Dietary supplementation of tiger nut alters biochemical parameters relevant to erectile function in l-NAME treated rats.

Tiger nut tubers have been reportedly used for the treatment of erectile dysfunction (ED) in folk medicine without scientific basis. Hence, this study evaluated the effect of tiger nut on erectile dysfunction by assessing biochemical parameters relevant to ED in male rats by nitric oxide synthase (NOS) inhibitor, Nω-nitro-l-arginine methyl ester hydrochloride (l-NAME) treatment. Rats were divided into five groups (n = 10) each: Control group; l-NAME plus basal diet; l-NAME plus Sildenafil citrate; diet supplemented processed tiger nut (20%) plus l-NAME;diet supplemented raw tiger nut (20%) plus l-NAME. l-NAME pre-treatment (40 mg/kg/day) lasted for 14 days. Arginase, acetycholinesterase (AChE) and adenosine deaminase (ADA) activities as well as nitric oxide levels (NO) in serum, brain and penile tissue were measured. l-NAME increased the activity of arginase, AChE and ADA and reduced NO levels. However, dietary supplementation with tiger nut caused a reduction on the activities of the above enzymes and up regulated nitric oxide levels when compared to the control group. The effect of tiger nut supplemented diet may be said to prevent alterations of the activities of the enzymes relevant in erectile function. Quercetin was revealed to be the most active component of tiger nut tuber by HPLC finger printing.

Effects of grape seed extract on oxidative stress and antioxidant defense markers in streptozotocin-induced diabetic rats.

BACKGROUND/AIM: To evaluate the effects of grape seed extract (GSE) supplementation on oxidative stress and antioxidant markers in streptozotocin (STZ)-induced diabetic rats. MATERIALS AND METHODS: Thirty-six male rats were divided into the following four groups: control, GSE-supplemented control, diabetic, and GSE-supplemented diabetic. Beginning on day 7 after STZ injection, the rats were administered GSE (100 mg kg(-1) day(-1) in drinking water for 6 weeks. At the end of week 6, rats were sacrificed by cardiac puncture. Plasma nitric oxide (NO) levels and xanthine oxidase (XO), adenosine deaminase (ADA), and glutathione peroxidase (GPx) activities were analyzed. RESULTS: Both XO and ADA activities increased and NO levels decreased in diabetic rats (P < 0.05). GSE supplementation normalized all of these changes. Antioxidant enzyme activities decreased in diabetic rats compared to the controls (P < 0.05). GSE supplementation increased antioxidant enzyme activities in both diabetic and healthy rats (P < 0.05). CONCLUSION: These findings suggest that 6 weeks of oral GSE supplementation may prevent oxidative stress and improve antioxidant status in diabetic rats.

Prevention of methotrexate-induced nephrotoxicity by concomitant administration of garlic aqueous extract in rat.

BACKGROUND/AIM: Methotrexate (MTX) has been widely used for treatment of cancer and rheumatoid arthritis, but its use has been limited by its nephrotoxicity. This study was carried out to determine whether garlic exerts a protective effect against MTX-induced nephrotoxicity. MATERIALS AND METHODS: Nephrotoxicity was induced in rats after a single i.p. injection of MTX (20 mg/kg). Garlic extract (1 mL/100 g b.w.) was given orally for 7 days before and after MTX administration. Serum samples were collected to evaluate urea, creatinine, sodium, phosphorous, potassium, and calcium. Reduced glutathione, catalase, adenosine deaminase, nitric oxide, and malondialdehyde were measured in renal tissue. Tubular injury was evaluated by histopathological examination. RESULTS: MTX increased urea and creatinine levels and led to imbalances in some electrolytes. It also depleted renal antioxidant enzyme levels and increased malondialdehyde, adenosine deaminase, and nitric oxide levels. Histopathological examination showed glomerular and tubular alterations. Pretreatment with garlic significantly improved renal function and increased renal antioxidant enzyme activities. Furthermore, garlic reduced renal oxidative stress and prevented alterations in renal morphology. CONCLUSION: Garlic treatment has a reversible biochemical and histological effect upon MTX-induced nephrotoxicity.

Effect of zinc supplementation on ecto-adenosine deaminase activity in lambs infected by Haemonchus contortus: highlights on acute phase of disease.

