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Psychological stress （pressure） has gradually become an important factor affecting human physical and mental health， and is one of the important factors in the progression of clinical chronic refractory diseases. Psychological stress response can be attributed to the category of emotional illness in traditional Chinese medicine （TCM）. In the theory of TCM， the liver controls dispersion and regulates mental activity. Relevant scholars believe that the liver is the core of psychological stress response in the TCM theory. When being stimulated by chronic or repeated psychological stress， the body can gradually change from the initial depression and anxiety-rela behaviors to the gastrointestinal dysfunctions， which is similar to the formation process of the syndrome of liver depression and spleen deficiency with liver-spleen disharmony. The syndrome of liver depression and spleen deficiency is also the common syndrome of TCM for psychological stress-related diseases. With the effect in soothing liver and invigorating spleen， Xiaoyaosan has been regarded as the classic formula for anti-stress. Modern studies have showed that gut microbiota not only get involved in the movement， structure and function of the digestive tract， but also affect the brain function and behavior of the host through the gut-brain axis. Therefore， the microbiota-gut-brain axis has become an important part of psychological stress to trigger the body's gastrointestinal symptoms and abnormal brain behaviors. Focusing on psychological stress， the authors explored the correlation between the syndrome of liver stagnation and spleen deficiency and the microbiota-gut-brain axis， and the intervention mechanism of Xiaoyaosan， so as to enrich the scientific connotation of the syndrome of liver stagnation and spleen deficiency.
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Objective:To observe the preventive and therapeutic effects of 5-week administration with Xiaoyaosan on rat liver injury caused by tripterygium Glycosides. Method:Thirty-one SD rats were randomly divided into 4 groups， namely normal group， tripterygium glycosides group， tripterygium glycosides+Xiaoyaosan group （treatment group）， and tripterygium glycosides+Xiaoyaosan for 1 week in advance group （prevention group）. Tripterygium glycosides （37.5 mg·kg-1） was administered intragastrically， and Xiaoyaosan （water decoction， 19.270 g·kg-1） was administered intrastrically. First， the rats of prevention group were intragastrically administrated with Xiaoyaosan at 8：00-9：00 am， and the rats of other groups were given an equal volume of normal saline. After 1 week， the rats of tripterygium glycosides group were administered intragastrically with tripterygium glycosides suspension at 8：00-9：00 am. The rats of the treatment group and the prevention group were intragastrically administrated with Xiaoyaosan at 8：00-9：00 am， and then tripterygium glycosides suspension 2 hours later. All the drugs were given once a day for 5 weeks. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of liver， enzyme-linked immunosorbent assay （ELISA） was used to detect serum interleukin-1β （IL-1β）， interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α）， chemical method was used to detect the content changes of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， glutathione peroxidase （GSH-Px）， superoxide dismu-tase （SOD）， trace malondiamine aldehyde （MDA）. Immunohist-ochemical staining was used to observe the expressions of IL-6， IL-1β and TNF-α in liver tissue. Result:Compared with the normal group， the tripterygium glycosides group showed inflammatory cell infiltration， hepatocyte edema， hepatic sinuses squeezing and narrowing， liver plate widening， and liver cell necrosis， the contents of serum IL-1β， IL-6， TNF-α， ALT， AST and MDA were significantly increased（P<0.01）， but the contents of GSH-Px and SOD were decreased significantly （P<0.05， P<0.01）， while the positive expressions of IL-6， TNF-α， IL-1β in liver tissue were significantly increased （P<0.01）. Compared with tripterygium glycosides group， rats in the treatment group and the prevention group had less inflammatory cells infiltration and reduced edema in the liver tissue， and disorders in some cell， the contents of serum IL-1β， IL-6， TNF-α， ALT， AST， MDA were significantly decreased （P<0.01）， the contents of GSH-Px and SOD were significantly increased （P<0.05）， and the positive expressions of IL-6， TNF-α， IL-1β in liver tissues were significantly decreased （P<0.01）， with a better efficacy in the prevention group. Conclusion:Xiaoyaosan can obviously alleviate the long-term liver toxicity caused by tripterygium polyglycoside to a certain extent， with a better prophylactic effect.
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Objective:To observe the changes of leptin receptor-tyrosine kinase Janus2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） pathway and the regulatory effect of Xiaoyaosan on the hypothalamic arcuate nuclei of rats with chronic mild unpredictable stress model （CUMS）. Method:Sixty male sprague-dawley rats were randomly divided into normal group， model group， Xiaoyaosan group， and fluoxetine group. After one-week adaptive feeding， the rats in model group， Xiaoyaosan group and fluoxetine group were uesd to replicate the chronic psychological stress rat model through mild unpredictable stimulation. Meanwhile ， they were simultaneously administered the corresponding drugs， Xiaoyaosan 19.27 g·kg-1·d-1， Fluoxetine 2 mg·kg-1·d-1 （based on the average adult body weight of 60 kg）， the rats in the normal group and the model group were given the same volume of normal saline for 6 weeks. The body weight， food intake， sucrose consumption ratios， and the experimental behavior in the open field test （OFT） of the groups were observed. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the expressions of ob-R， JAK2， and STAT3 in the arcuate nucleus of rat hypothalamus. Result:Compared with the normal group， the body weight and food intake of the model group were significantly decreased （P<0.05， P<0.01）， the sucrose consumption ratios ， the total behavioral distance of the experimental field and the total distance of the central area were significantly reduced， the protein and mRNA expressions of ob-R， JAK2， STAT3 in the arcuate nucleus of hypothalamus in rats increased significantly （P<0.05， P<0.01）. Compared with the model group， the body weight of Xiaoyaosan group increased significantly on the 7th， 14th， 21st and 28th days （P<0.05， P<0.01）， the food intake of rats increased significantly on the 21st and 35th days of the experiment （P<0.05）， and the sucrose consumption ratios， the total distance of the experimental behavior in the open field test （OFT） and the total distance of the central area were significantly improved. Xiaoyaosan had a corresponding regulatory effect on the protein and mRNA expressions of ob-R， JAK2， STAT3 in the arcuate nucleus of hypothalamus in model rats （P<0.05， P<0.01）. Conclusion:Xiaoyaosan regulates the body weight， appetite， and energy metabolism of chronically mild and unpredictable stress rats， which may be related to the ob-R-JAK2/STAT3 pathway in the hypothalamic arcuate nucleus.
