Objective To study the medication law of Professor Zhang Yunling in the treatment of headache based on data mining technology;To provide ideas for the clinical treatment of headache.Methods Professor Zhang Yunling's outpatient TCM prescription data for the treatment of headache from Sep.2017 to Dec.2020 were collected,and the Ancient and Modern Medical Record Cloud Platform 2.3.5 was used to mine the selected TCM prescriptions for herbal medicine frequency statistics,property,taste and meridian tropism statistics,herbal medicine efficacy statistics,correlation analysis,clustering analysis,complex network analysis,etc.Results Through collection and screening,totally 332 prescriptions were included,involving 178 kinds of Chinese materia medica,with a total frequency of 5 380 times.The top 10 kinds of Chinese materia medica were Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Testudinis Carapax et Plastrum,Bambusae Caulis in Taenia,Glycyrrhizae Radix et Rhizoma,Astragali Radix,Amomi Fructus Rotundus,Pinelliae Rhizoma Praeparatum,and Polygalae Radix.They were mainly warm,mild and slightly cold in properties,sweet,pungent and bitter in tastes,and liver,lung,spleen meridian in meridian tropism.In the statistics of herbal medicine efficacy,expelling wind and relieving pain,suppressing liver yang,promoting blood circulation and qi,clearing heart and relieving restlessness,clearing heat and detoxifying,softening liver and relieving pain were used more frequently.The combinations in herbal medicines association included"Atractyodis Macrocephalae Rhizoma-Chuanxiaong Rhizoma","Testudinis Carapax et Plastrum-Paeoniae Radix alba","Glycyrrhizae Radix et Rhizoma-Paeoniae Radix alba","Testudinis Carapax et Plastrum-Chuanxiaong Rhizoma","Bambusae Caulis in Taenia-Chuanxiaong Rhizoma".Herbal medicines clustering clustered 32 kinds of high-frequency herbal medicines used more than 60 times into 6 categories.Complex network analysis screened out the core formula for the treatment of headache:Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Pinelliae Rhizoma Praeparatum,Testudinis Carapax et Plastrum,Astragali Radix,Amomi Fructus Rotundus,and Glycyrrhizae Radix et Rhizoma.Conclusion In the treatment of headache,Professor Zhang Yunling holds that the pathogenesis of headache is deficiency in origin and excess in superficiality,deficiency of qi and blood,loss of nourishment of brain collaterals,stagnation of phlegm and dampness,disturbance of wind pathogen,obstruction of brain collaterals,and the location of the disease is related to the five viscera and involves the stomach.Focuses on tonifying deficiency and reducing excess,treats exterior and interior separately,and gives consideration to both the symptoms and the root causes,which often uses drugs to treat headache,such as dispelling wind and relieving pain,promoting blood circulation and relieving pain,relieving spasm and relieving pains,eliminating phlegm and dampness,invigorating qi and spleen,nourishing blood and yin,eliminating dampness and regulating stomach,relieving depression and restlessness,which can provide some reference for the clinical treatment of headache.

Persistent Müllerian duct syndrome(PMDS) is a rare disorder that arises from a lack of active anti-Müllerian hormone(AMH) or type Ⅱ AMH receptor(AMHR2) deficiency in males with a normal 46, XY chromosome karyotype.It presents that the external genitalia appears normally while the Müllerian duct structure(uterus, fallopian tubes, upper vagina) persists in the body.Common pathogenic factors are mutations in the AMH and AMHR2 genes, inherited in an autosomal recessive manner.This study reported two families with PMDS.The first patient was diagnosed with PMDS due to cryptorchidism in May 2019.Gene sequencing analysis revealed a new missense mutation(c.579G>T; p.W193C) and a splicing mutation(c.622-3C>A; splicing) in the AMHR2 gene.His father had the missense mutation(c.579G>T; p.W193C), and his mother had the splicing mutation(c.622-3C>A; splicing).The second patient was diagnosed with PMDS due to bilateral cryptorchidism, transverse testis ectopia in the right testicle in March 2023.Undegraded Müllerian tube derivatives were found between the two testicles, and serum AMH levels were very high(565.00 μg/L).Gene sequencing analysis reported that the AMHR2 gene had a new deletion mutation(c.835_837del; p.Leu279del).Both his father and mother had a deletion mutation(c.835_837del; p.Leu279del).This study reports two new AMHR2 gene mutations that expand the mutation sites of this rare disease.It is recommended to consider PMDS in the differential diagnosis of cryptorchidism, undergo surgery as early as possible, and treat Müllerian duct derivatives based on individual anatomical characteristics.

