1.Reliability and Validity of Dampness Syndrome Scale of Chinese Medicine Using for Persistent Asthma Patients: a Cross-Sectional Study
Yihe CHI ; Feiting FAN ; Shushan WEI ; Yuewei LI ; Jingmin XIAO ; Lei WU ; Lin LIN ; Yuanbin CHEN
Journal of Traditional Chinese Medicine 2024;65(11):1132-1138
ObjectiveTo evaluate the reliability and validity of the Dampness Syndrome Scale of Chinese Medicine (DSSCM) among patients with persistent asthma, and to explore the correlation between dampness syndrome and clinical characteristics of persistent asthma. MethodsA cross-sectional survey was conducted. Basic information, examination results, DSSCM, Asthma Control Test (ACT), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scores were collected from 206 patients with persistent asthma to evaluate the reliability and validity of DSSCM and to explore the correlation between dampness syndrome and clinical characteristics. ResultsThe mean score of DSSCM among 206 patients was 14.59 ± 10.53. The overall Cronbach α coefficient and Spearman-Brown split-half reliability coefficient of the scale were both greater than 0.8, and the success rate of scale convergent and discriminant validity calibration were greater than 80%. The confirmatory factor analysis showed that the χ2/df was 2.309, and the root mean square error of approximation (RMSEA) was 0.08; the root mean square residual (RMR) was 0.049, whereas the comparative fit index (CFI), the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), the normed fit index (NFI) and the incremental fit index (IFI) were less than 0.9. Correlation analysis showed that DSSCM scores were positively correlated with disease duration, GAD-7 scores, and PHQ-9 scores (P<0.05), and negatively correlated with ACT scores (P<0.01). The DSSCM scores were significantly different between patients with different disease severity (H = 10.92, P = 0.01), and the DSSCM scores of allergic patients were higher than those of non-allergic patients (Z = -4.19, P<0.001). ConclusionDSSCM has acceptable reliability and validity for patients with persistent asthma. The scores of DSSCM correlated with the disease duration, ACT score, GAD-7 score, PHQ-9 score, disease severity and allergic status of persistent asthmatics.
2.Xianqi Qinglong Formula (仙芪青龙方) for the Treatment of Cough Variant Asthma with Lung and Kidney Deficiency and Exuberant Wind-induced Spasm and Tension Syndrome: A Randomized, Positive-controlled, Non-inferiority Clinical Trial
Xiaochun CHEN ; Jianya YANG ; Jingmin XIAO ; Feiting FAN ; Mingjuan ZHOU ; Lei WU ; Lin LIN ; Yuanbin CHEN
Journal of Traditional Chinese Medicine 2024;65(20):2109-2115
ObjectiveTo evaluate the clinical efficacy and safety of Xianqi Qinglong Formula (仙芪青龙方, XQF) in the treatment of cough variant asthma (CVS) patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome. MethodsA randomized, positive-controlled, non-inferiority clinical trial was designed. Totally, 102 CVS patients with lung and kidney deficiency and exuberant wind-induced spasm and tension syndrome were randomly divided into a treatment group (52 cases) and a control group (50 cases). The treatment group was given XQF granules orally, 1 dose per day, 2 bags each time (9.25 g/bag), twice a day, after breakfast and dinner; the control group was given XQF granules placebo orally combined with inhaled fluticasone propionate inhalation aerosol (125 μg each time, twice a day). Both groups were treated for 12 weeks and followed up for 12 weeks, with a total of 24 weeks. The primary outcome was the cough symptom score (including daytime, nighttime and total score), evaluated before treatment (at enrollment), during treatment (after the 6th week of enrollment), at the end of treatment (after the 12th week of enrollment), and at the end of follow-up (after the 24th week of enrollment). The non-inferiority was determined by the lower limit (LCL) of the unilateral 95% confidence interval. The secondary outcomes included cough relief and disappearance, total score of TCM syndrome, cough visual analogue (VAS) score, Leicester Cough Questionnaire (LCQ) score, and lung function indicators including forced expiratory volume in 1 second (FEV1), percentage of predicted forced expiratory volume in 1 second (FEV1%pred), forced vital