Cardiorenal Syndrome: A Literature Review.

Cardiorenal syndrome (CRS) is a condition characterized by the intricate two-way relationship between the heart and kidneys, which can lead to acute or chronic dysfunction in these organs. The interplay between cardiorenal connectors and both hemodynamic and non-hemodynamic factors is crucial to understanding this syndrome. The clinical importance of these interactions is evident in the changes observed in hemodynamic factors, neurohormonal markers, and inflammatory processes. Identifying and understanding biomarkers associated with CRS is valuable for early detection and enabling intervention before significant organ dysfunction occurs. This comprehensive review focuses on the clinical significance of biomarkers in the diagnosis, prognosis, and management of CRS. Finally, it highlights the necessity for further advancements in managing this condition.

Phenotypic and Genetic Characteristics in a Cohort of Patients with Usher Genes.

Background: This study aimed to compare phenotype−genotype correlation in patients with Usher syndrome (USH) to those with autosomal recessive retinitis pigmentosa (NS-ARRP) caused by genes associated with Usher syndrome. Methods: Case notes of patients with USH or NS-ARRP and a molecularly confirmed diagnosis in genes associated with Usher syndrome were reviewed. Phenotypic information, including the age of ocular symptoms, hearing impairment, visual acuity, Goldmann visual fields, fundus autofluorescence (FAF) imaging and spectral domain optical coherence tomography (OCT) imaging, was reviewed. The patients were divided into three genotype groups based on variant severity for genotype-phenotype correlations. Results: 39 patients with Usher syndrome and 33 patients with NS-ARRP and a molecular diagnosis in an Usher syndrome-related gene were identified. In the 39 patients diagnosed with Usher syndrome, a molecular diagnosis was confirmed as follows: USH2A (28), MYO7A (4), CDH23 (2), USH1C (2), GPR98/VLGR1 (2) and PCDH15 (1). All 33 patients with NS-ARRP had variants in USH2A. Further analysis was performed on the patients with USH2A variants. USH2A patients with syndromic features had an earlier mean age of symptom onset (17.9 vs. 31.7 years, p < 0.001), had more advanced changes on FAF imaging (p = 0.040) and were more likely to have cystoid macular oedema (p = 0.021) when compared to USH2A patients presenting with non-syndromic NS-ARRP. Self-reported late-onset hearing loss was identified in 33.3% of patients with NS-ARRP. Having a syndromic phenotype was associated with more severe USH2A variants (p < 0.001). Eighteen novel variants in genes associated with Usher syndrome were identified in this cohort. Conclusions: Patients with Usher syndrome, whatever the associated gene in this cohort, tended to have an earlier onset of retinal disease (other than GPR98/VLGR1) when compared to patients presenting with NS-ARRP. Analysis of genetic variants in USH2A, the commonest gene in our cohort, showed that patients with a more severe genotype were more likely to be diagnosed with USH compared to NS-ARRP. USH2A patients with syndromic features have an earlier onset of symptoms and more severe features on FAF and OCT imaging. However, a third of patients diagnosed with NS-ARRP developed later onset hearing loss. Eighteen novel variants in genes associated with Usher syndrome were identified in this cohort, thus expanding the genetic spectrum of known pathogenic variants. An accurate molecular diagnosis is important for diagnosis and prognosis and has become particularly relevant with the advent of potential therapies for Usher-related gene

Post-infectious cough of different syndromes treated by traditional Chinese medicines: A review.

The application of traditional Chinese medicines (TCMs) has a history of more than 2000 years, which have the characteristics of multi-component, multi-target, and high safety. Post-infectious cough (PIC) is a respiratory disease with high incidence. It belongs to subacute cough and accounts for as much as 40%-50%. Cough is the main clinical manifestation of PIC. PIC seriously affects people's life quality because of complex etiology, long-term course of disease, treatment difficulties and other characteristics. Western medicines are based on the principle of symptomatic treatment, so they are often difficult to control PIC fundamentally. These factors could due to that PIC is prolonged and unable to heal repeatedly. TCMs have obvious advantages in treating PIC, with accurate curative effects, less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators, enhancing patients' life quality and reducing pain. TCMs, guided by holistic concept and syndrome differentiation, advocate determine treatment on the basis of pattern types, and have remarkable clinical treatment effects. As for TCMs etiology, pathogenesis and syndrome types of PIC, TCM scholars have not yet reached a unified standard. However, most of them think that wind pathogen can cause PIC alone, or it can be combined with other evils, which might be the main mechanism of PIC. This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology, pathogenesis, distribution of syndrome types and treatment of TCMs. This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen, providing ideas in treating PIC of TCMs clinically and innovative drug development.

[Correlation analysis of serum progesterone with clinical indicators and common traditional Chinese medicine syndrome types in male type 2 diabetic patients].

