The appearance of the school of confluence of western medicine and Traditional Chinese Medicine in modern times, the combination of western and Chinese medicine after liberation, and the modernization of traditional Chinese medicine in recent years have exerted great influence on the development of the theory of TCM.

Objective: To observe effect of method of regulating Qi to dissipate blood stasis and phlegm on degree of heart failure, ventricular remodeling, disease progression in patients with Qi deficiency and blood stasis type chronic heart failure (CHF).Method: One hundred and thirty-four patients with CHF were randomly divided into control group (62 cases) and observation group (62 cases) by random number table. The patients in control group got spironolactone tablets, 20 mg/time and qd. Benazepril, 20 mg/time and qd. Bisoprolol, 10 mg/time and qd. And digaoxin tablets if necessary. Based on the treatment in control group, patients in observation group additionally received Danshenyin and Xuefu Zhuyutang, 1 dose/day. The treatment course was 3 months in both groups. Before and after treatment, scores of Lee heart failure score were graded, cardiac function classification of the New York Heart Association (NYHA), 6 mins' walking test (6 MWT), scores of Qi deficiency and blood stasis and Minnesota living with heart failure questionnaire (MLHFQ) were evaluated. Echocardiography, left ventricular ejection fraction (LVEF), Left ventricular end-diastolic diameter (LVEDd), left ventricular end-stolic diameter (LVEDs), interventricular septum thickness at end-diastole (IVSd) and left ventricular myocardial mass index (LVMI) were recorded. Levels of matrix metalloprotein-9 (MMP-9), tissue inhibitor of matrix metalloprotease-1 (TIMP-1), transforming growth factor-β₁ (TGF-β₁), N-terminal pro-B-type na-triuretic peptide (NT-proBNP), galectin-3 and copeptin were detected.Result: Ridit analysis showed that after treatment, effect on cardiac function in observation group was better than that in control group (P<0.05). Classification of cardiac function of NYHA was lower than that in control group (P<0.05). The LVEDd, LVEDs and LVMI in observation group were all less than those in control group (P<0.05), while LVEF was higher than that in control group (P<0.05). There was no statistically significant difference in IVSd between two groups. Scores of Lee heart failure score, MLHFQ and Qi deficiency and blood stasis in observation group were lower than those in control group, and distance of 6 mins' walking was larger than that in control group (P<0.01). Levels of serum MMP-9, TGF-β₁, NT-proBNP, galectin-3 and copeptin in observation group were lower than those in control group, while level of TIMP-1 was higher than that in control group (P<0.01).Conclusion: Based on the routine western medicine treatment, additional Danshenyin and Xuefu Zhuyutang can ameliorate symptoms of heart failure, relieve degree of heart failure, improve exercise tolerance and quality of life, inhibit ventricular remodeling, improve cardiac rehabilitation and delay progress of the disease for the CHF patients with Qi deficiency and blood stasis.

Objective: To discuss the effect of Peiyuan Tongnao capsules on neurological impairment of patients with ischemic stroke at convalescence, and discuss the mechanism of action in microcirculation improvement, anti-inflammation and neuroprotection. Method: One hundred and thirty one patients were randomly divided into control group (66 cases) and observation group (65 cases) by random number table. Patients in control group were given aspirin enteric-coated tablets, 0.1 g/day, simvastatin tablets, 10 mg/days, and treated by percutaneous nerve electrical stimulator for 30 times, 30 min/time, 1 time/day, 5 times/week. In addition of the therapy in control group, patients in observation group were also given Peiyuan Tongnao capsules, 3 grains/time, 3 times/days. A course of treatment was 12 weeks. Before treatment, and at the 4^th, 8^th and 12^th weeks, neurological deficits in the national institutes of health (NIHSS), activity of daily life scale (ADL), berg balance scale (BBA), fugl-meyer scale (FMA) and traditional Chinese medicine (TCM) syndromes were scored. And levels of brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), homocysteine (Hcy) and serum cystatin C (Cys-C) and hemorheological indicators whole blood viscosity, high shear rate, low shear rate, reduced viscosity, plasma viscosity, platelet aggregation rate, fibrinogen (FIB) and blood sedimentation rate (ESR)were detected. Result: At the 8^th and 12^th week after treatment, score of NIHSS in observation group was lower than that in control group (P<0.01), and NIHSS in observation group declined more than that in control group (P<0.01). Scores of ADL, BBA and FMA and levels of BDNF were higher than those in control group (P<0.01), while scores of TCM syndromes and levels of NSE, IL-6, TNF-α, Hcy, Cys-C and hemorheological indices were all lower than those in control group (P<0.01). And by rank sum test, the clinical effect in observation group was superior to that in control group (P<0.05). Conclusion: Peiyuan Tongnao capsules can promote the recovery of neurological impairment at recovery period of ischemic stroke, regulate inflammatory factors, improve blood rheology, protect neural function, and improve the effect of routine western medicine rehabilitation therapy.

