1.Study on the Characteristics of Traditional Chinese Medicine Syndrome and Syndrome Elements of Hypothyroidism Induced by Immunotherapy in Patients with Advanced Non-Small Cell Lung Cancer
Wenjing ZHANG ; Zhanpeng LIANG ; Ao ZHANG ; Ting CHEN ; Huatang ZHANG ; Cantu FANG ; Luzhen LI
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(2):283-292
Objective To explore the characteristics of traditional Chinese medicine(TCM)syndrome,syndrome elements and their combination,and the distribution of TCM syndrome types in advanced non-small cell lung cancer(NSCLC)patients suffering from hypothyroidism after treatment with immune checkpoint inhibitors(ICIs).Methods The analysis was conducted on 168 patients with NSCLC at stage ⅢB-ⅣB confirmed by pathological findings,whose epidermal growth factor receptor/anaplastic lymphoma kinase(EGFR/ALK)was negative,and then suffering from hypothyroidism after treatment with ICIs from January 2020 to June 2023,who admitted to Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine.The patients'information collected by four diagnostic methods of TCM was analyzed,and then cluster analysis was used to explore the characteristics of TCM syndrome and the distribution of TCM syndrome types of immunotherapy-induced hypothyroidism in advanced NSCLC.Moreover,the distribution of TCM syndrome types in the patients with different genders,age groups,and hypothyroidism grades was analyzed.Results(1)The TCM syndrome of hypothyroidism appearing in 168 patients with advanced NSCLC after immunotherapy was characterized by deficiency type,which manifested as follows:cough,fatigue and weakness,amnesia,lusterless complexion,spontaneous sweating,dry skin,white sputum,unwilling to talk,dizziness,nocturnal polyuria,blurred vision,emaciation,poor skin elasticity,poor appetite or even anorexia,somnolence,long-term poor appetite,edema,insomnia,low voice,dull pain,light white color of fingernails,spitting,frequently intolerance of cold,thirst,bright pale complexion,preference of warmth and aversion to cold,thirst with preference of hot drink,dyspnea,frequent constipation,dry stools,puffiness of face and eyelid,dreaminess,abdominal fullness,lumbar pain,and weakness in defecation.The tongue manifestation and pulse condition were characterized by white and thin coating,pale-red tongue,tongue with tooth-marks,pale and enlarged tongue,pale tongue,deep pulse,slippery pulse,feeble pulse,weak cubital pulse,and thready pulse.(2)The disease-location syndrome elements usually involved in the lung,spleen,and kidney,and the disease-nature syndrome elements usually involved in qi deficiency,yang deficiency,blood deficiency,and water retention.(3)The cluster analysis yielded three syndrome types,and they were lung and spleen qi deficiency syndrome,kidney yang deficiency syndrome,and qi deficiency and water retention syndrome in decreasing sequence of occurrence frequency.(4)Statistically significant difference of the distribution of TCM syndrome types was presented in the patients with various age groups(P<0.01).Lung and spleen qi deficiency syndrome was the main syndrome type in the patients aged 60-69 years old,kidney yang deficiency syndrome was frequently seen in the patients being or over 70 years old,and qi deficiency and water retention syndrome was frequently seen in the patients less than 50 years old.No statistically significant difference of the distribution of TCM syndrome types was presented in the patients with various genders and in the patients with various grades of hypothyroidism(P>0.05).Conclusion The immunotherapy-induced hypothyroidism in patients with advanced NSCLC is usually differentiated as the TCM syndrome types of lung-qi and spleen-qi deficiency,kidney yang deficiency,and qi deficiency and water retention.Deficiency of healthy qi contributes to the fundamental pathogenesis of the development and progression of the disease.Clinicians should pay attention to the changes of symptoms in time and monitor the thyroid function indicators of the patients,thus to avoid serious immunotherapy-related adverse events(irAEs).
2.Research on the differential diagnosis of phlegm and blood stasis pattern and qi deficiency and blood stasis pattern in stable angina pectoris based on coronary artery CT angiography radiomics
Dongsheng WEI ; Jiajie QI ; Xiaosheng LIU ; Luzhen LI ; Han LI ; Yuting LIU ; Chengkang DENG ; Xu DAI ; Baoying ZHAO ; Zhe ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(4):545-554
Objective To establish a differential model of phlegm and blood stasis pattern and qi deficiency and blood stasis pattern in stable angina pectoris using radiomics.Methods A total of 91 patients with stable angina pectoris who underwent coronary artery CT angiography in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2021 to January 2022 were collected,including 47 cases of phlegm and blood stasis pattern and 44 cases of qi deficiency and blood stasis pattern.The patients were divided into train set(64 cases)and test set(27 cases)according to the ratio of 7∶3 by stratified random sampling method.3D-slicer software was used to extract the radiomics features of pericoronary adipose tissue(PCAT)images.Principal component analysis was used to visualize the distribution of radiomics features of pattern of phlegm and blood stasis and pattern of qi deficiency and blood stasis.The least absolute shrinkage and selection operator regression analysis and support vector machine decreasing feature elimination were used for feature selection.The multinomial logistics regression was used for model construction.The receiver operating characteristic(ROC)curve was used to verify the model in the train set and the test set to evaluate the effectiveness of the radiomics features in differentiating phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.Finally,Spearman coefficient was used to analyze the correlation between the differential features and clinical physicochemical data.Results A total of 837 radiomics features were extracted from PCAT images by 3D-slicer software.In the principal component analysis,PC1 and PC2 explained 77.9%and 8.1%of the total variance,respectively,and there was a relatively obvious separation trend between the two pattern groups.After feature screening,7 radiomics features were used to construct the differential model of phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.The area under the ROC curve(AUC)of the differential model was 0.844 in the train set and 0.834 in the test set.Spearman correlation analysis showed that the differential features were significantly correlated with cTnI,neutrophil,triglyceride,total cholesterol,and leukocyte.Conclusion The CT radiomics model based on PCAT has a high discrimination efficiency for stable angina pectoris with phlegm and blood stasis pattern and qi deficiency and blood stasis pattern.
