1.UHPLC Fingerprinting and Spectroscopic Relationship of Antioxidant Activity of the Miao Medicine Ficus Tikoua Bur.
Mingyu YANG ; Mengyu LI ; Zhe HUANG ; Qi HE ; Qingwen SUN ; Ye YANG
Chinese Journal of Modern Applied Pharmacy 2024;41(6):787-796
OBJECTIVE
To establish the UHPLC fingerprint of Miao Medicine Ficus tikoua Bur., study its spectrum-effect relationship with antioxidant activity, and screen the antioxidant active components.
METHODS
UHPLC was used to establish the fingerprint of Ficus tikoua Bur.. Evaluation System for Similarity of Chromatographic Fingerprint of Chinese Herbal Medicine (Version 2012) was used to evaluate the similarity and identify the common peaks. SPSS 16.0 and SIMCA 14.1 software were used for hierarchical cluster analysis(HCA) and principal component analysis(PCA). The 1,1-diphenyl-2-picrylhydrazyl(DPPH) free radical scavenging method, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt(ABTS) free radical scavenging method and total antioxidant capacity method were used to evaluate the antioxidant activity of 16 batches of ethanol extracts from Ficus tikoua Bur. Three methods including grey relational analysis(GRA), bivariate correlation analysis and partial least squares regression(PLSR) were used to study the spectrum-effect relationship.
RESULTS
The UHPLC fingerprints of 16 batches of Ficus tikoua Bur. were established and 13 common peaks were identified. The similarities were 0.613−0.996. At the same time, it was identified that peak 9 was rutin, peak 10 was isoquercetin, and peak 12 was narcissin. The results of HCA showed that the samples were clustered into two categories, which was consistent with the PCA results. Sixteen batches of Ficus tikoua Bur. had different degrees of antioxidant activity. The results of GRA showed that the correlation between 13 common peaks and antioxidant activity was >0.8, and all of them had high correlation. The results of bivariate correlation analysis and PLSR analysis showed that the correlation coefficient and regression coefficient of peak 5, peak 9(rutin), peak 10(isoquercetin), peak 11 and peak 12(narcissin) were positively correlated with antioxidant activity, and the contribution rate was larger(variable importance in projection>1), which were the main active components of antioxidant activity.
CONCLUSION
All the 16 batches of Ficus tikoua Bur. have good antioxidant activity, and its antioxidant effect is the result of the synergistic action of the internal antioxidant component group. The components corresponding to the common peaks 5, 9, 10, 11, 12 are closely related to their antioxidant activity, revealing the pharmacodynamic material basis of the antioxidant activity of Ficus tikoua Bur.
2.Analysis of long-term efficacy of CO 2 laser partial excision of vocal folds for 599 cases in the treatment of vocal cord leukoplakia
Haizhou WANG ; Xiaoyu LIU ; Xueyan LI ; Liyu CHENG ; Rong HU ; Qingwen YANG ; Yanru LI ; Wen XU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(10):1029-1036
Objective:To analyze long-term prognosis and influencing factors of recurrence in vocal fold leukoplakia treated by endoscopic cordectomy with CO 2 laser. Methods:A retrospective review was conducted on 599 patients with vocal fold leukoplakia [566 males and 33 females, aged 17-84 years (median age 55 years)], undergoing endoscopic cordectomy by CO 2 laser under general anesthesia at the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University, from January 2000 to December 2023. The study analyzed the clinical features, pathological grade, surgical methods, postoperative voice function, recurrence, malignant changes and analyzed the long-term efficacy and and its influencing factors. The patients were followed up for a duration of 6-249 months postoperatively, with a median follow-up time of 48 months. SPSS 20.0 software was used for statistical analysis. Results:Among the 599 patients, the histopathological grades included simple squamous cell hyperplasia in ( n=264, 44.08%), mild dysplasia ( n=96, 16.03%), moderate dysplasia ( n=74, 12.35%), severe dysplasia( n=43, 7.81%), carcinoma in situ( n=35, 5.84%), and carcinoma in situ with microinvasion( n=87, 14.52%). The 3-year and 5-year overall