1.Study on Zhang Yunling's Medication Law in Treating Headache Based on Data Mining
Hongxi LIU ; Xiao LIANG ; Jingzi SHI ; Jingjing WEI ; Wei SHEN ; Guojing FU ; Yue LIU ; Liuding WANG ; Yunling ZHANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):59-64
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.
2.Clinical Application of Supplementing Essence and Boosting Marrow Method in the Treatment of Encephalopathy Based on the Marrow Sea Theory
Hongxi LIU ; Mengying LU ; Xiao LIANG ; Jingjing WEI ; Yue LIU ; Yunmeng CHEN ; Xiansu CHI ; Guojing FU ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2023;64(18):1877-1884
As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine (TCM), The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years, analyzed the treatment method and effects from eight aspects in terms of stroke, dizziness, insomnia, headache, constraint syndrome, dementia, tremor syndrome, and atrophy syndrome, and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow, the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes, which can effectively improve the symptoms of the disease, delay the progression, increase the daily life ability of the patients, and improve the quality of life. Based on the marrow sea theory, the method of supplementing essence and boosting marrow, rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.
3.Study on the Medication Rule of the National Patent of Traditional Chinese Medicine Compound Formula in the Treatment of Depression
Hongxi LIU ; Jingzi SHI ; Xiao LIANG ; Wei SHEN ; Jingjing WEI ; Yue LIU ; Guojing FU ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2023;64(19):2027-2032
ObjectiveTo explore the medication rules of traditional Chinese medicine compounds for depression in the National Patent Database using data mining, and to provide ideas for the clinical treatment and the development of new drugs for depression. MethodsThe patent data of traditional Chinese medicine compounds for the treatment of depression were searched from inception to July 1st, 2022 on the Patent Publication Announcement website of China National Intellectual Property Administration. The selected traditional Chinese medicine compounds were analyzed by using the data mining section of the ancient and modern medical record cloud platform (V2.3.5) for drug frequency, and based on this, the nature, flavor, channel entry and function of the medicinals were analyzed. Representative high-frequency herbal combinations were obtained through correlation analysis, while the classification of Chinese medicine compounds for depression was analyzed by cluster analysis, and the core combinations of herbs for the treatment of depression were screened out using complex network analysis. ResultsA total of 325 Chinese medicine compounds were included, involving 452 herbs, with a total frequency of 3532 times. The top 10 mostly used herbs were Yujin (Radix Curcumae, 122 times), Chaihu (Radix Bupleuri, 122 times), Baishao (Radix Paeoniae Alba, 109 times), Suanzaoren (Spina Date Seed, 95 times), Fuling (Poria, 94 times), Danggui (Radix Angelicae Sinensis, 94 times), Yuanzhi (Radix Polygalae, 84 times), Baizhu (Rhizoma Atractylodis Macrocephalae, 72 times), Shichangpu (Rhizoma Acori Graminei, 71 times), and Danshen (Salvia Miltiorrhiza, 61 times). The natures of the herbs were mainly warm (998 times), neutral (944 times), slightly cold (596 times) and cold (497 times); the flavors were mainly sweet (1648 times), acrid (1392 times), and bitter (1337 times); the channels of entry were mainly liver (1695 times), heart (1521 times), spleen (1326 times) and lung (1268 times). The medicinals with the function of soothing liver to relieve constraint, moistening the intestines to promote defecation, calming the heart and the mind, moving qi to relieve constraint were used more frequently. The high frequency herbal combinations by association analysis included “Chaihu (Radix Bupleuri)→ Baishao (Radix Paeoniae Alba)”, “Danggui (Radix Angelicae Sinensis)→Chaihu (Radix Bupleuri)” and “Baishao (Radix Paeoniae Alba)→ Yujin (Radix Curcumae)”. The 22 high frequency medicinals used more than 40 times could be clustered into six categories. Complex network analysis found the core herbal combination for the treatment of depression was the formula of Chaihu (Radix Bupleuri), Yujin (Radix Curcumae), Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis), Fuling (Poria), Suanzaoren (Spina Date Seed), and Xiangfu (Cyperi Rhizoma). ConclusionTraditional Chinese medicine compounds for the treatment of depression is mainly based on the pathogenesis of constraint, stasis and deficiency, focusing on the liver, heart, spleen and lung, commonly using medicinals with the function of soothing liver to relieve constraint, fortifying spleen and nourishing heart, regulating qi and invigorating blood, and moistening the intestines to promote defecation, which can provide a reference for the clinical treatment and new drug research and development for depression.