capacity (FVC), and peak expiratory flow (PEF). Blood routine and liver and kidney function were tested before and after treatment, and the adverse events were recorded. ResultsA total of 101 patients were included in the full analysis set (FAS), including 52 cases in the treatment group and 49 cases in the control group. After treatment, the daytime, nighttime and total cough symptom scores during treatment, at the end of treatment and at the end of follow-up all decreased in both two groups (P<0.01). The unilateral 95% LCL of the total cough symptom scores during treatment, at the end of treatment and at the end of follow-up of the two groups were -0.14, -0.47 and -0.27 (95% LCL all>-0.6). There were no significant differences in the cough relief rate, cough disappearance rate, cough relief days and cough disappearance days between the two groups at each time point (P>0.05). Compared to those before treatment, the TCM syndrome scores and cough VAS scores during treatment, at the end of treatment and at the end of follow-up decreased in both groups, while the LCQ scores increased (P<0.01), but there were no significant differences in FEV1, FEV1%, FVC and PEF before and after treatment (P>0.05). There were no significant differences in TCM syndrome scores, cough VAS scores, LCQ scores, FEV1, FEV1%, FVC, and PEF between the two groups at each time point (P>0.05). No clinically significant abnormal liver and kidney function were found in the two groups before and after treatment. ConclusionXQF is not inferior to fluticasone propionate inhalation aerosol in relieving cough symptoms, reducing cough scores, decreasing the number of cough attack days, and improving the quality of life when treating CVS patients with lung and kidney deficiency and exuberant wind-induced spasms and tension syndrome, and relatively safe.
3.Cardamomine attenuates cardiotoxicity induced by anthracyclines in rats by regulating Notch/NF-κB signal pathway mediated pyroptosis
Xiao-Lei YU ; Wen-Xin LI ; Pan-Pan CHEN ; Yun-Fei LIANG ; Yan-Rong CUI ; Hai-Jing JIAO ; Fan XU
The Chinese Journal of Clinical Pharmacology 2024;40(9):1277-1281
Objective To investigate the protective effect of cardamomine(CAR)on anthracycline-induced cardiotoxicity in rats by regulating the pyroptosis mediated by Notch/nuclear factor-κB(NF-κB)signal pathway.Methods The rat model of cardiotoxicity was established by intraperitoneal injection of doxorubicin(DOX).The model rats were randomly divided into DOX group,CAR-L group,CAR-H group and Jagged1 group.Another 10 rats were taken as the control group.The control group and the DOX group were given the same amount of 0.9%NaCl.The CAR-L group and CAR-H group were given 40 and 80 mg·kg-1 CAR by gavage,respectively.The Jagged1 group was given 80 mg·kg-1 CAR+and 25 ng·kg-1 Jagged1 by gavage once a day for 4 weeks.Myocardial injury markers creatine kinase isoenzyme(CK-MB)and troponin Ⅰ(cTn Ⅰ)were detected by kit.The expression of pyroptosis protein Nod-like receptor protein 3(NLRP3)and desquamate D(GSDM-D)were observed by immunohistochemistry.The expression of Notch1 and phosphorylated NF-κB p65(p-NF-κB p65)protein in myocardial tissue was detected by Western blotting.Results The levels of CK-MB in control group,DOX group,CAR-L group,CAR-H group and Jagged1 group were(48.51±5.39),(175.93±13.27),(106.83±9.73),(83.71±8.39)and(126.08±9.74)U·L-1;the levels of cTn Ⅰ were(1.95±0.18),(12.46±1.83),(7.15±0.64),(4.13±0.38)and(8.01±0.78)ng·mL-1;the average optical density of NLRP3 protein were 0.19±0.07,0.36±0.05,0.25±0.05,0.21±0.03 and 0.31±0.06;the average optical density of GSDM-D were 0.18±0.04,0.43±0.06,0.24±0.03,0.19±0.04 and 0.32±0.05.There were significant differences in the above indexes between DOX group and control group(all P<0.05).There were significant differences in the above indexes between CAR-L group,CAR-H group and DOX group(all P<0.05),and there were significant differences between CAR-L group and CAR-H group(all P<0.05).The above indexes in Jagged1 group were significantly different from those in CAR-H group(all P<0.05).Conclusion CAR can improve myocardial injury in DOX cardiotoxic rats,reduce oxidative stress,inflammatory reaction and pyroptosis,and its mechanism may be related to the inhibition of Notch/NF-κB pathway.
