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ObjectiveTo study the clinical efficacy of the Qingre Lishi Huazhuo method on patients with chronic gouty arthritis of dampness-heat obstruction syndrome and the effect on nucleotide-binding oligomerization domain-like receptor 3（NLRP3）/interleukin-1β （IL-1β） signaling pathway to preliminarily explore its mechanism. MethodSixty patients with chronic gouty arthritis of dampness-heat obstruction syndrome were enrolled and divided into a treatment group （30 cases） and a control group （30 cases） according to the random number table method. Thirty people were assigned to the healthy group. Patients in the control group were treated with oral Febuxostat， while those in the treatment group were treated with modified Simiaosan combined with Febuxostat. Treatment lasted four weeks. The general clinical data， traditional Chinese medicine （TCM） syndrome scores， serum uric acid （UA）， serum creatinine （SCr）， blood urea nitrogen （BUN）， fasting blood glucose （FPG）， low-density lipoprotein （LDL）， triglyceride （TG）， total cholesterol （TC）， erythrocyte sedimentation rate （ESR）， and C-reactive protein （CRP） of patients were recorded. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of IL-1β，TNF-α， and IL-6，and the levels of NLRP3，cysteinyl aspartate-specific protease-1 （Caspase-1）， and apoptosis-associated speck-like protein containing a CARD （ASC） were detected by Western blot. ResultBefore treatment， the levels of body mass index （BMI）， systolic blood pressure （SBP），diastolic blood pressure （DBP），UA，SCr，BUN，FPG，LDL，TG，and TC in both groups significantly increased （P<0.05，P<0.01），and the levels of HDL significantly decreased as compared with those in the healthy group（P<0.05）. Additionally， the levels of IL-1β， TNF-α， and IL-6 in both groups significantly increased before treatment （P<0.01）. Compared with the results before treatment， patients in the two groups had significant reductions in tube pain， joint tenderness， joint swelling，joint fever， activity disorders， body fatigue， sliminess， bitter mouth， yellow and red urine， and tongue manifestation scores （P<0.05，P<0.01）. Compared with patients in the control group after treatment， those in the treatment group had a significant decrease in joint fever， body fatigue， sliminess， bitter mouth，sticky stool，yellow and red urine， tongue manifestation score， and pulse score （P<0.05）. The total effective rate in the treatment group was 80.0% （24/30）， higher than 56.7% （17/30）in the control group（χ2=11.916，P<0.05）. Compared with the results before treatment， BMI， SBP， DBP， UA， SCr， BUN， FPG， LDL， TG， TC， ESR，CRP， IL-1β， TNF-α， IL-6 levels， and VAS score in both groups significantly decreased （P<0.05，P<0.01）. Compared with patients in the control group after treatment， those in the treatment group had decreased DBP，ESR， IL-1β levels， and VAS score （P<0.05）. Western blot results showed that before treatment， the protein expression of NLRP3， Caspase-1， and ASC in peripheral blood mononuclear cells （PBMCs） of patients in both groups were higher than those in the healthy group （P<0.01）. Compared with the results before treatment， the protein expression of NLRP3， Caspase-1， and ASC in PBMCs in patients of both groups after treatment decreased （P<0.05，P<0.01）. Compared with the control group after treatment， the treatment group showed decreased expression levels of NLRP3 and Caspase-1（P<0.05）. ConclusionThe Qingre Lishi Huazhuo method can effectively improve the clinical symptoms and reduce inflammation of chronic gouty arthritis of dampness-heat obstruction syndrome with good safety. The mechanism may be related to the inhibition of the NLRP3/IL-1β signaling pathway.
ABSTRACT
OBJECTIVE@#To translate the English version of the assessment of chronic illness care (ACIC) to Chinese, to conduct a trial in Hunan province and to develop a Chinese version ACIC.@*METHODS@#According to the WHO rules, we translated the English version of the ACIC to Chinese and took the culture factor into account. Three hundred and ninety persons, who engaged in the work of chronic disease management in primary medical and health services in Hunan province, were enrolled for this study. One hundred and eighty three valid questionnaires were randomly selected. Six methods including discrete tendency method, good-poor analysis, correlation analysis, stepwise regression analysis, Cronbach's alpha coefficient and factor analysis were used for evaluation the questionnaire items.@*RESULTS@#The items in Chinese version ACIC showed as follows: 1) good sensitivity. The standard deviation of each item was more than 2 and the P value from the t test between the good and poor group was less than 0.001; 2) good representation. The correlation coefficients range of each item with the total score and each dimension score was 0.588-0.916; 3) high internal consistency. Cronbach's alpha coefficient for the total scale was 0.975, and for each dimension range was 0.854-0.936; 4) independent. Factor loadings were greater than 0.40 entries, and factor loadings ranged from 0.487-0.798; 5) importance. Stepwise regression analysis α(in)=0.01, α(out)=0.05) showed 34 items were kept in the equation.@*CONCLUSION@#Items of Chinese version ACIC retains ACIC 7 dimensions of 34 items in the original English version, which are sensitivity and typical with the internal consistency, independence and importance.
Subject(s)
Humans , China , Chronic Disease , Factor Analysis, Statistical , Language , Regression Analysis , Surveys and QuestionnairesABSTRACT
Objective: To evaluate the situation for chronic disease management in China, and to seek the method for improving the collaborative management for chronic diseases in community. Methods: We searched literature between January 2008 and November 2013 from the Database, such as China Academic Journal Full-Text Database, and PubMed. The screening was strictly in accordance with the inclusion and exclusion criteria and a summary was made among the selected literature based on a collaboration model. Results: We got 698 articles atfer rough screen and ifnally selected 33. All studies were involved in patient’s self-management support, but only 9 studies mentioned the communication within the team, and 11 showed a clear team division of labor. Conclusion: Chronic disease community management in China displays some disadvantages. It really needs a general service team with clear roles and responsibilities for team members to improve the service ability of team members and provide patients with various forms of self-management services.
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Objective To establish a tibial cancer pain model with MADB-106 mammary gland carcinoma cell line and to conduct therapeutic research through the behavior pain, X-ray, histological observation of the model. MethodsA rat model of bone cancer pain was established by intra-tibial inoculations of MADB-106 rat mamnary gland carcinoma cells in SD rats. Spontaneous pain was assessed by the reflection of spontaneous paw withdraw, move-evoked pain was observed by the extent of lower extremity claudication when the rats walked and heat hyperalgesia was evaluated by using a thermal dolorimeter. The structural damage of the bone was monitored by X-ray and histology.ResultsThe model group spontaneously withdrawed their paws (14.42±1.24) times on the 15th day after operation (P ＜0.001), (18.33±1.37) times on the 22nd day (P ＜0.001), (21.25±1.54) times on the 25th day (P ＜0.001). The radiant pain thresholds of the model group was (1 1.86±1.63) s on the 15th day after operation (P ＜0.001), (8.38±1.05) s on the 22nd day (P ＜0.001), (7.47±1.25) times on the 25th day (P ＜0.001). The move-evoked pain score of the model group was (1.25±0.62) on the 15th day after operation (P ＜0.001), (2.00±0.95) on the 22nd day (P ＜0.001), (2.33±1.07)on the 25th day (P ＜0.001). The results showed that rats of the model group displayed the gradual development of spontaneous pain, heat hyperalgesia and move-evoked pain on the 15-25 days after injection of the tumor cells. The X-ray of the tibia showed clear bone destruction. The histology of the bone showed the bone marrow cavity was full of tumor cells and the cortical bone had been destroyed. ConclusionThe bone cancer model has been built well and it will be useful to evaluate the therapy of cancer pain after two weeks.