Haemonchus contortus (order Strongylida) is a common parasitic nematode infecting small ruminants and causing significant economic losses worldwide. It induces innate and adaptive immune responses, which are essential for the clearance of this nematode from the host. Ecto-adenosine deaminase (E-ADA) is an enzyme that plays an important role in the immune system, while Zinc (Zn) has been found playing a critical role in E-ADA catalysis. Therefore, the aim of this study was to assess the effect of Zn supplementation on E-ADA activity in serum of lambs experimentally infected with H.contortus. To reach this purpose 28 male lambs (in average 25 kg) were used. The animals were divided into four groups: A and B composed of healthy animals (uninfected); C and D, infected with H.contortus. Groups B and D were supplemented with Zn Edetate, subcutaneously with 3 mg kg of live weight, on days 11 and 25 post-infection (PI). Blood and fecal samples were collected on the days 11, 25 and 39 PI, in order to assess hematocrit, seric E-ADA, and eggs per gram (EPG) counting, respectively. The animals of groups C and D showed severe hematocrit reduction (days 25 and 39 PI) and were EPG positive (days 11, 25 and 39 PI). On day 41 PI, three animals each group were subjected to necropsy. This procedure showed that animals of groups A and B did not have helminths in abomasum and intestines, while H.contortus were observed in groups C (5782.5 ± 810.9) and D (6185.0 ± 150.0). Infected and untreated animals (group C) showed a reduction in E-ADA activity, but this was not observed when the animals were supplemented with Zn (Group D). Therefore, based on our results, it was possible to observe that Zn supplementation exercised a positive effect on E-ADA activity in lambs infected with H.contortus, and did not allow a reduction in E-ADA activity, as occurred in the group infected and without supplementation. However, Zn supplementation was not able to prevent the worm burden.

Modulation of 3',5'-cyclic AMP homeostasis in human platelets by coffee and individual coffee constituents.

3',5'-Cyclic AMP (cAMP) is one of the most important second messengers in mammalian cells, mediating a multitude of diverse cellular signalling responses. Its homeostasis is primarily regulated by adenylate cyclases and phosphodiesterases (PDE), the activities of which are partially dependent on the downstream events of adenosine receptor signalling. The present study was conducted to determine whether coffee constituents other than caffeine can influence the homeostasis of intracellular cAMP in vitro and in vivo by evaluating the effects of selected constituents present in coffee, coffee brews and coffee extracts on platelet PDE activity. In addition, to evaluate the potential effects of these constituents on platelet cAMP concentrations and PDE activity in humans, a 7-week pilot intervention study with eight subjects was conducted. The subjects consumed a regular commercial coffee and a low-caffeine coffee at a rate of 750 ml/d for 2 weeks each. The in vivo results revealed a highly significant inhibition of PDE activity (P< 0·001) after coffee intervention that was not directly dependent on the caffeine content of coffee. Although our in vitro and in vivo findings suggest that caffeine plays some role in the modulation of platelet cAMP status, other natural and roasting-associated compounds such as pyrazines and other currently unidentified species also appear to contribute significantly. In conclusion, moderate consumption of coffee can modulate platelet PDE activity and cAMP concentrations in humans, which may contribute to the putative beneficial health effects of coffee. Further detailed mechanistic investigations will be required to substantiate these beneficial effects and to elucidate the underlying mechanisms.

Effect of zinc supplementation on E-ADA activity, seric zinc, and cytokines levels of Trypanosoma evansi infected Wistar rats.

The aim of this study was to evaluate the effect of zinc supplementation on the ecto-adenosine deaminase activity (E-ADA), zinc seric levels and cytokines (TNF-α, IL-1, IL-6, and IL -10) on rats experimentally infected by Trypanosoma evansi. Four groups with 10 rats each were used as negative controls (groups A and B), while the animals from the groups C and D were infected intraperitoneally with 0.1 mL of cryopreserved blood containing 1.4 × 10(4) of trypanosomes. Animals of groups B and D received two doses of Zinc (Zn) at 5 mg kg(-1), subcutaneously, on the 2nd and 7th day post-infection (PI). Blood samples were collected on days 5 (n = 5) and 15 PI (n = 5). Zn supplementation was able to increase the rat's longevity and to reduce their parasitemia. It was observed that seric Zn levels were increased on infected animals under Zn supplementation. Animals that were infected and supplemented with Zn showed changes in E-ADA activity and in cytokine levels (P < 0.05). Zn supplementation of healthy animals (Group B), increased the E-ADA activity, as well as reduced the concentration of cytokines. Infected animals from groups C and D showed increased levels of cytokines. Finally, we observed that Zn supplementation led to a modulation on cytokine's level in rats infected by T. evansi, as well as in E-ADA activity.