4.Research status of non-coding RNA in viral myocarditis
Xiao-Long HE ; Xin-Xin HU ; Fan-Ning WANG ; Wen-Xin WANG ; Guo-Lei ZHOU ; Kang YI ; Tao YOU
The Chinese Journal of Clinical Pharmacology 2024;40(14):2143-2147
Viral myocarditis(VMC)is the leading cause of dilated cardiomyopathy,which can lead to heart failure and sudden cardiac death.With the development of high-throughput sequencing technology,non-coding RNA(ncRNA)plays an important role in the occurrence and development of VMC.ncRNA promotes the occurrence and development of VMC by regulating viral replication,immune cell function,myocardial cell death,myocardial interstitial fibrosis,and other pathological processes.This article reviews the research progress of ncRNA in VMC and provides new ideas for the pathogenesis,diagnosis,and treatment of VMC.
5.Hypericin inhibits the expression of NLRP3 in microglia of Parkinson's disease mice and alleviates the damage of DA-ergic neurons
Li-Shan FAN ; Jia ZHANG ; Si-Xiang NIU ; Qi XIAO ; Hui-Jie FAN ; Lei XU ; Li-Xia YANG ; Lu JIA ; Shao-Chen QIN ; Bao-Guo XIAO ; Cun-Gen MA ; Zhi CHAI
The Chinese Journal of Clinical Pharmacology 2024;40(17):2523-2527
Objective To observe the intervention effect of hypericin(HYP)on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)mice model and its mechanism.Methods Thirty C57BL/6 mice were randomly divided into normal,model and experimental groups with 10 mice per group.PD mouse model was established after 7 days of intraperitoneal injection of MPTP,and drug intervention was carried out from the first day of modeling.Normal group and model group were intraperitoneally injected with 500 μL·kg·d-1 0.9%NaCl.The experimental group was intraperitoneally injected with 25 mg·kg·d-1 HYP.The three groups of rats were given the drug once each time for 14 days.The expression levels of tyrosine hydroxylase(TH),Nod-like receptor thermal protein domain protein 3(NLRP3)and ionized calcium binding adapter molecule 1(Iba1)in the striatum of nigra were detected by Western blot.Results The climbing time of normal,model and experimental groups was(5.35±0.43),(9.71±1.19)and(8.07±0.34)s;suspension scores were(2.92±0.15),(1.38±0.28)and(1.96±0.28)points;the relative expression levels of TH protein were 1.04±0.06,0.51±0.09 and 0.75±0.07;the relative expression levels of NLRP3 protein were 0.51±0.03,1.00±0.04 and 0.77±0.06;the relative expression levels of Iba1 protein were 0.68±0.10,1.30±0.28 and 0.89±0.05,respectively.The above indexes in the model group were statistically significant compared with the experimental group and the normal group(all P<0.01).Conclusion HYP plays a therapeutic role in PD by inhibiting the expression of NLRP3 inflammasome in PD mice.