ObjectiveTo discuss the thought of treatment of orifices in the Chinese herbal classics in the past dynasties based on the correspondence between drugs and symptoms to guide the clinical treatment based on syndrome differentiation. MethodAll the literature data of Chinese herbal classics were retrieved from the database of the Chinese Medical Dictionary， involving 76 works of Chinese herbal classics and covering representative works from the Han dynasty to the Ming and Qing dynasties. The information on Chines herbal drugs for the treatment of orifices was collected and sorted out. According to Chinese Materia Medica （11^th Edition） and Pharmacopoeia of the People's Republic of China （2020 Edition）， the nature， flavor， and meridian tropism of the selected Chinese herbal drugs were statistically analyzed. The pathogenesis elements in the treatment of orifices were classified and counted， and the contents of syndrome differentiation and treatment in various Chinese herbal classics were extracted. ResultIn 76 Chinese herbal classics in the past dynasties， 93 Chinese herbal drugs for the treatment of orifices were selected. The nature of drugs was mainly warm， followed by cold and mild. The flavor was mainly pungent， followed by bitter and sweet. In terms of meridian tropism， drugs mainly acted on the lung meridian， followed by stomach， heart， liver， spleen， and kidney meridians. The pathogenesis elements of orifices could be divided into six categories， i.e.， wind invasion， turbid obstruction and Qi stagnation， water and dampness stagnation， blood stasis and collaterals blockage， heat and toxin damage， deficiency of vital Qi and cold coagulation. ConclusionOrifices are mainly treated with drugs effective in dispelling wind and pathogenic factors， resolving turbidity and removing stagnation， inducing diuresis and eliminating dampness， promoting blood circulation and dredging collaterals， clearing heat and purging fire， tonifying deficiency and dispelling cold， which are used in combination. Eliminating pathogenic factors and dredging， tonifying deficiency and purging excess are the main characteristics of treatment of orifices based on syndrome differentiation， which is in line with the physiological dysfunction state of orifices in losing the function， evil Qi blockage and healthy Qi deficiency.

Objective:To investigate the urinary sediment findings and the clinicopathologic features of IgA nephropathy (IgAN) patients with acute kidney injury (AKI).Methods:It was a retrospective study. The patients with renal biopsy-proven primary IgAN in Peking University First Hospital from January 31, 2013 to July 31, 2015 were selected. According to whether AKI occurred at renal biopsy or not, the patients were divided into AKI group and non-AKI group. Morning urine samples were obtained on the day of renal biopsy. Urine sediments, including various cells and casts, were examined. The clinical data, urinary sediments, and renal pathological changes were compared between the two groups. Logistic regression analysis was performed to identify the association between clinical pathological changes, urinary sediment indicators and AKI, or clinical pathological changes and urinary sediment indicators.Results:There were 502 IgAN patients enrolled in this study, with age of (36.1±12.1) years old and 261 males (52.0%). The incidence of AKI was 11.4% (57/502) among the enrolled patients at the time of renal biopsy. Common causes of AKI included gross hematuria-induced AKI (10 cases), acute tubulointerstitial nephritis (10 cases), crescentic IgAN (9 cases), malignant hypertensive renal damage (6 cases), and multiple etioloqy or unknown etiology (22 cases). Compared with non-AKI group, AKI group had higher proportions of males and malignant hypertension, higher levels of proteinuria and urinary erythrocyte counts, and higher frequencies of gross hematuria, leukocyturia, renal tubular epithelial cells, and granular casts (all P<0.05). AKI group also had higher proportions of severe tubular atrophy/interstitial fibrosis (T2) and cellular/cellular fibrous crescent formation (C2) than non-AKI group (both P<0.05). Logistic regression analysis results showed that, there were statistically significant differences in the correlation between AKI and gender, 24 h urinary protein, urinary erythrocyte counts, granular casts and renal tubular atrophy/interstitial fibrosis (T) scores (all P<0.05). Hematuria, leukocyturia, red blood cell casts, white blood cell casts, granular casts, and fatty casts were correlated with endothelial hypercellularity (E) and cellular/cellular fibrous crescent formation (C) scores, respectively (all P<0.05). Hematuria was correlated with mesangial hypercellularity (M) scores ( OR=2.613, 95% CI 1.520-4.493, P=0.001). Hematuria ( OR=1.723, 95% CI 1.017-2.919, P=0.043) and fatty casts ( OR=2.646, 95% CI 1.122-6.238, P=0.026) were correlated with segmental sclerosis or adhesion (S) scores. Leukocyturia ( OR=1.645, 95% CI 1.154-2.347, P=0.006) and fatty casts ( OR=2.344, 95% CI 1.202-4.572, P=0.012) were correlated with T scores. Epithelial cell cast was correlated with C scores ( OR=1.857, 95% CI 1.174-2.939, P=0.008). Conclusions:AKI is a common complication among IgAN patients with diverse etiology and more severe clinicopathological features. Urinary sediment findings can reflect renal pathological changes to some extent, and therefore assist in the clinical diagnosis and treatment of IgAN patients with AKI.

