Postpartum depression in mothers and fathers: a structural equation model.

BACKGROUND: Post-partum depression (PPD) is a growing mental health concern worldwide. There is little evidence in the Chinese context of the relationship between paternal PPD and maternal PPD. Given the growing global concerns this relationship requires further exploration. METHODS: A survey was conducted with 950 total couples from March 2017 to December 2018. The study was conducted using a standardized questionnaire that included basic demographic information, information on the relationship between the mother-in-law and daughter-in-law, marital satisfaction (both maternal and paternal), and PPD symptoms. Structural Equation Modelling (SEM) analysis was used to explore the underlying mechanism for PPD symptoms in mothers and fathers. RESULTS: In 4.4% of the couples both the wife and the husband showed depressive symptoms. Maternal marital satisfaction showed a significant mediating effect on paternal PPD (B = -0.114, p < 0.01), and there was a direct effect of maternal PPD on paternal PPD (B = 0.31, p < 0.001). CONCLUSIONS: This is the first study to investigate the possible correlation between maternal PPD, mother-in-law and daughter-in-law relationship satisfaction, maternal marital satisfaction, paternal marital satisfaction, and paternal PPD. It is important for future PPD interventions to target both maternal and paternal mental health, as well as the mechanisms identified that can lead to PPD.

Efficient inhibition of growth of metastatic cancer cells after resection of primary colorectal cancer by soluble Flt-1.

Removal of primary tumors often leads to increases in growth of metastatic tumor cells. Thus, development of an efficient treatment to inhibit the growth of metastatic tumor cells after resection of primary tumors appears to be critical for cancer therapy. Here, we reported that administration of a Chinese medicine Shiquandabutao (SQDBT) after removal of the primary cancer significantly inhibited the growth of metastatic cancer cells in mouse liver. Further analyses showed that the effect of SQDBT resulted from one of its main component, Siwutang (SWT), rather than from another main component, Sijunzitang (SJZT). Moreover, we found that the soluble Flt-1 from SWT neutralized the increased placental growth factor (PLGF) secreted by the metastatic cancer cells after primary cancer resection and subsequently inhibited the cancer neovascularization to suppress the metastatic cancer growth. Thus, our study reveals an essential role of SQDBT in inhibiting the growth of metastatic cancer after removal of primary cancer and further highlights PLGF as a potential target for metastatic cancer treatment.

Berberine-induced haemolysis revisited: safety of Rhizoma coptidis and Cortex phellodendri in chronic haematological diseases.

Two commonly used berberine-containing Chinese herbs, Rhizoma coptidis (RC) and Cortex phellodendri (CP), have been banned in Singapore for the past three decades due to implication of berberine in aggravating jaundice and kernicterus in neonates with glucose-6-phosphate dehydrogenase deficiency. Here we conducted a single arm, phase I/II clinical study on Chinese herbal medicine for patients with chronic cytopenic haematological conditions and we analysed a subset of 20 patients who also had RC, CP or both in their herbal concoction. We found no organ toxicity or electrolyte imbalance in these 20 patients where RC was administered for 1055 patient-days and CP for 1252 patient-days. In three patients with thalassemia intermedia, transient elevation in serum bilirubin level was observed but this was not associated with any aggravation of anaemia or liver dysfunction. A review of the literature found conflicting evidence of varying levels either supporting or refuting the allegation of neonatal jaundice and kernicterus caused by berberine. There were, however, very few clinical reports of adverse reaction attributable to RC or CP in oral TCM concoction. We conclude that based on traditional dosage and indication, the use of RC and CP in oral concoction is safe.

[Chinese herbal decoction Shiquan Dabu Tang inhibits tumor growth and angiogenesis of metastasis after primary tumor surgical removal in mice].

