Metabolic syndrome (MS) is a complex polygenic inheritance disease, caused by the accumulative effect of multiple genes and some environmental factors. Insulin resistance is the pathophysiologic foundation of MS. From the viewpoint of TCM, phlegm is the basic pathological factor of MS. In different periods and different symptoms of the disease, phlegm can be found during the whole disease course. Genes as an important component of the innate factors, play an important role in the formation of phlegm syndrome. Researches on correlation between susceptibility genes and phlegm syndrome in MS are important to enrich the connotation of phlegm syndrome and improve the level of diagnosis and treatment for this disease.

Objective:To explore the relationships of pathology of phlegm syndrome of TCM with blood sugar,insulin and insulin resistance in metabolic syndrome(MS).Methods:The information of 233 cases of MS was collected by four diagnostic methods,syndrome differentiation by syndrome element was used to analyze the diagnosis information,and the blood glucose,insulin and HOMA-IR were detected.Results:①Fasting blood glucose and 30 min,60 min,120min,180 min postprandial blood glucose level had positive correlation with phlegm.Correlation coefficient were 0.158(P

Objective: To explore the TCM pathogenic characteristic of hyperuricemia and its relation with renal function,Methods: Hyperuricemia rat models were established by the adenine and ethambutol.The models were treated with Simiaosan,Erchentang,Xuefuzhuyutang respectively.The indexes such as uric acid(UA),Crea(Cr),urea nitrogen(BUN)and xanthinoxidase(XOD) were detected.Results: ①Compared with normal group,the UA of and XOD in model group increased obviously(P

0.05).Conclusion:The location of acne is liver and kidney which manly manifested as the heat syndrome.The syndrome is co-related to the changes of sexual hormones.

Objective To analyze the characteristics of concurrent pattern elements of the patients with phlegm or non-phlegm pattern in metabolic syndrome, explore the correlation between different disease locations as well as complicated diseases and physicochemical parameters in patients with metabolic syndrome, and to provide a theoretical basis for the early detection, diagnosis and treatment of the disease. Methods The 2005 International Diabetes Federation diagnostic criteria and pattern element differentiation method were used to select 334 patients of metabolic syndrome with phlegm pattern and 288 patients of metabolic syndrome with non-phlegm pattern into this study. Physical and chemical parameters and TCM four diagnostic data were entered and analyzed with SPSS 20.0 to explore characteristics of concurrent pattern elements of phlegm and non-phlegm patterns in patients with metabolic syndrome,and to explore the correlation between different locations as well as complicated diseases and physicochemical parameters in patients of metabolic syndrome. Results 1.Disease locations of liver, spleen, kidney, lung,gallbladder, stomach distributed in phlegm group were more frequent than those in non-phlegm group;the percentage of patients with dampness, fever, qi stagnation, blood stasis, qi deficiency, yin deficiency,yang deficiency and blood deficiency were higher than those in non-phlegm group. 2.In male patients with phlegm pattern, the frequency of disease location in the liver was lower than that in the spleen and stomach,while the female patients had opposite distribution. The age of the liver and spleen groups were less than the age in the kidney group among patients with phlegm pattern. 3. In phlegm-pattern patients,the frequency of blood deficiency pattern among male patients was lower than that of qi deficiency,yin deficiency and yang deficiency patterns, while the frequency of females was higher than those of the three groups. The levels of uric acid (UA) and creatinine (Cr) in yang-deficiency pattern group were higher than those in blood deficiency pattern group. Cr levels in yin deficiency pattern group were also higher than those in blood deficiency pattern group. Conclusions Disease locations of phlegm pattern group in metabolic syndrome were: liver, spleen, kidney, lung, gallbladder, stomach and miscellaneous diseases were dampness,heat,qi stagnation, blood stasis, qi deficiency, yin deficiency, yang deficiency, and blood deficiency; Non-phlegm pattern group presented no concurrent pattern element characteristics. Disease locations were in the stomach in the male while they were changed to the liver in the female. Concurrent pattern elements was blood deficiency in patients of phlegm pattern in metabolic syndrome. In addition, the order of disease location of metabolic syndrome patients with phlegm pattern was spleen,liver and kidney. There was a correlation between yin-yang disharmony and levels of UA and Cr.

