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ObjectiveTo explore the elements， distribution and characteristics of traditional Chinese medicine （TCM） syndromes in depressive episodes of bipolar disorder （BD）. MethodsBasic information， along with the four examination information， the Hamilton Depression Scale and Young Mania Rating Scale scores， were collected from 293 outpatients with BD at Beijing Anding Hospital， Capital Medical University. The four examination information with an occurrence rate greater than 12% were retained. The R language “dist” function was used to calculate the distances between samples using the Euclidean distance method. The hierarchical clustering of the four examination information was performed using the “hclust” function and the squared Euclidean distance method. A team of five researchers was formed to determine the nature and location of the essential elements of TCM syndrome in BD based on the clustering results. The PC algorithm was used to construct a Bayesian network model of the essential elements. The working group combined the essential elements of TCM syndromes in the Bayesian network according to the reference model results， and then extracted common TCM syndromes. The score of each patient based on the essential elements was matched with the common TCM syndromes to determine the syndrome type of each patient. The working group then performs conformity and revision based on this， obtaining the final distribution of TCM syndromes for the patients. ResultsThere were 77 common TCM symptoms in BD with a frequency greater than 12%. The top 15 symptoms with higher frequencies were slippery pulse， mental fatigue and lack of strength， wiry pulse， excessive rumination， preference for solitude， vexation， agitation and irritability， dry mouth， palpitations， profuse dreaming， unwarranted worries， chest oppression， thin white coating， amnesia， frequent sighing， and poor appetite. TCM syndrome elements of BD can be grouped into 11 categories. The nature of disease-related essential elements included fire， qi deficiency， blood deficiency， qi counterflow， yin deficiency， dampness， heat， fire from constraint， and phlegm. The location of disease-related essential elements included heart， liver， spleen， stomach， kidney， bladder channel， and gallbladder. By constructing a Bayesian network model and considering the opinions from the experts， six common syndromes of BD were identified， among which the highest proportion was heart-stomach heat accumulation， accounting for 27.99% （82 cases）， followed by heart-spleen deficiency （55 cases， 18.77%）， non-interaction between the heart and the kidney （49 cases， 16.72%）， liver constraint and blood deficiency （42 cases， 14.33%）， heart qi deficiency （37 cases， 12.63%）， and damp-heat in the liver and gallbladder （28 cases， 9.56%）. ConclusionsThe nature of disease-related elements of BD are predominantly fire and heat， while the location of disease-related essential elements are primarily associated with the heart， liver， and spleen. The most common TCM syndromes are heart-stomach heat accumulation and heart-spleen deficiency.
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Introducción: A consecuencia de la emergencia sanitaria por el virus SARS-CoV2, las actividades académicas migraron de forma repentina a un entorno de trabajo remoto; esto provocó que los hogares de todo el mundo se convirtieran en el asentamiento urgente de las estaciones de trabajo académico. La ergonomia como disciplina científica cobra relevancia al ser un aliado subsanador para mitigar los riesgos asociados con la aparición de lesiones musculoesqueléticas. De acuerdo con la memoria estadística del Instituto Mexicano de Seguridad Social, IMSS1, en el primer año de pandemia de COVID-19 se registraron 30 860 atenciones por lesiones en la región de manos y muñecas, 9696 en la zona de cabeza y cuello, 6251 dorsopatías y 1673 atenciones por astenopia a jóvenes de entre 18 a 29 años que desarrollaban actividades escolares. Objetivo: En este sentido, se aborda la presente investigación para conocer la composición de los espacios de trabajo académico en casa y analizar si existen factores o elementos que incidan en el riesgo de lesiones musculoesqueléticas en los estudiantes del nivel superior. Metodología: A través de un modelo de ecuaciones estructurales que cuenta con el constructo latente de las posibles lesiones (PL) en manos, espalda, piernas, cabeza, vista, oído, agotamiento físico y la respiración, las variables observables se atribuyen a los espacios utilizados para las actividades académicas en casa, muebles y equipos, Condiciones y Medio Ambiente (CyMAT). Resultados y discusión: Se encontró que un mal diseño de la estación de trabajo académico en casa, aunado a la utilización inadecuada de los muebles y equipos, aumenta la posibilidad de presentar síntomas asociados con las LMEs y, por tanto, daños en la salud del estudiante. Conclusión: La mediación de las estaciones de trabajo a través de la implementación de elementos ergonómicos mejora de forma sustancial la calidad de trabajo académico en casa, y hace evidente la importancia de la ergonomía como disciplina científica.
