Based on the theory of the liver's"using bitter herbs to nourish or purge"from Huangdi Neijing,this paper systematically elucidates the theoretical foundation for treating functional constipation from liver.Focusing on the physiological characteristic of"liver desires to disperse"and the pathological manifestation of"liver bitterness and urgency,"combined with the"liver communicates with the large intestine"theory,this paper establishes a diagnostic and therapeutic framework for managing functional constipation by regulating liver function.The pathological evolution of functional constipation manifests in three distinct stages:in the early stage,liver qi stagnation leads to large intestine qi obstruction,where damaged by an excess of seven emotions resulting in symptoms such as difficult defecation,abdominal bloating,and hypochondriac pain;in the middle stage,liver depression transforms into fire,scorching bodily fluids to generate dryness,thereby creating a pathological interplay of stagnation,fire,and dryness,which is marked by anal heat,dry mouth,and yellow urine;in the late stage,yin deficiency in liver and kidney causes large intestine malnutrition,resulting in a complex pathological state where yin deficiency,collateral blockage,dryness accumulation,and blood stasis intertwine,clinically manifesting as pellet-like stools(resembling sheep feces)and soreness and weakness of the waist and knees.In treatment,the formula design follows the principle of"sweetness to relieve,acridity to tonify,and sourness to purge,"with treatment principles varying across stages.In the early stage,the focus is on dispersing liver and regulating qi,and unblocking the zang-fu viscera;in the middle stage,the priority shifts to clearing heat-fire,nourishing large intestine,and promoting fluid production;whereas,in the late stage,the emphasis lies on nourishing yin,unblocking collaterals,and promoting blood circulation.This staged treatment of functional constipation overcomes the limitations of solely focusing on nourishing large intestine and facilitating feces excretion,thereby advancing the treatment of different stages based on syndrome differentiation and personalized treatment.It provides theoretical support for improving patients' intestinal function and enhancing overall health outcomes.

Based on the theory of the liver's"using bitter herbs to nourish or purge"from Huangdi Neijing,this paper systematically elucidates the theoretical foundation for treating functional constipation from liver.Focusing on the physiological characteristic of"liver desires to disperse"and the pathological manifestation of"liver bitterness and urgency,"combined with the"liver communicates with the large intestine"theory,this paper establishes a diagnostic and therapeutic framework for managing functional constipation by regulating liver function.The pathological evolution of functional constipation manifests in three distinct stages:in the early stage,liver qi stagnation leads to large intestine qi obstruction,where damaged by an excess of seven emotions resulting in symptoms such as difficult defecation,abdominal bloating,and hypochondriac pain;in the middle stage,liver depression transforms into fire,scorching bodily fluids to generate dryness,thereby creating a pathological interplay of stagnation,fire,and dryness,which is marked by anal heat,dry mouth,and yellow urine;in the late stage,yin deficiency in liver and kidney causes large intestine malnutrition,resulting in a complex pathological state where yin deficiency,collateral blockage,dryness accumulation,and blood stasis intertwine,clinically manifesting as pellet-like stools(resembling sheep feces)and soreness and weakness of the waist and knees.In treatment,the formula design follows the principle of"sweetness to relieve,acridity to tonify,and sourness to purge,"with treatment principles varying across stages.In the early stage,the focus is on dispersing liver and regulating qi,and unblocking the zang-fu viscera;in the middle stage,the priority shifts to clearing heat-fire,nourishing large intestine,and promoting fluid production;whereas,in the late stage,the emphasis lies on nourishing yin,unblocking collaterals,and promoting blood circulation.This staged treatment of functional constipation overcomes the limitations of solely focusing on nourishing large intestine and facilitating feces excretion,thereby advancing the treatment of different stages based on syndrome differentiation and personalized treatment.It provides theoretical support for improving patients' intestinal function and enhancing overall health outcomes.