OBJECTIVE: This study aimed to investigate the effects of Shiquan Dabu Tang (SDT) on growth and angiogenesis of subcutaneously implanted tumors, hepatic metastases, and incision-implanted tumors after surgical removal of primary colon tumor in mice. METHODS: Three experimental models were built after surgical removal of primary colon tumor and the mice were randomly divided into three groups: primary tumor resection (TR) group, primary tumor-preserved (TP) group and SDT group. After resection of the primary tumor and SDT treatment for 10 d, levels of vascular endothelial growth factor (VEGF), angiostatin (AS) and endostatin (ES) were examined by enzyme-linked immunosorbent assay (ELISA); microvascular density (MVD) and cell proliferation of metastasis were detected by streptavidin-peroxidase immunohistochemical staining; tumor cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) assay. RESULTS: In the subcutaneously implanted tumor model, the average volume of metastases of the SDT group was significantly lower than that of the TR group (P<0.01); the incidence rate of metastases was 50%. In the hepatic metastases model, the average number of hepatic metastases nodules of the SDT group was significantly lower than that of the TR group (P<0.01); the incidence rate of metastases was 40%. In the incision-implanted tumor model, the average volume of metastases of the SDT group was significantly lower than that of the TR group; the incidence rate of metastases was 30%. MVD was significantly inhibited by SDT and Ki67 expression of the SDT group was significantly lower than that of the TR group (P<0.01). TUNEL apoptotic index of tumor of the SDT group was higher than that of the TR group (P<0.01). ELISA showed that the serum VEGF level was significantly decreased and the serum ES level was significantly increased in the SDT group compared with those in the TR group (P<0.01). CONCLUSION: Resection of primary tumor in mice causes imbalance of VEGF, AS and ES, thus promoting angiogenesis and metastasis of tumors. SDT can inhibit growth, angiogenesis and cell proliferation of the metastatic tumor and promote cell apoptosis after surgical removal of the primary tumors.

[Effects of medicated serum prepared with Chinese herbal medicine Changweiqing on pharmacokinetics of oxaliplatin in colon cancer cells].

OBJECTIVE: To investigate the effects of Changweiqing-medicated serum, which was prepared with a compound traditional Chinese herbal medicine, on the reversal of oxaliplatin (L-OHP) resistance and the relationship between the reversal and cellular accumulation of platinum and proteins associated with copper transporter in HCT116/L-OHP cells. METHODS: For clarifying the reversal effect of Changweiqing, methyl thiazolyl tetrazolium was applied to determine the L-OHP resistance of HCT116/L-OHP cell line. The relationship between the cellular accumulation of platinum and the L-OHP resistance in HCT116/L-OHP cells, and the effects of drug-medicated serum on intracellular contents of platinum were detected by atomic absorption spectrophotometry. Western blot method was used to determine the expressions of human copper transporter 1 (hCTR1), ATPase Cu(2+) transporting alpha polypeptide (ATP7A), copper-transporting P-type adenosine triphosphatase (ATP7B), glutathione S-transferase-π (GST-π) and multidrug resistance-associated protein 2 (MRP2). RESULTS: The inhibitory concentration 50% values of different pairs of L-OHP-sensitive and -resistant cells were 7.2 and 89.00. The resistance index of HCT116/L-OHP cells was 12.36. The reverse index of drug serum on HCT116/L-OHP cells was 2.74. The platinum content in HCT116/L-OHP cells was decreased compared with HCT116 cells in condition of 7.2 µg/mL L-OHP. After treating by 7.5% Changweiqing-medicated serum, the intracellular platinum contents in L-OHP-sensitive and -resistant cells were increased. It was dose-dependent that drug-medicated serum promoted the uptake of L-OHP by HCT116 or HCT116/L-OHP cells and inhibited the discharge. The 7.5% Changweiqing-medicated serum increased the expression of hCTR1 and decreased the expressions of ATP7A and ATP7B in HCT116/L-OHP cells, but had no effects on GST-π and MRP2 protein expressions. CONCLUSION: Changweiqing can reverse the L-OHP resistance of HCT116/L-OHP by increasing the cellular platinum-DNA accumulation. Down-regulation of expression of ATP7B and ATP7A, and up-regulation of hCTR1 may cause the increase of intracellular platinum content in HCT116/L-OHP cells.