Medium chain acyl CoA dehydrogenase deficiency is a mitochondrial fatty acid oxidative deficiency disease. It has various clinical manifestations,such as hypoglycemia,lethargy,myasthenia,etc. Different clinical manifestations and atypical biochemical examination can increase the difficulty of diagnosis,which is more likely to result in misdiagnosis. If it is not treated in time,mortality and the rate of sequelae are high,but if confirmed by neonatal screening and treated in time,satisfactory results can be obtained.

Objective: To evaluate the effect of propofol with different concentrations on the expression of inflammatory mediators of interleukin and tumor-necrosis factor-α (TNF-α) by stimulating the mouse primary monocytes and human monocytic cell line with lipopolysaccharide (LPS) and also discuss the effect of propofol on the secretion of inflammatory mediator and its possible molecular mechanism. Methods: The mononuclear cells of mouse spleen were separated and then purified to obtain the primary monocytes. The dose-effect relationship of production of pro-inflammatory cytokines by monocytes which were stimulated by LPS, namely the monocytes were stimulated by the dose of 0-500 ng/mL for 24 h. ELISA was employed to detect the concentration of IL-6, IL-8 and TNF-α. The effect of propofol on the secretion of above pro-inflammatory cytokines by the monocytes was observed. Cells were divided into the control group, the 0.1% DMSO group, the LPS group and the treatment group with LPS + different dose of propofol (propofol 1-100 μg/mL). ELISA was employed to detect the concentration of IL-6, IL-8 and TNF-α. The change in the expression of important signaling molecules in Toll-like receptor and NF-κB signaling pathway was detected after THP-1 cells were treated with propofol. Results: The concentration of TNF-α was (3. 863 ± 153) pg/mL after 12 h of stimulation by LPS and then its concentration was decreased gradually. But the concentration of IL-6 and IL-8 was relatively high after 24 h of stimulation by LPS, (5. 627 ± 330) pg/mL and (1. 626 ± 200) pg/mL, respectively. The propofol could inhibit the expression of IL-6, IL-8 and TNF-α caused by LPS. After the intervention treatment of 50 μg/mL propofol, the concentration of IL-6, IL-8 and TNF-α was significantly decreased (P < 0.01). Conclusions: The propofol can inhibit the expression of TLR-4 and NF-κB to inhibit the activation of p38 and the expression of pro-inflammatory cytokines.

BACKGROUNDTo evaluate the efficacy of alpha-2b interferon alone or combined with alpha1-thymosin in treatment of patients with chronic hepatitis B (CHB) resistant to lamivudine.

METHODSSixty six patients with CHB resistant to lamivudine were enrolled and randomized into treatment group A, treatment group B and control group. In the treatment group A 26 cases, after giving interferon-alpha alone for 1 month, lamivudine was withdrawn and continuously treated with interferon-alpha for 5 months. In the treatment group B 10 cases, after treatment with interferon-alpha and thymosin-alpha1 for 1 month, lamivudine was withdrawn and continuously treated with interferon-alpha and thymosin-alpha1 for 5 months. In control group (30 cases), after lamivudine was directly withdrawn, no anti-virus drug was given. Hepatic function tests and serum virological index were detected at regular intervals in all patients.

RESULTSNormalization rate of hepatic function, HBV DNA seroconversion rate and HBeAg/HBeAb seroconversion rate in two treatment groups were significantly higher than those in control group.

CONCLUSIONThe study suggested that interferon-alpha alone or combined with thymosin-alpha1 in treatment of patients with chronic hepatitis B resistant to lamivudine showed a beneficial effect.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; genetics ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B e Antigens ; immunology ; Hepatitis B virus ; drug effects ; genetics ; immunology ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Recombinant Proteins ; Thymosin ; therapeutic use ; Treatment Outcome

OBJECTIVE: The study aimed to investigate the efficacy and adverse effects of sublingual immunotherapy (SLIT) of dust mite drops to allergic rhinitis with mite allergy. The compliance and satisfaction of SLIT were also assessed. METHOD: One hundred and three patients of allergic rhinitis sensitive to dust mites were treated with SLIT for 6 months or more. The symptom questionnaire,including items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance were obtained before and 6 months after SLIT. The patients' satisfaction and adverse effects were also investigated. RESULT: Seventy-five of the 103 patients insist on SLIT for more than 6 months and completed the questionnaire. The duration of receiving SLIT was 9.8 months on average (range from 6 to 13 months). The satisfaction rate was 89.3%. The drop-out rate of SLIT was 31.0%. CONCLUSION The subjective symptoms were improved with SLIT in patients with allergic rhinitis sensitive to dust mites. The drop out rate was high despite of the symptomatic improvement.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Patient Compliance ; Patient Satisfaction ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; psychology ; therapy ; Sublingual Immunotherapy ; psychology ; Treatment Outcome ; Young Adult