6.Analysis of Helicobacter pylori infection in the natural population of Sanya City
Shi-Mei HUANG ; Lian-Guo LAN ; Da-Ya ZHANG ; Run-Xiang CHEN ; Xiao-Dong ZHANG ; Chen CHEN ; Fan ZENG ; Da LI ; Xian-Feng HUANG ; Qi WANG ; Shi-Ju CHEN ; Lei GAO ; Jun-Tao ZENG ; Fei-Hu BAI
Modern Interventional Diagnosis and Treatment in Gastroenterology 2024;29(2):141-145
Objective To explore the current status of H.pylori infection in the natural population of Sanya City,analyze its influencing factors,and provide a reference basis for the prevention and control of H.pylori infection.Methods A total of 677 residents from four districts of Sanya City were selected by overall stratified random sampling method,and were subjected to urea 14C breath test and questionnaire survey to calculate the positive rate of H.pylori in the natural population and analyze the influencing factors of H.pylori infection.Results A total of 606 residents were included,and the number of H.pylori positive detections was 261,with a positive detection rate of 38.5%.Among them,different ethnicity,marital status,smoking,eating vegetables and fruits,and literacy level were associated with H.pylori infection(P<0.05);gender,age,BMI,alcohol consumption,drinking water source,betel quid chewing,and the number of cohabitants were not significantly associated with H.pylori infection(P>0.05).Family infection was an independent risk factor for H.pylori infection in the natural population of Sanya City,and Li ethnicity,frequent consumption of fruits and vegetables,and college and higher education level were independent protective factors for H.pylori infection in the natural population of Sanya City.Conclusion The rate of H.pylori infection in the natural population of Sanya City is lower than the national average.Consuming more fruits and vegetables and improving the awareness of hygiene protection are conducive to the prevention of H.pylori infection;and the promotion of the family and related members with the same examination and treatment is important to avoid aggregation of infection within the family.
7.Single-center study of COVID-19 in patients with chronic lymphocytic leukemia
Xiao LU ; Ling GAO ; Siqi QIAN ; Luomengjia DAI ; Ziyuan ZHOU ; Tonglu QIU ; Yi XIA ; Yi MIAO ; Shuchao QIN ; Lei FAN ; Wei XU ; Jianyong LI ; Huayuan ZHU
Chinese Journal of Hematology 2024;45(10):923-930
Objective:To investigate the vaccination status, characteristics and prognosis of patients suffering from a combination of COVID-19 and chronic lymphocytic anemia (CLL) in China.Methods:Clinical data of 328 patients with chronic lymphocytic leukemia (CLL) who were first diagnosed with COVID-19 and treated in the Department of Hematology of Jiangsu Provincial People’s Hospital between November 2022 and February 2023 were retrospectively analyzed. Univariate and multivariate analysis of data of patients with severe/critical COVID-19 were conducted by applying the binary logistic regression model.Results:The median age of the CLL patients was 60 (24-87) years. 23.5% (77/328) of these patients suffered from severe/critical COVID-19 infection. Univariate analysis of the data demonstrated that a combination of factors including age >67 years ( OR=2.15, 95% CI 1.24- 3.73, P=0.006), diabetes ( OR=2.09, 95% CI 1.05-4.20, P=0.037), chronic hepatitis B ( OR=2.91, 95% CI 1.30-6.51, P=0.010), CLL progressive ( OR=3.79, 95% CI 1.57-9.15, P=0.003) and CD20 antibody-based treatments within three months prior to the COVID-19 infection ( OR=2.79, 95% CI 1.35-5.77, P=0.006) were the risk factors for severe/critical COVID-19. According to the multivariate analysis, CLL progressive ( OR=2.98, 95% CI 1.10-8.10, P=0.033) was an independent risk factor for severe/critical COVID-19 and administration of the BTK (Bruton tyrosine kinase) inhibitor monotherapy might exert a protective effect and influence a positive outcome of the COVID-19 infection ( OR=0.38, 95% CI 0.16-0.90, P=0.028). Among the 242 patients who were followed up until October 2023, 9.1% (22/242) had multiple subsequent COVID-19 infections (≥3), and 2.1% (5/242) had persistent COVID-19 infections (patients with persistent positive test for the SARS-CoV-2 antigen testing until missing follow-up for any reason). The peak value of the anti-SARS-CoV-2-IgG titres was observed between three and four months post symptom onset (median: 3.511 S/CO vs 1.047 S/CO, P<0.05). The levels of immunoglobulin A gradually decreased following infection with COVID-19, and its trough levels were attained between two to four weeks post infection (median: 0.30 g/L vs 0.74 g/L, P<0.05). According to this study the mortality of patients suffering from a combination of COVID-19 infection and CLL was 2.7% (9/328), and the main reason for their death was respiratory failure and heart failure. Conclusions:A low rate of COVID-19 vaccination and a high rate of severe/critical COVID-19 infection was observed in the CLL patients. CLL progressive was associated with severe/critical COVID-19. Anti-CD20-based treatments received within the past three months might be a risk factor for exacerbation of COVID-19 infection, whereas a monotherapy with BTK inhibitors exert a protective effect and improve outcome of COVID-19 infection.