Syzygium cumini is more effective in preventing the increase of erythrocytic ADA activity than phenolic compounds under hyperglycemic conditions in vitro.

Syzygium cumini (S. cumini) is a plant known for its antidiabetic properties. The aim of this study was to evaluate the effect of Sc aqueous leaf extract (ASc) on adenosine deaminase (ADA) activity in erythrocytes (RBCs) exposed to high glucose concentrations (30 mM) in vitro. We also investigated the effects of the main phenolic compounds found in ASc (gallic acid, rutin, and chlorogenic acid) and the effects of insulin, caffeine, and dipyridamole, which are substances involved in the adenosine metabolism, on ADA activity in vitro. Blood samples were obtained from healthy volunteers and a suspension of RBCs was used for the determination of ADA activity. The results showed that: (1) the effect of ASc on ADA activity was more significant than the combination of phenolic compounds; (2) insulin, caffeine, or dipyridamole prevented high glucose increase of ADA activity at doses as low as 50 µU/mL, 25 µM, and 1 µM, respectively; (3) the inhibitory effect caused by ASc on erythrocyte ADA activity remained practically the same after the combination of the extract with insulin or caffeine; (4) when RBCs were exposed to ASc plus dipyridamole, this chemical attenuated the effect of ASc on ADA activity, suggesting an antagonism or a competition with ASc by the same site of action. Therefore, ASc was more effective in preventing the increase in ADA activity than phenolic compounds, suggesting that ASc may collaborate to improve endothelial dysfunction, antioxidant, anti-inflammatory, and antithrombotic properties of adenosine by affecting its metabolism. The results of this study help to provide evidence of the empirically supported benefits of the use of S. cumini in diabetes.

The effect of regular exercise and massage on oxidant and antioxidant parameters.

This experimental study aimed to determine the effects of the combined application of regular exercises and massage on the values of Malondialdehyde (MDA), Nitric Oxide (NOx), Glutathione (GSH), Adenosine Deaminase (ADA) and Superoxide Dismutase (SOD). Twenty five sedentary women (32-50 years) who did not have the habit of getting regularly massages or exercising and participated voluntarily in the study. The subjects were randomly separated into three groups: control group (CG, n = 9), exercise group (EG, n = 8), and massage and exercise group (MEG, n = 8). The basic result of this study was that a statistically significant decrease was observed in the post-test MDA values of both EG and MEG subjects. Moreover, when the GSH and SOD values are compared to CG, a statistically significant increase was determined in the values of both EG and MEG. As a result, the findings show that regular physical activities and massage manipulations significantly decrease MDA, increase SOD and GSH activities, and result in no change in NOx and ADA activities supports the assumption that regular physical activity has positive health effects.

Effects of grape seed extract supplementation on exercise-induced oxidative stress in rats.

The aim of the present study was to investigate the effects of grape seed extract (GSE) supplementation on exercise performance and oxidative stress in acutely and chronically exercised rats. A total of sixty-four male rats were used in the study. Rats were divided into six groups: control, chronic exercise control, acute exercise control (AEC), GSE-supplemented control, GSE-supplemented chronic exercise and GSE-supplemented acute exercise groups. Chronic exercise consisted of treadmill running at 25 m/min, 45 min/d, 5 d a week for 6 weeks. Rats in the acute exercise groups were run on the treadmill at 30 m/min until exhaustion. GSE were given at 100 mg/kg of body weight with drinking water for 6 weeks. Plasma was separated from blood samples for the analysis of oxidative stress markers. There was no significant difference in time of exhaustion between the acute exercise groups. Plasma malondialdehyde (MDA) levels were higher in the acute exercise groups and lower in the chronic exercise groups. GSE supplementation decreased MDA levels. Xanthine oxidase and adenosine deaminase activities were higher in the AEC group compared to all the other groups. NO levels were increased with both chronic exercise and GSE supplementation. Superoxide dismutase and glutathione peroxidase activities were lower in the acute exercised groups and higher in the chronic exercised groups. GSE supplementation caused an increase in antioxidant enzyme activities. In conclusion, GSE supplementation prevents exercise-induced oxidative stress by preventing lipid peroxidation and increasing antioxidant enzyme activities.