OBJECTIVE: To analyze the correlation of serum progesterone (PROG) level with blood biochemical parameters and common traditional Chinese medicine (TCM) syndromes in male patients with type 2 diabetes mellitus (T2DM). METHODS: We collected the clinical data of 192 male patients with T2DM, who were admitted in the Department of Endocrinology, Nanjing Hospital of Chinese Medical Affiliated to Nanjing University of Chinese Medicine between January, 2018 and March, 2019. The general clinical data, C-peptide level, blood glucose level, glycated hemoglobin (HbA1c), HOMA, blood lipid level, and sex hormones were compared between the patients with normal PROG and elevated PROG levels and also between the patients with two common TCM syndromes, namely qi and Yin deficiency syndrome and damp- heat accumulation in the spleen syndrome. We further compared the sex hormones, C-peptide level, HOMA, HbA1c, and blood glucose level among the patients with the two TCM syndromes having normal or elevated PROG levels. RESULTS: Compared with those in patients with normal PROG level, BMI, C-peptide, HOMA-ß, and HOMA2-IR were significantly lowered and HOMA-IS, E2, and T were significantly increased in patients with elevated PROG level; no statistical differences were found in age, disease duration, waist-to-hip ratio (WHR), smoking history, blood pressure, blood glucose, blood lipids, HbA1c, LH, FSH or PRL between the two groups. Compared with the patients with damp-heat accumulation syndrome group, the patients with qi and Yin deficiency syndrome were older and had a longer disease duration, a greater BMI, and higher levels of PROG, C-Peptide, HOMA-ß, HOMA2-IR and HOMA-IS, but the smoking history, WHR, HbA1c, blood glucose, and sex hormone levels were comparable between the two groups. Among the 4 groups of patients with different PROG levels and TCM syndromes, significant differences were found in the levels of C-peptide, HOMA-ß, HOMA-IS, HOMA2-IR, PROG, E2, T, LH and FSH, and the patients with qi and Yin deficiency syndrome as well as an elevated PROG level had the lowest C-peptide level, HOMA-ß and HOMA2-IR and the highest HOMA-IS, PROG, E2, T, LH and FSH. CONCLUSIONS: An elevated PROG level is closely related to islet cell dysfunction and TCM syndrome types in male patients with T2DM.

Study on the Distribution Pattern of Traditional Chinese Medicine Syndromes in Patients with Dry Eye and Its Correlation with Gender and Age / 广州中医药大学学报

Objective To explore the etiology and pathogenesis of dry eye by studying the distribution pattern of gender,age and traditional Chinese medicine(TCM)syndrome type in dry eye patients and by analyzing their correlation.Methods A total of 244 patients with dry eye who met the inclusion criteria were selected.The distribution of gender,age and TCM syndrome types was statistically analyzed,and then the correlation of TCM syndrome types with gender and age of dry eye patients was explored.Results(1)Of the 244 dry eye patients,96(39.34%)were male and 148(60.66%)were female,the incidence of the female being higher than that of the male.There were 124(50.82%)patients younger than 45 years old,81(33.20%)patients aged 45-60 years old,and 39(15.98%)patients older than 60 years old.The proportion of the patients younger than 45 years old was higher than that of other age groups.(2)Among the 244 patients with dry eyes,89 cases(36.47%)were differentiated as liver and kidney deficiency syndrome,75 cases(30.74%)were differentiated as qi stagnation and blood stasis syndrome,69 cases(28.28%)were differentiated as spleen and kidney deficiency,and 11 cases(4.51%)were differentiated as yin deficiency and damp-heat syndrome.And the occurrence frequency of the above four syndrome types was in descending order.(3)In the dry eye patients of various age groups,patients aged＜45 years old predominantly suffered from qistagnation and blood stasis syndrome,accounting for 41.94%(52/124);patients aged 45-60 years old and those aged＞60 years old predominantly suffered from liver and kidney deficiency syndrome,accounting for 46.91%(38/81)and 53.85%(21/39),respectively.The distribution of TCM syndrome types varied in the patients with different age groups,and the difference was statistically significant(χ2 = 22.128,P＜0.01).(4)In male dry eye patients,qi stagnation and blood stasis syndrome was predominant,accounting for 39.58%(38/96);among female dry eye patients,liver and kidney deficiency syndrome and spleen and kidney deficiency syndrome were prevalent,accounting for 41.89%(62/148)and 31.08%(46/148),respectively.The distribution of TCM syndrome types varied in the patients with different genders,and the difference was statistically significant(χ2 = 82.610,P＜0.01).Conclusion The TCM syndromes of patients with dry eyes are frequently differentiated as liver and kidney deficiency syndrome,followed by the qi stagnation and blood stasis syndrome.The prevalence of dry eyes is related to the gender and age,and gender and age are correlated with the TCM syndrome types to certain extent.

Real-World Analysis of the Curative Effect in Patients with Proliferative Diabetic Retinopathy of Different Traditional Chinese Medicine Syndrome Types Treated by Anti-vascular Endothelial Growth Factor Combined with Pars Plana Vitrectomy / 广州中医药大学学报