Introduction: As a result of the health emergency of the SARS-CoV2 virus, academic activities suddenly migrated to a remote work environment, causing homes around the world to become the urgent settlement of academic workstations. Ergonomics as a scientific discipline becomes relevant as it is a healing ally to mitigate the risks associated with the appearance of musculoskeletal injuries. According to the statistical report of the Mexican Institute of Social Security, IMSS1, in the first year of the COVID 19 pandemic, 30,860 care for injuries in the hands and wrists region, 9,696 in the head and neck area, 6,251 dorsopathies and 1,673 care for asthenopia were registered to young people between 18 and 29 years old who develop school activities. Objective: In this sense, this research is addressed to know the composition of academic workspaces at home and analyze if some factors or elements affect the risk of musculoskeletal injuries in students of the higher level. Methodology: Through a structural equations model that has the latent construct of possible injuries (PL) in the hands, back, legs, head, eyesight, hearing, physical exhaustion, and breathing; the observable variables are attributed to the spaces used for academic activities at home, furniture and equipment, conditions and environment (CyMAT) Results and discussion: It is explored that a bad design of the academic workstation at home coupled with the inappropriate use of furniture and equipment increases the possibility of presenting symptoms associated with SCI and therefore, damage to the student's health. Conclusion: The mediation of workstations through the implementation of ergonomic elements substantially improves the quality of academic work at home, making evident the importance of ergonomics as a scientific discipline
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Fluoride is the organic and inorganic compound of the element fluorine, has detrimental effect to all animals including fish at higher concentration. Ground water with elevated concentration of fluoride is a major global problem including India. On the other hand, Morinda citrifolia (also called ‘Noni’ in Polynesia) is a medicinal plant, has antioxidative, anti-inflammatory and immunostimulatory properties. The ameliorating effect of M. citrifolia fruit extract dietary supplementation against fluoride induced toxicity on the growth performance, haematological parameters, and fluoride accumulation in the muscular tissue was investigated in the freshwater fish, Cyprinus carpio L. for 35 days in triplicate. One hundred and twenty acclimated C. carpio fingerlings were randomly allocated into five experimental groups (Groups I, II, III, IV and V) each with 24 fish divided into three replicates (eight fish/replicate). Group I (Control) and II (Toxic control or negative control) were provided with basal/control diet, whereas groups III, IV, and V were provided with 0.25% (2.5 g/kg), 0.50% (5.0 g/kg) and 0.75% (7.5 g/kg) M. citrifolia fruit extract supplemented diet respectively. All groups except for group I were exposed to 10% of the LC50 of fluoride. Selected growth and haematological parameters were estimated. The fluoride content in the muscular tissue of fish was also estimated following SPADNS method. Results revealed that exposure of sublethal concentration of fluoride significantly (P <0.05) reduced the growth performance and haematological parameters in Gr. II (toxic control) compared to the Gr. I (control). However, M. citrifolia dietary supplementation significantly (P <0.05) improved fluoride induced alteration of growth performance and haematological parameters of fish in the groups III, IV and V compared to Gr. II. Morinda citrifolia fruit extract dietary supplementation also significantly (P <0.05) decreased the accumulation fluoride in the muscular tissue of fish in groups III, IV and V compared to the Gr. II (toxic control). In conclusion, M. citrifolia dietary supplementation ameliorates the fluoride toxicity by preventing the accumulation of fluoride in the muscular tissue of the fish. The M. citrifolia dietary supplementation at 0.25% showed the best response, hence it is considered as the optimum dose.
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Objective:To evaluate the efficacy of self-made Xiaogan Tiaopi Kaiwei Decoction combined with conventional western medicine therapy in the treatment of infantile anorexia of spleen-stomach weakness.Methods:Randomized controlled trial. A total of 100 children with anorexia of spleen-stomach weakness ,who were treated in the First Clinical Medical College of Shaanxi University of Chinese Medicine between April 2020 and September 2021, were selected as the observation subjects in a prospective cohort study, and they were divided into two groups by the random number table method, with 50 in each group. The control group was given routine treatment, and the Traditional Chinese Medicine (TCM) group was given self-made Xiaogan Tiaopi Kaiwei Decoction on the basis of the control group. The TCM syndromes were scored before and after treatment. The levels of trace elements such as iron, zinc and calcium were detected by atomic spectrometer, the absorptivity of D-xylose was measured by colorimetry. The adverse events during treatment were recorded. After 6 months of follow-up, the height, weight and BMI were measured and recorded, and the clinical efficacy was assessed.Results:The total response rate was 96.0% (48/50) in the TCM group and that in the control group was 84.0% (42/50) ( χ2=4.00, P=0.046). The scores of decreased appetite, anorexia, sallow complexion, abdominal fullness and distention and shortness of breath and laziness to speak and total score in the TCM group after treatment were significantly lower than those in the control group ( t=12.47, 13.42, 14.19, 16.39, 9.15, 17.72, P<0.01). The levels of blood trace elements such as iron [(414.58 ± 57.52) mg/L vs. (350.85 ± 53.33) mg/L, t=5.75 ], zinc [(8.26 ± 1.55) mg/L vs. (7.64 ± 1.37) mg/L, t=2.12 ] and calcium [(77.26 ± 15.30) mg/L vs. (71.05±14.26) mg/L, t=2.10] and urine D-xylose absorption rate [(31.76±5.28) % vs. (27.97 ± 4.61) %, t=3.82 ] in the TCM group were significantly higher than those in the control group ( P<0.01 or P<0.05). During treatment, there was no serious adverse reaction in the TCM group and 1 case of nausea in the control group. There was no statistical significance in the incidence rate of adverse reactions between the two groups ( χ2=1.01, P=0.315). After follow-up, the weight in the TCM group was significantly higher than that of the control group ( t=2.17, P=0.032). Conclusion:Self-made Xiaogan Tiaopi Kaiwei Decoction combined with conventional western medicine therapy can relieve the clinical symptoms, promote the absorption of trace elements and improvement of spleen-stomach function, and enhance the long-term efficacy in the treatment of children with anorexia of spleen-stomach weakness, and it has no adverse reactions.