4.Clinical Application of Toxin Pathogen Causing Disease in Common Nervous System Diseases: A Review
Hongxi LIU ; Wei SHEN ; Jingjing WEI ; Yue LIU ; Jingzi SHI ; Guojing FU ; Xiansu CHI ; Xiao LIANG ; Yunling ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(24):244-252
The diverse nervous system diseases (NSDs) are common complex refractory systemic diseases in clinical settings, which are manifested as trigeminal neuralgia, facial paralysis, neuromyelitis optica, multiple sclerosis, stroke, vascular dementia, encephalitis B, Parkinson's disease, epilepsy, Alzheimer's disease, amyotrophic lateral sclerosis, and diabetic peripheral neuropathy. Amid the accelerating population aging, the morbidity and prevalence of NSDs have been on the rise, posing a threat to quality of life of patients and bringing a heavy burden to society and individuals. This is also a challenge to the clinical prevention and treatment of the diseases. At the moment, NSDs are mainly treated with western medicine which is effective. However, in the long-term use and progression of the diseases, there are some potential risks such as adverse drug reactions, easy recurrence after withdrawal, drug dependence, and drug resistance. From the holistic view, traditional Chinese medicine (TCM) excels in treating diseases based on syndrome differentiation. According to the etiology, location, and pathogenesis of diseases in TCM, the overall therapy is applied, shows obvious advantages in alleviating disease symptoms, delaying disease progression, and improving the quality of life. TCM has a long history and categorizes NSDs into encephalopathy. According to clinical practice and theories, toxin is an important pathogen of NSDs in TCM. To be specific, the external toxins are insect and beast toxins, food toxin, toxin of six excesses, and epidemic toxin, and the internal toxins are phlegm toxin, dampness toxin, stasis toxin, fire toxin, and turbid toxin. Accumulation of all pathogens will lead to diseases with multiple syndromes. In the case of sudden attack of toxin, the disease is characterized by rapid onset. In the instance of fierce toxin, disease progresses rapidly. If the toxin is dependent, the disease symptoms are diverse. If the toxin is stubborn and frequently occurs, disease recurrence is common. In the case that toxin damages the collaterals, the healthy Qi is impaired. Controlling physiological function of the body, nervous system corresponds to the house of brain in TCM, which is the extraordinary organ, the house of intelligence, and the seat of mental activities that governs the whole body. In the case of toxin damaging the brain collaterals, cerebrospinal injury and orifice obstruction will occur, followed by disharmony of Qi and blood, Yin-yang imbalance, vital activity injury, disorder of primordial spirit, and dysfunction. The treatment principle should be detoxification and eliminating pathogen, and different diseases should be treated with the same method. At the moment, many doctors and scholars have focused on the prevention and treatment of NSDs based on the toxin pathogen. This paper summarizes the research on the clinical application of toxin pathogen causing disease in NSDs, including the peripheral nerve disease, demyelinating disease of the central nervous system, cerebrovascular disease, infectious disease of central nervous system, movement disorders, epilepsy, nervous system degenerative disease and nervous system complications of internal medicine disease, which is expected to provide some ideas and methods for the prevention and treatment of NSDs with TCM.
