Metabolic syndrome(MetS)is a cluster of metabolic disorders with diverse clinical manifestations.Jingui Yaolue,or Synopsis of the Golden Chamber,discusses over 40 different diseases in total.This study reveals that some of these diseases,including tanyin(phlegm-dampness),xulao(consumptive disease),and xiaoke(wasting and thirst),exhibit clinical manifestations similar to those of MetS.Furthermore,there are also correspondences between these diseases and MetS in terms of the etiology and pathogenesis.For example,the pathogenesis involves multiple organs,but is centered on the spleen;the disease arises from deficiency and ultimately leads to a dual deficiency of yin and yang;the syndrome patterns are complex and predominantly characterized by phlegm-turbidity.This article summarizes targeted treatment approaches for MetS mentioned in Synopsis of the Golden Chamber,including focusing on the spleen in the treatment of diseases involving multiple organs,supporting the vital energy while dealing with excess syndrome,balancing yin and yang in a state of dual deficiency of both yin and yang,and treating phlegm and blood stasis simultaneously due to the close connection between body fluids and blood.Integrating these treatment principles into current traditional Chinese medicine treatment plans for MetS may help optimize traditional Chinese medicine treatment protocols for MetS and improve clinical outcomes.

Objective To compare the morphological and functional outcomes of different degrees of ocular burns patients receiving amniotic membrane transplantation (AMT) at different time points after ocular burn.Methods A retrospective analysis was performed.Ninety-two eyes of 76 acute ocular chemical burn patients were enrolled from January 2012 to December 2016 in Henan Eye Hospital.The ocular chemical burns were classified by Dua classifications.According to the operation time of AMT,the patients were divided into within 1 day after injury group,2-6 days after injury group and more than 6 days after injury group.The best corrected visual acuity and limbal stem cell deficiency score were recorded during the at least one year of follow up.The risk factors affecting limbal stem cell deficiency and visual outcome were analyzed.Results Of all the burned eyes,29 eyes (31.5 ％) were result from acid burn,41 eyes(44.6％) were result from alkaline burns and 22 eyes (23.9％) were result from thermal burn.The average burn severity scores of patients with limbal stem cell deficiency score of 0,1 and 2 was 1.86±0.54,3.60±0.94 and 5.35 ± 0.63,respectively,and the overall difference was statistically significant (F =65.532,P ＜0.01).In mild to moderate ocular surface burn patients,the limbal stem cell deficiency score in more than 6 days after injury group was significantly higher than that in within 1 day after injury group and 2-6 days after injury group (Z=-2.21,P=0.03;Z=-2.33,P=0.02).In severe ocular surface burn patients,there was no significant difference in limbal stem cell deficiency score between the groups (P=0.26).At the last follow-up,the average visual acuity of all eyes was 3.19 ± 1.47.COX regression analysis showed that burn grade and operation timing were the main risk factors for visual prognosis (OR =4.925,1.368;both at P＜0.01).Prognostic visual acuity was linearly correlated with the timing of amniotic membrane occlusion and degree of burn (R2 =0.078,0.685;both at P＜0.01),but for the Ⅴ grade and Ⅵ grade eyes,amniotic membrane timing couldn't improve the score of limbal stem cell deficiency.Conclusions Dua classifications is of great significance in evaluating prognosis of ocular burn patients.AMT is an effective adjunctive treatment in the management of acute ocular chemical burns to support epithelial healing and restore ocular surface integrity with potential to improve vision.AMT can't prevent limbal stem cell deficiency or restore vision in eyes with severe burns.