recurrence rates were 12.91% and 16.00%, respectively. In patients with precancerous lesion, 3.91% of recurrences presented with an upgraded pathologic grade and 2.34% evolved into carcinoma. The risk of recurrence was higher in lesions involving the anterior commissure, larger lesions, significant reduction/absence of mucosal waves, neovascularization/suspected neovascularization, and pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinvasion( F=44.76,21.54,11.55,8.78,23.20,respectively, P<0.05). Additionally, patients with recurrent disease exhibited higher reflux symptom index scores compared to those without recurrence. Exophytic lesion characteristics and the inability to cease smoking postoperatively were identified as independent risk factors for recurrence with an upgraded pathological grade, with odds ratios of 8.675 and 11.380 times greater than those with non-exophytic lesions and successful smoking cessation, respectively. At the 6-months postoperative assessment, patients who underwent subepithelial cordectomy (typeⅠ) demonstrated a statistically significant increase in fundamental frequency ( t=-3.38, P<0.05), and while other voice acoustic parameters were not significantly different.Conversely, those who underwent transmuscular cordectomy (TypeⅢ) exhibited significant alterations in multiple voice acoustic parameters when compared to preoperative values ( P<0.05). Furthermore, postoperative vocal fold adhesions developed in 84 patients with 13 of these individuals requiring surgical intervention for adhesion release. Conclusions:Lesions involving the anterior commissure, larger lesions, pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinfiltration, significant reduction/absence of vocal fold mucosal waves, and neovascularization visible under NBI are indicative of an increased risk of recurrence, whereas exophytic lesions and the inability to cease smoking postoperatively significantly increase the risk of recurrence with elevated pathologic grade. Recovery of postoperative voice quality is procedure-dependent, underscoring the importance of surgical approach selection in the management of vocal fold leukoplakia.
3.Preliminary mining and analysis of ADE signal of ofatumumab
Xiaojuan YANG ; Qingwen ZHANG ; Xiaosa DU ; Jinpeng DONG ; Yiming HU ; Shudi WANG ; Yubin FENG
China Pharmacy 2024;35(17):2120-2125
OBJECTIVE To screen potential adverse drug event (ADE) signals for the treatment of multiple sclerosis (MS) with ofatumumab, and to provide reference for the safe use of drugs in clinical practice. METHODS Using “ofatumumab” and the trade name “Kesimpta” as the search keywords, adverse event (AE) reports related to ofatumumab included in FDA Adverse Event Reporting System database from January 2009 to December 2023 were screened, and their reason contained the “multiple sclerosis”; ADE signal mining and analysis were conducted by reporting odds ratio method and proportional reporting ratio method. RESULTS A total of 21 759 eligible AE reports were selected, involving 62 449 AE cases; 27 system organ classes included general diseases and various reactions at the site of administration (15 021 cases), neurological diseases (9 668 cases), infectious and invasive diseases (5 967 cases), injury, poisoning and surgical complications (4 952 cases), musculoskeletal and connective tissue disorders (4 647 cases). A total of 21 759 AE reports correspond to 606 ADE signals, including 234 ADE positive signals. A total of 107 ADE positive signals were not included in drug instruction of ofatumumab, including flu-like diseases, nasopharyngitis, cough, urinary tract infection, sore throat, insomnia, runny nose, anemia, hair loss, atrial fibrillation, and thrombocytopenia, etc. CONCLUSIONS In the process of using ofatumumab for MS, sufficient attention should be paid to ADE included in drug instructions. The ADE with strong signal strength screened in this study should also be paid special attention to, such as flu-like diseases, hemocytopenia, temperature intolerance, optic neuritis, and moyamoya disease. The increased risk of infection, cardiovascular disease, and potential damage to the respiratory and spiritual systems caused by ofatumumab can not be ignored.