CD26/dipeptidyl-peptidase IV and adenosine deaminase serum levels in psoriatic patients treated with cyclosporine, etanercept, and psoralen plus ultraviolet A phototherapy.

OBJECTIVE: The aim of this study is to determine serum levels of soluble forms of CD26/dipeptidyl-peptidase IV (DPP-IV) and adenosine deaminase (ADA), thought to be markers of T-cell activation, and changes in their levels in response to cyclosporine, etanercept, and psoralen plus ultraviolet A (PUVA) treatments with respect to disease activity. METHODS: This study is designed as a prospective clinical study with a control group and three months of follow-up. The study included 41 patients with psoriasis and 41 healthy controls that were older than 18years of age. There were three different treatment groups: PUVA (n=15), cyclosporine (n=15), and etanercept (n=11). To determine disease severity of patients with psoriasis, psoriasis area and severity index (PASI) scores were calculated. RESULTS: Only mean serum ADA levels were different between patients with psoriasis [mean1±standard deviation (SD)=13.9±3.3U/ml] and control group (mean±SD=12±3.5U/ml). Mean serum ADA levels were significantly higher before treatment than after treatment (mean±SD=12.4±3.4U/ml). Contrarily, following three months of therapy, mean serum CD26 levels increased significantly from 777.7±214.6 to 835.3±203ng/ml (P<0.05) and mean serum DPP-IV activity increased significantly from 12.1±4 to 15.9±4.2nmol/min (P<0.05). There was no correlation between ADA and CD 26/DPP-IV with PASI values. CONCLUSIONS: The results show that ADA might be a useful marker indicating disease activity and T-cell activation. As significant changes were observed in serum CD26/DPP-IV before and after treatment, we think CD26/DPP-IV might play a role in psoriasis pathogenesis, which should be clarified by further studies.

Syzygium cumini extract decrease adenosine deaminase, 5'nucleotidase activities and oxidative damage in platelets of diabetic patients.

Diabetes mellitus, a chronic metabolic disorder, has assumed epidemic proportions and its long-term complications can have devastating consequences. The oxidative stress in diabetes was greatly increased due to prolonged exposure to hyperglycemia and impairment of oxidant/antioxidant equilibrium. Syzygium cumini is being widely used to treat diabetes by the traditional practitioners over many centuries. Adenosine deaminase (ADA) and 5'-Nucleotidase (5'NT) are enzymes of purine nucleoside metabolism that play an important role in the regulation of adenosine (Ado) levels. In this study, we investigated the effect of Syzygium cumini aqueous leaves extract (ASc) on ADA and 5'NT activities and on parameters of oxidative stress under in vitro conditions, using platelets of patients with Type 2 diabetes mellitus. Platelet-Rich Plasma (PRP) was assayed by ADA, 5'NT, Catalase (CAT), Superoxide Dismutase (SOD) activities and Thiobarbituric acid reactive substances (TBARS) levels. We observed that ADA, 5'NT activities and TBARS levels were significantly higher when compared to the control group, and ASc (100 and 200 µg/mL) prevented these effects. Our study demonstrates that ASc was able to remove oxidant species generated in diabetic conditions and modulates in the Ado levels. Then, ASc may promote a compensatory response in platelet function, improving the susceptibility-induced by the diabetes mellitus.

[Levels of adenosine deaminase and dipeptidyl peptidase IV in patients with panic disorder]. / Panik bozuklugunda adenozin deaminaz ve dipeptidil peptidaz IV enzim düzeyleri.