Objective To study the accuracy and safety of oral mucosal exfoliated cell specimens used in the bedside rapid detection of MTHFR C677T genotype by using the fluorescent probe method.Methods The outpatients and inpatients with hypertension visited and admitted in the department of cardiovascular medicine of this hospital from January 2019 to September 2020 were selected.The plasma homocysteine (Hcy) level in all patients was detected in the laboratory,a total of 482 hypertensive patients with Hcy≥10 μmol/L were se-lected,and the oral mucosal cells and whole blood sample were collected in all patients,and the genotypes of the above specimens were detected by the oral mucosal exfoliative cell fluorescent probe method and whole blood sample contrast reagents.If the two test results were inconsistent,the "gold standard" Sanger sequen-cing method was used to detect the whole blood sample for the final determination of MTHFR C677T geno-type.The coincidence rate was compared between the two detection methods,and the probability of adverse e-vents during the samples collection was observed and recorded.The accuracy and safety of fluorescence probe method for detecting MTHFR C677T genotype in the patients with oral mucosa exfoliation was evaluated.Re-sults The oral mucosal exfoliated cell samples and whole blood samples from 482 hypertensive patients were successfully collected,and no obvious adverse reactions occurred during the sampling process.The incidence rate of total mutation of MTHFR C677T gene detected by the fluorescence probe method and contrast reagent all were 73.23％ (353/482),the coincidence rate of homozygous wild type (CC type) in MTHFR C677T gene detected by the two methods was 100.00％ (95％CI:97.11-100.00),which of heterozygous mutant type (CT type) was 99.14％ (95％CI:96.91-99.76),which of homozygous mutant type (TT type) was 99.17％(95％CI:95.47-99.85),the total coincident rate of MTHFR C677T genotype was 99.38％ (95％CI:98.19-99.79)and the detection results consistency Kappa value was 0.9902.Conclusion The detection of MTHFR C677T gene mutation in oral mucosal exfoliated cells by fluorescent probe method is simple with less invasion,moreover which is rapid,safe and accurate.

[Objective] To construct a Nomogram model for the prediction of essential hypertension (EH) risks with the use of traditional Chinese medicine (TCM) syndrome elements principles in conjunction with cutting-edge biochemical detection technologies. [Methods] A case-control study was conducted, involving 301 patients with essential hypertension in the hypertensive group and 314 without in the control group. Comprehensive data, including the information on the four TCM diagnoses, general data, and blood biochemical indicators of participants in both groups, were collected separately for analysis. The differentiation principles of syndrome elements were used to discern the location and nature of hypertension. One-way analysis was carried out to screen for potential risk factors of the disease. Least absolute shrinkage and selection operator (LASSO) regression was used to identify factors that contribute significantly to the model, and eliminate possible collinearity problems. At last, multivariate logistic regression analysis was used to both screen and quantify independent risk factors essential for the prediction model. The “rms” package in the R Studio was used to construct the Nomogram model, creating line segments of varying lengths based on the contribution of each risk factor to aid in the prediction of risks of hypertension. For internal model validation, the Bootstrap program package was utilized to perform 1000 repetitions of sampling and generate calibration curves. [Results] The results of the multivariate logistic regression analysis revealed that the risk factors of EH included age, heart rate (HR), waist-to-hip ratio (WHR), uric acid (UA) levels, family medical history, sleep patterns (early awakening and light sleep), water intake, and psychological traits (depression and anger). Additionally, TCM syndrome elements such as phlegm, Yin deficiency, and Yang hyperactivity contributed to the risk of EH onset as well. TCM syndrome elements liver, spleen, and kidney were also considered the risk factors of EH. Next, the Nomogram model was constructed using the aforementioned 14 risk predictors, with an area under the curve (AUC) of 0.868 and a 95% confidence interval (CI) ranging from 0.840 to 0.895. The diagnostic sensitivity and specificity were found to be 80.7% and 85.0%, respectively. Internal validation confirmed the model’s robust predictive performance, with aconsistency index (C-index) of 0.879, underscoring the model’s strong predictive ability. [Conclusion] By integrating TCM syndrome elements, the Nomogram model has realized the objective, qualitative, and quantitative selection of early warning factors for developing EH, resulting in the creation of a more comprehensive and precise prediction model for EH risks.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.