Chronic Disease ; Consensus ; Heart Failure ; diagnosis ; therapy ; Humans ; Integrative Medicine

·Hemophilia is a rare disorder that occasionally has visual symptoms after diagnosis. The authors present a case in which visual symptoms led to the initial diagnosis, a 22-year-old man who represented with spontaneous fundal haemorrhage. There is no history of bleeding and trauma. The fundal haemorrhage was absorbed significantly without any treatment after 3 months follow-up. Hemophilia A was found to be the causative disorder in this previously healthy man. The authors present a rare case in which unilateral visual complaints led to the diagnosis of hemophilia A. Thus, though uncommon, hemophilia should be considered in the differential diagnosis of otherwise unexplained fundal haemorrhages.

Objective To dynamically observe the concentrations of plasma neuropeptide Y(NPY)in the patients with lower extremity arteriosclerosis obliterans(ASO)before and after vascular interventional therapy.Methods The levels of plasma NPY were detected by radioimmunoassay in 13 patients with lower extremity ASO(ASO group)before vascular intracavitary therapy and immediately,1 d,3 d and 5 d after vascular intracavitary therapy.Meanwhile,15 healthy subjects were served as control group.Besides,the ankle-brachial indexes(ABI)and clinical staging of ASO group were also obtained and compared before and 3 d after vascular intracavitary therapy.Results Compared with control group,the level of NPY in ASO group was much higher before vascular intracavitary therapy[(250.67?88.27)pg/mL vs(168.40?64.64)pg/mL,P

Objective To investigate the clinical effects of gastric bypass( GBP) on type 2 diabetes mel-litus(type 2 diabetes mellitus, T2DM)patients with different body mass index(BMI).Methods T2DM patients undergoing GBP from Sep.2012 to Jul.2013 were divided into 2 groups:obese group( BMI≥28 kg/m2 , 16 ca-ses)and overweight group(BMI<28 kg/m2,21 cases).Changes of fasting plasma glucose(FPG), insulin resist-ance index(HOMA-IR)and insulin stimulation release(INS), C peptide release, BMI, glycosylated hemoglobin ( HbA1c) at 3 and 6 months after surgery were observed.Results INS and C peptide improved 3 months after surgery(P<0.05),and they were close to normal at 6 months after surgery.HbA1c significantly decreased 3 months after surgery compared with that before surgery( P<0.05) and it was close to normal at 6 months after sur-gery.Patients in obese group had significantly declined weight 3 months after surgery compared with that before surgery, and reached the steady state 6 months after surgery.15 cases(93.7%) in the obese group had BMI<25 kg/m2 , and the difference had statistical significance ( P<0.05 ) .Patients in the overweight group had their weight declined but no statistical difference was found(P>0.05).Blood sugar in the obese group decreased with different degrees at 3 and 6 months after surgery.The effective rate was 92%for the obese group and 78%for the overweight group.The overall effective rate was 90%.Conclusion GBP has significant therapeutic value for T2DM patients with different BMI, especially for patients in obese group, which is worth of clinical promotion.

Objective: To systematically evaluate the efficacy and safety of Xinkeshu combined with conventional western medicine in the treatment of unstable angina pectoris. Methods: The randomized controlled clinical trials of Xinkeshu combined with conventional western medicine for the treatment of unstable angina pectoris were searched from PubMed database, Viper database, CNKCN, Wanfang database and other databases from the establishment of the database to April 2020.The literatures were screened according to inclusion and exclusion criteria, and Rev Man5.3 software was used for Meta analysis. Results: A total of 1569 patients were included in 19 randomized controlled trials. Meta-analysis results showed that Xinkeshu combined with conventional western medicine reduced the frequency of angina attacks (SMD=-1.16, 95%CI [-1.75, -0.57], P=0.000 1), decreased the duration of angina (MD=-2.75, 95%CI [-3.77, -1.73], P < 0.000 01), reduced the dosage of nitroglycerin (MD=-0.67, 95%CI [-0.78, -0.56], P < 0.000 01), improved ECG efficacy (RR=1.26, 95%CI [1.18, 1.35], P < 0.000 01), angina pectoris efficacy (RR=1.26, 95%CI [1.20, 1.33], P < 0.000 01), decreased triglyceride (MD=-0.57, 95%CI [-1.02, -0.12], P=0.01), total cholesterol (MD=-0.78, 95%CI [-1.15, -0.41], P < 0.000 1), low-density lipoprotein cholesterol (MD=-0.58, 95%CI [-0.80, -0.36], P < 0.000 01), raised high-density lipoprotein cholesterol (MD=0.24, 95%CI [0.08, 0.40], P=0.004), decreased whole blood viscosity (MD=-1.32, 95%CI [-2.25, -0.39], P=0.005), and plasma viscosity (MD=-0.29, 95%CI [-0.38,-0.21], P < 0.000 01), fibrinogen (MD=-1.06, 95% CI [1.29, 0.83], P < 0.000 01), lower C-reactive protein (MD=-1.70, 95% CI [2.33, 1.06], P < 0.000 01), endothelin 1 (MD=-7.81, 95% CI [10.05, 5.57], P < 0.000 01), and homocysteine (MD=-2.35, 95% CI [2.63, 2.07], P < 0.000 01), improved the effect of nitric oxide (MD=8.74, 95%CI [7.00, 10.47], P < 0.000 01), which was better than that of the pure western medicine group, and subgroup analysis results showed that the treatment course was greater than or equal to three months with better treatment. There was no statistically significant difference in the incidence of adverse reactions (P=0.56), liver and kidney function were not abnormal in all the studies. Conclusion: Clinical application of Xinkeshu combined with conventional western medicine in the treatment of unstable angina pectoris is clear, which is recommended in clinical application.