4.Longitudinal evaluation of tissue prolapse after carotid stenting by optical coherence tomography
Xuan SHI ; Yunfei HAN ; Xiaohui XU ; Qingwen YANG ; Fang WANG ; Qin YIN ; Rui LIU ; Xinfeng LIU
Chinese Journal of Neurology 2024;57(8):848-858
Objective:To assess the prevalence and type of tissue prolapse (TP) occurring after endovascular treatment (ET), investigate the association between TP types and plaque morphological characteristics before ET, and observe in-stent neointimal hyperplasia (NIH) using optical coherence tomography (OCT).Methods:Patients who underwent carotid artery stenting and received pre- and post-ET OCT assessment at Jinling Hospital between July 2018 and December 2019 were collected. Baseline plaque characteristics and TP features were evaluated using OCT. The TPs were classified into two categories: smooth TP (STP) and irregular and/or high attenuated TP (I/HTP). The association between I/HTP and plaque characteristics was analyzed, while NIH feature was also summarized.Results:A total of 29 patients were included in the study, of whom 23 patients (79.3%) presented with TP. Among these 23 patients, 9 were classified as I/HTP and 14 were classified as STP. Compared with STP, I/HTP was more commonly observed in lipid-rich plaques (7/9 vs 2/14, P=0.007), and lesions with cap rupture (7/9 vs 4/14, P=0.036). Additionally, the longitudinal length of TP appeared to be longer in cases with I/HTP compared to those with STP [3.0 (1.5, 4.6) mm vs 1.1 (0.7, 3.2) mm, Z=1.294, P=0.201]. Six patients underwent OCT follow-up for a mean duration of 6.7 months, of whom 3 patients with I/HTP showed severe heterogeneous NIH (50.1%-61.8%), while 1 patient with STP and 2 patients without TP only demonstrated mild NIH. Conclusions:The study observed that I/HTP was commonly found in plaques with larger lipid core and/or cap rupture, and suggested a potential relationship between I/HTP and NIH. These preliminary findings obtained from a limited sample should be verified by prospective large-scale studies.
5.Study on the Influence of Yunnan Rice Products on Blood Sugar
Murong JIANG ; Yuanqin LEI ; Ke ZHANG ; Qiumei LIU ; Wenli YANG ; Hongyi LIU ; Jie YAN ; Qingwen ZHANG
Journal of Kunming Medical University 2023;44(12):41-45
Objective To explore the effect of Yunnan specialty rice products on blood sugar by measuring the glycemic index of 5 Yunnan special rice foods:rice noodles,rice cakes,rice rolls,sour rice noodles and dry rice noodles.Methods Following the national standard method to determine the carbohydrate content of 5 Yunnan specialty rice products,and the target amount of the test substance was calculated.Food Glycemic Index Determination Method was used to determine the glycemic index of 5 Yunnan specialty rice products and observe their impact on blood sugar.Results The GI value of Yunnan specialty food rice noodle is 63,rice cake is 64,rice roll is 46,sour rice noodles is 38,and dry rice noodles is 33.Conclusion Yunnan specialty foods rice noodle and rice cake belong to medium GI foods,and diabetes patients should reduce consumption;rice roll,sour rice noodles,and dry rice noodles belong to low GI foods and can be a better staple food source for diabetes patients.
6.Machanism of methyleugenoc in protecting islet cells from hypoxia/reoxygenation injury
Qingwen LI ; Huifang YANG ; Ji ZHANG ; Mengqin WANG ; Jiasi ZHANG ; Kailun SUN ; Zhiheng WANG ; Nianqiao GONG
Chinese Journal of Organ Transplantation 2023;44(4):229-236
Objective:To explore the protective effect of methyl eugenol (Me) on islet ischemia/reperfusion (I/R) injury and elucidate its underlying mechanism.Methods:The islets were isolated and purified from 6-8 week male BALB/c mice and divided into four groups of normal control (normal culture without any treatment), hypoxia/reoxygenation (H/R treatment), H/R+ dimethyl sulfoxide (DMSO dosing plus H/R treatment) and H/R+ Me (Me dosing plus H/R). Viability of islet cells in each group was detected by acridine orange (AO)/propidium iodide (PI) double stain.Function of islet cells (insulin secretion) was measured by enzyme-linked immunosorbent assay (ELISA). Murine islet β Min6 cells were selected for detecting the effect of Me on the proliferative activity of normal cultured and H/R treated islet cells under different concentration gradients by CCK8.Then Min6 cells were divided into four groups of normal, H/R, H/R+ DMSO and H/R+ Me.The definition of group was the same as that of primary murine islets.Flow cytometry and Hoechst 33342 nuclear stain were utilized for detecting cell