Objective:To investigate the correlation between the clinical features and endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) in patients with cirrhosis.Methods:A total of 148 patients with cirrhosis and portal hypertension who underwent EUS-PPG measurement at the Third Xiangya Hospital of Central South University from March 15, 2022 to June 20, 2023 were selected. The clinical data of patients collected before EUS-PPG measurement were analyzed. Variations in the EUS-PPG across different clinical data subgroups were analyzed. Multivariate linear regression analysis was used to explore the independent factors influencing EUS-PPG.Results:The EUS-PPG was significantly elevated in patients exhibiting red signs (16.62±5.33 mmHg VS 13.44±5.34 mmHg, t=3.616, P<0.001), gastroesophageal varices (15.78±5.30 mmHg VS 9.70±4.77 mmHg, t=4.247, P<0.001), hepatic encephalopathy (20.83±7.52 mmHg VS 14.92±5.35 mmHg, t=2.606, P=0.010), thrombocytopenia (15.66±5.39 mmHg VS 13.29±5.83 mmHg, t=2.136, P=0.034), hypoproteinemia (16.13±5.86 mmHg VS 14.12±5.03 mmHg, t=2.230, P=0.027), and an increased international normalized ratio (16.25±6.00 mmHg VS 14.40±5.11 mmHg, t=2.022, P=0.045). Conversely, the EUS-PPG was significantly reduced in patients with a history of splenectomy and devascularization (13.17±5.88 mmHg VS 15.73±5.34 mmHg, t=-2.379, P=0.019). The EUS-PPG in patients with varying degrees of ascites (no VS slight VS moderate or severe: 13.40±5.48 mmHg VS 15.90±5.49 mmHg VS 16.69±5.17 mmHg, F=5.188, P=0.007) and different Child-Pugh classifications (A VS B VS C: 14.07±5.05 mmHg VS 15.69±5.74 mmHg VS 17.64±5.99 mmHg, F=3.066, P=0.049) increased gradually. Multivariable linear regression analysis showed that red signs ( β=2.44, t=2.732, P=0.007), gastroesophageal varices ( β=4.45, t=2.990, P=0.003), ascites ( β=1.75, t=2.368, P=0.019), and hepatic encephalopathy ( β=5.82, t=2.644, P=0.009) were independent factors for the elevated EUS-PPG. Conclusion:There is a significant correlation between EUS-PPG and the clinical features related to the severity of cirrhotic portal hypertension, which indicates the feasibility of EUS-PPG in evaluating cirrhotic portal hypertension.

Objective:To investigate the diagnostic value of multi-slice spiral CT(MSCT)perfusion imaging parameters in the differential diagnosis of benign and malignant solitary pulmonary nodules(SPN).Methods:A total of 80 patients with SPN admitted to our hospital from Oct 2021 to Oct 2022 were selected.All patients underwent MSCT perfusion imaging and pathological examination after admission.According to the histopathological examination results,the patients were divided into benign nodule group and malignant nodule group.MSCT perfusion imaging parameters(blood volume,mean transit time,blood flow,surface permeability coefficient)of the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the value of MSCT perfusion imaging parameters in the differential diagnosis of benign and malignant SPN.Results:Among the 80 patients with SPN,47 were diagnosed as malignant nodules and 33 as benign nodules by pathological examination.There was no significant difference in mean transit time between 2 groups(P＞0.05).The blood volume,blood flow and surface permeability coefficient in malignant nodule group were higher than those of benign nodule group(P＜0.05).The results of ROC curve showed that the area under the curve(AUC)of blood volume,blood flow and surface permeability coefficient separately and in combination were 0.823(95% CI:0.721-0.926),0.855(95% CI:0.761-0.949),0.850(95% CI:0.752-0.948)and 0.963(95% CI:0.924-1.000)for the diagnosis of benign and malignant SPN,all of which had certain diagnostic value.When blood volume,blood flow and surface permeability coefficient were 4.405 ml/100 g,51.325 ml/(min·100 g)and 21.115 ml/(min·100 g),respectively,the best diagnostic efficiency could be obtained,and the combined diagnosis value was higher.Conclusion:The combination of blood volume,blood flow and surface permeability coefficient of MSCT perfusion imaging parameters have high value in the differential diagnosis of benign and malignant SPN,which can provide effective basis for the early diagnosis and treatment of benign and malignant SPN.

Echinostoma revolutum is a zoonotic food-borne intestinal trematode that can cause intestinal bleeding, enteritis, and diarrhea in human and birds. To identify a suspected E. revolutum trematode from a red-crowned crane (Grus japonensis) and to reveal the genetic characteristics of its mitochondrial (mt) genome, the internal transcribed spacer (ITS) and complete mt genome sequence of this trematode were amplified. The results identified the trematode as E. revolutum. Its entire mt genome sequence was 15,714 bp in length, including 12 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes and one non-coding region (NCR), with 61.73% A+T base content and a significant AT preference. The length of the 22 tRNA genes ranged from 59 bp to 70 bp, and their secondary structure showed the typical cloverleaf and D-loop structure. The length of the large subunit of rRNA (rrnL) and the small subunit of rRNA (rrnS) gene was 1,011 bp and 742 bp, respectively. Phylogenetic trees showed that E. revolutum and E. miyagawai clustered together, belonging to Echinostomatidae with Hypoderaeum conoideum. This study may enrich the mitochondrial gene database of Echinostoma trematodes and provide valuable data for studying the molecular identification and phylogeny of some digenean trematodes.