3.Correlation between characteristics of MSCT to early changes in renal blood perfusion and fasting plasma glucose in patients with diabetes
Kai LI ; Liling LONG ; Luzhen WU ; Chunbin LIU
Journal of Practical Radiology 2015;(10):1641-1644
Objective To explore the change characteristics of early renal blood infusion in patients with diabetes and its relation-ship with fasting blood sugar by using multi-slice spiral CT (MSCT)perfusion scan.Methods Thirty cases of T2DM patients within five years of disease course that meet clinical diagnostic criteria (poor DN glycemic control group and good DN glycemic control group with 1 5 cases in each group)and 1 5 cases in the control group underwent bilateral renal perfusion scan using 64-detector spiral CT,thus obtaning their cortical perfusion parameters of bilateral kidneys,including blood flow (BF),blood volume (BV),mean transit time (MTT)and capillary permeability surface (PS).At the same time,for each case,fasting glucose,blood urea nitrogen, serum creatinine and blood uric acid value on the third days after and before perfusion were also measured;the glomemlar filtration rate (C-GFR)was estimated.Statistical analysis was performed on all of these obtained values.Results (1).For the poor DN gly-cemic control group,the average BF value,average BV value and average PS value were reduced,average MTT was prolonged sig-nificantly,and compared with normal group,average BF value and average MTT were statistically significant (P <0.05);for good DN glycemic control group,average BF value and average BV value were increased,the average MTT was prolonged,and compared with the normal group,the difference was statistically significant (P <0.01);compared with the good DN glycemic control group, the average BF value and average BV value of the poor DN glycemic control group were significantly reduced,and the average MTT was significantly prolonged.(2).Fasting blood glucose had the highest correlation with average BF and average MTT and was linear-ly dependent with renal perfusion parameters.(3).The glomemlar filtration rate was not statistically significant (P >0.05)for both normal control group and DN groups in the third day before and after renal CT perfusion imaging examination.Conclusion BF,BV and MTT of MSCT perfusion scan can reflect the characteris-ticsof early renal blood infusion in patients with diabetes.And changes of fasting blood sugar in patients with diabetes may influence mean BF and mean MTT of kidney.
4.Research Progress of Sonodymanic Therapy on Tumour
Chinese Medical Equipment Journal 1989;0(02):-
Because of the penetrability of ultrasound,there is no need of endoscope when deep tumor is treated by using ultrasound.Besides,ultrasound treatment devices are simple,inexpensive and has lower phototoxicity.The outline of the sonodymanic therapy research progress is carried on from such four aspects as the sonodymanic therapy mechanism,the sound sensitive medicinal preparation choice,the supersonic parameter optimization and the sonodymanic therapy with other tumor treatment methods.The research tendency of sonodymanic tumor treatment is pointed out that the sonodymanic therapy is possible to become a new method for curing tumour clinically.[Chinese Medical Equipment Journal,2008,29(2):37-38,41]
5.Expression of MMP-2 mRNA and MMP-9 mRNA in pulmonary arterioles of rats with pulmonary hypertension induced by chronic hypoxia hypercapnia
Jiwu LI ; Yongsheng GONG ; Xiaofang FAN ; Lianggang HU ; Luzhen ZHENG ; Zhongsun JIANG
Chinese Journal of Pathophysiology 1989;0(05):-
AIM: To investigate the expression of matrix metalloproteinases(MMPs) in pulmonary arterioles of rats with chronic hypoxia and hypercapnia-induced pulmonary hypertension. METHODS: MMP-2, MMP-9 and MMP-2 mRNA, MMP-9 mRNA were observed in pulmonary arterioles by the techniques of immunohistochemistry and in situ hybridization. RESULTS: ①The mean pulmonary artery pressure (mPAP) and weight ratio of right ventricle to left ventricle and septum (RV/LV+S) of hypoxia-hypercapnia groups were higher than those of normal control group ( P

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