To explore the way of quantified diagnosis of blood stasis syndrome (BSS) and the essence of BSS.

With the wide application of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD), it is a popularly concerned problem within clinical doctors to promote the patients' early recovery and improve their health related quality of life (HR-QoL).

A UPLC-ESIMS method was developed for simultaneous analysis of seven major bioactive flavonolignans in silymarin including silychristins A(1) and B(2), silydianin(3), silybins A(4) and B(5), and isosilybins A(6) and B(7). In this study, the seven major active flavonolignans including the diastereomers 1/2, 4/5, and 6/7 were completely separated using UPLC with an ACQUITY UPLC C18 column and MeOH-water (formic acid) mobile phase system. The collision-induced dissociation (CID) MS/MS spectra of these flavonolignans were studied systematically using ESI-MS. The results with the present methodology showed that UPLC-MS/MS can be used for general screening of active natural products from plant extracts and for the specific quality control of silymarin.
Chromatography, High Pressure Liquid ; methods ; Molecular Structure ; Plant Extracts ; chemistry ; Silymarin ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; methods

Objective: To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), by observing the effects of moxibustion at Tianshu (ST25) and Shangjuxu (ST37) on microRNA-133b (miRNA-133b), pituitary homeobox family factor 3 (Pitx3)/tyrosine hydroxylase (TH), and neurotransmitters in the brain tissue of IBS-D rats. Methods: Healthy Sprague-Dawley rats were randomly divided into a normal group, a model group, a moxibustion group, and a Western medicine group, with 12 rats in each group. Except for the normal group, the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups. No intervention was performed in the normal and model groups. Mild moxibustion was applied to both Tianshu (ST25) and Shangjuxu (ST37) in the moxibustion group. Rifaximin was given by gavage in the Western medicine group. The physical status of rats in each group was observed at different periods. After the intervention, hematoxylin- eosin staining was performed to observe the histopathological morphology of rat colon; enzyme-linked immunosorbent assay was used to measure the levels of dopamine (DA), noradrenaline (NE), and 5-hydroxytryptamine (5-HT) in plasma, colon, and midbrain tissue of rats; the relative expression levels of miRNA-133b, Pitx3 mRNA, and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction, and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence. Results: The body weights of rats among groups and at different time points were statistically different (P<0.01). The body weight of the normal group was higher than that of the other groups over time (P<0.01). After modeling, the minimum volume threshold of abdominal withdrawal reflex (AWR) was significantly lower (P<0.01) and the loose stool rate was significantly higher (P<0.01) in the model, moxibustion, and Western medicine groups compared with the normal group; the miRNA-133b expression in the midbrain tissue was significantly lower (P<0.01), the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher (P<0.01), and the levels of DA, NE, and 5-HT in plasma, colon and midbrain tissue were significantly higher (P<0.01). After the intervention, the minimum volume threshold of AWR was significantly higher (P<0.01), the loose stool rate was significantly lower (P<0.01), the miRNA-133b expression was significantly increased (P<0.01 or P<0.05) and the expression levels of Pitx3 and TH were significantly decreased (P<0.01) in the midbrain tissue, the levels of DA, NE, and 5-HT in plasma, colon, and midbrain tissue were significantly reduced (P<0.01) in the moxibustion and Western medicine groups compared with the model group; the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group (P<0.05), and there was no statistical difference compared with the remaining groups (P>0.05). Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3 (r<0, P<0.01); Pitx3 with TH, TH with DA, and NE with 5-HT were positively correlated (r>0, P<0.01).Conclusion: Moxibustion at Tianshu (ST25) and Shangjuxu (ST37) improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats. The mechanism may be related to up-regulating miRNA-133b, inhibiting Pitx3/TH, and reducing neurotransmitter expression levels in the midbrain tissue.

Objective:To develop the Traditional Chinese Medicine (TCM) symptom scores of qi depression and phlegm obstruction patternfor dyslipidemia patients, in order to optimize the TCM pattern evaluation method.Methods:According to Delphi method, the two roundsquestionnaires were distributed to experts through face-to-face interviews or emails, survey were recorded and analyzed via Excel 2016 and SPSS 17.0.Results:The experts are members of the Standing Committee of the Cardiovascular Diseases Branch of the China Association of Chinese Medicine, and the number of experts in the two rounds was 30 and 33, respectively. Active coefficients of both rounds were 100%. The Cronbach’s Alpha of consultations in the first and second rounds were 0.896 and 0.885, respectively. There were 36 symptom items in the initial scales of TCM symptom scores. In the first round, 17 items were eliminated, and in the second round, 1 item was added, 5 items were eliminated. The 15 items scales includededobesity, dizziness, head weight such as wrapping, head faintness, mouth viscosity, phlegm, chest depression, chest and flank distension, abdominal distension, heavy numbness, fatigue and fatigue, body weight, depression, stagnant stool and sighing frequently. The items for symptom rating scale were suitable.Conclusion:The TCM symptom scores of qi depression and phlegm obstruction pattern can be used to evaluate the effect of TCM treatment for the patients with dyslipidemia and TCM pattern of qi depression with phlegm obstruction, and the studyprovides important guidance for TCM in the diagnosis and treatment of dyslipidemia. In addition, the enthusiasm and authority of experts, as well as its concentration, reliability and coordination, are all well considered in this study, and the results of this consultation are desirable.

In the theory of "opening-closing-pivoting"， the opening and closing pivot of a portal is used as a metaphor for the operating state of human qi and blood. Opening， closing and pivoting are well functioned together to maintain stable blood pressure， otherwise the imbalance of qi， blood， yin and yang in the body occurs when any of them is abnormal， thereby causing hypertension. During treatment， it is necessary to identify the impaired state of the three functions. If the "opening" is abnormal， it should be treated to restore qi’s function of external defense and distribution. If the "closing" is abnormal， it is necessary to regulate the deficiency and excess state of yang qi and restore the storage function. For "pivoting" disorder， it should be the key to regulate the circulation of qi and blood. Combined with clinical symptoms， the main treatment methods such as "sweat promotion"， "warming"， "clearing"， "purgation"， "supplementation" and "harmonization" are used to restore the function of the "opening-closing-pivoting"， making the blood and vessels of the body unblocked， and qi ascending and descending balanced， in order to achieve the effect of "moving pivot to facilitate opening and closing" and "opening and closing to transport pivot".

Based on the clinical thinking of combining diseases and patterns， we combined disease identification， pattern differentiation， and constitution identification， and put forward the theory of identifying and treating critical hypertension， which is "examining the symptoms first， identifying the constitutions as reference， and combining the diseases and patterns". Firstly， the starting point of identifying the disease is to examine the symptoms， and those with precise diagnosis and strong specificity will be diagnosed with the disease， while those with relatively broad diagnosis and fuzzy characteristics will be emphasised on identifying constitutions and differentiating patterns. Focusing on the impact of constitution identification on disease identification and pattern differentiation， constitution identification could be the basis when no symptoms to identify， and based on the theory of "constitution-disease correlation" and "constitution-pattern correlation" to improve the understanding of borderline hypertension from the group and individual level， which helps to identify and predict the development of the diseases and patterns； if the symptoms are complicated and difficult to identify， it is necessary to take syndrome as the outline， use the syndrome to unify the disease， and then refer to the constitution to legislate and prescribe medications. This paper summarizes the traditional Chinese medicine clinical differentiation and treatment strategy of borderline hypertension clear and easy to grasp， with a view to provide a feasible and efficient reference for prevention and treatment of borderline hypertension with traditional Chinese medicine.