Objective To compare the clinical efficacy of anti-vascular endothelial growth factor(VEGF)combined with pars plana vitrectomy(PPV)treatment for patients with proliferative diabetic retinopathy(PDR)of different traditional Chinese medicine(TCM)syndrome types in the real world.Methods A prospective real-world study was performed in the 36 patients(involving 42 eyes)with PDR treated by anti-VEGF combined with PPV in the Department of Ophthalmology of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2019 to December 2019.According to the TCM syndrome manifestations,the patients were differentiated as qi-yin deficiency complicated with blood stasis obstructing collaterals type(15 cases,involving 18 eyes;shorten as qi-yin deficiency type),liver-kidney deficiency and ocular collaterals failing in the nourishment type(14 cases,involving 17 eyes;shorten as liver-kidney deficiency type),and yin-yang deficiency complicated with blood stasis and phlegm coagulation type(7 cases,involving 7 eyes;shorten as yin-yang deficiency type).The patients were treated with anti-VEGF therapy first and then received PPV after 5-7 days.Aqueous humor was sampled during anti-VEGF therapy and PPV.After treatment,the efficacy of PDR patients with different TCM syndromes was compared.Moreover,the patients were observed in the best corrected visual acuity(BCVA)of the affected eyes before surgery and 3 months after surgery,levels of cytokines in the aqueous humor before and after anti-VEGF treatment,macular central retinal thickness(CRT),area of the foveal avascular zone(FAZ),the blood density of macular center,inner ring,outer ring and intact macula 3 months after surgery,and the postoperative complications.Results(1)The difference of the therapeutic efficacy of PDR patients with various TCM syndrome types was statistically significant(P＜0.05).Among 3 syndrome types,the best efficacy was found in the qi-yin deficiency type,followed by liver-kidney deficiency type,and then yin-yang deficiency type,with the total efficacy rate being 88.89%(16/18),52.94%(9/17),and 42.86%(3/7),respectively.(2)Three months after surgery,the logarithmic value of minimum angle of resolution(LogMAR)for BCVA of patients with qi-yin deficiency type was significantly superior to that of patients with yin-yang deficiency type,with the difference being statistically significant(P＜0.05).After the anti-VEGF treatment,the levels of cytokines in the aqueous humor of the patients varied in the 3 syndrome types:vascular endothelial growth factor A(VEGF-A)level in the patients with the 3 syndrome types was significantly lower,placental growth factor(PLGF)and angiopoietin-like protein 4(ANGPTL4)levels in the patients with qi-yin deficiency type were higher,and interleukin 8(IL-8)level in the patients with liver-kidney deficiency type was higher than those before treatment,and the differences were statistically significant(P＜0.05 or P＜0.01).The blood density of macular outer ring and intact macula in the patients with qi-yin deficiency type and liver-kidney deficiency type was larger than that in the patients with yin-yang deficiency type,and the differences were statistically significant(P＜0.05).However,the differences of CRT,FAZ area,and blood density of macular center and inner ring among the 3 syndrome types were not statistically significant(P＞0.05).(3)The incidence of postoperative complications in the patients with yin-yang deficiency type was relatively high,but the difference among the 3 syndrome types was not statistically significant(P＞0.05).Conclusion In the real world,the best efficacy of anti-VEGF combined with PPV treatment in PDR patients with different TCM syndrome types can be achieved in the patients differentiated as qi-yin deficiency type,followed by liver-kidney deficiency type,and then yin-yang deficiency type.After anti-VEGF treatment,the levels of cytokines in the aqueous humor of the patients vary in the 3 syndrome types.Three months after the operation,the patients with qi-yin deficiency type and liver-kidney deficiency type have larger blood density of macular outer ring and intact macula,and exert good prognosis.

Construction of Knowledge Graph Based on Literature Data by Taking Treatment of Diabetic Peripheral Neuropathy with Traditional Chinese Medicine as An Example / 中国实验方剂学杂志

ObjectiveTo systematically sort out the knowledge framework and conceptual logic relationship of "disease-syndrome-treatment-prescription-medicine" in the existing literature on traditional Chinese medicine（TCM） treatment of diabetic peripheral neuropathy（DPN）， to construct of the knowledge map of TCM treatment of DPN， and to promote the explicitation of the implicit knowledge in the literature on the treatment of DPN with TCM. MethodTaking the literature of China National Knowledge Infrastructure about TCM treatment of DPN as the main data source， TCM-related concepts and entities were constructed by manual citation， and the corresponding relationships between the entities were established. Structured data were formed by processing with Python 3.7， and the knowledge graph was constructed based on Neo4j 3.5.34 graph database. ResultThe resulting knowledge graph with TCM diagnosis and treatment logic， defined 12 node labels such as prescriptions， Chinese medicines and syndrome types at the schema layer， as well as 4 types of relationships， such as inclusion， correspondence， selection and composition. It could support the query and discovery of nodes（syndrome elements， syndrome types and treatment methods）， as well as the relationship between each node. ConclusionBased on the literature data， this study constructed a knowledge map for TCM treatment of DPN， which brought together various methods of TCM treatment of DPN， including internal and external treatment. The whole chain knowledge structure of syndrome differentiation and classification for DPN treatment is formed from syndrome element analysis， syndrome type composition to treatment method selection， which can provide new ideas and methods for literature data to serve clinical and scientific research work， as well as reference for visualization of TCM literature knowledge， intellectualization of TCM knowledge services and the standardization of TCM diagnosis and treatment.

Study on the Distribution of Traditional Chinese Medicine Syndrome Types in Patients with Diabetic Kidney Disease at Stages Ⅲ and Ⅳ / 广州中医药大学学报

