Objective To explore the characteristics of Xin'an doctors in the syndrome differentiation and treatment of liver cirrhosis from the dimensions of symptoms,syndromes and medication using data mining methods.Methods Medical cases and prescriptions for liver cirrhosis were collected from Xin'an medical literature.Data mining was performed using frequency analysis,complex network analysis,Louvain clustering analysis and factor analysis to investigate syndromes,symptoms,and medicines.Results A total of 363 prescriptions were analyzed,involving 15 syndromes and 325 kinds of Chinese materia medica,with 33 identified as core medications.Tonifying herbs were the most frequently used;the primary syndromes were liver qi stagnation and water retention;core symptoms of liver qi stagnation included emotional distress,reduced appetite and hypochondriac pain,with core medications such as Bupleuri Radix and Poria;core symptoms of water retention included lower limb edema and abdominal distension,with core medications such as Pinelliae Rhizoma,Citri Reticulatae Pericarpium,Magnoliae Officinalis Cortex and Poria.Factor analysis of core medications identified 12 common factors.Conclusion The pathogenesis of liver cirrhosis involves deficiency in nature and excess in superficiality,primarily affecting the liver and closely related to the spleen and kidneys.Xin'an doctors emphasize treating the symptoms with qi-regulating,blood-activating,dampness-drying and heat-clearing strategies,while simultaneously addressing the root with qi-tonifying,spleen-strengthening,liver-nourishing and kidney-replenishing therapies.

Objective To explore the characteristics of Xin'an doctors in the syndrome differentiation and treatment of liver cirrhosis from the dimensions of symptoms,syndromes and medication using data mining methods.Methods Medical cases and prescriptions for liver cirrhosis were collected from Xin'an medical literature.Data mining was performed using frequency analysis,complex network analysis,Louvain clustering analysis and factor analysis to investigate syndromes,symptoms,and medicines.Results A total of 363 prescriptions were analyzed,involving 15 syndromes and 325 kinds of Chinese materia medica,with 33 identified as core medications.Tonifying herbs were the most frequently used;the primary syndromes were liver qi stagnation and water retention;core symptoms of liver qi stagnation included emotional distress,reduced appetite and hypochondriac pain,with core medications such as Bupleuri Radix and Poria;core symptoms of water retention included lower limb edema and abdominal distension,with core medications such as Pinelliae Rhizoma,Citri Reticulatae Pericarpium,Magnoliae Officinalis Cortex and Poria.Factor analysis of core medications identified 12 common factors.Conclusion The pathogenesis of liver cirrhosis involves deficiency in nature and excess in superficiality,primarily affecting the liver and closely related to the spleen and kidneys.Xin'an doctors emphasize treating the symptoms with qi-regulating,blood-activating,dampness-drying and heat-clearing strategies,while simultaneously addressing the root with qi-tonifying,spleen-strengthening,liver-nourishing and kidney-replenishing therapies.

Objective To investigate the characteristics and outcome of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in patients with renal injury. Methods AAV patients with renal injury diagnosed in the Department of Nephrology, Renmin Hospital of Wuhan University, from January 2012 to January 2017 were included into this study. Patients were divided into MPO-ANCA positive and PR3-ANCA positive groups for further study. The clinical characteristics, pathological and laboratory indexes, treatment and prognosis were retrospectively analyzed. Results A total of 68 cases were enrolled, among which 52 cases (76.5%) were MPO-ANCA positive and 16 cases (23.5%) were PR3-ANCA positive, and 41 patients (60.3%) were over 65 years old. The incidences of interstitial lung disease, digestive and nervous system damage in PR3-ANCA positive group were significantly higher than those MPO - ANCA positive group (P<0.05). There were significant differences of hemoglobin, complement C3, complement C1q, IgE, 24 h urinary protein,erythrocyte sedimentation rate, procalcitonin, BVAS score and eGFR in two groups (P<0.05). 19 cases had done renal biopsy ,among them 14 cases were MPO-ANCA positive and 5 cases were PR3-ANCA positive. Incidence of crescentic necrotizing glomerulonephritis in PR3-ANCA positive group was significantly higher than that in MPO - ANCA positive group, and incidence of diffuse global glomerulosclerosis in MPO-ANCA positive group was significantly higher than that in PR3-ANCA positive group (all P<0.05). At the median follow-up time of 32 months, the relapse rate at 6 month of MPO-ANCA-positive and PR3-ANCA-positive patients were 46.2% and 75.0%, respectively (P<0.05). Multivariate logistic regression analysis showed that PR3-ANCA positive, age≥65 years old, baseline eGFR<30 ml·min-1·(1.73 m2)-1, and combined with pulmonary interstitial lesions were all independent risk factors for relapse. And the incidence of ESRD were 42.3%and 75.0%during the follow-up period and 10 patients (14.7%) died. COX regression analysis showed that patients older than 65 years old, BVAS score≥18 points, eGFR<30 ml·min-1·(1.73 m2)-1 and complicated with pulmonary interstitial disorders at the onset were independent risk factors causing ESRD or death. Conclusion The PR3-ANCA-positive patients had more severe renal injury than those with MPO-ANCA-positive patients, and the injury of extrarenal organs was more serious, recurrence rate was higher, and the prognosis was worse.