Objective: To investigate the synergistic effect and mechanism of the combined application of recombinant human bone morphogenetic protein-2 (rhBMP-2) and basic fibroblast growth factor (bFGF). Methods: 24 KM male mice were randomly divided into 6 groups with 4 mice in each group, namely, Group A (control group), Group B (only treated with collagen), Group C (treated with 2 ng bFGF+collagen), Group D (treated with 4 μ g rhBMP-2+collagen), Group E (treated with 4 μ g rhBMP-2+2 ng bFGF+collagen) and Group F (treated with 4 μ g rhBMP-2+4 ng bFGF+collagen). The composites were implanted into the intermuscular septum of hind legs mice; whereas in control group, intermuscular septum of mice was separated and no implantation was performed. General observation, detection of concentration of calcium content, micro computed tomography (Micro-CT), three-dimensional reconstruction scan, measurement of bone mineral density (BMD), bone volume fraction (BVF) and trabecular thickness (Tb.Th), as well as histological observation with HE staining and ALP and CD34 immumohistochemical staining were performed. Results: Ectopic osteogenesis was found in Groups D, E and F mice. The difference in concentration of calcium contents was statistically significant between Groups D and E (. P<0.05), but insignificant between Groups E and F (. P>0.05). Micro-CT and three-dimensional reconstruction revealed continuous newborn bone substance in external surface of ectopic bone formation, and the center of bone formation did not show obvious substantial filling by bone substance. The differences in BMD, BVF and Tb.Th were statistically significant between Groups D and E or F (. P<0.01 or <0.05). HE staining showed that in Groups D, E and F, newborn bone substance was mainly located at the edge of ectopic bone formation, and the bone formation in Groups E and F was better than that in Group D. ALP and CD34 immumohistochemical staining revealed the positive expression mainly at the edge of ectopic bone formation, and area of positive expression in Groups E and F was larger than that in Groups D. Conclusions: rhBMP-2 possesses the capacity to induce ectopic osteogenesis independently, but bFGF does not have this ability; the combined application of rhBMP-2 and bFGF can enhance the synergetic effect on inducing ectopic osteogenesis.

Objective: To screen the frosting qualitymarkers (Q-marker) of Mori Foliumand identify Mori Folium after frost. Method: The HPLC-DAD-MSⁿ fingerprints of Mori Folium before and after frost were established,the common peaks were markedand the characteristic components were selected by orthogonal partial least squares discrimination analysis (OPLS-DA). The components with a large content change were used as marker components,and the relatively stable component was used as an internal reference component. The ratio of the marker components to the peak area of the internal reference component was used as component characteristic to identify the frost of Mori Folium,andqualitative study of frosting markerswere performed by MSⁿ and authentic standards. Result: The fingerprints were established and 33 common peaks were marked. Through OPLS-DA,peaks 1,23,14 were determined as marker components,peak 12 was determined as internal reference component. The frosting quality markers of Mori Folium were characterized as citric acid derivatives,saponin F,tryptophan and neochlorogenic acid by MSⁿ and standards. The ratios of the peak areas of citric acid derivatives,saponin F,tryptophan and neochlorogenic acid before and after frost were 0.15±0.054,1.0±0.48; 0.14±0.073,0.98±0.48,0.13±0.088,0.89±0.49,respectively. Conclusion: In the fingerprints established in this study,the peak area ratios of citric acid derivatives,saponin F,tryptophan to new chlorogenic acid had specificity,which can be used as frosting quality markers for identification of Mori Folium. This study expanded the connotation of the Q-marker specificity of traditional Chinese medicine. The results can provide experimental data for the quality evaluation and drug-forming properties of Mori Folium,and provide reference for similar research.

Objective: To understand the characteristics and trend of the premature death rate of 4 major chronic diseases in Ji'nan from 2015 to 2020. Methods: The death cause surveillance data and population data during 2015-2020 in Ji'nan were collected, and abbreviated life table, Joinpoint regression analysis and other methods were used to analyze the characteristics and change trends of the premature death rates of 4 major chronic diseases. Results: The crude mortality rate and age standardized mortality rate changes for the 4 major chronic diseases from 2015 to 2020 range from 568.65/100 000 to 604.06/100 000 and 366.77/100 000 to 432.48/100 000, respectively. The annual premature death rate of 4 major chronic diseases declined by 3.33% averagely from 2015 to 2020 (95%CI: -6.25%--0.32%), which might be explained by the declines of the premature death rates of cardiovascular and cerebrovascular diseases [average annual percentage change (AAPC)=-3.23%, 95%CI: -6.32%--0.05%] and cancer (AAPC=-3.58%,95%CI:-6.83%--0.21%). The average decline rate in women (AAPC=-4.19%,95%CI:-7.56%- -0.70%) was higher than that in men (AAPC=-2.92%,95%CI: -5.65%--0.11%). Conclusions: The premature death rate of 4 major chronic diseases showed a downward trend in Ji'nan from 2015 to 2020. Men should be considered as a key population in the prevention and control of 4 major chronic diseases, and attention should also be paid to the non-significant declines in the premature death rates of chronic respiratory diseases and diabetes.
Cerebrovascular Disorders ; Chronic Disease ; Diabetes Mellitus ; Female ; Humans ; Male ; Mortality, Premature ; Regression Analysis