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Objective:To study the evolution of Traditional Chinese Medicine (TCM) syndromes of 171 cases of Kawasaki disease (KD) under the intervention of gamma globulin therapy based on factor analysis.Methods:A cross-sectional study. 171 cases of KD children hospitalized in the Department of Cardiology of Guangzhou Women's and Children's Medical Center from July 2019 to December 2020 were collected. All patients were treated with intravenous gamma globulin (2 g/kg) for 1 week. According to the results of the treatment with C-ball, 171 children with C-ball sensitive KD were selected to collect the four diagnostic data, and the representative syndromes of defensive level, qi level, yin level, and nutritive level were observed. Factor analysis was used to analyze the evolution of syndrome in 171 children with KD c-ball sensitivity.Results:The result of factor analysis showed that the KMO statistics of 171 children with c-ball sensitivity before treatment was 0.792, and Bartley test was significant ( P<0.01). 16 common factors were extracted, and 23 syndromes were screened, mainly including defensive level disorder, qi level disorder,nutritive level disorder,yin level disorder, heat stagnation and blood stasis syndrome. One week after treatment, the statistic of KMO test was 0.787, and Bartley test was significant ( P<0.01). 9 common factors were extracted, and 10 syndromes were screened, mainly including qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome. Conclusion:Before treatment, the TCM syndromes in KD C-cell sensitive children are mainly nutritive level disorder, defensive level disorder, qi level disorder yin level disorder, and heat stagnation and blood stasis syndrome; after treatment, the main TCM syndromes are mainly qi deficiency syndrome, yin deficiency syndrome and blood stasis syndrome.
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Objective To construct a nomogram prediction model for the treatment effect of anlotinib with the participation of traditional Chinese medicine syndrome elements on the patients with extensive-stage small cell lung cancer (ES-SCLC) who previously received multiple lines of chemotherapy. Methods The clinical data of 127 patients with ES-SCLC who received at least two cycles of anlotinib treatment were retrospectively studied. Kaplan-Meier method was used to analyze the relationship between each factor and the overall survival time. Cox regression analysis was applied to screen the independent influencing factors of the prognosis of patients with ES-SCLC. R language was employed to build a nomogram prediction model, C-index was used to evaluate the model, and calibration curve was adopted to verify the accuracy of the model. Results Age, PS score, brain metastases, qi deficiency syndrome, yin deficiency syndrome, and blood stasis syndrome were related risk factors for ES-SCLC treated with anlotinib. PS score, brain metastasis, and blood stasis syndrome were independent prognostic factors. On the basis of these three independent influencing factors, a nomogram model was established to predict the prognosis of patients with ES-SCLC treated with anlotinib. The predicted risk was close to the actual risk, showing a high degree of coincidence. Conclusion The nomogram model established with PS score, blood stasis syndrome elements, and brain metastasis as independent factors can predict the prognosis of patients with ES-SCLC receiving second- and third-line treatment of anlotinib.
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To clarify the content characteristics of the main active components and mineral elements of Cynomorium songaricum under different habitat conditions, and further explore the relationship between the quality of C. songaricum and habitats, this study took C. songaricum from 25 different habitats in China as the research object, and measured the contents of 8 main active components and 12 mineral elements separately. Diversity analysis, correlation analysis, principal component analysis and cluster analysis were carried out. The results showed that the genetic diversity of total flavonoids, ursolic acid, ether extract, potassium(K), phosphorus(P) and zinc(Zn) in C. songaricum was high. The coefficient of variation of crude polysaccharide, ether extract, gallic acid, protocatechuic aldehyde, catechin, epicatechin, calcium(Ca), sodium(Na), magnesium(Mg), sulfur(S), iron(Fe), manganese(Mn), selenium(Se) and nickel(Ni) were all over 36%, indicating that the quality of C. songaricum was significantly affected by habitats. There were strong synergistic and weak antagonistic effects among the contents of the 8 active components, and complex antagonistic and synergistic effects among the contents of the 12 mineral elements. Principal component analysis revealed that crude polysaccharide, ursolic acid, catechin, epicatechin and total flavonoids could be used as the characteristic components to evaluate the quality of C. songaricum, and Na, copper(Cu), Mn and Ni were the characteristic elements to evaluate the quality of C. songaricum. In cluster ana-lysis, the second group with the main active components as cluster center had better quality in terms of the content of active substances, and the second group with the mineral elements as cluster center had higher utilization potential in the exploitation of mineral elements. This study could provide a basis for resource evaluation and breeding of excellent varieties of C. songaricum in different habitats, and provide a reference for cultivation and identification of C. songaricum.
