS: Compared with the healthy control group, the expression of serum proteins peak was down-regulated in GDS with M/Z being 6 589 and 4 182 Da, in DHS with M/Z being 5 710 Da, in YDS with M/ Z being 6 992 Da, while it was up-regulated in PDS with M/Z being 5 816 Da and in BSS with M/Z being 4 297 Da, showing statistical difference (P < 0.01). Compared with before intervention, the expression of serum proteins peak was down-regulated in GDS with M/Z being 6 589 and 4 182 Da, in PDS with M/Z being 5 816 Da, in DHS with M/Z being 5 710 Da in BSS with M/Z being 4 297 Da, while it was up-regulated in YDS with M/Z being 6 992 Da, showing statistical difference (P < 0.05, P < 0.01). CONCLUSION: There was statistical difference in changes of serum protein fingerprinting in PLC patients of different Chinese medical syndromes before and after interventional treatment.

[Analysis of Chinese medical syndrome features of patients with primary liver cancer before and after transcatheter arterial chemoembolization].

OBJECTIVE: To observe the Chinese medical syndrome features of patients with primary liver cancer before and after transcatheter arterial chemoembolization (TACE). METHODS: Recruited were 106 primary liver cancer (PLC) patients treated with TACE at the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi Medical University from May to November 2009. Using self-control study, the distributions of 8 syndrome types were compared, such as qi stagnation syndrome, blood stasis syndrome, excess-heat syndrome, fluid and damp syndrome, qi deficiency syndrome, blood deficiency syndrome, yin deficiency syndrome, and yang deficiency syndrome. The scoring for each syndrome quantization was performed to all patients before and after TACE. RESULTS: Eight syndromes occurred in the 106 patients before treatment, amounting to 412 cases. The proportions of syndrome types in PLC patients before TACE were ranked from high to low as blood stasis syndrome [(92 cases, 86.8%)], excess-heat syndrome [(73 cases, 68.9%)], qi stagnation syndrome [(62 cases, 58.5%)], qi deficiency syndrome [(62 cases, 58.5%)], yin deficiency syndrome [(60 cases, 56.6%)], blood deficiency syndrome [(30 cases, 28.3%)], yang deficiency syndrome [(18 cases, 17.0%)], fluid and damp syndrome [(15 cases, 14.2%)]. The 8 syndromes occurred in 456 cases after TACE. The proportions of syndrome types in PLC patients after TACE were ranked from high to low as blood stasis syndrome [(89 cases, 84.0%)], qi deficiency syndrome [(87 cases, 82.1%)], excess-heat syndrome [(85 cases, 80.2%)], qi stagnation syndrome [(52 cases, 49.1%)], yin deficiency syndrome [(49 cases, 46.2%)], blood deficiency syndrome [(42 cases, 39.6%)], yang deficiency syndrome [(32 cases, 30.2%)], fluid and damp syndrome [(20 cases, 18.9%)]. After TACE the proportions of qi deficiency syndrome and yang deficiency syndrome increased with statistical difference (P<0.01, P<0.05). There were no statistical difference in terms of other syndromes between before and after TACE (P>0.05). Blood stasis syndrome and qi stagnation syndrome got the highest quantization scores before TACE. After TACE blood stasis syndrome and qi deficiency syndrome got the highest quantization scores. After TACE the score of qi stagnation syndrome decreased, while that of excess-heat syndrome, qi deficiency syndrome, blood deficiency syndrome, yang deficiency syndrome increased (all P<0.05). CONCLUSIONS: It's necessary to pay attention to regulating qi, clearing heat, replenishing qi, and removing stasis for treating liver cancer patients. Clearing heat, replenishing qi, enriching blood, and warming yang after TACE should also be paid equal attention to while using syndrome typing methods.

[A mathematical model for re-analysis of the relationship between essence of syndromes in traditional Chinese medicine and clinical biochemical indicators based on the residual-split method and its application].