Objective: To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in patients with posthepatitic cirrhosis by analyzing the relationships between signs and symptoms and biochemical parameters. Methods: A total of 440 patients with hepatitis B cirrhosis treated in Shanghai Public Health Center and Shuguang Hospital, Longhua Hospital and Central Hospital of Putuo District Affiliated to Shanghai University of Traditional Chinese Medicine during January 2002 to January 2006 were enrolled in this study. Signs and symptoms and biochemical information of patients were collected by using a self-designed questionnaire regarding the four examinations of TCM. Signs and symptoms were firstly analyzed to find the frequency of occurrence. Then, the patients were divided into two groups according to non-existent or existent sign and symptom and the correlations between the signs and symptoms which occurred most frequently and their biochemical parameters were analyzed. Results: Sixteen symptoms which occurred most frequently were fatigue, colored urine, liver palms, opaque complexion, string-like pulse, weakness at waist and knees, dry month and bitter taste in the mouth, profuse dreaminess and poor sleepiness, heaviness of limbs, abdominal distention, yellow eyes, fine pulse, impetuosity and susceptibility to rage, splenomegaly, poor appetite, and distension and fullness in the chest and hypochondrium. A previous study on syndrome differentiation of 900 patients with posthepatitic cirrhosis showed 4 syndrome patterns: internal accumulation of dampness-heat, liver-kidney yin deficiency, internal accumulation of blood stasis-heat, and liver depression and spleen deficiency. Further analysis showed that internal accumulation of dampness-heat syndrome was characterized by obvious hepatic inflammation, poor synthesis function and more asctites. Liver-kidney yin deficiency syndrome was characterized by low-level hepatic inflammation, poor synthesis function and more ascites. Internal accumulation of blood stasis-heat syndrome was characterized by low-level hepatic inflammation, poorer synthesis function, ascites and splenomegalia, and liver depression and spleen deficiency syndrome was characterized by slight hepatic inflammation, synthesis function injury, decreased internal portal vein diameter and less ascites. Conclusion: Different syndrome patterns have different pathological features, showing the complexity and polymorphism of syndrome construction.

OBJECTIVE: To investigate the effects of Fuzheng Huayu Recipe on renal interstitial fibrosis in rats induced by the toxic substances. METHODS: Forty Wistar rats were divided into 3 groups, including the normal group, model control and Fuzheng Huayu Recipe treated group. The renal fibrotic model was induced with intraperitoneal injection of dimethylnitrosamine (DMN) for 4 weeks and oral administration of food containing heavy metals such as Hg, etc for 8 weeks. From the 5th week, the rats were orally administered Fuzheng Huayu Recipe for 4 weeks. The renal tissue was stained with HE and periodic acid-silver metheramine, respectively. The serum creatinine and urea nitrogen were assayed with the kits, and the renal hydroxyproline (Hyp) contents in the homogenate of kidney tissue were measured with HCl hydrolysis. RESULTS: In the model group, the renal tubule was swollen, and the tubular epithelial cells were degenerated, necrosed and detached, with the infiltration of inflammatory cells; the tubular interstitium was expanded, characterized with the deposition of large collagens; the tubular basement membrane became thicker and wrinkled; and the renal Hyp content and serum creatinine and urea nitrogen levels increased remarkably as compared to the normal group. After the treatment with Fuzheng Huayu Recipe, the renal tubular inflammation and interstitial collagen deposition were alleviated, and the serum creatinine and urea nitrogen levels decreased significantly as compared to the model group. CONCLUSION: Administration of DMN and heavy metals can induce the renal interstitial fibrosis and impair the renal function. Fuzheng Huayu Recipe can improve the impaired renal functions and reverse the renal interstitial fibrosis.