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Cynomorium , Catechin , Plant Breeding , Selenium , Ethers , Ethyl Ethers , Flavonoids , Plant ExtractsABSTRACT
ObjectiveTo analyze the characteristics of tradition Chinese medicine (TCM) syndromes in patients with urolithiasis. MethodA syndrome questionnaire was developed to collect the general data and four diagnosis information on 296 patients with urolithiasis who were treated from September 2021 to September 2022. Tongue images, pulse images, symptoms, and signs were statistically analyzed, and the characteristics of syndrome were explored by association rule analysis, factor analysis, and cluster analysis. Result① In the distribution of tongue images, the single tongue images with a frequency of more than 20% were white fur, red tongue, thick fur, greasy fur, and yellow fur. In the distribution pf pulse images, the single pulse with the frequency of more than 20% was fine pulse, string pulse, slippery pulse, and sinking pulse. There were 27 symptoms and signs with a frequency of more than 10%. The characteristic symptoms of acute onset such as lumbar and abdominal pain and nausea, frequent urination, hematuria, and poor urination were relatively common, and other symptoms were chill and fever, defecation, and digestion. ② Among the 14 strong association rules, 5 were yang-deficiency and cold-dampness syndromes, 4 were yin-deficiency and heat syndromes, 1 was kidney-deficiency syndrome, and 3 were renal colic with accompanying symptoms. ③ Sixteen common factors were extracted by factor analysis, and the main elements of the disease location were represented by spleen and kidney. The main elements of disease natures were Yin deficiency, Yang deficiency, dampness, and heat, and often mixed with deficiency-excess in complexity. Six syndromes were obtained by cluster analysis, and the represented syndromes were mainly kidney deficiency and dampness and stasis, Qi stagnation and heat accumulation, Yin deficiency and dampness heat, spleen-kidney Yang deficiency, spleen deficiency and dampness, and dampness-heat accumulation. ConclusionThe syndrome manifestations of urolithiasis are chill and fever, defecation, sweating, and digestive tract symptoms. The deficiency syndromes are mainly Yin deficiency, Yang deficiency, kidney deficiency, and spleen deficiency. The excess syndromes are mainly wet and heat. The deficiency and excess syndromes often exist simultaneously. The spleen deficiency is the important pathogenesis of urolithiasis besides the kidney deficiency.
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Este texto apresenta os principais conceitos e manifestações que constituem a Cultura Corporal, com ênfase no público leitor de "alunos de Ensino Médio". Partimos de uma pesquisa bibliográfica nos clássicos da Educação Física (crítico- superadora) e de um mapeamento de manifestações concretas do jogo, dança, luta, ginástica, esportes e práticas de aventura. A exposição delineou o seguinte caminho: I) Introdução a questão "o que é Cultura Corporal", características essenciais (controle de si, controle da ação do outro e projeção artística) e dimensões gerais dos sentidos e finalidades (competitivas, lúdicas, estéticas, históricas, de aventura, políticas, éticas, morais, entre outras); II) Identificação de diferentes manifestações da Cultura Corporal; III) Exposição dos determinantes de cada atividade da Cultura Corporal. Consideramos que essa síntese pode contribuir pedagogicamente para a compreensão dos estudantes de Ensino Médio e trabalho educativo dos professores, sobre a Cultura Corporal, para além do senso comum, pela mediação de conceitos.
This text presents the main concepts and activities that constitute Corporal Culture, with an emphasis on the readership of "high school students". We start from a bibliographical research in the classics of Physical Education (critical-overcoming) and from a mapping of concrete manifestations of the game, dance, fight, gymnastics, sports and adventure practices. The exhibition outlined the following path: I) Introduction to the question "what is Corporal Culture", essential characteristics (self-control, control of the other's action and artistic projection) and general dimensions of meanings and purposes (competitive, playful, aesthetic, historical, adventure, political, ethical, moral, among others); II) Identification of different manifestations of the Corporal Culture; III) Exposition of the determinants of each activity of the Corporal Culture. We consider that this synthesis can contribute pedagogically to the understanding of high school students and teachers' educational work, about Corporal Culture, beyond common sense, through the mediation of concepts.
Este texto presenta los principales conceptos y actividades que constituyen la Cultura Corporal, con énfasis en el público lector de "estudiantes de secundaria". Partimos de una investigación bibliográfica en los clásicos de la Educación Física (crítico-superación) y de un mapeo de manifestaciones concretas de las prácticas del juego, la danza, la lucha, la gimnasia, el deporte y la aventura. La exposición trazó el siguiente camino: I) Introducción a la pregunta "qué es la Cultura Corporal", características esenciales (autocontrol, control de la acción del otro y proyección artística) y dimensiones generales de significados y finalidades (competitivas, lúdicas, estéticas, histórico, de aventura, político, ético, moral, entre otros); II) Identificación de diferentes manifestaciones de la Cultura Corporal; III) Exposición de los determinantes de cada actividad de la Cultura Corporal. Consideramos que esta síntesis puede contribuir pedagógicamente a la comprensión del trabajo educativo de estudiantes y profesores de secundaria, sobre la Cultura Corporal, más allá del sentido común, a través de la mediación de conceptos.