apoptotic rate in each group.The protein expressions of p-JNK, p-p38, JNK, p38, Bcl-2 and Bax were detected by Western blot.And the data were processed by one-way ANOVA or t test.Results:The proportion of dead islet cells in H/R group was (29.47±2.65)% and it was significantly lower than that in normal group (7.63±1.53)%.And the inter-group differences were statistically significant ( P<0.001). The proportion of dead islet cells was (20.63±3.07)% in H/R+ Me group.It was higher than that in H/R group (29.47±2.65)% and in H/R+ DMSO group (30.13±1.50)% and inter-group difference was statistically significant ( P<0.05 & P<0.01). Under the stimulation of high glucose, the insulin secretion level of islet in H/R+ Me group was (1.76+ 0.08) mg/L, which was higher than that in H/R group and H/R+ DMSD group(1.24±0.14)mg/L and(1.27±0.05)mg/L, and the difference was statistically significant[(1.76±0.08) vs. (1.24±0.14) mg/L; (1.76±0.08) vs.(1.27±0.05) mg/L, P<0.01]. There was no significant effect on cell viability after Me dosing within a certain concentration range (0-40 μmol/L). After Me dosing (5 μmol/L), cell viability of H/R-treated Min6 cells was significantly higher than that without Me.And the difference was statistically significant[(1.19±0.03) vs.(1.00±0), P<0.01]. As compared with H/R and H/R+ DMSO groups, overall apoptotic rate declined in H/R+ Me group (Hoechst 33342 stain: 14.50%±1.05% vs. 23.30%±1.18%, 14.50%±1.05% vs. 22.77%±1.75%, P<0.001; Flow cytometry: 4.36%±0.54% vs. 21.44%±1.02%, 4.36%±0.54% vs. 21.68%±3.06%, P<0.01). The expressions of p-JNK and p-p38 were down-regulated (p-JNK: 0.77±0.06 vs. 1.03±0.05, 0.77±0.06 vs.0.93±0.04, P<0.001; p-p38: 0.80±0.05 vs. 1.01±0.08; 0.80±0.05 vs. 1.00±0.05, P<0.05) while Bcl-2/Bax ratio rose (1.62±0.13 vs. 0.72±0.10, 1.62±0.13 vs. 0.74±0.13, P<0.01). Conclusions:Me can improve the viability and function of islets and suppress the apoptosis of Min6 cells after H/R.The mechanism is correlated with JNK and p38 MAPK signaling pathways.
7.Effect of Huashi Runzao Prescription on Structure and Function of Submandibular Gland in Sjögren's Syndrome Model Mice
Qian HE ; Xinbo YU ; Ziwei HUANG ; Jiahe LIAO ; Guangyao CHEN ; Zihua WU ; Jiaqi CHEN ; Jianying YANG ; Jing LUO ; Qingwen TAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):36-44
ObjectiveTo investigate the effects of Huashi Runzao prescription (HRP) on the histopathological injury and function of submandibular gland in naive non-obese diabetic (NOD/Ltj) mouse model of Sjögren's syndrome (SS) and its regulatory effect on aquaporin 5 (AQP5) expression in submandibular gland cells. MethodThe SS model was induced in NOD/Ltj mice. The NOD/Ltj female mice aged nine weeks were selected and randomly assigned into model group,HRP group (7.15 g·kg-1·d-1),and hydroxychloroquine (HCQ) group (1.30 g·kg-1·d-1), and female BALB/c mice in the same age were selected and assigned into the normal group, with six mice in each group. Drug intervention lasted eight weeks. The water consumption and salivary flow rate (SFR) of each group were recorded. The pathological staining results of the submandibular gland of mice in each group were observed and scored. AQP5 expression was determined by immunohistochemistry (IHC) and Western blot. ResultCompared with the normal group, the model group showed increased water consumption (P<0.05) and reduced SFR (P<0.05). Compared with the model group, the HRP group showed decreased water consumption (P<0.05) and increased SFR (P<0.05), and the HCQ group showed increased SFR (P<0.05). In terms of histopathological results of the submandibular gland,compared with the normal group,the model group showed increased pathological score, number of lymphocyte infiltration foci,and percentage of lymphatic infiltration area (P<0.05). Compared with the model group, the HRP group showed reduced pathological scores and number of lymphocyte infiltration foci (P<0.05), and the HRP group and the HCQ group showed reduced percentage of lymphatic infiltration area(P<0.05). The results of IHC and Western blot showed that compared with the normal group,the model group showed down-regulated expression level of AQP5 protein (P<0.05), and compared with the model group and the HCQ group,the HRP group showed up-regulated expression level of AQP5 protein (P<0.05). ConclusionHRP can improve the secretion function of submandibular gland acinous cells and glandular structure injury in SS model mice, and its mechanism may be related to the up-regulation of AQP5 protein expression level in submandibular gland cells.