Chinese materia medica resource (CMM resource) is the foundation of the development of traditional Chinese medicine. In the study of sustainable utilization of CMM resource, adopting innovative theory and method to find new CMM resource is one of hotspots and always highlighted. Pharmacophylogeny interrogates the phylogenetic relationship of medicinal organisms (especially medicinal plants), as well as the intrinsic correlation of morphological taxonomy, molecular phylogeny, chemical constituents, and therapeutic efficacy (ethnopharmacology and pharmacological activity). This new discipline may have the power to change the way we utilize medicinal plant resources and develop plant-based drugs. Phylogenomics is the crossing of evolutionary biology and genomics, in which genome data are utilized for evolutionary reconstructions. Phylogenomics can be integrated into the flow chart of drug discovery and development, and extends the field of pharmacophylogeny at the omic level, thus the concept of pharmacophylogenomics could be redefined in the context of plant pharmaceutical resources. This contribution gives a brief discourse of knowledge pedigree of pharmacophylogeny, epistemology and paradigm shift, highlighting the theoretical and practical values of pharmacophylogenomics. Many medicinally important tribes and genera, such as Clematis, Pulsatilla, Anemone, Cimicifugeae, Nigella, Delphinieae, Adonideae, Aquilegia, Thalictrum, and Coptis, belong to Ranunculaceae family. Compared to other plant families, Ranunculaceae has the most species that are recorded in China Pharmacopoeia (CP) 2010. However, many Ranunculaceae species, e. g., those that are closely related to CP species, as well as those endemic to China, have not been investigated in depth, and their phylogenetic relationship and potential in medicinal use remain elusive. As such, it is proposed to select Ranunculaceae to exemplify the utility of pharmacophylogenomics and to elaborate the new concept empirically. It is argued that phylogenetic and evolutionary relationship of medicinally important tribes and genera within Ranunculaceae could be elucidated at the genomic, transcriptomic, and metabolomic levels, from which the intrinsic correlation between medicinal plant genotype and metabolic phenotype, and between genetic diversity and chemodivesity of closely related taxa, could be revealed. This proof-of-concept study regards pharmacophylogenomics as the updated version of pharmacophylogeny and would enrich the intension and spread the extension of pharmacophylogeny. The interdisciplinary knowledge and techniques will be integrated in the proposed study to promote development of CMM resource discipline and to boost sustainable development of Chinese medicinal plant resources.
China ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Knowledge ; Medicine, Chinese Traditional ; Phylogeny ; Plants, Medicinal ; chemistry ; classification ; genetics

Objective To study endothelial nitric oxide synthase (eNOS) gene transfecting endothelial cells (ECs). Methods eNOS gene was transfected into the steady ECs system by cationic liposomal transduction and check the transfection effect by RT-PCR and immunohistochemistry assay. To test the concentrations of NOS, nitric oxide (NO) and von willebrand factor (vWF) in culture media by colorimetry and ELISA, respectively,and transfected EC function was observed. Results The effect of transfection was satisfactory with RT-PCR products electrophoresis, sequence and immunohistochemistry. The concentrations of NOS and NO in transfected EC culture media increased with time (P

Objective To amplify all immunoglobulin V genes of human atherosclerosis by PCR and to sequence the products of PCR cloned into T-vector. Methods Peripheral blood samples of 50 patients with atherosclerosis were collected,from which lymphocytes were segregated by density gradient centrifugation and total RNA was extracted by TRIzol reagent.V genes of VL(including VK and V?) and VH were amplified by RT-PCR,and the products were digested by restriction enzyme and then cloned into T-vector.Two clones were picked randomly to sequence.(Results)Total RNA were extracted purely with integrity,and all V genes of VL and VH were amplified by PCR successfully.The sequences were highly homologous to human immunoglobulin genes. Conclusion All immunoglobulin V genes of human artherosclerosis were amplified successfully,which lays a foundation for the construction and (selection) of phage library.

ObjectiveTo investigate the clinical manifestation, mechanism and optimal treatment of hydronephrosis after spinal cord injury. Methods58 slight and moderate cases were retrospectively analyzed. ResultsThere were no differences in the remitted time among the therapies of indwelling catheter, intermittent catheterization and medicine, mixed therapy. 56 (96.55%) SCI hydronephrosis remitted after treatment, 28(48.28%) recurred within 3 months. The recurrence rate of the patients with detrusor sphincter dyssynergia (57.14%) was higher than that of the detrusor hyperreflexia (28.57%) and the detrusor hyporeflexia (14.29%). The recurrence was associated with the fact that many patients couldn't keep up with the systematic therapy.ConclusionThe onset of SCI hydronephrosis is indistinct and recurrent easily. Keeping up with intermittent catheterization and taking medicine can prevent SCI hydronephrosis recurrence effectively.

ObjectiveTo observe the efficacy and tolerability of tolterodine on spinal cord injured (SCI) patients with detrusor hyperreflexia.Methods39 cases were treated with tolterodine administration for at least two weeks (8.31±6.47 months in average), the range of drug dosage was 1 mg to 12 mg per day, 5.82±3.13 mg in average. Twelve of them have taken the drug (1-8 mg per day) for one year.ResultsAfter two weeks of treatment, 37 cases (94.87%) had a good effect, and the bladder volume increased 74.36±35.32 ml (P<0.001), the mean frequency of micturition decreased 3.85±2.38 times (P<0.001), urine of each micturition increased 49.74±41.20 ml (P<0.001), the residual urine increased 64.62±41.98 ml(P<0.001).Additionally, hydronephrosis of two cases was remitted. The adverse events: 8 cases of thirsty, 1 case of tachycardia and 1 case of urine retention.ConclusionTolterodine has a good effect and limited side effects on SCI patients with detrusor hyperreflexia.