Studying the essence of syndromes (Zheng) in traditional Chinese medicine (TCM) is a fundamental challenge in basic theoretical research of TCM. The relationship between any given syndrome and biochemical indicators is one of the important aspects of the study. As the indexes selected in each study are specific to a particular Western medical disease diagnosis, and the disease factor is inevitably introduced into the study, the effect of disease factor on the index changes cannot be assessed effectively by traditional data processing methods. This is known as "the same syndrome with different reasons", which has resulted in confusion in TCM research. This study aimed at providing a mathematical tool to address this issue. Based on information theory and the residual-split method, the syndrome information, which was covered in the index variation, was quantitatively calculated in this paper as an independent part of the disease factor. A mathematical model capable of objectively assessing and statistically testing the effect of the syndrome factor on the index changes was established. Applying this model to literature data of studies on the relationship between cyclic nucleotides and yang-deficiency syndrome showed following results. First, the values of yang-deficiency syndrome information were negative for cyclic adenosine monophosphate (cAMP) while positive for cyclic guanosine monophosphate (cGMP) in all included literature. This indicated that the group of yang-deficiency syndrome was correlated with an obvious trend of reduced cAMP levels and increased cGMP levels. Second, the statistical test results of yang-deficiency syndrome information of the two indexes were different among the literature included. The quality of original data was considered as a possible reason. Third, the significant differences between the yang-deficiency group of a specific disease and the normal group may, in some cases, be caused by a disease factor rather than a syndrome factor. The mathematical model provided a reasonable mathematical tool for the analysis of disease factor and syndrome factor in clinical research of TCM, suggesting that the mathematical model may give rise to innovative ideas and methods in the study of syndromes.

[Mathematical analysis of characteristics of glucocorticoid-induced yang deficiency or yin deficiency syndrome in animal models based on information entropy theory].

OBJECTIVE: Based on information entropy theory, this study analyzes the experimental indicators of glucocorticoid-induced traditional Chinese medicine yang deficiency or yin deficiency syndrome in animal models, thus laying the foundation of defining and interpreting the model state. METHODS: Data of biochemical indicators from 24 groups of animal models with different modeling conditions (type of modeling agent, dosage of modeling agent and modeling time) were collected. Information gain values for three study objects (type of modeling agent, dosage of modeling agent and modeling time) were calculated respectively after standardization, and then characteristics of yang deficiency or yin deficiency syndrome models were interpreted with these values and ranking map. RESULTS: Greatest information gain values of most indicators were got when the study object was the type of modeling agent, which is the most important factor in the differentiation of model state. With this study object, triglyceride (TG), total cholesterol (TC), total protein (TP), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and corticosteroid (CS) got larger information gain values than testosterone (T), lactic dehydrogenase (LDH), and cyclic adenosine monophosphate (cAMP). This indicated that the former seven indicators may be significantly different between the two animal models induced by hydrocortisone and dexamethasone, respectively. In the study of the modeling time, AST may be affected more than others. In the study of the dosage of modeling agent, TC and ALB may be affected more in the model of hydrocortisone and no indicators were significantly affected by the dosage of modeling agent in the dexamethasone model. CONCLUSION: Mathematical method based on information entropy theory allows researchers to analyze experimental data in several experiments at the same time and to interpret the trend and stability of indicators. Based on this study and by analyzing the impacts of different modeling conditions on the indicators, elucidations of the characteristics of glucocorticoid-induced yang deficiency or yin deficiency syndrome in animal models and some biochemical indicators for model comparison are in need.

Traditional Chinese medicine in diagnosis and treatment of fibromyalgia syndrome.

Fibromyalgia Syndrome (FS) is known for the difficulties arising from classification. The accompanying pain in skeletal muscles, myofascial peri-articular structures and a number of polymorphic symptoms cannot be separated into complexes of symptoms. The application of principles of Traditional Chinese Medicine (TCM) helps in analyzing the symptoms of FS to detect a leading syndrome and thereby establish an individual therapy. Medical histories and objective examinations of 25 patients with FS and 22 patients with vertebrogenic pain syndromes were analyzed according to TCM. A questionnaire was used to determine the leading constitutional type according to the 5-elements-theory. Analyses of the results showed that 83% of patients with FS were of constitutional type of the element earth. The following syndromes were found to be important in FS: 1) liver-Qi-stagnation, 2) Yin and blood deficiency of the liver, 3) Yang-weakness of the spleen and kidney, 4) Yin-weakness of the kidney. Applying TCM for FS allows for separating a group of symptoms and thus individual therapy. The determination of the constitutional type according to the 5-elements-theory may be used for a better understanding of the disharmony pattern.

[Mathematical analysis of the relationship between yang deficiency syndrome in traditional Chinese medicine and its objective indicators in clinical literature].