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Objective Few studies are reported about the values of the levels of plasma lipoprotein related phospholipase A2 (LP-PLA2) and serum resistin in predicting the prognosis of atherosclerotic cerebral infarction (ACI).This article aims to evaluate the predictive values of LP-PLA2 and serum resistin in the prognosis of ACI.Methods This study included 136 cases of ACI diagnosed and treated in Huaihe Hosptial from September 2013 to September 2014.The patients were followed up for 2 years,during which 48 were found with adverse outcomes (the poor prognosis group) 76 without disease progression (the good prognosis group).We analyzed the influencing factors on prognosis using the Cox proportional hazard model and evaluated the sensitivity and specificity of these factors in predicting the prognostic risks of the patients by ROC curve analysis.Results The rate of poor prognosis was 38.71％ among the included patients.Analysis with the Cox proportional hazard model showed significant impacts of LP-PLA2 (OR =2.105,95％ CI:1.878-2.413) and serum resistin (OR=1.784,95％ CI:1.509-2.213) on the prognosis of the patients.Compared with the good prognosis group,the poor prognosis group exhibited markedly higher levels of LP-PLA2 ([128.78±76.22] vs [268.65±89.02] mg/L,P＜0.01)and serum resistin ([20.71±6.15] vs [24.36±4.87] mg/L,P＜0.01).The sensitivity and specificity of LP-PLA2 combined with serum resistin were 81.35％ and 78.26％,respectively.Conclusion The combination of LP-PLA2 with serum resistin has a good predictive value for the prognosis of atherosclerotic cerebral infarction and is expected to be widely applied as a routine index in clinical practice.
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Objective Few researches have been reported about thromboelastography(TEG)in detecting the complications after stent-assisted coiling for intracranial aneurysms. This study aimed to investigate the value of TEG in predicting thromboembolic complications in patients with intracranial aneurysms after stent-assisted coiling. Methods We retrospectively analyzed the clinical data on 152 cases of intracranial aneurysms undergoing stent-assisted coiling in our department,18 with and 134 without thrombosis. We assessed the effects of antiplatelet drugs by TEG,recorded the general data and postoperative complications,and identified the po-tential risk factors for thromboembolic complications by multivariate logistic regression analysis. Results The incidence rate of aspi-rin resistance was significantly lower than that of clopidogrel resistance(10.5% vs 30.3%,P<0.05). Thromboembolic complications were observed in 18 patients during the perioperative and follow-up periods. Multivariate logistic regression analysis showed that the in-dependent risk factors for thromboembolic complications were the maximum amplitude of TEG(OR=1.152,95% CI:1.002-1.300, P=0.021)and aspirin resistance(OR=4.945,95% CI:1.408-17.375,P=0.013). Conclusion TEG is effective in evaluating the effects of antiplatelet drugs in patients with intracranial aneurysms undergoing stent-assisted coiling. Elevated maximum amplitude of TEG and aspirin resistance may increase the risk of thromboembolic complications.
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<p><b>OBJECTIVE</b>To formulate the standard measuring tool for the evaluations on fire-heat syndrome in oral cavity by means of Chinese medicine (CM).</p><p><b>METHODS</b>The measuring scale for fire-heat syndrome in the oral cavity by means of CM was investigated by symptom collection, item pool formulation, item selection, pre-investigation, evaluations on the reliability, validity and reactivity of the measuring scale, according to the principles for measuring scale design and under the guidance of CM theories.</p><p><b>RESULTS</b>The measuring scale was composed of two integrative parts: the self-filling section and the interview section. As far as the reliability was concerned, the total Cronbach α coefficient of the measuring scale was 0.866, the total test-retest reliability coefficient was 0.726 and the split-half reliability coefficient was 0.851. As far as the validity was concerned, the scores for the subjects of fire-heat syndrome in oral cavity and healthy people in their oral cavity in the items of symptoms were statistically different (P<0.01); three common divisors were extracted according to the theoretical dimensions, the accumulated contribution rate was 63.468%. As far as the reactivity was concerned, the difference between the symptom scores before and after the test in which 31 subjects used the Chinese herb toothpaste was statistically significant (P<0.01).</p><p><b>CONCLUSIONS</b>This measuring scale has relatively good reliability, validity and reactivity, and it can be used in an objective quantitative evaluation on patients suffering from fire-heat syndrome in oral cavity, and thus lay the foundations for the evaluations on the therapeutic effects of Chinese herb toothpaste on fire-heat syndrome in oral cavity.</p>