Expression and predictive value of NLRP3 in patients with atrial fibrillation and stroke.

OBJECTIVE: To investigate the expression and prognostic value of NLRP3 in non-valvular atrial fibrillation (NVAF) patients with ischemic stroke (IS). METHODS: A retrospective analysis from January 2019 to December 2021 was conducted in 105 patients with NVAF who were treated in our hospital and were divided into the simple NVAF group (simple group) and combined IS group (consolidation group) according to the occurrence of IS. The relative expression of NLRP3 in serum was tested via qRT-PCR. The serum TNF-α, IL-6, and CRP levels were measured by double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA), and the correlation between the expression of NLRP3, TNF-α, IL-6, CRP and non-valvular atrial fibrillation stroke risk score (CHA2DS2-VASc score) was analyzed by Pearson method. The independent predictors of NVAF combined with IS were analyzed by regression equation. Meanwhile, the predictive value of the factors was assessed by receiver operating characteristic (ROC) curve. RESULTS: The scores of NLRP3, TNF-α, IL-6, CRP and CHA2DS2-VASc in the consolidation group were obviously higher than those in the simple group. Pearson analysis revealed that the NLRP3, TNF-α, IL-6, and CRP levels in IS patients were positively correlated with CHA2DS2-VASc score. Logistic analysis revealed that NLRP3, IL-6, CRP and CHA2DS2-VASc could be used as potential factors to predict the merging of NVAF with IS. ROC showed that combined detection of NLRP3, IL-6, CRP and CHA2DS2-VASc in predicting NVAF complicated with IS exhibited an area under the curve of more than 0.9. CONCLUSION: NLRP3 is highly expressed in peripheral blood of patients with NVAF complicated with IS, which is a potential indicator for predicting NVAF complicated with IS.

Analysis of clinical syndromes in 47 patients with pancreatic cancer at late stage.

OBJECTIVE: To analyze the law governing the distribution of traditional Chinese medicine (TCM) syndromes of pancreatic cancer. METHODS: The authors used retrospective study to statistically analyze TCM syndromes of patients, separated complex syndromes and calculated the frequency of appearance of single syndromes. RESULTS: The patients mainly suffered from 4 syndromes: blood stasis syndrome, qi stagnation syndrome, qi (yang) deficiency syndrome, and phlegm dampness syndrome. The distribution of syndromes is rarely related to sex, age and morbid site of patients. CONCLUSION: Owing to complicated distribution of its syndromes, pancreatic cancer should be diagnosed and treated according to its characteristics of deficiency in origin and excess in superficiality.

[Chinese herbal medicine Jianpi Jiedu Formula down-regulates the expression of vascular endothelial growth factor in human gastric cell line MKN45 induced by Helicobacter pylori by inhibiting cyclooxygenase-2].

OBJECTIVE: To investigate the effects of Jianpi Jiedu Formula (JPJDF), a compound Chinese herbal medicine, on vascular endothelial growth factor (VEGF) expression induced by Helicobacter pylori (Hp) in human gastric cancer cells, and to explore the possible mechanism. METHODS: Human gastric MKN45 cancer cells were infected with standard Hp NCTC11637 by coculture, and the cells were divided into 7 groups: normal control group, Hp group, NS398 inhibitor group, blank serum group, and 5%, 10% and 20% JPJDF groups. The expressions of VEGF and cyclooxygenase-2 (COX-2) mRNAs in human gastric cancer cells infected by Hp were evaluated by real-time fluorogenic quantitative polymerase chain reaction (PCR). After inhibiting the expression of COX-2 with COX-2 specific inhibitor NS398 (50 µmol/L), VEGF mRNA expression induced by Hp in human gastric cancer MKN45 cells was evaluated by real-time fluorogenic quantitative PCR. RESULTS: Real-time fluorogenic quantitative PCR results showed that COX-2 mRNA expression increased significantly after MKN45 cells were infected with Hp for 6 h (P<0.01), and VEGF mRNA expression also increased significantly after MKN45 cells were infected with Hp for 12 h as compared with the normal control group (P<0.01). After inhibiting COX-2 expression with COX-2 specific inhibitor NS398, Hp-induced VEGF mRNA expression significantly reduced (P<0.01). 5%, 10% and 20% JPJDF-containing sera all down-regulated VEGF and COX-2 mRNA expressions induced by Hp in a dose-dependent manner as compared with the Hp infection group. CONCLUSION: Hp could induce the expressions of COX-2 and VEGF in human gastric cancer cells, and JPJDF down-regulates Hp-induced expression of VEGF by inhibiting COX-2, which might be one of the important mechanisms of its prevention and treatment of gastric cancer.