This paper summarized Professor ZHANG Yunling's experience in the treatment of amyotrophic lateral sclerosis （ALS） from emphasis on both spleen and kidney. It is considered that the characteristic of ALS manifested as overlap of atrophy-flaccidity disease and convulsive disease， and the core pathogenesis are the deficiency of spleen and kidney and the inner pathogenic qi. ZHANG advocated that ALS should be treated from tonifying both the spleen and kidney， as strong spleen and kidney led the latent pathogen at peace. Usually applied Huangqi （Astragalus mongholicus）， Baizhu （Atractylodes macrocephala） combined with Taizishen （Pseudostellaria heterophylla）， fried Yiyiren （Coix lacryma-jobi）， Doukou （Myristica fragrans） and Sharen （Wurfbainia villosa） to tonify the middle and replenish qi， ascend lucidity and descend turbidity to invigorate the spleen； Roucongrong （Cistanche deserticola）， Tusizi （Cuscuta chinensis） combined with Shanyao （Dioscorea oppositifolia）， Shanzhuyu （Cornus officinalis） and prepared Dihuang （Rehmannia glutinosa） are used to support the fire and nourish the water， so as to replenish the spleen. The empirical formula regarded invigorateing the spleen and replenishing the kidney as the core therapeutic principle throughout the treatment of the whole process， which aimed at extinguishing inner wind and pacifying latent pathogen when treating the root.

OBJECTIVE To study the effect of different concentrations of 17-AAG and EGCG monotherapy or in combination on the induced apoptosis in human nasopharyngeal carcinoma, and to explore new molecular targets for the treatment of nasopharyngeal carcinoma. METHODS MTT colorimetric method and fluorescent staining were used to detect the change of CNE proliferation inhibition rate and cell morphology. And furthermore, the expression level of Bcl-2, Bax, Caspase-3 were detected by RT-PCR. RESULTS 1. 17-AAG or EGCG alone had inhibitory effect on the human nasopharyngeal carcinoma CNE cells at 24 h, 48h and 72 h, and it was related with time and dose(P<0.01). The inhibition effect of combination of 17-AAG and EGCG was significantly increased,which was time and dose dependent(P<0.01). 2. RT-PCR was used to detect the mRNA expression level of Bcl-2, Bax and caspase-3. The level of Caspase-3 and Bax mRNA expression after treated by 17-AAG and EGCG was significantly higher, and the level of bcl-2 mRNA expression was lower than that after treated by 17-AAG or EGCG alone. CONCLUSION Our investigation implied that 17-AAG and EGCG in combination can effectively inhibit the proliferation of human nasopharyngeal carcinoma CNE cells. The involved mechanisms may be associated with the upregulation of Bax and Caspase-3 expression.

OBJECTIVETo study the methylation changes in promoter CpG islands induced by low-dose X-ray radiation (LDR).

METHODSTwenty male BALB/c mice were randomly divided into control and fractionated radiation group exposed to 6 MV X-ray for 10 days (0.05 Gy/day). All the mice were sacrificed 2 h after the last radiation on day 10, and blood samples were collected for detecting DNA methylation changes using Roche-NimbleGen mouse DNA methylation 3×720K Promoter Plus CpG Island Array. MeDIP-qPCR was used to further validate the methylation status of specific genes.

RESULTSA total of 811 genes were found to show specific hypermethylation in fractional radiation group as compared with the control group, involving almost all the main biological processes by GO analysis. Eight candidate genes (Rad23b, Tdg, Ccnd1, Ddit3, Llgl1, Rasl11a, Tbx2, and Slc6a15) were confirmed to be hypermethylated in LDR samples by MeDIP-qPCR, consistent with the results of the methylation chip study.

