Diagnosis, Differential ; Heart Failure ; diagnosis ; therapy ; Humans ; Medicine, Chinese Traditional

Data Collection ; methods ; Metabolomics ; methods

Objective To explore the TCM syndrome characteristics of cardiac syndrome X(CSX).Methods The signs and symptoms of 51 patients with CSX were analyzed according to the diagnosis of TCM syndromes to summarize their syndrome character- istics.Results of the 51 CSX cases,the following signs and symptoms took dominance:chest pain,fullness in chest,epigastric and abdominal distention,emotional distress,dark purple tongue with petechia,greasy coating,string-taut pulse.The syndromes were mainly of Biao-Superficial excess,including qi stagnation,phlegm retention and blood stasis,occupying 66. 7%,accompanied with Benroot deficiency,including qi deficiency,yin deficiency,qi and yin both deficiency,occupying 33.3%.Conclusion Qi stagnation, phlegm retention and blood stasis are the primary syndromes of CSX.

Objective To study the influence of HBV replication regulator,enhancer I and Pre- S2,on the immune response of HBV DNA vaccine.Methods DNA fragments of HBsAg,PreS2 HBsAg,HBsAg-enhancer I and PreS2-HBsAg-enhancer I region of HBV were amplified by PCR using the complete genome DNA of HBV adr subtype,and inserted into VR1012 vectors,respective- ly.The recombinant plasmids were transfected into HepG2 cells,and injected into Balb/C mice.The expression of HepG2 cells and the cellular and humoral immune response of mice were tested by cell immuno-chemistry,ELISA and ELISPOT.Results The target protein were expressed by transfected HepG2 cells,enhancer I and Pre-S2 can promote the expression of HBsAg in transfected cells.The HBsAb and the HBsAg specific CTL in inoculated mice were found in the second week after injection, PreS2 but not enhancer I can promote the immune response in inoculated mice.Conclusions When inserted into HBV DNA vaccine,enhancer I and PreS2 can promote the expression of HBsAg in transfected HepG2 cells,PreS2 can promote the immune response in inoculated Balb/C mice.

Objective To evaluate the effectiveness of treating depressive patients with somatic symptoms with combined TCM and western medicine.Methods 69 patients were randomly divided into 2 groups:a combined therapy group (treated with Yangyin-Qinggan decoction and paroxetine) and mono-therapy (treated with paroxetine alone as an active control),The depressive and somatic symptoms were assessed before (0 week),during (2 weeks and 4 weeks) and at the end point (8 weeks) of the treatment.Results ①Both therapies alleviated the depressive symptoms:HAMD assessed among patients receiving combined therapy are listed as:(0 week:19.29±2.38),(2 weeks:17.38 ± 2.37),(4 weeks:15.27 ± 2.15),(8 weeks:13.35 ± 2.09) ;combined therapy started to ease the depressive symptoms after 2 weeks of treatment (2 week compared with 0weeks),similar improvements could also be noticed after 4 weeks of treatment 4 weeks with 2 weeks:P＜0.05)and at the end of this research (after 8 weeks of treatment:8 weeks with 4 weeks:P＜0.05).HAMD for mono-therapy are as:(0 week:18.69±3.03),(2 weeks:16.63±3.09),(4 weeks:15.20±2.95),(8 weeks:14.60±2.72) ; mono-therapy started to alleviate the depressive symptoms also,after 2 weeks of treatment (2 weeks compared with 0 week:P＜0.05),yet only slight improvements could be seen after 4 weeks (4 weeks with 2 weeks:P＞0.05) and 8 weeks of the treatment (8 weeks with 4 weeks:P＞0.05).The combined therapy turned to be more effective in alleviating depressive symptoms at the end point of the treatment (P＜0.05).②In terms of improving the somatic symptoms,the Somatization Symptom Scale (SSS) among patients with combined therapy were as follows:(0 week:48.74±4.07),(2 weeks:46.74±4.16),(4 weeks:43.74±3.77),(8 weeks:41.18 ± 3.50) ; Combined therapy was witnessed to start to ease those symptoms after 2 weeks o f treatment (2week compared with 0 weeks,P＜0.05),similar patterns were found again,after 4 weeks (4 weeks with 2 weeks:P＜0.05) and 8 weeks of the treatment (8 weeks with 4 weeks:P＜0.05).Mono-therapy was found to ease the somatic symptoms in a less-effective way,yet no difference was found between any two SSS after 2 weeks,4weeks or 8 weeks of treatment (P＞0.05,respectively).Combined therapy was better at improving the somatic symptoms (P＜ 0.01).Conclusion Combined therapy proved to be more effective in both relieving depression and somatic symptoms.

OBJECTIVETo observe the effect of Yangxue Qingnao Granule (YQG) on the expression of CD11b in CA1 region of hippocampus of vascular dementia rats, and to explore its regulation on microglias.