5.Biomechanical analysis and clinical application of 3D printed bone tumor prosthesis of lower limb
Yanjun PEI ; Jun FU ; Jing LI ; Guojing CHEN ; Zhigang WU ; Changning SUN ; Zheng GUO
Chinese Journal of Orthopaedics 2020;40(12):760-768
Objective:To design 3D printed prosthesis in an individualized way and explore the short-term clinical efficacy of reconstruction of segmental defect after resection of bone tumor in lower extremities with 3D-printed prosthesis.Methods:From January 2017 to June 2019, 6 patients with lower limb bone tumor who met the inclusion criteria were recruited, including 3 males and 3 females, aged 8.67±1.11 years (range 6-11 years). All 6 cases were primary bone tumors, and the Enneking stages were all IIB, including 3 cases of left tibial tumors, 2 cases of right tibial tumors, and 1 case of right femoral tumor. These 3D-printed prostheses were designed based on the preoperative imaging data. The mechanical stability of the prosthesis was evaluated by three-dimensional finite element analysis. After tumor resection, the 3D-printed prosthesis was installed and fixed to reconstruct the segmental bone defect. All patients were clinically followed up and evaluated by imaging regularly after operation. The functional status was assessed by the Musculoskeletal Tumor Society (MSTS) score. Oncology results and complications were recorded in detail.Results:All operations were successfully performed, including 3 cases underwent left tibial tumor resection, 2 cases underwent right tibial tumor resection, and 1 case underwent right femoral tumor resection. The length of the bone defect after tumor resection was 18.19±3.74 cm, the average operation time was 165.83±54.17 min, and the average intraoperative bleeding was 233.33±133.33 ml. These finite element analysis data show that the overall stress of these prostheses are lower than the maximum mechanical strength of the corresponding materials. These 3D printed prostheses match well with the excision defect and meet the expected effect. There were no adverse reactions during the operation. The mean follow-up period was 16.83±7.17 months. At the last follow-up, all patients survived without tumor recurrence or metastasis. Postoperative imaging results showed that all the implants were stable without complications such as peripheral infection, aseptic loosening, prosthesis fracture. These 3D-printed prostheses composite resulted in substantial bone integration at follow-up. The average MSTS score was 83.67%±9.11%.Conclusion:The individualized 3D printed prosthesis can be used to reconstruct the bone defect after the resection of osteosarcoma in the lower extremities, and the clinical efficacy was satisfactory in the short-term follow-up.
6.Clinical management of acute superior mesenteric vein thrombosis
Ji WANG ; Xi WANG ; Guojing ZHANG ; Li LU ; Yongjia YAN ; Weihua FU
Chinese Journal of General Surgery 2018;33(12):1034-1037
Objective To evaluate the diagnosis and treatment of acute superior mesenteric venous thrombosis (ASMVT).Methods Clinical data of 36 ASMVT patients admitted to our department from Jan 2014 to Oct 2017 were retrospectively analyzed,the differences of the clinical data and prognosis of nonsurgical group and surgical group were studied.Results All patients received anticoagulation therapy immediately after diagnosis,and recanalization rate was 42%.Surgical group included 21 cases,of which 9 cases received emergency surgery,12 cases received delayed bowel resection.There was significant difference between non-surgical group and surgical group (P > 0.05) in hemoglobin level at admission (124 ±29)g/L vs.(93 ± 13) g/L,t =3.880,P =0.006.Compared with delayed bowel resection group emergency surgery group had longer bowel resection (65 ± 58) cm vs.(13 ± 6) cm,t =2.700,P =0.035,more loop ileostomy (6 vs.1,x2 =7.875,P =0.016),more postoperative complication rate (56% vs.8%,x2 =5.619,P =0.046),but there was no significant difference in hospitalization time,hospitalization cost,postoperative recurrence and mortality rate (P > 0.05).Conclusions Early anticoagulantion therapy is advised for ASMVT patients to avoid bowel resection or reduce the length of intestinal resection.It is advisable for those who can be tided over to delayed bowel resection with intestinal obstruction.