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in diabetic kidney disease(DKD),and to explore the correlation between TCM syndrome types and laboratory indices,so as to provide an objective basis for the TCM syndrome differentiation and treatment of DKD.Methods Syndrome differentiation was carried out in the 157 patients with DKD at stages Ⅲ and Ⅳ,and then the distribution of the syndromes of deficiency in the origin and the syndromes of excess in the superficiality was explored.The levels of 24-hour urinary total protein(24hUTP),serum creatinine(Scr),blood urea nitrogen(UREA),plasma albumin(Alb),total cholesterol(TC),and triglyceride(TG)of the patients were detected,and then the relationship between the TCM syndrome types and the biochemical indexes was analyzed.Results(1)The distribution of the syndromes of deficiency in the origin in DKD patients at different stages showed that DKD patients at stage Ⅲ were mainly differentiated as yin deficiency and dryness-heat syndrome[58.57％(41/70)],qi and yin deficiency syndrome[28.57％(20/70)],yin and yang deficiency syndrome[10.00％(7/70)],and spleen and kidney qi deficiency syndrome[2.86％(2/70)];DKD patients at stage Ⅳ were mainly differentiated as yin deficiency and dryness-heat syndrome[40.23％(35/87)],qi and yin deficiency syndrome[29.89％(29/87)],spleen and kidney qi deficiency syndrome[18.39％(16/87)],and yin and yang deficiency syndrome[11.49％(10/87)].The differences in the distribution of the syndromes of deficiency in the origin among the DKD patients at different stages were statistically significant(P<0.05).However,with the progression of the disease,DKD patients at different stages in general showed a trend of the decrease in the proportion of yin deficiency and dryness-heat syndrome while the increase in the proportions of qi and yin deficiency syndrome,spleen and kidney qi deficiency syndrome,and yin and yang deficiency syndrome.(2)The distribution of the syndromes of excess in the superficiality in DKD patients at different stages showed that DKD patients at stage Ⅲ were mainly differentiated as damp-heat syndrome[54.29％(38/70)],phlegm-stasis syndrome[27.14％(19/70)],blood-stasis syndrome[10.00％(7/70)],and cold-damp syndrome[8.57％(6/70)];DKD patients at stage Ⅳ were mainly differentiated as damp-heat syndrome[44.83％(39/87)],phlegm-stasis syndrome[35.63％(31/87)],cold-damp syndrome[14.94％(13/87)],and blood-stasis syndrome[4.60％(4/87)].There were no significant differences in the distribution of the syndromes of excess in the superficiality among the DKD patients at different stages(P>0.05).(3)The analysis of relationship between TCM syndrome type and biochemical indexes showed that Scr and UREA levels of DKD patients with spleen and kidney qi deficiency syndrome were significantly higher than those of patients with yin deficiency and dryness-heat syndrome,and the differences were statistically significant(P<0.05);Scr and 24hUTP levels of DKD patients with cold-damp syndrome were significantly higher than those of patients with damp-heat syndrome,and the differences were statistically significant(P<0.05).Conclusion DKD patients at stages Ⅲ and Ⅳ are all predominantly suffering from yin deficiency and dryness-heat syndrome,and with the progression of the disease,the syndrome of yin deficiency and dryness-heat develops into qi and yin deficiency syndrome,spleen and kidney qi deficiency syndrome,and yin and yang deficiency syndrome sequentially.Pathogenic dampness and blood stasis are the main pathogenic factors of DKD.And Scr,UREA,and 24hUTP are correlated with the TCM syndrome types of DKD,which will be helpful for the differentiation of TCM syndrome types of DKD.

Serum Metabolomics Characteristics of Chronic Atrophic Gastritis Patients with Liver-Stomach Qi Stagnation Syndrome and Spleen-Stomach Weakness Syndrome / 广州中医药大学学报

Objective To analyze the metabolomics characteristics of chronic atrophic gastritis(CAG)patients with liver-stomach qi stagnation and spleen-stomach weakness syndromes based on non-targeted metabolomics technology,and to identify the serum differentiated metabolites related to traditional Chinese medicine(TCM)syndrome of CAG patients,so as to provide a reference for the objectification of syndrome differentiation.Methods Sixty patients with CAG were included,including 30 cases of liver-stomach qi stagnation syndrome and 30 cases of spleen-stomach weakness syndrome.Fasting blood of 5 mL was collected from the cubital vein of patients in the two groups,and the serum levels of metabolites were detected by ultra-high-performance liquid chromatography-mass spectrometry(UPLC-MS)methods.The principal component analysis(PCA),orthogonal partial least squares-discriminant analysis(OPLS-DA),and cluster analysis were used to screen the differentiated metabolites of CAG patients with liver-stomach qi stagnation syndrome and spleen-stomach weakness syndrome.Finally,metabolite pathway analysis was performed for the obtained differentiated metabolites using the KEGG database.Results The results for the screening of differentiated metabolites showed that significant differences of amino acid derivatives and small peptide metabolites were presented between CAG patients with liver-stomach qi stagnation syndrome and CAG patients with spleen-stomach weakness syndrome.The amino acid derivatives consisted of N-acetylglycine,histamine,O-phosphoserine,selenomethylselenocysteine,and methyl-tyrosine.And the small peptide metabolites consisted of tyrosine-leucine-phenylalanine,histidine-alanine-glutamate-lysine,L-asparagine-L-proline-L-serine,and L-isoleucine-L-isoleucine.Conclusion Differences in amino acid metabolism exist between CAG patients with liver-stomach qi stagnation syndrome and those with spleen-stomach weakness syndrome,and metabolites such as N-acetylglycine,intermethyltyrosine,and O-phosphoserine may be the potential biomarkers for distinguishing liver-stomach qi stagnation syndrome from spleen-stomach weakness syndrome in CAG patients.