Mental health outcomes among Chinese prenatal and postpartum women after the implementation of universal two-child policy.

BACKGROUND: Poor mental health status among both pregnant and postpartum women is commonly reported worldwide. The associations between mental health outcomes and giving birth to the second child since the implementation of China's universal two-child policy have not been identified. METHODS: A large-scale based mental health survey was conducted between March 2017 and December 2018 in Suzhou, China. The survey evaluated the symptoms of anxiety, hypomania, depression and poor sleep quality among both pregnant and postpartum women. RESULTS: A total of 3113 questionnaires were collected, the prevalence of anxiety, hypomanic and depressive symptoms and poor sleep quality in our sample were 3.2% (95%CI: 2.6%-3.9%), 51.7% (95%CI: 49.9%-53.4%), 12.4% (95%CI: 11.3%-13.6%) and 37.8% (95%CI: 36.0%-39.5%), respectively. Logistic regression showed that giving birth to the second child was positively associated with women's age, and was negatively correlated with higher educational level and living in rented housing. Women with the second pregnancy or child were positively associated with anxiety symptoms in the whole sample (OR = 1.75, 95%CI: 1.11-2.75) and among prenatal women (OR = 2.11, 95%CI: 1.16-3.83), while it was inversely correlated with depressive symptoms among postpartum women (OR = 0.63, 95%CI: 0.41-0.99). CONCLUSIONS: Women giving birth a second time were more prone to have anxiety symptoms among the prenatal women and the whole sample, and less likely to have depressive symptoms among the postpartum women. Efficacious measures and interventions are essential to improve maternal mental health.

Screening for postpartum hypomania among Chinese women after childbirth.

This study examines the prevalence and risk factors for postpartum hypomania in women after childbirth as well as examining the potential influence of personality traits in relation to experiencing symptoms of postpartum hypomania. A total of 1022 women no later than 1 month post-birth were recruited in Suzhou, China, between March 2017 and December 2018. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32), and a total score of 14 or higher was defined as having hypomanic symptoms. We found 43.6% of the women in our sample had hypomanic symptoms. The results of multiple logistic regression showed that rural residence [p = 0.01, odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.5-0.9], education background (p = 0.005, OR = 0.6, 95% CI = 0.5-0.9), marriage satisfaction (p = 0.048, OR = 0.9, 95% CI =0.8-1.0), Pittsburgh Sleep Quality Index (PSQI) (p = 0.001, OR = 0.9, 95% CI = 0.9-1.0), Eysenck Personality Questionnaire-Extraversion (p < 0.001, OR = 1.2, 95% CI = 1.1-1.2), Eysenck Personality Questionnaire-Lie (p = 0.01, OR = 0.9, 95% CI = 0.9-1.0), and General Anxiety Disorder-7 (p = 0.02, OR = 1.1, 95% CI = 1.0-1.1) were independently associated with exhibiting hypomanic symptoms. The current study provided insights into hypomanic symptoms in Chinese postpartum women. We also found that extraversion and lie personality were significantly associated with an increased risk of hypomanic symptoms in postpartum women. It is urgent to arrange screening for women at risk of developing postpartum hypomania as soon as possible after giving birth and at regular intervals in the first 6 months to prevent the women developing psychological disorders such as depression and bipolar disorder later on.