OBJECTIVE: The primary aim of this research is to systematically sort out and analyze available documents for yang deficiency syndrome in traditional Chinese medicine, providing innovative ideas and methods for statistical study of yang deficiency syndrome. METHODS: Based on the China National Knowledge Internet (CNKI) and Chongqing VIP databases, using "yang deficiency", "deficiency cold", and "patient" as keywords, we searched literature of clinical researches and used "ratio-comparison" and "integration-comparison" to analyze objective data after data preprocessing. Relative importance value of physiological and biochemical parameters were reflected by P value calculated by ratio-comparison or Q value by integration-comparison. RESULTS: With calculation of relative importance values of clinical indicators among various systems, we got the ranking of relative importance of different indexes. Triiodothyronine and urine 17-hydroxycorticosteroid of endocrine system, immunoglobulin A of immune system, and the ratio of cyclic adenosine monophosphate to cyclic guanosine monophosphate, which had great |P| (or |Q|) values and negative P (or Q) values, had a clearly lower level in yang deficiency patients than in the control; hemorheological indicators such as plasma viscosity, whole blood reduced viscosity and erythrocyte electrophoresis time had small |P| (or |Q|) values. These indicators, however, showed less importance for reflecting yang deficiency. CONCLUSION: Ratio-comparison method and integration-comparison method employed in this study have merits of efficiency and robustness. After detailed compiling and mining of all available data, we have made reasonable advice on the most relevant index of yang deficiency for further study of the essence of this syndrome.

[Study on the relation between Pi-deficiency pattern and metabolic syndrome in patients with polycystic ovarian syndrome].

OBJECTIVE: To evaluate the relation between Pi-deficiency syndrome (PDS) pattern and metabolic syndrome (MS) in patients with polycystic ovarian syndrome (PCOS), for exploring their internal pathologic mechanism. METHODS: Among the 102 PCOS patients, 22 complicated with MS (PCOS-MS) and 80 not complicated with MS (PCOS-NMS), the Chinese medicine syndrome pattern was differentiated as PDS in 50 patients and non-PDS in 52. The clinical data, in terms of fasting blood glucose (FBG), fasting insulin (FINS), waistline, body weight (BW), stature, blood pressure (BP), etc. was collected and compared and the relation between data was analyzed. RESULTS: Levels of FINS and homeostasis model of assessment for insulin resistence index (HOMA-IR), in PCOS-MS patients were significantly higher than those in PCOS-NMS patients, also higher in patients of PDS pattern than those of non-PDS pattern (P < 0.01); the occurrences of MS and PDS were highly positively correlated with levels of FINS and HOMA-IR (P < 0.01); incidence of MS in patients of PDS pattern was significantly higher than those in patients of non-PDS pattern (P < 0.05); presenting of PDS was positively related with the existence of MS (P < 0.05), but in case of the FINS or HOMA-IR factor being controlled, statistical meaning of the relativity between them turned to insignificant (P > 0.05). CONCLUSIONS: PCOS patients of PDS pattern are the high-risk population of MS, which might be related with the insulin resistance. So, early treatment of PCOS, especially on patients of PDS pattern, is of important significance for preventing the complication, as MS, of the disease.

[Relationship between Chinese medicine syndrome type and mRNA expressions of IL-10, IL-18 and Fas in peripheral blood mononuclear cells in patients with systemic lupus erythematosus].

OBJECTIVE: To explore the mRNA expressions of IL-10, IL-18 and Fas in peripheral blood mononuclear cells (PBMCs) in systemic lupus erythematosus (SLE) patients of various Chinese medicine syndrome types in order to seek the objective indices for syndrome differentiation of SLE. METHODS: SLE patients were sorted into various syndrome types by Chinese medicine syndrome differentiation. In them, patients with the 4 often encountered types were selected, i.e. the qi-xue excessive heat type (Group A, 12 patients), the Pi-Shen yang-deficiency type (Group B, 19 patients), the qi-yin deficiency with blood stasis type (Group C, 23 patients), and the qi stagnation and blood stasis with gan stagnation type (Group D, 28 patients). The mRNA expressions of IL-10, IL-18 and Fas in PBMCs were detected by SYBR Green I real time PCR. RESULTS: The mRNA expressions of IL-10, IL-18 and Fas in PBMC of all SLE patients (0.40 +/- 0.53, 1.41 +/- 1.93 and 0.33 +/- 0.70) were significantly higher than those in the normal control group (0.07 +/- 0.11, 0.24 +/- 0.25, 0.08 +/- 0.21, P<0.01, P<0.05), their levels in different syndrome types decreased in order of type A-->B-->C-->D. The levels of the three indices in patients of type A and B were obviously higher than those in patients of type C and D (P<0.01), while no significant difference was found between type A and B (P>0.05), and between type C and D (P>0.05). CONCLUSION: The mRNA expressions of IL-10, IL-18 and Fas in PBMCs could be taken as the objective indices for reference in syndrome differentiation of SLE.

