Objective To investigate the effect of Shanzha Xiaozhi Capsules (SXC) on body weight, metabolic indexes, body fat accumulation and distribution of obesity patients with phlegm-dampness constitution. Methods Fifty obesity patients with phlegm-dampness constitution were randomized into control group and medicine group, 25 cases in each group. The control group was given lifestyle instructions for diet and exercises, and the medicine group was treated with SXC orally besides the instructions for lifestyle. The treatment for both groups covered 12 weeks. Before and after treatment, we observed the outcomes including scores of phlegm-dampness, body weight, waist circumference, hip circumference, blood pressure, fasting blood glucose, serum lipid profile, urine acid, body fat accumulation and distribution, and visceral fat accumulation. Results(1) The scores of phlegm-dampness were decreased significantly in both groups after treatment (P<0.05 or P<0.01), and the decrease was obvious in the medicine group(P<0.01).(2) Body weight and BMI were decreased significantly in both groups after treatment(P<0.01), and the decrease was obvious in the medicine group(P<0.05). Waist circumference was decreased significantly in the medicine group(P <0.05) but stayed unchanged in the control group(P>0.05). Hip circumference was decreased significantly in both groups(P <0.05 or P<0.01) , but the difference between the two groups was insignificant(P>0.05).(3) Systolic pressure and diastolic pressure were decreased significantly in both groups (P<0.01). But the difference of blood pressure decrease between the two groups was insignificant(P > 0.05).(4) Fasting blood glucose, 2-hour blood glucose after oral glucose tolerance test, serum lipid profile and urine acid remained unchanged in both groups after treatment (P>0.05). (5) The general body fat accumulation of both groups was decreased significantly after treatment (P <0.05 or P<0.01), and the decrease was obvious in the medicine group(P<0.01). Body fat accumulation in legs, trunk and gynoid region were decreased significantly in both groups after treatment(P<0.05 or P<0.01), but the difference of fat accumulation decrease between the two groups was insignificant(P>0.05). Waist fat accumulation had no significant decrease in the control group (P > 0 . 05), but was decreased in the medicine group (P<0.01). Visceral fat accumulation was decreased significantly in both groups after treatment(P<0.01), and the decrease was obvious in the medicine group (P<0.01). Conclusion In addition to its contribution to body weight loss, SXC also contribute to the reduction of visceral fat accumulation in obesity patients with phlegm-dampness constitution .

Objective To investigate the effects of Shanzha Xiaozhi capsule on body weight, metabolic index, percentage and distribution of body fat in obese patients with dampness-heat constitution. Methods A total of 60 obesity patients with dampness-heat constitution were enrolled in this study and randomly categorized into the control group ( n=30) and treatment group (n=30). Control group was given the diet and exercise regime, and treatment group was given Shanzha Xiaozhi capsule based on the same diet and exercise regime for 12 weeks. Scores of dampness-heat, body weight, waist circumference, hip circumference, blood pressure, blood glucose, serum lipid profile, urine acid (UA), fasting plasma insulin, serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, adiponectin, lipopolysaccharide (LPS), percentage and distribution of body fat were measured before and after treatment. Results (1) Data of scores of dampness-heat and diastolic blood pressure were significantly decreased after treatment in drug group. The above indexes and hip circumference were significantly decreased after the treatment in treatment group compared with those of control group ( P<0.05). (2) The triglyceride (TG), UA, insulin, HOMA-IR, LPS and IL-1βwere significantly decreased after the treatment in treatment group than those of control group, while there were no significant differences in fast blood glucose (FBG), 2 h postprandial plasma glucose (2 hPG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), TNF-α, IL-6 and adiponectin between two groups. (3) The percentage of visceral fat was significantly decreased in treatment group than that of control group. There were no significant differences in fat changes of limbs and buttocks between two groups. Conclusion Shanzha Xiaozhi capsule can decrease body weight and visceral fat content, reduce insulin resistance, and improve chronic inflammation state in obese patients with dampness- heat constitution.