METHODSTotally 144 SD rats were randomly divided into the sham-operation group, the vascular dementia model group (model), and the YQG treated group (treated). The vascular dementia rat model was prepared by modified Pulsinelli's four-vessel occlusion. Rats in the sham-operation group and the model group were administered with normal saline -(at the daily dose of 10 mL/kg) by gastrogavage, while those in the treated group were administered with YQG (0.32 g/mL, at the daily dose of 10 mL/kg) by gastrogavage. All administration was performed once per day for 8 successive weeks. The expression of CD11b in CA1 region of hippocampus of vascular dementia rats was detected at week 1, 2, 4, and 8, respectively.

RESULTSCompared with the sham-operation group, the expression of CD11b in CA1 region of hippocampus of vascular dementia rats were significantly enhanced in the model group at each time point (P < 0.01). Compared with the model group, the expression of CD11b in CA1 region of hippocampus of vascular dementia rats significantly decreased in the treated group at each time point (P < 0.01), especially at week 2.

CONCLUSIONObvious activation and proliferation of microglias could be seen in CA1 region of hippocampus of vascular dementia rats, and YQG could inhibit activation and proliferation of microglias.

Animals ; CA1 Region, Hippocampal ; drug effects ; metabolism ; CD11b Antigen ; metabolism ; Dementia, Vascular ; drug therapy ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Microglia ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the objective special features and role of various indexes of treadmill exercise test (TET) in patients of coronary heart disease (CHD) caused angina pectoris with Qi-Yin deficiency syndrome (QYD) with or without accompanied phlegm and blood stasis syndrome (PBS), to provide references for preventing and treating CHD in clinical practice.

METHODSOne hundred and one patients, whose diagnosis measured to the diagnostic standard and the inclusion criteria of angina pectoris and CHD, were classified according to their TCM syndrome type to two groups, the QYD without PBS group (49 cases) and the QYD with PBS group (52 cases). TET was conducted on all the patients. The relative parameters were measured and compared.

RESULTSAs compared with the QYD without PBS group, in the QYD with PBS group, (1) the TET positive rate was higher; (2) total exercise time was lesser; (3) the maximal metabolic equivalent (Max MET) was lower; (4) the average depression of ST segment at the exercise endpoint of test (mV) was higher; (5) the time of ST segment depressed for 0.1mV (min) was longer; (6) the metabolic equivalent during ST-segment depressed by 0.1mV was shorter; and (7) the change of QRS wave time-limit before and immediately after TET was more evident. Moreover, in the testing time more patients revealed angina episode after exercise, and less patients had their heart rate reached the requirement in the QYD with PBS group than those in the QYD without PBS group. Comparison between the two groups in all the above-mentioned indices showed significant difference respectively (P < 0.01 or P < 0.05).

CONCLUSIONPatients with CHD caused angina pectoris of QYD with PBS are worse in the tolerance for exercise and severer in pathological change of coronary artery than those in those without PBS, they belong to the severe phase of TCM syndrome.

Angina Pectoris ; physiopathology ; Coronary Artery Disease ; physiopathology ; Diagnosis, Differential ; Exercise Test ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Qi ; Yin Deficiency

Objective To investigate the effects of interaction between human umbilical vein endothelial cells (HUVECs) which were infected with dengue virus type 2 (DENV-2) and CD4+T cells on the expression of ICAM-1 (intercellular adhesion molecule 1),VCAM-1 (vascular cell adhesion molecule 1),IL-10 and TGF-β1 at mRNA level for further understanding the immunological mechanism of DENV infection.Methods HUVECs were treated with CYM-5442,a selective agonist for sphingosine-1-phosphate receptor 1 (S1P1),for 24 hours and then infected with 103 TCID50 (50% tissue culture infective dose) of DENV-2 before co-culturing with CD4+T cells.Changes in the expression of NS1 (DENV-2 nonstructural protein),SPHK1 (sphingosine kinase 1,phosphorylating sphingosine to S1P),ICAM-1,VCAM-1,IL-10 and TGF-β1 at mRNA level were detected by real-time PCR after 4,8,12,24,48 and 72 hours of co-culturing.Results There was a certain timeliness in the expression of NS1 at mRNA level after infecting HUVECs with DENV-2 and the expression reached a peak at 24 h.Treating HUVECs with or without CYM-5442 had no significant influence on the expression of DENV-2 NS1 at mRNA level.The expression of SPHK1 at mRNA level was significantly increased after treating HUVECs with CYM-5442 and DENV-2 (P<0.05).Compared with DENV-2-infected or untreated HUVECs,Co-culturing DENV-2-infected HUVECs with CD4+T cells increased the expression of ICAM-1 and VCAM-1 in HUVECs at mRNA level (P<0.01) as well as the expression of IL-10 in CD4+T cells at mRNA level (P<0.05),but had no significant influence on the expression of TGF-β1 in CD4+T cells at mRNA level.Conclusion This study shows that DENV-2 can replicate and proliferate in HUVECs,but CD4+T cells inhibit the replication and proliferation.CD4+T cells play an important role in promoting the expression of VCAM-1 and ICAM-1 in DENV-2-infected HUVECs at mRNA level,activating HUVECs and increasing inflammation,which may be associated with increased vascular permeability induced by DENV-2 infection.Co-culturing CD4+T cells with DENV-2-infected HUVECs promotes the expression of IL-10 in CD4+T cells at mRNA level,but has no significant effect on TGF-β1.