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ABSTRACT BACKGROUND: The efficacy of anti-thyroid drugs in conjunction with radioactive iodine therapy in the management of Graves' disease is still controversial. OBJECTIVE: To compare the efficacy of pretreatment with methimazole before the administration of radioactive iodine for the treatment of Graves' disease. DESIGN AND SETTING: A systematic review and meta-analysis was conducted at a teaching/tertiary hospital in Ibadan, Nigeria. METHODS: A systematic search of the PubMed, Embase, Cochrane Library, and Web of Science databases was performed from inception to December, 2021. RESULTS: Five studies with 297 participants were included. There was no difference in the risk of persistent hyperthyroidism when radioactive iodine was used in conjunction with methimazole compared with when radioactive iodine was used alone (relative risk: 1.02, 95% confidence interval, CI: 0.62-1.66; P = 0.95, I2 = 0%). Subgroup analysis based on the duration between discontinuation of methimazole and the administration of radioactive iodine showed a lower risk of persistent hyperthyroidism when methimazole was discontinued within 7 days before radioactive iodine use, although this did not reach statistical significance (risk ratio: 0.85, CI: 0.28-2.58). CONCLUSIONS: The use of methimazole before radioactive iodine administration was not associated with an increased risk of persistent hyperthyroidism. Concerns about medication toxicity and adverse effects should be considered when clinicians make decisions on combination therapies for the treatment of Graves' disease. PROSPERO REGISTRATION: CRD42020150013, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=150013.
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The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.
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Humans , Moxibustion , Acupuncture Therapy , Meridians , Acupuncture Points , Headache/therapy , Migraine Disorders/therapyABSTRACT
ObjectiveTo summarize the modeling elements， evaluation indicators， characteristics， and drawbacks of the animal models of diabetic nephropathy， and thus provide guidance for the standardized modeling and rational application of these models. MethodThe articles about the animal experiments of diabetic nephropathy published in the last decade were retrieved from China National Knowledge Infrastructure， Wanfang Data， and PubMed. The data of animal species， sex， modeling techniques， modeling criteria， and evaluation indicators were analyzed in Excel. ResultA total of 287 publications were included in this study. Male SD rats were mainly used for the modeling of diabetic nephropathy. The animal models of type 1 diabetes were mainly established by intraperitoneal injection of streptozotocin （STZ） at 60-69 mg·kg-1 once or 50 mg·kg-1 for 5 continuous days， and those of type 2 diabetes by intraperitoneal injection of STZ at 30-39 mg·kg-1 once or 30 mg·kg-1 for 2 continuous days combined with 4 weeks of high-fat and high-sugar diet. Blood glucose and 24-hour urine protein were mainly used to determine whether the modeling was successful. The evaluation indicators of the animal models mainly included basic indicators， glucose and lipid metabolism indicators， and renal function indicators. ConclusionAnimal models are commonly used in the research on diabetic nephropathy， while there is no unified standards for the preparation or evaluation of the animal models. Moreover， Chinese medicine is rarely considered in the modeling. Through literature review and data analysis， this paper summarizes the modeling elements and standards， key evaluation indicators， characteristics， and shortcomings， aiming to build the animal models of diabetic nephropathy with a high success rate and with the characteristics in line with the clinical pathogenesis and syndromes.
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ObjectiveTo clarify the evolutionary laws of syndromes and syndrome elements at different stages during the malignant transformation of chronic hepatitis B （CHB）. MethodsA total of 671 patients with hepatitis B virus infection， who were admitted to the outpatient and inpatient departments of Dongzhimen Hospital of Beijing University of Chinese Medicine and The Fifth Medical Center of Chinese PLA General Hospital from July 1st， 2020 to June 30th， 2021， were included， involving 120 cases of CHB， 340 cases of hepatitis B liver cirrhosis （HBLC）， 64 cases of precancerous lesions with hepatitis B liver cirrhosis （PLHC）， and 147 cases of hepatitis B liver cirrhosis with hepatocellular carcinoma （HCC）. A Survey form of traditional Chinese medicine syndrome during malignant transformation of chronic hepatitis B was designed， and the general information， auxiliary examination and the four examinations results were collected. Factor analysis and K-means clustering were used to determine and statistically analyze the syndrome and syndrome elements. ResultsFive traditional Chinese medicine （TCM） syndrome types were identified in CHB patients， while there were six TCM syndrome types in HBLC， PLHC and HCC stages. Among CHB patients， the main syndromes were liver constraint and spleen deficiency （53.33%） and liver-gallbladder damp-heat （21.67%）， and the dominant syndrome elements were qi stagnation （27.60%）， heat （17.71%） and qi deficiency （17.71%）. In the HBLC stage， the syndromes were mainly blood stasis obstructing the collaterals （23.83%） and liver constraint and spleen deficiency （22.35%）， with dominant syndrome elements being blood stasis （19.25%）， dampness （17.46%）， and qi deficiency （15.01%）. For the PLHC stage， the primary syndrome types were blood stasis obstructing the collaterals （29.68%） and liver-kidney yin deficiency （20.31%）， and the leading syndrome elements were blood stasis （22.12%）， yin deficiency （15.93%）， and qi deficiency （15.04%）. In the HCC stage， the syndrome was dominated by blood stasis obstructing the collaterals （33.34%） and liver-kidney yin deficiency （19.73%）， with the main syndrome elements being blood stasis （24.52%）， yin