Study on the Relationship between Platelet Activation and TCM Syndrome Distribution in Patients with Diabetic Peripheral Neuropathy / 浙江中医药大学学报

[Objective]To investigate the relationship between platelet activation and traditional Chinese medicine(TCM)syndrome distribution in patients with diabetic peripheral neuropathy(DPN).[Methods]A total of 188 DPN patients admitted to our hospital from February 2020 to December 2022 were collected.The TCM syndrome type usesd the index cluster analysis to draw the cluster diagram.The correspondence between TCM syndrome type and lesion degree was analyzed by simple correspondence analysis,and shown on the two-dimensional plan.It compared the general clinical data,platelet parameters and platelet activation of different TCM syndrome types,so as to explore the relationship between platelet activation and the distribution of TCM syndrome types.[Results]The syndrome types summarized in different positions of the cluster map were different.Among them,D-point interception could be divided into five syndrome types:Qi deficiency syndrome,Yin deficiency syndrome,Yang deficiency syndrome,stagnation of blood stasis syndrome and phlegm-dampness blocking collaterals syndrome.Among the 188 DPN patients,phlegm-dampness blocking collaterals syndrome was found in 18 cases(9.57％),stagnation of blood stasis syndrome in 53 cases(28.19％),Yang deficiency syndrome in 28 cases(14.89％),Yin deficiency syndrome in 39 cases(20.74％),and Qi deficiency syndrome in 50 cases(26.60％).The grade of DPN lesion was grade Ⅰ in 56 cases(29.79％),grade Ⅱ in 76 cases(40.43％),and grade Ⅲ in 56 cases(29.79％).The syndrome of phlegm-dampness blocking collaterals and stagnation of blood stasis in the middle of the two-dimensional projection map did not deviate to a certain grade of DPN lesion degree;Yang deficiency syndrome inclined to grade Ⅲ,Yin deficiency syndrome to grade Ⅱ,and Qi deficiency syndrome to grade Ⅰ.Compared with Qi deficiency syndrome,platelets(PLT),mean platelet volume(MPV),platelet distribution width(PDW),granular membrane protein-140(GMP-140),platelet activating factor(PAF)and E26 transformation specific-l(ETS-l)in patients with Yin deficiency syndrome and Yang deficiency syndrome were significantly higher(P＜0.05),and PLT,MPV,PDW,GMP-140,PAF and ETS-1 in patients with Yang deficiency syndrome were higher than those of Yin deficiency syndrome(P＜0.05).[Conclusion]DPN can be routinely divided into five basic syndrome types:Qi deficiency,Yin deficiency,Yang deficiency,stagnation of blood stasis and phlegm-dampness blocking collaterals.With the development of DPN,TCM syndromes are transformed from Qi deficiency to Yin deficiency to Yang deficiency,while blood stasis and phlegm-dampness blocking collaterals are accompanied by various stages of DPN patients.In the progress of DPN,platelet activation may be involved in the transformation of TCM syndrome types.

Post-infectious cough of different syndromes treated by traditional Chinese medicines: A review / 中草药·英文版

The application of traditional Chinese medicines (TCMs) has a history of more than 2000 years, which have the characteristics of multi-component, multi-target, and high safety. Post-infectious cough (PIC) is a respiratory disease with high incidence. It belongs to subacute cough and accounts for as much as 40%–50%. Cough is the main clinical manifestation of PIC. PIC seriously affects people's life quality because of complex etiology, long-term course of disease, treatment difficulties and other characteristics. Western medicines are based on the principle of symptomatic treatment, so they are often difficult to control PIC fundamentally. These factors could due to that PIC is prolonged and unable to heal repeatedly. TCMs have obvious advantages in treating PIC, with accurate curative effects, less side effects and adverse reactions and are effective in improving PIC-related symptoms and indicators, enhancing patients' life quality and reducing pain. TCMs, guided by holistic concept and syndrome differentiation, advocate determine treatment on the basis of pattern types, and have remarkable clinical treatment effects. As for TCMs etiology, pathogenesis and syndrome types of PIC, TCM scholars have not yet reached a unified standard. However, most of them think that wind pathogen can cause PIC alone, or it can be combined with other evils, which might be the main mechanism of PIC. This paper discusses the advantages and limitations of TCMs in PIC treatment from etiology, pathogenesis, distribution of syndrome types and treatment of TCMs. This article focuses on the treatment methods and pharmacodynamic material basis of wind pathogen, providing ideas in treating PIC of TCMs clinically and innovative drug development.

Morphological differences in the hip of femoral head necrosis with different traditional Chinese medicine syndromes observed with 3D graphics: Feasibility of non-surgical hip preservation / 中国组织工程研究