Background Local medical treatment of refractory immunologic keratitis is unsuccessful,and systemic steroids and immunosuppressive agents could cause severe side-effects.Tacrolimus is a potent immunosuppressive drug,it has been proved that topical application of tacrolimus could reduce immunologic inflammation.The safety and efficacy of 0.05％ tacrolimus eye drops for refractory immunologic keratitis has not been described.Objective This study was to evaluate efficacy and safety of 0.05％ tacrolimus eye drops for refractory ulcerative keratitis.Methods A retrospective study was performed.Twenty-one eyes of 17 patients with refractory immunologic keratitis,which had uncontrolled inflammation despite initially treatment including topical steroids and 1％ cyclosporine A,were enrolled,including 11 males and 6 females,with the mean ages of 52 years.Infectious ulcer was excluded by laboratory tests.No systemic disease was found in 11 patients,and Wegener's granulomatosis,rheumatoid arthritis and ulcerative colitis were seen in 1 patient,4 patients and 1 patient respectively before presentation and they were all in remission under conventional systemic therapy.Four patients got binocularly involved and thirteen patients were monocularly involved.Of the 21 eyes,2 eyes with ulcer were ≥ 3 quarters of the limbus,and 19 eyes with ulcer were ≤ 2 quarters.All patients were treated with 0.05％ tacrolimus eyedrops after discontinuing cyclosporine A.The dosage was adjusted according to the severity of inflammation and was gradually tapered when improvement occurred.The corneal lesions were examined under the slit lamp microscope and Heidelberg HRT3 Rostock Cornea Module regularly,and inflammatory cell infiltrations were analyzed with Cell Count(R) software (Heidelberg Engineering GmbH).The safety variables were monitored regularly,including adverse response of eye,tacrolimus blood concentrations measured by chemiluminescent microparticle immunoassay (CMIA) and laboratory examinations of blood routine,blood glucose level,liver and kidney function.Results The patients were treated and followed-up for a mean duration of 18.1 months (range,8-24 months).Corneal ulcer area was obviously reduced 1 month after treatment in 19 eyes,and 2 eyes of 2 cases received anterior lamellar keratoplasty due to progressive corneal destruction despite of tacrolimus therapy.Corneal ulcer was cured 3 months after treatment,and stromal edema and infiltration disappeared 6 months after treatment under the slit lamp microscope.The inflammatory cell densities at lesion zone were (958±329),(858±339),(459±261),(192±124),(98±52),(44±24) and (3±2)/mm2 before treatment and 1 week,1 month as well as 3,6,12,24 months following treatment,respectively,showing a gradually decline as time lapse (F =125.439,P =0.000),and the inflammatory cells were significantly decreased in 1,3,6,12 and 24 months following the administration of 0.05％ tacrolimus eye drops in comparison with that before treatment (all at P =0.000).The therapy duration was 12 months in 9 eyes and 24 months in 12 eyes.Transient irritation sensation occurred in 4 eyes during the treating period.Blood concentrations of tacrolimus were below 1.0 ng/ml in all of the patients.No abnormality was found in laboratory tests.Conclusions The use of 0.05％ tacrolimus eye drops is a safe and effective approach to refractory immunologic keratitis.

Objective To explore the efficacy and safety of low dose dopamine combined with phentolamine in the treatment of primary nephrotic syndrome (PNS) with edema. Methods Retrospective control studies were performed in 155 patients of PNS with edema, who received comprehensive treatment with small dose dopamine combined with phentolamine (group A). Patients treated with furosemide infusion were recruited as control (group B). Results The urinary output, urinary sodium increased after therapy in group A, showing significant differences (P ＜ 0. 01). But urinary potassium excretion, serum sodium and potassium showed no significant difference after therapy in group A. The urinary output, urinary sodium and potassium excretion increased and the serum sodium and potassium decreased after therapy in group B, all showing significant differences between before and after treatment (P ＜0. 01). The edema relief rate,urinary output, urinary sodium excretion, serum sodium and potassium in group A was significantly higher whereas urinary potassium excretion were significantly lower than those of group B(P ＜0. 01). The rate of drug adverse reaction in group A was significantly lower than that of group B. Conclusion Low dose dopamine combined with phentolamine in PNS with edema is safe and effective,which may be a substitute of diuretic like furosemide in the treatment of edema of patients with different blood volume.