[Effect of Penqiangyan Granule on the immune function of patients with chronic pelvic inflammatory disease of blood-stasis and Shen-deficiency syndrome type].

OBJECTIVE: To explore the effect of Penqiangyan Granule (PG) on the immunity of patients with chronic pelvic inflammatory disease (CPID) of blood stasis and Shen-deficiency syndrome (BSSDS) type. METHODS: Sixty patients were randomly assigned to two groups: the treatment group treated with PG and the control group with Penyanjing Granule, 30 cases in each group. The treatment course was 4 weeks for both groups. The clinical efficacy, plasma levels of CD4 and CD8, and the serum levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) were measured before and after treatment. RESULTS: After treatment, the total effective rate in the treatment group and the control group was 96.7% and 63.3% respectively with significant difference between groups (P < 0.05); in the treatment group the plasma CD4, CD4/CD8 and serum IL-2 increased obviously, while the plasma CD8 and serum TNF-alpha decreased markedly (P < 0.05), all were significantly different with those in the control group (P < 0.05). CONCLUSION: PG can improve the immune function and alleviate inflammation in CPID patients of BSSDS type.

[Establishment and analysis of serum two-dimensional gel electrophoresis profiles of myasthenia gravis patients with spleen and kidney deficiency syndrome].

OBJECTIVE: The purpose of this study was to establish two-dimensional gel electrophoresis (2-DE) profiles of serum of myasthenia gravis patients, and to identify the differential proteomic expressions between normal persons and myasthenia gravis patients with spleen and kidney deficiency syndrome. METHODS: Samples of serum protein were extracted by repeated freeze-thaw method and separated by two-dimensional electrophoresis. Differential proteomic expressions between the myasthenia gravis patients and the normal control persons were identified by two-dimensional polyacrylamide gel electrophoresis, silver staining, image-master 2-DE software analysis, peptide mass fingerprinting based on matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), BioWorks and NCBI software database searching. RESULTS: The two-dimensional polyacrylamide gel electrophoresis profiles of serum proteins were successfully established by 2-DE. Twenty-one of the significant differential proteins were selected and identified by MALDI-TOF-MS. Eight of them were finally identified. CONCLUSIONS: The 2-DE profiles of serum proteins were established and the differential proteomic expressions were identified by proteome technique in our study. This can be an experimental basis for further research of the pathogenesis and treatment of myasthenia gravis.

Reduction of perception of chronic fatigue in an observational study of patients receiving 12 weeks of Kampo therapy.

OBJECTIVE: The aim of this study was to observe the influence of Kampo therapy on latent chronic fatigue of patients with chronic diseases. SUBJECTS: One hundred and seventy-three (173) consecutive patients with chronic diseases came to our department for the first time. DESIGN: This was a prospective study. Patients were divided into two groups: a chronic fatigue group (CFG) and a nonchronic fatigue group (NCFG). Based on Kampo diagnosis, both groups were prescribed Kampo formulae as an extract or decoction for 12 weeks. OUTCOME MEASURES: By using questionnaires, patients were assessed concerning their physical and mental types of fatigue, their sleep situation, and their attitude toward work or housekeeping, both before and after 12 weeks of treatment, according to Kampo diagnosis. RESULTS: The mental fatigue, physical fatigue, and sleep scores of both groups, and the work score of CFG, were decreased. The rate of reduction of the fatigue score was significantly greater in CFG than in NCFG. The factor responsible for this difference in fatigue score was physical fatigue. CONCLUSIONS: A reduction of the perception of chronic fatigue was observed in patients receiving 12 weeks of Kampo therapy.