BACKGROUND: Some studies have found a certain relationship between the distribution of traditional Chinese medicine syndrome types and the morphological differences in femoral head necrosis. OBJECTIVE: To observe the morphological differences of hip joints of different types of traditional Chinese medicine syndromes with femoral head necrosis through 3D graphics, and to evaluate the efficacy of standardized and comprehensive non-surgical hip preservation for femoral head necrosis. METHODS: From December 2016 to February 2017, 73 femoral head necrosis patients (108 hips) treated with non-surgical hip preservation in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were enrolled in this study. According to the syndrome type of traditional Chinese medicine, the patients were divided into the kidney deficiency and blood stasis group (47 hips), the accretion group (30 hips) and the Qi stagnation and blood stasis group (31 hips). X-ray films and CT spiral scans of both hips were taken to measure the central hip angle, Sharp angle, upper and lower acetabular diameter, anteroposterior diameter, and acetabularity depth, acetabular abduction angle, and acetabular anteversion angle. Totally 88 cases (131 hips) of femoral head necrosis treated with standardized comprehensive hip preservation from December 2016 to February 2017 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine underwent traditional Chinese medicine, physical therapy, and functional exercise. The clinical function of hips was diagnosed by visual analogue scale and Harris scores, and the necrosis in the treatment area was evaluated by X-ray films. This study was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, approval No. Y[2019]118. RESULTS AND CONCLUSION: (1) X-ray films showed significant differences in Sharp angle and central edge angle among the three groups (P < 0.01). Among them, the sharp angle was largest; the central edge angle was smallest in the kidney deficiency and blood stasis group. The Sharp angle was smallest and the central edge angle was largest in the Qi stagnation and blood stasis group. (2) CT spiral scan showed that there was a difference in abduction angle between the three groups (P < 0.001), of which the kidney deficiency and blood stasis group was largest. Acetabularity depth was smaller in the kidney deficiency and blood stasis group than in the Qi stagnation and blood stasis group (P < 0.05). There was no significant difference in the upper and lower acetabular diameters, anteroposterior diameters, and acetabular anteversion angles of the three groups. (3) After 2 years of comprehensive hip-sparing treatment, 88 patients had significantly improved pain and hip function. Imaging results showed an improvement of 89 hips and 21 unchanged hips, with an improvement rate of 67.9%. (4) The results showed that there was a difference in hip joint morphology between different syndrome types. The development of the acetabulum of kidney deficiency and blood stasis type was poorer than that of Qi stagnation and blood stasis type and accretion type. Standardized and comprehensive non-surgical hip-sparing treatment of femoral head necrosis in the early and middle stages can significantly improve the symptoms of patients in the short term.

Correlation analysis of serum progesterone with clinical indicators and common traditional Chinese medicine syndrome types in male type 2 diabetic patients / 南方医科大学学报

OBJECTIVE@#To analyze the correlation of serum progesterone (PROG) level with blood biochemical parameters and common traditional Chinese medicine (TCM) syndromes in male patients with type 2 diabetes mellitus (T2DM).@*METHODS@#We collected the clinical data of 192 male patients with T2DM, who were admitted in the Department of Endocrinology, Nanjing Hospital of Chinese Medical Affiliated to Nanjing University of Chinese Medicine between January, 2018 and March, 2019. The general clinical data, C-peptide level, blood glucose level, glycated hemoglobin (HbA1c), HOMA, blood lipid level, and sex hormones were compared between the patients with normal PROG and elevated PROG levels and also between the patients with two common TCM syndromes, namely and deficiency syndrome and damp- heat accumulation in the spleen syndrome. We further compared the sex hormones, C-peptide level, HOMA, HbA1c, and blood glucose level among the patients with the two TCM syndromes having normal or elevated PROG levels.@*RESULTS@#Compared with those in patients with normal PROG level, BMI, C-peptide, HOMA-β, and HOMA2-IR were significantly lowered and HOMA-IS, E2, and T were significantly increased in patients with elevated PROG level; no statistical differences were found in age, disease duration, waist-to-hip ratio (WHR), smoking history, blood pressure, blood glucose, blood lipids, HbA1c, LH, FSH or PRL between the two groups. Compared with the patients with damp-heat accumulation syndrome group, the patients with and deficiency syndrome were older and had a longer disease duration, a greater BMI, and higher levels of PROG, C-Peptide, HOMA-β, HOMA2-IR and HOMA-IS, but the smoking history, WHR, HbA1c, blood glucose, and sex hormone levels were comparable between the two groups. Among the 4 groups of patients with different PROG levels and TCM syndromes, significant differences were found in the levels of C-peptide, HOMA-β, HOMA-IS, HOMA2-IR, PROG, E2, T, LH and FSH, and the patients with and deficiency syndrome as well as an elevated PROG level had the lowest C-peptide level, HOMA-β and HOMA2-IR and the highest HOMA-IS, PROG, E2, T, LH and FSH.@*CONCLUSIONS@#An elevated PROG level is closely related to islet cell dysfunction and TCM syndrome types in male patients with T2DM.

Application of Laboratory Indexes in Traditional Chinese Medicine Syndrome Differentiation of Multiple Myeloma / 广州中医药大学学报

Objective To study the relationship between traditional Chinese medicine (TCM)syndrome differentiation of multiple myeloma(MM)and laboratory indexes of MM,thus to supply evidence for the syndrome differentiation of MM. Methods A total of 59 MM patients were enrolled in the study. TCM syndrome differentiation was performed. And we also collected the laboratory indexes of serum protein electrophoresis (SPE),immunofixation electrophoresis (IFE),blood urea nitrogen (BUN),creatinine (CREA),serum beta 2 microglobulin,serum calcium(Ca),hemoglobin(Hb),Bence Jones protein,flow cytometric-immunophenotyping(FCM) and bone marrow cytology. The differences of the laboratory indexes in various syndrome types of MM were analyzed. Results No significant differences were found in myeloma cell morphology, M protein content, IFE typing results, Bence Jones protein positive rate and the concentration of Ca of various syndrome types of MM (P >0.05). However,the concentrations of BUN,CREA,serum beta 2 microsglobulin,Hb,and the positive rates of CD19- and CD56+ were significantly different in various syndrome types of MM (P < 0.05 or P < 0.01). Moreover,Hb,BUN,CREA,and serum beta 2 microspheres were significantly correlated with each other(P<0.05 or P < 0.01). Conclusion Hb, BUN, CREA, blood beta 2 microglobulin and FCM detection can be sued for the auxiliary diagnosis of syndrome types of MM, and for preliminary demonstration of illness severity and prognosis. The results will provide the basis for the treatment of MM with traditional Chinese medicine and western medicine.