7.Aplication of 3D-printed prosthesis on construction of long segmental bone defect after tumor resection
Jun FU ; Zheng GUO ; Hongbin FAN ; Jing LI ; Guojing CHEN ; Yanjun PEI ; Fei WANG ; Peng GAO ; Fengwei SHI ; Zhen WANG
Chinese Journal of Orthopaedics 2017;37(7):433-440
Objective To explore the feasibility and clinical efficacy of long-segmental bone defects after en bloc tumor resection of lower limb segment with composite of titanium alloy 3D printed prosthesis and vascularized fibular autograft and bioceramics.Methods 5 patients with lower extremity tumor (1 high grade chondrosarcoma,1 Ewing sarcoma,1 single metastatic tumor and 2 osteosarcoma) were treated by en bloc resection and precise reconstruction with segmental 3D-printed,custom-made prosthesis from August 2015 to November 2016,which composed of 1 male and 4 females,ranged from 16 to 56 years old,the average was 32± 19.3 years old.Three-dimensional computed tomography reconstructed images of patients' tumors were built before surgery.Custom-made prostheses were manufactured based on the patients' reconstructed images with micro-pores on the surface.After en bloc tumor resection with the help of osteotomy guide plate,the defects were reconstructed with 3D-printed,custom-made prostheses.Vascularized fibular autografts were put inside the prostheses,and the interval space among them was filled with bioceramics.Results All the 5 cases were performed surgical planning before the surgery with prosthesis and guide plate were designed at the same time.After verification of the finite element analysis SLM (2 cases) and the EBM (3 cases) were used to process prosthesis,and were designed into porous sharp with 210.98±66.16 mm in length and 26 901.76±12 903.96 mm3 in volume.Then the prosthesis would be cleaned and sterilized.All 5 operation were proceeded according to the plan of preoperative.The intra-operative guide plate were installed on the bone surface stably.The bone cutting was guided according to the plan of preoperative.By intra-operative frozen pathological examination,there were no malignant tissues in near and far marrow cavity.Unfolded fibular flap with 168.75±49.07 mm in length and porous tricalcium phosphate particle composite implants with 10±4.08 g were used in 4 cases and bone cement was used in 1 cases of metastatic tumor.The average operation time was 261±85 min and average blood loss was 540±182 ml.After a mean follow-up time of 6.4 months (1-15 months),all 5 cases survived with no local recurrence and pulmonary metastasis tumor.2 cases with vascular pedicle fibular transplant confirmed the survival of fibula via bone scan 3 months after operation.All cases were no infection,fractures,prosthesis loosening,except broken screw in 1 case.The Musculoskeletal Tumor Society (MSTS) 93 score was 17-26.Conclusion Long segment tubular titanium alloy 3D printed prosthesis with vascularized fibular autograft and bioceramics could reconstruct the segmental defects caused by tumor resection.
8.One stage cholecystectomy during radical gastrectomy for gastric cancer with gallbladder disease
Guojing ZHANG ; Ruotong LI ; Zhicheng ZHAO ; Weidong LI ; Weihua FU
Chinese Journal of General Surgery 2016;31(1):40-42
Objective To evaluate radical gastrectomy combined with cholecystectomy for gastric cancer patients with concomitant gallbladder disease.Methods Clinical data of 702 gastric cancer patients undergoing radical gastrectomy (614 patients) only or combined with cholecystectomy during radical gastrectomy from October 2009 to September 2014 in our department was retrospectively analyzed.Results The operating time of patients with simultaneous cholecystectomy was(348 ± 111)min.the operating time of patients with radical gastrectomy only was (274 ± 89) min (t =3.812,P < 0.05).Perioperative and postoperative complications,hospitalization expenses and 5-year survival rates were not statistically significant (P > 0.05).Conclusions Radical gastrectomy with cholecystectomy for gastric cancer with gallbladder disease patients is safe and feasible.