8.Effect of Huashi Runzao Prescription on Primary Sjögren's Syndrome
Zihua WU ; Ziwei HUANG ; Jiaqi CHEN ; Qian HE ; Jianying YANG ; Yan ZHANG ; Jiahe LIAO ; Xinbo YU ; Jing LUO ; Qingwen TAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):45-51
ObjectiveTo observe the efficacy and safety of Huashi Runzao prescription for patients with primary Sjögren's syndrome (pSS) of combined dryness and dampness pattern. MethodA total of 105 eligible patients were randomized into the experimental group (65 cases) and control group (40 cases), and they were respectively treated with Huashi Runzao prescription and hydroxychloroquine for 12 weeks. Visual Analogue Scale (VAS) was employed to assess the symptoms. The symptoms of dryness, fatigue, and pain, European League Against Rheumatism (EULAR) Sjögren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren's syndrome disease activity index (ESSDAI), and immune inflammatory indicators before and after treatment were compared between the two groups, and adverse reactions were observed. ResultAfter treatment, the ESSPRI score was lower than that before treatment in the experimental groups (P<0.01) and was lower in the experimental group than in the control group (P<0.05). The VAS scores of dry mouth, dry eyes, overall dryness, fatigue, and pain in the experimental group decreased compared with those before treatment (P<0.01), and the experimental group had lower VAS scores of dry mouth and overall dryness than the control group (P<0.01). After treatment, the ESSDAI score of both groups decreased compared with that before treatment (P<0.05, P<0.01), but there was no significant difference between the groups. After treatment, the level of immunoglobulin M (IgM) decreased (P<0.01) and the level of complement C3 increased (P<0.01) in the experimental group, while the level of complement C3 decreased in the control group (P<0.05). There was no significant difference in the laboratory indexes between groups. During the treatment, stomachache occurred to one case in the experimental group, which was alleviated after the treatment, and no adverse reaction was observed in the control group. According to the chi-square test, the occurrence of adverse reactions was insignificantly different between the two groups. ConclusionHuashi Runzao prescription can alleviate the symptoms of dryness, fatigue, and pain, and reduce disease activity without associated side effects in pSS patients with combined dampness and dryness pattern.
9.Characteristics of Tongue Manifestations and Syndromes of Patients with Primary Sjögren's Syndrome of Different Time
Yan ZHANG ; Jianying YANG ; Lining ZHANG ; Zihua WU ; Qi HU ; Ziwei HUANG ; Jiaqi CHEN ; Xinbo YU ; Jing LUO ; Qingwen TAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):52-58
ObjectiveTo explore the characteristics of tongue manifestations and traditional Chinese medicine (TCM) syndromes in patients with primary Sjogren's syndrome (pSS) of different time. MethodpSS patients who visited TCM Department of Rheumatism in China-Japan Friendship Hospital from December 2018 to October 2021 were included and grouped according to the disease courses (short<5 years, medium 5-10 years, long > 10 years). Chi-square test was used for comparison between three groups and Bonferroni method for multiple comparisons. In the pairwise comparison, P<0.017 indicated significant difference. Chi-square test was performed on the syndrome and specific tongue manifestations with inter-group differences to analyze the trend of tongue manifestations and TCM syndromes over time (interval: two years). ResultA total of 193 pSS patients were enrolled, with 85 (44.0%) of short disease course, 69 (35.8%) of medium disease course, and 39 (20.2%) of long disease course. The common tongue manifestations were crimson tongue, fissured tongue, thin tongue, lack of fluid, and dry coating, which showed no significant difference among the three groups. Higher proportion of patients with light red tongue was observed in the group with short disease course than in group with medium disease course (χ2=6.407, P<0.017). Higher proportions of patients with thick coating (χ2=6.784, P<0.017) and phlegm-dampness syndrome (χ2=11.545, P<0.017) and lower proportion of patients with Qi deficiency syndrome (χ2=12.706, P<0.017) were found in the group with short disease course than in the group with long disease course. Patients with medium (χ2=6.358, P<0.017) and long (χ2=8.279, P<0.017) disease course tended to have exfoliated coating compared with those with short disease course, and the proportion of patients with exfoliated coating rose and the proportion of patients with thick greasy coating decreased over time (Ptrend<0.05). In addition, the proportion of patients with phlegm-dampness syndrome decreased and that with Qi deficiency syndrome increased over time (Ptrend<0.05). ConclusionIn the early stage, patients with pSS often show both dryness and dampness, as manifested by the thick greasy coating and phlegm-dampness syndrome. In the medium and late stage, patients often have Qi-Yin deficiency, as evidenced by exfoliated coating and Qi deficiency. In the clinical practice, medicines should be prescribed based on tongue manifestations and TCM syndrome of patients.