Correlation between syndrome types of primary hepatic carcinoma and coagulation function / 国际检验医学杂志

Objective To explore the association between syndrome types of primary hepatic carcinoma(PHC) and coagulation function.Methods From Jan.2015 to May.2016,a total of 176 cases of PHC patients were enrolled to analyze the correlation between syndrome types and coagulation function.Results The liver stagnation and spleen deficiency syndrome(34.66%) was the most common syndrome in all patients,followed by wet and heat resistance syndrome(22.73%) and qi stagnation and blood stasis syndrome(17.05%).Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and D-dimer(D-D) levels of patients were significantly increased,with significant differences between liver stagnation and spleen deficiency group and wet and heat resistance syndrome group,liver and kidney Yin deficiency syndrome group(P0.05).Conclusion Coagulation function in PHC patients with spleen and kidney Yang deficiency syndrome,wet and heat resistance syndrome and liver and kidney Yin deficiency syndrome could be poor,but that in patients with qi stagnation and blood stasis syndrome and liver stagnation and spleen deficiency could be relatively good.Increasing of PT,APTT,TT and D-D could be with certain significance to identify liver stagnation and spleen deficiency syndrome with other syndrome types.

Analysis on Heart Rate Variability and Its Influencing Factors of Hypertensive Patients from Different TCM Syndrome / 中国中医药信息杂志

Objective To investigate the syndrome type distribution of hypertensive patients; To analyze the correlation of characteristics of HRV time domain parameters and its influence factors. Methods Totally 515 cases of hypertensive patients were included and were put under syndrome type distribution. Demographic information, laboratory test parameters, risk factors and clinical symptoms were collected for correlation analysis. HRV time domain parameters were recorded by using 24 h ambulatory electrocardiogram. The differences in SDNN, SDNN Index, HRV Index, PNN50, and RMSSD of different TCM syndrome types were compared. Results Among 515 patients: 160 cases with hyperactivity of yang due to yin deficiency syndrome, 136 cases with turbid phlegm and blood stasis syndrome, 83 cases with overabundant liver-fire syndrome, 69 cases with deficiency of kidney qi, and 67 cases with abundant phlegm-dampness syndrome. By comparing different TCM syndromes, the level of SDNN was significantly reduced in the hyperactivity of yang due to yin deficiency syndrome, overabundant liver-fire syndrome,deficiency of kidney qi syndrome compared with turbid phlegm and blood stasis syndrome, abundant phlegm-dampness syndrome (P<0.05); SDNN Index and HRV Index decreased significantly in the hyperactivity of yang due to yin deficiency and overabundant liver-fire syndrome compared with abundant phlegm-dampness syndrome (P<0.05). SDNN Index decreased significantly in the deficiency of kidney qi compared with abundant phlegm-dampness syndrome (P<0.05). The level of PNN50 was significantly reduced in the deficiency of kidney qi compared with hyperactivity of yang due to yin deficiency syndrome (P<0.05). RMSSD decreased significantly in the hyperactivity of yang due to yin deficiency syndrome, deficiency of kindney qi syndrome, overabundant liver-fire syndrome compared with turbid phlegm and blood stasis syndrome (P<0.05). Discriminant analysis showed that SBP, DBP, MBPS, SDNN, SDNN Index, HRV Index, PNN50, RMSSD were correlated with the diagnosis of five syndrome types. Logistic regression analysis showed that the factors including gender (female), insomnia, elevated systolic blood pressure, MBPS, decreased SDNN Index and PNN50 were positively correlated to hyperactivity of yang due to yin deficiency; other factors including gender (female), advanced age, elevated blood pressure, decreased SDNN, HRV Index and RMSSD were positively correlated with turbid phlegm and blood stasis syndrome. And the study also showed that advanced age, family history of hypertension, elevated blood pressure, decreased SDNN Index, HRV Index and PNN50 were positively correlated to abundant phlegm-dampness syndrome. Conclusion HRV time domain parameters can be significantly reduced in the hyperactivity of yang due to yin deficiency, overabundant liver-fire syndrome, and deficiency of kidney qi syndrome. The autonomic nerve function is damaged seriously. Hyperactivity of yang due to yin deficiency syndrome, abundant phlegm-dampness syndrome turbid phlegm and blood stasis syndrome are closely related to the influencing factors that lead to cardiovascular and cerebrovascular events.

Mechanism of St-Elevation Acute Myocardial Infarction in Different Forms and Distribution of Its Traditional Chinese Medicine Syndrome Types / 广州中医药大学学报