deficiency （16.09%）， and qi deficiency （15.33%）. During the progression of CHB to malignancy， there was a gradual decrease in excess syndromes including liver-gallbladder damp-heat and water-dampness internal obstruction from 21.67% to 19.04%. In contrast， deficiency syndromes including liver-kidney yin deficiency and spleen-kidney yang deficiency increased from 15.83% to 31.97%. Additionally， excess syndrome elements including qi stagnation， heat and dampness decreased from 59.89% to 34.48%， while deficiency syndrome elements including qi deficiency， yin deficiency and yang deficiency increased from 32.30% to 41.00%. ConclusionDuring the malignant transformation of CHB， there exists a progression of syndrome and syndrome elements， shifting from qi stagnation， heat and qi deficiency to blood stasis （predominantly excess）， dampness and qi deficiency， and then to blood stasis （predominantly deficiency）， yin deficiency and qi deficiency， characterized by “deficiency-excess complex， and shift from excess to deficiency”.
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Objective To evaluate predictive factors affecting the short-term efficacy of PD-1 inhibitors in non-small cell lung cancer (NSCLC) and to construct a prediction model. Methods From October 2019 to November 2021, 221 patients with advanced NSCLC who met the inclusion criteria and were treated with PD-1 inhibitors were prospectively enrolled. Patients who were enrolled before May 1st, 2021 were included inthe modeling group (n=149), whereas those who enrolled thereafter were included in the validation group (n=72). The general clinical data of patients, information of the four TCM diagnoses were collected, and TCM syndrome elements were identified. R software version 4.0.4 was used in constructing a nomogram clinical prediction model of objective response rate. The predictive ability and discrimination of the model were evaluated and externally validated by using a validation group. Results After two to four cycles of PD-1 inhibitor therapy in 221 patients, the overall objective response rate was 44.80%. Multivariate logistic regression analysis of the modeling group showed that the TPS score (OR=0.261, P=0.001), number of treatment lines (OR=3.749, P=0.002), treatment mode (OR=2.796, P=0.019), qi deficiency disease syndrome elements (OR=2.296, P=0.043), and syndrome elements of yin deficiency disease (OR=3.228, P=0.005) were the independent predictors of the short-term efficacy of PD-1 inhibitors. Based on the above five independent predictors, a nomogram prediction model for the short-term efficacy of PD-1 inhibitors was constructed. The AUC values of the modeling and validation groups were 0.8317 and 0.7535, respectively. The calibration curves of the two groups showed good agreement between the predicted and true values. The mean absolute errors were 0.053 and 0.039, indicating that the model has good predictive performance. Conclusion The nomogram model constructed on the basis of the syndrome elements of Qi-deficiency disease and Yin-deficiency syndrome of TCM, as well as TPS score, number of treatment lines and treatment mode, is a stable and effective tool for predicting the short-term efficacy of PD-1 inhibitors in advanced non-small cell lung cancer.
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@#[Objective] To construct a Nomogram model for the prediction of essential hypertension (EH) risks with the use of traditional Chinese medicine (TCM) syndrome elements principles in conjunction with cutting-edge biochemical detection technologies. [Methods] A case-control study was conducted, involving 301 patients with essential hypertension in the hypertensive group and 314 without in the control group. Comprehensive data, including the information on the four TCM diagnoses, general data, and blood biochemical indicators of participants in both groups, were collected separately for analysis. The differentiation principles of syndrome elements were used to discern the location and nature of hypertension. One-way analysis was carried out to screen for potential risk factors of the disease. Least absolute shrinkage and selection operator (LASSO) regression was used to identify factors that contribute significantly to the model, and eliminate possible collinearity problems. At last, multivariate logistic regression analysis was used to both screen and quantify independent risk factors essential for the prediction model. The “rms” package in the R Studio was used to construct the Nomogram model, creating line segments of varying lengths based on the contribution of each risk factor to aid in the prediction of risks of hypertension. For internal model validation, the Bootstrap program package was utilized to perform 1000 repetitions of sampling and generate calibration curves. [Results] The results of the multivariate logistic regression analysis revealed that the risk factors of EH included age, heart rate (HR), waist-to-hip ratio (WHR), uric acid (UA) levels, family medical history, sleep patterns (early awakening and light sleep), water intake, and psychological traits (depression and anger). Additionally, TCM syndrome elements such as phlegm, Yin deficiency, and Yang hyperactivity contributed to the risk of EH onset as well. TCM syndrome elements liver, spleen, and kidney were also considered the risk factors of EH. Next, the Nomogram model was constructed using the aforementioned 14 risk predictors, with an area under the curve (AUC) of 0.868 and a 95% confidence interval (CI) ranging from 0.840 to 0.895. The diagnostic sensitivity and specificity were found to be 80.7% and 85.0%, respectively. Internal validation confirmed the model’s robust predictive performance, with aconsistency index (C-index) of 0.879, underscoring the model’s strong predictive ability. [Conclusion] By integrating TCM syndrome elements, the Nomogram model has realized the objective, qualitative, and quantitative selection of early warning factors for developing EH, resulting in the creation of a more comprehensive and precise prediction model for EH risks.