10.Clinical Characteristics of Geographic Tongue in Patients with Primary Sjögren's Syndrome
Jiahe LIAO ; Lining ZHANG ; Yan ZHANG ; Jianying YANG ; Ziwei HUANG ; Zihua WU ; Jing LUO ; Qingwen TAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(8):59-65
ObjectiveTo analyze the clinical characteristics of geographic tongue in patients with primary Sjögren's syndrome (pSS). MethodPatients with pSS treated in the China-Japan Friendship Hospital from December 2018 to October 2021 were enrolled and divided into different groups according to the presence of geographic tongue or the severity. Phi correlation analysis,Chi-square test, and Mann-Whitney test were used to analyze the clinical characteristics of patients with geographic tongue. ResultA total of 182 pSS patients were included in this study,including 75 (41.2%) patients with geographic tongue and 107 (58.8%) without geographic tongue. Partial exfoliation was more common than total exfoliation, and the anterior part of the tongue was the most common exfoliation site. The number of patients with severe geographic tongue was more than those with mild-to-moderate geographic tongue. Compared with pSS patients without geographic tongue,those with geographic tongue were more common in fissured tongue (92.0%/41.1%,χ2=48.491,P<0.05),red or crimson tongue (48.0%/23.3%,χ2=12.009,P<0.05),Yin deficiency syndrome (100.0%/43.9%,χ2=62.739,P<0.05),and Qi deficiency syndrome (94.7%∶50.5%,χ2=40.046,P<0.05),less common in phlegm-dampness syndrome (33.3%/72.0%,χ2=26.709,P<0.05),and showed higher proportions in hyperglobulinemia (89.3%/65.4%,χ2=13.547,P<0.01),ANA ≥1∶160 (78.1%/57.3%,χ2=8.227,P<0.01),and positive RF (51.4%/36.5%,χ2=3.877,P<0.05). Compared with pSS patients with mild geographic tongue,pSS patients with moderate-to-severe geographic tongue had higher proportions in hyperglobulinemia (98.1%/68.2%,χ2=14.617,P<0.01),positive anti-CENP-B (26.0%/4.8%,χ2=4.214,P<0.05),and reduced complement 3 (26.4%/4.5%,χ2=4.647,P<0.05). The geographic tongue was positively associated with fissured tongue (φ=0.531),Yin deficiency syndrome (φ=0.587),and Qi deficiency syndrome (φ=0.469),negatively associated with phlegm-dampness syndrome (φ=-0.447),and weakly associated with tongue color (φ<0.4). There was no statistical difference in the disease activity index between patients with or without geographic tongue and severity. ConclusionMore than 40% of pSS patients had geographic tongue accompanied by fissured tongue. Geographic tongue is positively associated with Yin deficiency syndrome and Qi deficiency syndrome,and negatively associated with phlegm-dampness syndrome, indicating that treatment should be based on tonifying Qi and nourishing Yin. Compared with pSS patients without geographic tongue, those with geographic tongue may have higher positive rate of some immune indicators,which deserves further exploration.


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