CONCLUSIONLDR induces promoter hypermethylation on specific genes, which may contribute to radiation-induced pathogenesis.

Animals ; CpG Islands ; radiation effects ; DNA Methylation ; Dose-Response Relationship, Radiation ; Genome ; Male ; Mice ; Mice, Inbred BALB C ; X-Rays

Objective To investigate the role of epigallocatechin gallate ( EGCG) in reversing the CpG island methylation of Rad23b and Ddit3 gene promoter and its mRNA expression induced by 0?5 Gy X-rays. Methods Thirty BALB/c male mice were randomly divided into 6 groups: control group, irradiation group, low/high dose of EGCG group, low/high dose of EGCG with irradiation group. For the irradiation group, mice were fractionally exposed with 6 MV X-rays for 10 d (0?05 Gy/d × 10 d). 2 hours after the final irradiation, all mice were killed and such tissues as blood, kidney, liver, spleen, brain, and lung were collected. Methylation and expression levels of Rad23b and Ddit3 were measured by bisulfate sequencing primers ( BSP) and Real-time PCR, respectively. Results Compare to the control group, Rad23b was hypermethylated in PBMC, liver, spleen, brain and lung (t= -20?19, -14?80, -12?05,-28?42, -12?58, P<0?05) in the irradiation group. Meanwhile, its mRNA expression level was down-regulated in PBMC, liver, brain and lung (t=25?25, 17?43, 11?53, 22?85, P<0?05). Similarly, a significant hypermethylation change of Ddit3 was observed in PBMC, liver and lung after irradiation ( t=-52?89, -20?31, -3?85, P<0?05) so that the mRNA expression of Ddit3 decreased in PBMC and liver ( t = 11?89, 16?52, P < 0?05 ). Compared to the irradiation group, EGCG with different concentrations of 10, 20 mg/kg significantly reduced the methylation level of Rad23b and Ddit3 ( t =-13?39-7?99, P<0?05), and induced re-expression of mRNA (t= -34?02 - -2?89, P<0?05). This change was more notable in the irradiation group with the high dose of EGCG. Conclusions As a natural drug, EGCG may play an important role in affecting DNA methylation and hence protects DNA from radiation damage.

Objective To study the methylation changes in promoter CpG islands induced by low-dose X-ray radiation (LDR). Methods Twenty male BALB/c mice were randomly divided into control and fractionated radiation group exposed to 6 MV X-ray for 10 days (0.05 Gy/day). All the mice were sacrificed 2 h after the last radiation on day 10, and blood samples were collected for detecting DNA methylation changes using Roche-NimbleGen mouse DNA methylation 3 × 720K Promoter Plus CpG Island Array. MeDIP-qPCR was used to further validate the methylation status of specific genes. Results A total of 811 genes were found to show specific hypermethylation in fractional radiation group as compared with the control group, involving almost all the main biological processes by GO analysis. Eight candidate genes (Rad23b, Tdg, Ccnd1, Ddit3, Llgl1, Rasl11a, Tbx2, and Slc6a15) were confirmed to be hypermethylated in LDR samples by MeDIP-qPCR, consistent with the results of the methylation chip study. Conclusion LDR induces promoter hypermethylation on specific genes, which may contribute to radiation-induced pathogenesis.

Objective To study the methylation changes in promoter CpG islands induced by low-dose X-ray radiation (LDR). Methods Twenty male BALB/c mice were randomly divided into control and fractionated radiation group exposed to 6 MV X-ray for 10 days (0.05 Gy/day). All the mice were sacrificed 2 h after the last radiation on day 10, and blood samples were collected for detecting DNA methylation changes using Roche-NimbleGen mouse DNA methylation 3 × 720K Promoter Plus CpG Island Array. MeDIP-qPCR was used to further validate the methylation status of specific genes. Results A total of 811 genes were found to show specific hypermethylation in fractional radiation group as compared with the control group, involving almost all the main biological processes by GO analysis. Eight candidate genes (Rad23b, Tdg, Ccnd1, Ddit3, Llgl1, Rasl11a, Tbx2, and Slc6a15) were confirmed to be hypermethylated in LDR samples by MeDIP-qPCR, consistent with the results of the methylation chip study. Conclusion LDR induces promoter hypermethylation on specific genes, which may contribute to radiation-induced pathogenesis.