Relationship between trait neuroticism and suicidal ideation among postpartum women in China: Testing a mediation model.

BACKGROUND: Suicidal ideation is a common phenomenon among postpartum women around the world. However, evidence of the relationship between neuroticism and suicidal ideation among postpartum women is still lacking. METHODS: From March 2017 to December 2018, a total of 1027 postpartum women (assessed no later than one month post-birth) were recruited to complete questionnaires assessing neuroticism, depression, anxiety and suicidal ideation. RESULTS: Anxiety and depression fully mediated the association between neuroticism and suicidal ideation (Total indirect effects = 0.11, 95%CI: 0.07, 0.15). The indirect effect of the pathway of EPQ (Neuroticism)-Anxiety-Suicidal ideation was more significant than other pathways (Indirect effects=0.04, 95%CI: 0.02, 0.07). CONCLUSION: Interventions for suicidal ideation in postpartum women need to target neuroticism and further research is necessary understand the mechanisms by which neuroticism affects suicidal ideation.

[Effects of interventional therapy with norcantharidin microsphere on hepatoma in rats and its mechanism].

OBJECTIVE: To investigate the effects of interventional therapy with norcantharidin-alginic acid/poly acid anhydride microspheres (N-MS) infusion via hepatic artery on hepatoma in rats. METHODS: N-MS was prepared by emulsion-chemical crosslink technique. Eighty-nine hepatoma-bearing rats were randomly divided into five groups, which were normal saline group, norcantharidin (NCTD) group, blank microsphere (B-MS) group, NCTD-lipiodol group and N-MS group. Normal saline, NCTD, B-MS, NCTD-lipiodol and N-MS were injected via hepatic artery accordingly. After the interventional therapy, eight rats from each group were observed for survival time, and the rest rats were killed on the 8th day after intervention to measure the tumor volume and necrostic degree. The apoptotic index of liver tumor cells was detected by TUNEL staining, and the expression of ki-67 was assayed by immuno-histochemical streptavidin-biotin peroxidase method. RESULTS: The survival time of the rats in the N-MS group was prolonged as compared with those in the other four groups, and the tumor volume of the rats in the N-MS group was smaller than those in the other four groups. The tumor growth rate and the expression level of ki-67 in the N-MS group were both significantly lower than those in the other four groups. The tumor necrotic degree and the apoptotic index in the N-MS group were significantly higher than those in the other four groups. CONCLUSION: Interventional therapy with N-MS could yield preferable therapeutic effects on hepatomas in rats. This anti-tumor efficacy may be associated with microvessel embolization in liver tumor and the sustained releasing of NCTD. Its inhibiting effect on tumor cell proliferation maybe result from decreasing the expression of Ki-67 and inducing the tumor cell apoptosis.

A Chinese herbal Formula, Chang-Wei-Qin, Synergistically Enhances Antitumor Effect of Oxaliplatin.

Chang-Wei-Qing (CWQ), a Chinese herbal formula, has long been employed clinically to treat cancers. In this study, we investigated the synergistic effect of CWQ with oxaliplatin (OXA) on the tumor growth inhibition of orthotopic transplanted colon cancer and explored the underlying mechanism. By generating the orthotopic transplanted nude mouse model of human colon carcinoma, we found that (1) CWQ enhanced OXA-mediated tumor suppression by 4.25-fold. (2) The body weights of nude mice in CWQ group and combination group were increased. (3) The survival time of tumor-bearing nude mice was dramatically improved in CWQ and CWQ/OXA group. (4) CWQ could restore OXA-mediated deregulation of copper transporter genes, hCTR1, ATP7A and ATP7B. (5) OXA-induced drug resistance index for OXA, 5-FU, HCPT and THP were 7.59, 4.28, 5.78 and 4.50 respectively, while the reversal index by combined CWQ treatment were 6.57, 2.61, 4.97 and 3.10, respectively. Our study demonstrates that the repeated intraperitoneal injection of OXA can induce multi-drug resistance of orthotopic transplanted nude mouse model of human colon carcinoma. The CWQ treatment can alleviate OXA-triggered side effects and reverse platinum drug resistance via up-regulation of hCTR1 expression and down-regulation of ATP7A and ATP7B levels.