OBJECTIVE: Adenosine deaminase and dipeptidyl peptidase IV are enzymes connected to T cells that play an important role in immune system functioning. In this study, in order to understand the immune processes in panic disorder, we determined the serum levels of adenosine deaminase and dipeptidyl peptidase IV in medication-free panic disorder patients and compared them to those of healthy controls. METHOD: Enzymes levels were determined in blood samples of 24 healthy controls and 33 panic disorder patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV that were medication free during the previous month and medically healthy. RESULTS: Levels of both enzymes were significantly higher in panic disorder patients than in the controls (P<0.001 for adenosine deaminase and P<0.05 for dipeptidyl peptidase IV). The levels of the enzymes did not correlate with sociodemographic variables, duration of the disorder, presence of agoraphobia, presence of stressors, number of panic attack symptoms, and Hamilton depression and anxiety rating scale scores. In addition, the 2 enzymes? levels did not correlate with each other. There was a correlation between Hamilton anxiety rating scale score and the number of panic attack symptoms (P<0.001); however, Hamilton anxiety rating scale scores were not correlated with the other variables. CONCLUSION: Our results suggest that there may be a primary or secondary impaired immune state in the course of panic disorder, as there is in many other psychiatric disorders, such as major depression. Future studies with larger samples are needed to clarify the relationship between the immune system and panic disorder.

The effects of quercetin on antioxidant status and tumor markers in the lung and serum of mice treated with benzo(a)pyrene.

Chemoprevention has emerged as a very effective preventive measure against carcinogenesis. Several bioactive compounds present in fruits and vegetables have revealed their cancer curative potential on benzo(a)pyrene (B(a)P) induced carcinogenesis. In the present study, the efficacy of quercetin on the level of lipid peroxides, activities of antioxidant enzymes and tumor marker enzymes in B(a)P induced experimental lung carcinogenesis in Swiss albino mice was assessed. In lung cancer bearing animals there was an increase in lung weight, lipid peroxidation and marker enzymes such as aryl hydrocarbon hydroxylase, gamma glutamyl transpeptidase, 5'-nucleotidase, lactate dehydrogenase and adenosine deaminase with subsequent decrease in body weight and antioxidant enzymes-superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase, glutathione reductase, reduced glutathione, vitamin E and vitamin C. Quercetin supplementation (25 mg/kg body weight) attenuated all these alterations, which indicates the anticancer effect that was further confirmed by histopathological analysis. Overall, the above data shows that the anticancer effect of quercetin is more pronounced when used as an chemopreventive agent rather than as a chemotherapeutic agent against B(a)P induced lung carcinogenesis.

Macrophages are a source of extracellular adenosine deaminase-2 during inflammatory responses.

Serum activity of the adenosine deaminase (ADA) isozyme, ADA2, has been reported to be elevated during various disease states. Macrophages have been suggested as the cellular source of extracellular ADA activity because they are one of the only cell types in which intracellular ADA2 activity has been measured, but extracellular secretion has never been demonstrated. Rat primary peritoneal macrophages (PPMs) and peripheral blood monocytes (PBMs) were harvested and incubated for 18 h in RPMI supplemented with horse serum. PPM and PBM lysates were assayed for intracellular ADA activity (ammonia production). In vitro and in vivo extracellular ADA activities were measured in media and rat serum, respectively. Activity of ADA1 was confirmed by selective inhibition with erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA). ADA2 activity was inhibited by 2'-deoxycoformcin only, and was increased at a low pH (6.5). Activity of both ADA isozymes was found in PPMs and PBMs, and their media. In a separate group of rats, peritonitis was induced by ip insertion of 400 mg/kg caecal slurry. PPMs were harvested 24 h later and incubated for 18 h. In PPMs from rats with peritonitis both isozymes were elevated by a similar proportion. In contrast, media from these PPMs had a lower ADA1 and a higher ADA2 activity compared to PPMs from nonseptic rats. This resulted in a greater proportion of ADA2 in media. The isozyme proportions in serum from septic rats more closely resembled that of the PPM media. The response of PBM was small relative to that of PPM. These results suggest that macrophages are a significant source of extracellular ADA isozymes, the activity of which increases during an inflammatory response. Because extracellular isozymes profiles differ from cellular concentrations, the data also suggest differential release of each isozyme from PPMs.

Serum adenosine deaminase levels in patients with psoriasis: a prospective case-control study.