8.Functional and oncologic outcomes of partial nephrectomy for cystic renal cell carci-noma:A single-center retrospective study
Fan SHU ; Yichang HAO ; Zhanyi ZHANG ; Shaohui DENG ; Hongxian ZHANG ; Lei LIU ; Guoliang WANG ; Xiao-Jun TIAN ; Lei ZHAO ; Lulin MA ; Shudong ZHANG
Journal of Peking University(Health Sciences) 2024;56(4):667-672
Objective:To investigate the postoperative renal function and oncologic outcomes of cystic renal cell carcinoma with partial nephrectomy,and to compared the single-center data on surgical out-comes with the Surveillance,Epidemiology,and End Results(SEER)database.Methods:This was a retrospective study that included the patients with cystic renal cell carcinoma who underwent partial ne-phrectomy in the Department of Urology,Peking University Third Hospital(PUTH)from 2010 to 2023.The clinical data and depicting baseline characteristics were collected.Renal dynamic imaging and the Chinese Coefficients for Chronic Kidney Disease Epidemiology Collaboration(C-CKD-EPI)formulae were used to calculate the estimated glomerular filtration rate(eGFR).The renal function curves over time were then plotted,and the patients were followed-up to record their survival status.Cases of cystic renal cell carcinoma in the SEER database between 2000 and 2020 were included,propensity score matching(PSM)was performed to balance the differences between SEER cohort and PUTH cohort,and the cancer-specific survival(CSS)curves for both groups were plotted and statistical differences were calcu-lated by the Kaplan-Meier method.Results:A total of 38 and 385 patients were included in the PUTH cohort and SEER cohort,respectively,and 31 and 72 patients were screened in each cohort after PSM.Of the baseline characteristics,only tumor size(P=0.042)was found to differ statistically between the two groups.There was no statistically significant difference between the two cohorts in terms of CSS after PSM(P=0.556).The median follow-up time in the SEER cohort was 112.5(65,152)months and a 10-year survival rate of 97.2%,while the PUTH cohort had a median follow-up of 57.0(20,1 172)months and a 10-year survival rate of 100.0%.There was no statistically significant difference between eGFR determined by preoperative renal dynamic imaging and the results of the C-CKD-EPI formulae based on creatinine estimation(P=0.073).There was a statistically significant difference in eGFR among the preoperative,short-term postoperative,and long-term postoperative(P<0.001),which was characterized by the presence of a decline in renal function in the short-term postoperative period and the recovery of renal function in the long-term period.Conclusion:Partial nephrectomy for cystic renal cell carcinoma is safe and feasible with favorable renal function and oncologic outcomes.