Effect of Chronic Psychological Stress on Liver Metastasis of Colon Cancer in Mice.

Metastasis to the liver is a main factor in colorectal cancer mortality. Previous studies suggest that chronic psychological stress is important in cancer progression, but its effect on liver metastasis has not been investigated. To address this, we established a liver metastasis model in BALB/c nude mice to investigate the role of chronic stress in liver metastasis. Our data suggest that chronic stress elevates catecholamine levels and promotes liver metastasis. Chronic stress was also associated with increased tumor associated macrophages infiltration into the primary tumor and increased the expression of metastatic genes. Interestingly, ß-blocker treatment reversed the effects of chronic stress on liver metastasis. Our results suggest the ß-adrenergic signaling pathway is involved in regulating colorectal cancer progression and liver metastasis. Additionally, we submit that adjunctive therapy with a ß-blocker may complement existing colorectal cancer therapies.

miR-21 Is a Promising Novel Biomarker for Lymph Node Metastasis in Patients with Gastric Cancer.

Background. Gastric cancer (GC) is an important malignant disease around the world. Abnormalities of microRNAs (miRNAs) have been implicated in carcinogenesis of various cancers. In the present study, we examined miR-21 expression in human gastric cancer with lymph node metastasis and attempted to uncover its relationship with clinicopathologic data, especially with lymph node metastasis. Materials and Methods. The expression levels of miR-21 in the tumor specimens of GC patients were quantified by RT-PCR. The correlation between miR-21 level and multiple clinicopathological factors was then examined by Mann-Whitney test, Kaplan-Meier survival analysis, and operating characteristic (ROC) analysis. Results. The expression level of miR-21 was higher in GC patients with lymph node metastasis than in those without lymph node metastasis (P < 0.05). Expression level of miR-21 was significantly correlated with histologic type, T stage, lymph node metastasis and pTNM stage. The overall survival rates in GC patients with low upregulated miR-21 expression were significantly higher than those with high upregulated miR-21 (P < 0.05). Conclusion. A close association is implicated between the elevated miR-21and lymph node metastasis, which could potentially be exploited as a practical biomarker for lymph node metastasis in patients with GC.

In vitro antimetastatic effect of Changweiqing through antiinvasion of hypoxic colorectal carcinoma LoVo cells.