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ObjectiveTo investigate the characteristics of traditional Chinese medicine syndrome and the evolution of pathogenesis in different stages of atherosclerotic thrombotic cerebral infarction （ATCI）. MethodsClinical data of 3088 ATCI patients from 8 hospitals in 6 provinces and cities were collected from the hospital information system during January 1， 2015 to December 31， 2019. After staging and counting clinical symptoms， common factors were extracted using the principal component analysis method in factor analysis. Cluster analysis was then carried out on the basis of the factor analysis. The results of the combination of the evidence element identification， cluster analysis and expert discussion were used to discuss the evidence of the different disease stages of atherosclerotic cerebral infarction. ResultsOf the 3088 ATCI patients included， 2290 cases were in the acute phase and 798 in the non-acute phase. Excluding the main symptoms of ischaemic stroke， such as numbness and weakness of limbs， unfavourable movement， unfavourable speech and dizziness， we identified 84 indicators with a frequency ≥5% of the four diagnostic information variables. Of these， 36 indicators were observed in the acute phase and 35 in the non-acute phase. Factor analysis extracted 14 common factors from each phase. We selected factors with a loading coefficient ＞0.3 for evidence determination. These 14 groups of common factors were used as variables for clustering. After clustering， the acute， non-acute phase were each divided into 5 categories. Based on a combination of clinical practice and expert opinion， the symptoms identified in the acute period were syndrome of deficiency of both qi and yin， syndrome of blockade of wind-phlegm-static blood （36.07%）， syndrome of qi deficiency and blood stasis （20.74%）， syndrome of upward disturbance of wind-fire （15.15%）， syndrome of stirring wind due to yin deficiency （9.43%）， and syndrome of spleen deficiency and liver hyperactivity （3.80%）. In the non-acute phase， the symptoms were qi and yin deficiency with syndrome of qi stagnation and blood stasis （45.49%）， syndrome of deficiency of both qi and yin （20.05%）， syndrome of qi stagnation and blood stasis （16.42%）， spleen-kidney deficiency syndrome （8.52%）， and syndrome of hyperactivity of liver yang （4.89%）. ConclusionThe acute phase of AICI is mainly characterized by blood stasis， fire， internal wind， hyperactivity of yang， qi deficiency and yin deficiency， while the non-acute phase is characterized by yin deficiency， qi deficiency， blood stasis and qi stagnation. The main pathomechanism of ATCI involves deficiency of qi and yin， as well as obstruction of the channels by phlegm and blood stasis， and the fundamental pathomechanism is deficiency of qi and yin.
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Objective:To investigate the clinical efficacy of five-element music therapy in the treatment of bipolar disorder.Methods:Eighty patients with bipolar disorder admitted to Shandong Mental Health Center from January 2018 to December 2019 were included in this study. They were randomly divided into a study group and a control group ( n = 40/group). The control group was treated with conventional drug treatment. The study group was treated with five-element music therapy based on conventional drug treatment. Before, during and after treatment, mania and depression were evaluated. Symptom self-evaluation scale and the Traditional Chinese Medicine Five State Emotion Questionnaire were completed to evaluate the curative effect. Patients were followed up by telephone call. Recurrence at 3, 6 and 12 months was recorded. Results:Before treatment, there were no significant differences in the scores of the Bech-Rafaelsen Mania Rating Scale (BRMs), Hamilton Depression Rating Scale (HAMD), Traditional Chinese Medicine Five State Emotion Questionnaire, Symptom Checklist-90 (SCL-90) between the two groups (all P > 0.05). During and after treatment, BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire, and SCL-90 scores were significantly decreased in each group compared with before treatment [Control group: BRMs score during and after treatment: (11.52 ± 1.57) points, (9.43 ± 1.05) points; HAMD score during and after treatment: (16.75 ± 3.05) points, (13.61 ± 2.51) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary (67.25 ± 5.7) points, (56.38 ± 4.97) points, physical symptoms (29.52 ± 3.94) points, (24.19 ± 3.05) points, SCL-90 score: (100.52 ± 10.26) points, (68.85 ± 7.33) points. Study group: BRMs score during and after treatment: (9.33 ± 1.09) points, (7.85 ± 0.82) points; HAMD score: (13.74 ± 2.54) points, (10.17 ± 1.97) points; Traditional Chinese Medicine Five State Emotion Questionnaire: emotional vocabulary: (58.19 ± 5.06) points, (46.85 ± 4.06) points, physical symptoms (25.14 ± 3.54) points, (20.11 ± 2.57) points; SCL-90 scores: (90.85 ± 8.97) points, (56.87 ± 5.81) points]. During and after treatment, scores of BRMs, HAMD, Traditional Chinese Medicine Five State Emotion Questionnaire and SCL-90 in the study group were significantly lower than those in the control group ( t = 3.77, 7.01, 4.48, 6.99, 8.78, 4.89, 6.05, 4.19, 7.57, all P < 0.05). Total response rate in the study group was significantly higher than that in the control group (90.0% vs. 72.5%, χ2 = 4.02, P < 0.05). At 3, 6 and 12 months after treatment, recurrence rate in the study group was 2.5%, 15.0% and 30.0%, respectively, which were significantly lower than 17.5%, 35.0%, and 52.5% in the control group ( χ2 = 5.00, 4.26, 4.17, all P < 0.05). Conclusion:Five-element music therapy for the treatment of bipolar disorder can markedly alleviate depression and mania, restore patient's emotional state, improve clinical efficacy, and decrease recurrence rate.