9.Prognostic analysis of gastrointestinal stromal tumors complicated with gastrointestinal bleeding
Ruotong LI ; Guojing ZHANG ; Weihua FU ; Weidong LI
Chinese Journal of Oncology 2016;38(5):377-380
Objective To study the relationship between clinicopathological characteristics, prognosis and gastrointestinal bleeding in primary gastrointestinal stromal tumors ( GIST ) . Methods The clinicopathological and follow?up data of 200 patients with gastrointestinal stromal tumors treated in our hospital from April 2008 to December 2014 were retrospectively reviewed. The correlation of gastrointestinal bleeding with gastrointestinal stromal tumor clinicopathological characteristics and prognosis were analyzed. Results The 200 GIST patients were divided into two groups according to the bleeding in the digestive tract, including 57 gastrointestinal bleeding patients and 143 non?bleeding patients. The mean tumor diameter was 6.5 cm (range 1.8?22 cm) in the bleeding group and 2.5 cm (range 0.4?18 cm) in the non?bleeding group ( P<0.05) . Of the 57 bleeding patients, 31 located in the stomach, 25 in the small intestine, and one had colorectal bleeding. Fifty patients had mitotic index ( MI) ≤5/50 HPF, other 6 patients ranged between 5 and 10/50 HPF and one patient had MI >10/50 HPF. Six GIST patients were complicated with tumor rapture. But in the non?bleeding group, 125 patients had gastric GIST, 8 in the small intestine, one colorectum, and 9 had esophageal or other GIST. 141 patients had MI ≤5/50 HPF, 1 patients ranged between 5 and 10/50 HPF and one patient had MI>10/50 HPF. Only 1 GIST patients was complicated with tumor rapture. The gastrointestinal bleeding was closely associated with tumor size, mitotic index, tumor location, risk classifications, tumor rapture and tumor recurrence (P<0.05 for all). The 3?year and 5?year survival rates of the 200 patients were 96.5% and 86.8%, respectively. 16 patients developed recurrence or metastasis, and 11 died of GIST. The 5?year survival rate of patients with gastrointestinal bleeding was 76.2%, significantly lower than that of patients without gastrointestinal bleeding ( 91. 6%, P<0. 05 ) . Conclusions GIST patients complicated with gastrointestinal bleeding have poor prognosis, and attention should be paid to stratifying patients for therapy.
10.Prognostic analysis of gastrointestinal stromal tumors complicated with gastrointestinal bleeding
Ruotong LI ; Guojing ZHANG ; Weihua FU ; Weidong LI
Chinese Journal of Oncology 2016;38(5):377-380
Objective To study the relationship between clinicopathological characteristics, prognosis and gastrointestinal bleeding in primary gastrointestinal stromal tumors ( GIST ) . Methods The clinicopathological and follow?up data of 200 patients with gastrointestinal stromal tumors treated in our hospital from April 2008 to December 2014 were retrospectively reviewed. The correlation of gastrointestinal bleeding with gastrointestinal stromal tumor clinicopathological characteristics and prognosis were analyzed. Results The 200 GIST patients were divided into two groups according to the bleeding in the digestive tract, including 57 gastrointestinal bleeding patients and 143 non?bleeding patients. The mean tumor diameter was 6.5 cm (range 1.8?22 cm) in the bleeding group and 2.5 cm (range 0.4?18 cm) in the non?bleeding group ( P<0.05) . Of the 57 bleeding patients, 31 located in the stomach, 25 in the small intestine, and one had colorectal bleeding. Fifty patients had mitotic index ( MI) ≤5/50 HPF, other 6 patients ranged between 5 and 10/50 HPF and one patient had MI >10/50 HPF. Six GIST patients were complicated with tumor rapture. But in the non?bleeding group, 125 patients had gastric GIST, 8 in the small intestine, one colorectum, and 9 had esophageal or other GIST. 141 patients had MI ≤5/50 HPF, 1 patients ranged between 5 and 10/50 HPF and one patient had MI>10/50 HPF. Only 1 GIST patients was complicated with tumor rapture. The gastrointestinal bleeding was closely associated with tumor size, mitotic index, tumor location, risk classifications, tumor rapture and tumor recurrence (P<0.05 for all). The 3?year and 5?year survival rates of the 200 patients were 96.5% and 86.8%, respectively. 16 patients developed recurrence or metastasis, and 11 died of GIST. The 5?year survival rate of patients with gastrointestinal bleeding was 76.2%, significantly lower than that of patients without gastrointestinal bleeding ( 91. 6%, P<0. 05 ) . Conclusions GIST patients complicated with gastrointestinal bleeding have poor prognosis, and attention should be paid to stratifying patients for therapy.

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