OBJECTIVE: To investigate the in vitro effects and the primary mechanisms of Changweiqing (, CWQ) on antimetastasis and antiinvasion of hypoxic colon carcinoma cells. In addition, to provide experimental evidence for the Chinese medicinal theory of "strengthening the body's resistance to eliminate pathogenic factors" in the treatment of colorectal cancer, including its invasion and metastasis. METHODS: First, CWQ sera were prepared with serum-pharmacology methods. Then, the modified hypoxic chamber was designed and flushed with 5% CO(2) and 95% N(2) at 37 °C to induce a hypoxic environment. The effect of CWQ serum on the viability of LoVo cells was tested with MTT cytotoxicity assay. The wound model and chamber model were established to estimate the effects of CWQ serum on migration and invasion of LoVo cells. The model for cell adhesion was established to evaluate the effect of CWQ serum on LoVo cells' adhesion. The gelatin zymography model was performed to determine the effects of CWQ serum on the activities of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). The effects of CWQ serum on the hypoxia-inducible factor 1 α (HIF-1α) nuclear translocation and the mRNA level of vascular endothelial growth factor (VEGF) in LoVo cells were determined by Western blot and reverse transcription-polymerase chain reaction (RT-PCR) analyses, respectively. RESULTS: CWQ inhibited LoVo cells' migration based on wound healing assay. The inhibitive effect could reach about 68.00% under hypoxic culture and about 29.87% under normoxic culture when cells were treated with 10% CWQ serum for 24 h. The results from both cell invasion and adhesion assays showed that CWQ serum could dose-dependently repress the invasion of LoVo cells and inhibit cells from adhering to extra cellular matrix (ECM). Under the hypoxic culture condition, RT-PCR analysis showed that 10% CWQ serum had down-regulated the expression of VEGF by 45.87%, and the result of Western blot analysis provided further evidence. The HIF-1α amount in the nucleus of the LoVo cells was also diminished in a dose-dependent manner, as shown by the Western blot. Gel zymogram assay revealed that CWQ serum could suppress the activities of MMP-2 and MMP-9. CONCLUSIONS: CWQ could effectively inhibit tumor metastasis in vitro The antimetastatic effects of CWQ were associated with the inhibition of cell motility, which was evidenced by inhibition of cell invasion and adhesion. The molecular mechanisms of the inhibition of tumor invasion by CWQ were due to the reduced expression of both HIF-1α and VEGF and the suppression of MMP-2 and MMP-9 expression.

Traditional Chinese herbal medicine in the supportive management of patients with chronic cytopaenic marrow diseases -- a phase I/II clinical study.

We report on a phase I/II, single arm clinical trial studying the safety and efficacy of Traditional Chinese Medicine (TCM) in patients with various chronic cytopaenic marrow diseases including myelodysplastic syndrome (MDS), myelofibrosis (MF), aplastic anaemia (AA) and thalassemia intermedia, who either have failed, are unfit for or refused currently available Western medical treatment. Patients took oral herbal concoctions according to their TCM syndromes for 24 weeks while continuing with western medical management. The median age of this group of 31 patients was 61 (26--84) years old and median disease duration was 5 years (0.3--40 years). TCM herbs were well tolerated in these patients with multiple comorbidities and previous disease-related complications. Twenty-three patients completed the study with 5 (2 with MDS, 2 with MF and 1 with SAA) achieving some degree of haematological improvement. EORTC quality of life indicators improved in more than half of patients. This small study offers positive results and provides the basis for future larger studies which should randomize patients with MDS, MF and AA managed with standard Western medical treatment to without and with upfront combinations with TCM herbs. This will conclusively define the role of TCM in the supportive management of these diseases. This study was registered with Clinicaltrial.gov as NCT01224496.

Serum FGF21 levels are increased in newly diagnosed type 2 diabetes with nonalcoholic fatty liver disease and associated with hsCRP levels independently.

OBJECTIVE: Fibroblast growth factor (FGF21) has beneficial effects on lipolysis. Highly sensitive C-reactive protein (hs-CRP) is a predictor of type 2 diabetes and nonalcoholic fatty liver disease (NAFLD). This study aimed to determine the levels of serum FGF21 and hs-CRP in newly diagnosed type 2 diabetes patients with and without NAFLD, and further explored the correlation between FGF21 with hs-CRP in newly diagnosed type 2 DM. RESEARCH DESIGN AND METHODS: 69 patients with newly diagnosed type 2 DM and 30 normal subjects were included in the study. FGF21 and hs-CRP were measured by ELISA kits. The severity of NAFLD was measured by ultrasound. RESULTS: Serum FGF21 in newly diagnosed type 2 DM with NAFLD group were significantly increased (p<0.01). There was no difference for the FGF21 level in normal control group and newly diagnosed type 2 DM without NFALD group. In type 2 DM group, the FGF21 level was positively correlated with hsCRP (r=0.417, p<0.001). In multiple stepwise regression models, only hsCRP was a significantly independent determinant for serum FGF21. CONCLUSIONS: Serum levels of FGF21 are closely related to liver steatosis in newly diagnosed type 2 DM patients.