Adenosine deaminase (ADA) activity is a nonspecific marker of T cell activation. T cell activation is thought to play an important role in the pathogenesis of psoriasis. Our purpose was to assess the significance of serum ADA activity in psoriasis and its relevance to disease activity. ADA activity was determined with an enzymatic method in 25 patients with psoriasis and in 15 healthy subjects. These measurements were repeated for 10 patients after either PUVA or cyclosporin A treatments. Disease activity was estimated by the PASI scoring system. Serum ADA level was significantly elevated in patients with psoriasis compared to healthy subjects (p<0.05). There was a significant decrease in the ADA levels after treatment compared to pretreatment values in the same patients (p<0.05). There was no correlation between ADA levels and PASI scores. These results support the evidence that T cell activation is involved in the pathogenesis of psoriasis and that ADA may be valuable in the assessment of disease activity in psoriasis.

Dipeptidyl peptidase IV and adenosine deaminase activity. Decrease in depression.

Dipeptidyl peptidase IV (DPPIV) and adenosine deaminase (ADA), two T cell associated enzymes, are known to have a possible interaction and play essential roles in immune system functioning. On the other hand, depression has been shown to be accompanied with some immune-inflammatory alterations. In this regard, in order to make a contribution to the understanding of the ongoing immune disturbances in depression, serum DPPIV and ADA activities were determined in minor and major depressives and compared with healthy controls. Both enzyme activities were found to be decreased in major depressives compared to controls while only DPPIV activity was significantly lower in major depressives than the minor depressives. There were significant inverse relationships between enzyme activities and the severity of depression. Moreover, a positive intracorrelation was found between decreased DPPIV and ADA levels. The correlated decrease in DPPIV and ADA, might be a further support for their possible association. Results also suggest that decreased enzyme activities might reflect the impaired immune state in depression while major depressed patients might have a greater tendency to immune dysfunction than the minor depressed ones.

[Study on essence of syndrome of traditional Chinese medicine in liver cirrhotic patients].

OBJECTIVE: To explore the essence of Syndrome of traditional Chinese medicine (TCM) in cirrhostic patients. METHODS: Eighty patients of post-hepatitis-B cirrhosis were classified, according to Syndrome Differentiation of TCM, into three types: the Liver-Qi Stagnancy and Spleen-Deficiency type (A), the Qi-Stagnancy and blood stasis type (B) and the Heat Stagnancy and blood stasis type (C), serum hyaluronic acid (HA), adenosine deaminase (ADA), glutathione-s-epoxide transferase (GST), N-acetyl-beta-D-glucosaminidase (NAG), hydroxyproline (HYP) and procollagen type III (PC III) of 52 patients were determined before and after treatment based on Syndrome Differentiation. RESULTS: Serum HA, ADA, GST and PC III of patients were significantly higher than those of the healthy control (P < 0.01), and the change of these parameters were closely associated with types of Syndrome, which were, in turn, C > B > A > control, the difference between groups was significant (P < 0.05, P < 0.01). After treatment, the liver function and above-mentioned serologic parameters were significantly improved (P < 0.05, P < 0.01). CONCLUSIONS: Syndrome of cirrhosis patients has its inherent essential content. Serum HA, ADA, GST and PC III could serve as objective indexes for establishing Syndrome Differentiation and guiding treatment. TCM treatment of cirrhosis based on Syndrome Differentiation has good effect with beneficial anti-fibrotic action.

[Correlation between serum adenosine deaminase, peripheral T lymphocyte subsets and syndrome types of traditional Chinese medicine in liver-cirrhosis patients].

Serum adenosine deaminase (ADA) of 74 liver cirrhosis patients and 100 healthy subjects as control were examined with improved Martinek microassay and peripheral T lymphocyte subsets of 38 liver cirrhosis patients and 60 healthy subjects studied by indirect immunofluorescence assay (IFA) for exploring the relationship between them and syndrome types of TCM. The result showed that level of ADA of liver cirrhosis patients was higher than that of control (P < 0.01) and increased in following order: the type of Liver-energy Depression and Spleen Deficiency, that of Heat-Stagnation and Blood Stasis and that of Yin-Deficiency and Microvessel Obstruction. The difference of serum ADA among the types were significant (P < 0.01). The result also showed that OKT8 of liver cirrhosis patients was higher, the ratio of OKT4/OKT8 was lower than the healthy subjects (P < 0.05-0.01), but the difference among the types were not significant (P > 0.05). Serum ADA seemed to be one of the reference indexes in differentiating syndrome types of TCM, determining the patient's condition and prognosis.