Objective To compare the diagnostic value of ultrasound,thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg),and their combination in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma(PTC).Methods The clini-cal data of 130 patients(144 lymph nodes in total)with PTC in Tangshan Gongren Hospital from January 2017 to March 2023 were retro-spectively analyzed.Patients were divided into metastatic and non-metastatic groups according to the pathological findings of the cervical lymph nodes.The ultrasonic characteristics,serum Tg,and eluate Tg levels were compared between the two groups.The diagnostic efficacy of ultrasound,FNA-Tg,and the combination for cervical lymph node metastasis was assessed using the receiver operating characteristic(ROC)curve.Results Among 144 cervical lymph nodes,64 comprised the metastatic group and 80 comprised the non-metastatic group.Compared with the non-metastatic group,the lymph nodes in the metastatic group had indistinct cortical-medullary demarcation,uneven echogenicity,cystic changes,microcalcifications,and abnormal blood flow,and the differences were statistically significant(all P＜0.05);however,there was no statistically significant difference between the two groups in transverse to longitudinal ratios and whether the margins were clear(all P＞0.05).Serum Tg in the metastatic and non-metastatic groups was 19.5(1.9-70.7)ng/mL and 20.4(8.9-38.3)ng/mL,respectively,and the difference between the two groups was not statistically significant(P＞0.05);eluate Tg in the metastatic and non-metastatic groups was 500.0(49.4-500.0)ng/mL and 2.4(0.6-6.5)ng/mL,and the difference between the two groups was statisti-cally significant(P＜0.05),with an optimal FNA-Tg critical value of 11.7 ng/mL.FNA-Tg diagnosed cervical lymph node metastasis with the highest specificity,accuracy,and positive predictive value,whereas the combination of ultrasound and FNA-Tg diagnosed cervical lymph node metastasis with the highest sensitivity and negative predictive value.Conclusion Ultrasound manifestations of PTC cer-vical meta-static lymph nodes include poorly demarcated corticomedullary stroma,uneven echogenicity accompanied by cystic changes,microcalcifications,and abnormal blood flow and have high diagnostic efficacy for PTC metastatic lymph nodes.When PTC cervical lymph node abnormalities are suspected on ultrasound,further FNA-Tg should be performed.The combination of ultrasound with FNA-Tg could improve the diagnostic efficacy of PTC cervical lymph node metastasis.

BACKGROUND:Internal heat-type acupuncture therapy is a new treatment technique that combines acupuncture therapy with hyperthermia.It has good clinical effects on steroid-induced osteonecrosis of the femoral head,but the mechanism of action is still not fully clear. OBJECTIVE:To explore the possible mechanism of internal heat-type acupuncture therapy in treating steroid-induced osteonecrosis of the femoral head in rabbits. METHODS:Thirty-two New Zealand rabbits were randomly divided into blank group,model group,internal heat-type acupuncture group and shock wave group using a random number table method,with 8 rabbits in each group.The model group,internal heat-type acupuncture group and shock wave group were modeled using methylprednisolone sodium succinate combined with Escherichia coli endotoxin.The internal heat-type acupuncture group received an internal heat-type acupuncture intervention on the buttocks of rabbits,once a week,for 20 minutes each time.The shock wave group received shock wave intervention on the buttocks of rabbits,once a week,with 2 000 beats per session.The blank group and model group were not given any treatment.After 4 weeks of intervention,blood samples and bilateral femoral head samples were collected from experimental rabbits.The levels of tumor necrosis factor-α and interleukin-6 in serum were detected by ELISA;the histomorphology of the femoral head was observed using hematoxylin-eosin staining and the rate of empty lacunae was calculated;the protein expressions of matrix metalloproteinase 2,matrix metalloproteinase 9,matrix metalloproteinase tissue inhibitor 1,and matrix metalloproteinase tissue inhibitor 2 were detected by immunohistochemistry and western blot. RESULTS AND CONCLUSION:Compared with the blank group,the model rabbits showed reduced food intake,mental fatigue,and decreased activity;compared with the model group,the above performance of the experimental rabbits was significantly improved after internal heat-type acupuncture and shock wave treatment.Compared with the blank group,the histomorphology of the femoral head in the model group deteriorated significantly and the rate of empty bone lacuna increased(P<0.001),while the histomorphology of the femoral head in the internal heat-type acupuncture group and shock wave group was significantly improved compared with the model group,and the rate of empty bone lacuna was reduced(P<0.001).The serum levels of tumor necrosis factor-α and interleukin-6 in the model group were significantly higher than those in the blank group(P<0.05),while the serum levels of tumor necrosis factor-α and interleukin-6 in the internal heat-type acupuncture group and the shock wave group were significantly lower than those in the model group(P<0.05).Compared with the blank group,the expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in the femoral head of the model group were significantly increased,while the expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly decreased(P<0.001);compared with the model group,the protein expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 were significantly decreased,while the protein expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly increased in the internal heat-type acupuncture group and the shock wave group(P<0.001).Overall,these findings indicate that internal heat-type acupuncture may promote the repair of the necrotic femoral head by regulating the levels of matrix metalloproteinases/matrix metalloproteinase tissue inhibitors and serum inflammatory factors,thus treating early steroid-induced osteonecrosis of the femoral head.