Melting temperature shift (T(m)-shift) is a new detection method that analyze the melting curve on real-time PCR thermocycler using SYBR Green I fluorescent dye. To establish a T(m)-shift method for the detection of Ancylostoma ceylanicum and A. tubaeforme in cats, specific primers, with GC tail of unequal length attached to their 5′ end, were designed based on 2 SNP loci (ITS101 and ITS296) of the internal transcribed spacer 1 (ITS1) sequences. The standard curve of T(m)-shift was established using the standard plasmids of A. ceylanicum (AceP) and A. tubaeforme (AtuP). The T(m)-shift method stability, sensitivity, and accuracy were tested with reference to the standard curve, and clinical fecal samples were also examined. The results demonstrated that the 2 sets of primers based on the 2 SNPs could accurately distinguish between A. ceylanicum and A. tubaeforme. The coefficient of variation (CV) of T(m)-values of AceP and AtuP was 0.07% and 0.06% in ITS101 and was 0.06% and 0.08% in ITS296, respectively. The minimum detectable DNA concentration was 5.22×10⁻⁶ and 5.28×10⁻⁶ ng/μl samples of AceP and AtuP, respectively. The accuracy of T(m)-shift method reached 100% based on examination of 10 hookworm DNA samples with known species. In the clinical detection of hookworm in 69 stray cat fecal sample, the T(m)-shift detection results were consistent with the microscopic examination and successfully differentiated between the 2-hookworm species. In conclusion, the developed method is a rapid, sensitive and accurate technique and can provide a promising tool for clinical detection and epidemiological investigation of cat-derived hookworms.
Ancylostoma ; Ancylostomatoidea ; Animals ; Cats ; DNA ; Freezing ; Methods ; Plasmids ; Polymorphism, Single Nucleotide ; Real-Time Polymerase Chain Reaction ; Tail

In this study, the leukemia K562 cell line was used as a model to elucidate the anticancer effects and preliminary mechanisms of PAMs. MTT assay showed that PAMs could cause cytotoxicities in K562 cells in dose- and time-dependent manners. AO-EB, Annexin-FITC/PI staining showed that the killing effects of PAMs in K562 cells were related to apoptosis, which was further confirmed by the following molecular and enzymatic assay. The mRNA levels of pro-apoptotic genes caspase-3, caspase-9 and bax were remarkably increased while the anti-apoptotic gene bcl-2 was significantly decreased determined by fluorescent quantitative PCR. Western blotting disclosed that PAMs could up-regulate caspase-3 and down-regulate anti-apoptotic survivin protein expression. The latter was also consistent with the results that PAMs could increase the enzymatic activities of both caspase-3 and caspase-9. All these results suggested that PAMs could effectively inhibit the proliferation of K562 cells and the mechanisms may be closely related to apoptosis induction. The work provides evidence basis for PAMs to be potentially developed as anti-cancer leukemia Chinese medicine.

To evaluate the prevalence of impaired fasting glucose(TFG)in outpatients with essential hypertension and the influencing factors.Methods 1026 essential hypertensive outpatients aged 15-87 years[531 males and 495 females,mean age(51.6±12.5)years]who visited Xuanwu hospital between February 2004 and January 2007 were recruited in the study.Their medical history,blood pressure,height,weight,waist ircumferences(WC),hip circumference(HC),fasting plasma glucose(FPG),TC,TG,LDL-C,HDL-C were detected and analyzed.Results The abnormal rate of FPG in hypertensive outpatients was 38.5% and incidence of IFG was 30.5%.The differences of gender,systolic blood pressure,BMI,waist-to-hip ratio(WHR),TG,TC between the normal glucose group and the IFG group were significant Gender,family history of diabetes mellitus,TC and LDL-C enter into the logistic regression model(P<0.05).Conclusions The detection rate of IFG is high in hypertensive outpatients and it is related with gender,family history of diabetes mellitus and disorders of lipid metabolism.

Objective: Accumulating evidence shows that hypertension is a chronic low-grade inflammatory disease,and inflammatory reaction is involved in the formation and progress of target-organ damage in hypertension.The authors aimed to explore the changes in the serum levels of interleukin-6(IL-6),soluble CD40 ligand(sCD40L),metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),lipid profile and left ventricular structure in patients with essential hypertension.Methods: The serum levels of IL-6,sCD40L,MMP-9 and TIMP-1,along with blood lipids were determined and echocardiography was performed to evaluate the cardiac structure and function of 158 hypertension patients and 22 age-and sex-matched controls.Results: The hypertension patients exhibited higher levels of IL-6(P

Objective:To detect the distribution of the receptor for advanced glycation end products(RAGE) in gingival tissues of patients with non-insulin dependent diabetes mellitus(NIDDM) accompanying periodontitis.Methods:5 patients with chronic periodontitits(CP) and 4 patients with NIDDM accompanying periodontitis were included. Immunohistochemical staining was performed to detect RAGE and tumor necrosis factor ?(TNF-?) expression in gingival tissues.Interleukin 6(IL-6) and TNF-? levels in gingival crevicular fluid and serum of these patients were examined by ELISA.Results:More RAGE cells were observed in the gingival tissus in the patients of NIDDM with CP than in those of CP(P0.05).Conclusion:RAGE may play a role in the destruction of periodontal tissues in NIDDM patients with CP.