OBJECTIVETo analyze medication laws of Chinese medicine (CM) treatment in hypertension patients with yin deficiency yang hyperactivity syndrome.

METHODSChina National Knowledge Infrastructure (CNKI, Jan. 1979-Dec 2014), Chinese Scientific Journals Database (VIP, Jan 1989-Dec2014), Chinese Biomedical Literature Database (CBM, Jan.1978-Dec.2014), Wanfang Database (Jan 1990-Dec 2014) were retrieved by using "hypertension", "CM", "Chinese herbs", "syndrome" as keywords. Totally 149 literatures concerning CM treatment for hypertension patients with yin deficiency yanghyperactivity syndrome were included in this study. The herbs database was established by SPSS20.0,and correlation laws were analyzed by SAS9.3. With the Pajek3.1, results were presented visually withcomplex networks.

RESULTSThere were 149 literatures including 131 kinds of herbs with 1,598 frequencies. The conventional compatibility program of herbs for asthenic yin and predominant yang syndrome of hypertension were two toothed achyranthes root, tall gastrodia rhizome, Cassia obtusifolia L., eucommiabark, baikal skullcap root, and so on, about 29 kinds. Of them, core herbs were two toothed achyranthes root, tall gastrodia rhizome, Cassia obtusifolia L., poria, prepared rhizome of rehmannia, oriental water-plantain tuber, asiatic cornelian cherry fruit, Uncariae Rhynchophylla, common yam rhizome, the rootbark of the peony tree, and so on.

CONCLUSIONMedication laws of CM treatment in hypertension patientswith yin deficiency yang hyperactivity syndrome obtained by analysis of complex networks reflected thetherapeutics of nourishing yin to suppress yang, which could further provide reference for clinical studies.

Asian Continental Ancestry Group ; China ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; therapy ; Medicine, Chinese Traditional ; Yin Deficiency ; therapy ; Yin-Yang

OBJECTIVETo evaluate the reliability, validity, and responsiveness of traditional Chinese medicine (TCM) clinical outcomes rating scale for heart failure (HF) based on patients' report.

METHODSTCM clinical outcomes rating scale for HF (TCM-HF-PRO) were evaluated based on 340 HF patients' report from multiple centers. The completion of the investigation was recorded. Cronbach's α coefficient and split-half reliability were used for reliability analysis, and factor analysis was used to assess the construct validity of the rating scale. Pearson correlation analysis was then used for criterion validity analysis. Discriminant analysis was used to assess the responsiveness of the scale. All 340 HF patients having complete TCM-HF-PRO data were assigned to the treatment group and the control group by central randomization. The total TCM-HF-PRO scores of the two groups were compared using paired t-test to reflect the longitude responsiveness of the scale before treatment and at week 2 after treatment.

RESULTS(1) The recycling rate of the scale was 100.0%. One of them was not filled completely, which was rejected thereby. So the completion rate was 99.7%. The completion time for TCM-HF-PRO scale ranged 15 to 25 min. (2) The Cronbach's α coefficient of rating scale was 0.903, split-half reliability was 0.844 and 0.849. (3) Confirmatory factor analysis showed that 7 factors and items formed according to maximum load factor basically coincided with the construct of the rating scale, 7 factors accumulated contribution rate was 43.8%. TCM clinical outcomes rating scale for HF based on patients' report was relatively better correlated with the Minnesota living with HF questionnaire (r = 0.726, P < 0.01). (4) Discriminant analysis showed that the rating scale correctly classified more than 78.8% of case studies having confirmed initial differential diagnosis by experts. The total scale of the rating scale decreased more in the two group after treatment, with significant difference as compared with before treatment (P < 0.01.

CONCLUSIONTCM clinical outcomes rating scale for HF based on patients' report had good reliability, validity and responsiveness, hence it could be used to assess clinical efficacy for HF patients.

Diagnosis, Differential ; Discriminant Analysis ; Factor Analysis, Statistical ; Heart Failure ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods ; standards ; Reproducibility of Results ; Surveys and Questionnaires