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Intelligent drug delivery is a promising strategy for cancer therapies. In recent years, with the rapid development of synthetic biology, some properties of bacteria, such as gene operability, excellent tumor colonization ability, and host-independent structure, make them ideal intelligent drug carriers and have attracted extensive attention. By implanting condition-responsive elements or gene circuits into bacteria, they can synthesize or release drugs by sensing stimuli. Therefore, compared with traditional drug delivery, the usage of bacteria for drug loading has better targeting ability and controllability, and can cope with the complex delivery environment of the body to achieve the intelligent delivery of drugs. This review mainly introduces the development of bacterial-based drug delivery carriers, including mechanisms of bacterial targeting to tumor colonization, gene deletions or mutations, environment-responsive elements, and gene circuits. Meanwhile, we summarize the challenges and prospects faced by bacteria in clinical research, and hope to provide ideas for clinical translation.
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Proteases are one of the most industrially important enzymes, which account for about 60% of total enzyme market. Protease production by submerged fermentation in shake flasks using Bacillus sp. isolated from the soil was studied. Soil samples were collected from different locations within Chukwuemeka Odumegwu Ojukwu University, Uli, Anambra state. The soil samples were serially diluted and inoculated on sterilized skim milk agar plates. The plates were incubated at 30oC for 72 h. A clear zone around the colonies gave an indication of protease-producing bacteria isolates. The selected protease producers were subsequently used for shake flask fermentation in 50 ml sterile medium. Optimization study was conducted to determine the effect of carbon sources, nitrogen sources, trace elements, agitation rates and pH. Twenty one bacteria isolates were found to be active protease producers and isolates RS-5 and OS-9 had the highest zone of clearance of 13.5 and 12.1 mm respectively. The result of submerged production of protease by the bacteria isolates revealed that the isolates RS-5 and OS-9 accumulated maximum protease yield of 3.23 and 2.71 U/ml respectively. The isolates were Gram positive and endospore formers, and were identified as Bacillus sp. RS-5 and OS-9.The addition of Starch and maltose stimulated optimum protease production of 3.47 and 2.77 U/ml by Bacillus sp. RS-5 and OS-9 respectively. Beef extract enhanced maximum enzyme yield of 3.35 and 2.90 U/ml for Bacillus sp. RS-5 and OS-9 respectively. Maximum protease yield of 3.28 U/ml for Bacillus sp. RS-5 and 2.85 U/ml for Bacillus sp. OS-9 was obtained by the supplementation of 0.4 g/l of FeS04 respectively. The maximum protease yield was observed at agitation rate of 200 rpm for Bacillus sp. RS-5 and 170 rpm for Bacillus sp. OS-9. At pH8, protease accumulation was highest for Bacillus sp. RS-5 and OS-9. The study revealed that the soil harbours some protease-producing bacteria strains and protease production can be greatly enhanced through optimization of process parameters.
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Siddha system is the foremost traditional system, which was introduced by ancient Siddhar’s. According to Siddhar’s, nature is man, man is nature. Man is said to be microcosm and universe is macrocosm. The universe is made up of five elements namely Earth, Water, Fire, Air, and Space. Our body is also made up of five elements (Panchaboothas), three vital humors known as Vatham (air, space), Pitham (fire), Kabam (Earth, water), seven physical constituents are Saram (nourishing fluid), Senneer (blood), Oonn (muscles), Kozhuppu (adipose tissue), Enbu (bone), Moolai (bone marrow), Sukkilam/Suronitham (sperm/ovum) respectively. The universe has stars and planets. Each planet has an influence that reflects in our bodies. Thoughts were controlled by cosmic force in the universe. Nine planets in the universe correlate with the organs in the body Sun-Heart, Moon-Brain, Mercury-Lungs, Jupiter-Liver, Saturn-Spleen, Mars-Gall Bladder. This article explains how the planets have a connection with our human body.