Objective To study the mechanism of different forms of ST-segment elevation in acute myocardial infarction(AMI),and to investigate the distribution of its traditional Chinese medicine (TCM)syndrome types.Methods Two hundred and twelve hospitalized AMI patients with ST-segment elevation from March of 2015 to July of 2017 were divided into group A and group B.Group A had 102 cases with the elevation of concavity of STsegment,and group B had 110 cases with the elevation of arch of ST-segment.The correlation of ST-segment elevation in different forms with TCM syndrome types was analyzed.Results (1) Patients of group B were usually male,young and middle-aged,with or without short-term medical history of coronary heart disease,and coronary angiography results indicated the stenosis or occlusion of the vessels without collateral circulation.Patients in group A were usually female,aged,with medical history of coronary heart disease,and coronary angiography results indicated the existence of collateral circulation.(2) Group A was dominated by Qi-deficiency and blood-stasis syndrome,and the frequency of its syndrome types was in decreasing sequence:Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,heat-toxicity and blood-stasis syndrome,phlegm blended with bloodstasis syndrome,syndrome of cold stagnation in heart vessels.Group B was dominated by heat-toxicity and bloodstasis syndrome,and the frequency of its syndrome types was in decreasing sequence:heat-toxicity and bloodstasis syndrome,Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,syndrome of cold stagnation in heart vessels,phlegm blended with blood-stasis syndrome.The difference of the distribution of syndrome types was significant between the two groups (P ＜ 0.01).(3) In respect of the differentiation of deficiency and excess syndromes,group A was dominated by deficiency interweaved with excess syndrome,while group B was dominated by excess syndrome.The difference of the distribution of deficiency and excess syndrome was significant between the two groups (P ＜ 0.01).Conclusion AMI patients with different forms of ST-segment elevation have different TCM syndrome types.The investigation results will provide a new vision for the clinical trial of AMI treated with Chinese medicine integrated with western medicine,and will supply evidence for the syndrome differentiation and treatment of AMI patients with different forms of ST-segment elevation,which will contribute to enhancing clinical efficacy,saving life and improving prognosis.

Correlation of Traditional Chinese Medicine Syndrome Types of Chronic Gastritis with Helicobacter pylori Eradication Rate / 广州中医药大学学报

Objective To investigate the correlation of traditional Chinese medicine (TCM) syndrome types of chronic gastritis with Helicobacter pylori (Hp) eradication rate after anti-Hp treatment. Methods A total of 180 chronic gastritis patients with Hp infection were differentiated into spleen-stomach insufficiency syndrome, spleen-stomach dampness-heat syndrome, and liver depression and qi stagnation syndrome, and each syndrome group had 60 cases. Patients in each group were evenly divided into two subtypes, and were treated with triple therapy or quadruple therapy for 10 days respectively. After treatment, the Hp eradication rate in each group was compared. Results (1) The overall Hp eradication rate was 78.3%. No matter after triple therapy or quadruple therapy, patients with spleen-stomach insufficiency syndrome had the lowest Hp eradication rate (61.7%), which was lower than that of the patients with spleen-stomach damp-heat syndrome (88.3%) and the patients with liver depression and qi stagnation syndrome (85.0%), the difference being statistical significance (P 0.05). (2) A total of 10 cases had adverse reaction such as nausea and vomiting, stomachache, and gastric distention, 8 cases from spleen-stomach insufficiency group, one from spleen-stomach dampness-heat group, and one from liver depression and qi stagnation group. Spleen-stomach insufficiency group had higher incidence of adverse reaction than the other two groups (P < 0.05). Conclusion The Hp eradication rate after anti-Hp treatment varied in chronic gastritis patients with different TCM syndrome types, and the rate in patients with spleen-stomach insufficiency syndrome was lower than that of the patients with spleen-stomach damp-heat syndrome and the patients with liver depression and qi stagnation syndrome no matter after triple therapy or quadruple therapy.

Correlation of Traditional Chinese Medicine Syndrome Types of Hypertension with Carotid Artery Intima-media Thickness and Plasma Lp-PLA2 Expression / 广州中医药大学学报

Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types of hypertension with carotid artery intima-media thickness (IMT) and plasma lipoprotein-associated phospholipase A2 (Lp-PLA2),so as to provide a TCM therapy for early prevention and treatment of hypertension and its complications in clinic.Methods We collected a total of 170 cases of hypertension patients,55 with kidney-essence insufficiency syndrome,50 with ascendant hyperactivity of liver yang syndrome,and 65 with phlegm-damp retention in middle energizer syndrome.IMT was measured by the carotid Doppler ultrasound,and plasma Lp-PLA2 expression was examined by enzyme-linked immunosorbent assay.And then the differences of IMT and Lp-PLA2 expression among the three groups were compared and analyzed.Results There were significant differences of carotid artery IMT and Lp-PLA2 among the three groups(P＜ 0.01),and the number of patients with carotid atherosclerosis and the expression level of Lp-PLA2 in the group of phlegm-damp retention in middle energizer syndrome were higher than those intheothertwogroups(P＜0.01).Conclusion Differentiation treatment based on phlegm may be more conducive to the prevention and treatment of hypertension and its complications.

Several Key Issues on Clinical Research Direction of Traditional Chinese Medicine Kidney Disease / 世界科学技术-中医药现代化

Clinical research of traditional Chinese medicine (TCM) kidney disease is controversial for a long time due to the unclear clinical research direction.Based on the long-term TCM clinical practice of kidney disease,we proposed that the kidney disease should be simply divided into a composite type,which was easier for the research design and statistical analysis.It also improved the actual practical ability in the clinical research.In the treatment aspect,further research should be conducted on the application of warm medicine,method of eliminating wind-dampness,method of clearing heat,detoxify and removing dampness,the role of strengthening the body resistance,as well as the combination of therapeutic principle and its application time.Related Chinese herbal medicine research is a common breakthrough point.The clinical efficacy evaluation system should be further improved.In a word,TCM clinical research should be from the clinical demand and followed by problem-oriented design.The implementation should be systematic and step by step in order to improve the research level.