9.Effects of Oral Use Combined with Percutaneous Iontophoresis of Osteoking on Pain,Lumbar Function and Serological Indicators of Patients with Lumbar Disc Herniation
Xin-Lei LUO ; Jing-Jing LIU ; Xiao-Xi WANG ; Jian-Yun FAN ; Qiang NA ; Chang-Tao LAO
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(6):1444-1449
Objective To investigate the effects of oral use combined with percutaneous iontophoresis of Osteoking(mainly composed of Citri Reticulatae Pericarpium,Carthami Flos,Notoginseng Radix et Rhizoma,Eucommiae Cortex,Ginseng Radix et Rhizoma,Daturae Flos,Astragali Radix,Radixet Caulis Schizophragma Integrifolia,and Trionycis Carapax)on the pain,lumbar function and serological indicators of the patients with lumbar disc herniation(LDH).Methods Ninety-two patients with LDH were randomly divided into control group(31 cases),oral use group(31 cases)and combination group(30 cases).The control group was given oral administration of Celecoxib,the oral use group was given oral administration of Osteoking,and the combination group was given oral administration combined with percutaneous iontophoresis of Osteoking.The course of treatment for the 3 groups covered 6 weeks.The changes of pain visual analogue scale(VAS)score,lumbar function Japanese Orthopedic Association(JOA)score,serum tumor necrosis factor alpha(TNF-α)and matrix metalloproteinase 3(MMP-3)levels in the three groups were observed before and after treatment.Results(1)During the trial,there were 2 patients from both control group and oral use group lost to follow-up,but none of the combination group was lost to follow-up.Eventually,29 patients in the control group,29 patients in the oral group and 30 patients in the combination group were included in the statistical analysis.(2)After treatment,the pain VAS score and lumbar function JOA score in the three groups were significantly lower than those before treatment(P<0.05).The intergroup comparison showed that the decrease of pain VAS score and lumbar function JOA score in the combination group was significantly superior to that in the control group and the oral use group(P<0.05),while there was no significant difference between the control group and the oral use group(P>0.05).(3)After treatment,the serum TNF-α level in the three groups was significantly lower than that before treatment(P<0.05),while no significant difference of TNF-α level was presented among the three groups after treatment(P>0.05).(4)After treatment,the serum MMP-3 level in the oral use group and combination group was significantly lower than that before treatment(P<0.05),but no obvious change of MMP-3 level was shown in the control group(P>0.05).The intergroup comparison showed that the decrease of serum MMP-3 level in the oral use group and combination group was significantly superior to that in the control group(P<0.05),while no significant difference of TNF-αlevel was presented between the oral use group and combination group(P>0.05).Conclusion Osteoking is effective on relieving the pain symptoms of LDH patients,improving the lumbar activity function,and decreasing the levels of serum TNF-α and MMP-3.The efficacy of Osteoking by oral use combined with percutaneous iontophoresis is stronger than that of Osteoking orally alone or Celecoxib.
10.Effect and possible mechanism of Wuzi Yanzong Pill on motor function of neurons in Parkinson's disease mice
Tao PAN ; Qi XIAO ; Hui-Jie FAN ; Lei XU ; Lu JIA ; Shao-Chen QIN ; Li-Ran WANG ; Cun-Gen MA ; Bo ZHANG ; Zhi CHAI
Medical Journal of Chinese People's Liberation Army 2024;49(5):550-556
Objective To observe the effects of Wuzi Yanzong Pill(WYP)on motor function in a mouse model of Parkinson's disease(PD)and to explore its potential mechanisms.Methods Twenty-four male C57BL/6 mice were randomly divided into control group,model group and WYP group,with 8 mice in each group.Mice in model and WYP group were intraperitoneally injected with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine for 7 consecutive days to establish a PD model.From the 1st day of model preparation,mice in WYP group were gavaged with WYP solution[16 g/(kg·d)]twice daily for 14 consecutive days.At the same time,mice in control group and model group were gavaged with 0.9%NaCl solution[50 ml/(kg·d)]twice a day.Gait experiment was utilized to assess the behavioral performance of mice in each group.Immunofluorescence staining was conducted to detect the number of tyrosine hydroxylase(TH)-positive cells in the substantia nigra region,the fluorescence intensity of nuclear factor E2-related factor 2(Nrf2),and the number of NeuN neurons co-labeled with Nrf2 in each group.Western blotting was employed to determine the expression levels of TH,Kelch-like ECH-associated protein 1(Keap-1),Nrf2,and heme oxygenase-1(HO-1)in the brain tissue of mice in each group.Results The gait experiment results showed that,compared with control group,standing time of the left front paw,right front paw,left hind paw,and right hind paw of the mice in model group was significantly shortened(P<0.01),while swinging time of the left front paw,right front paw,left hind paw,and right hind paw was significantly prolonged(P<0.05).Compared with model group,standing time of the left front paw and right hind paw of the mice in WYP group was significantly prolonged(P<0.05),while swing time of the left front paw and right front paw was significantly shortened(P<0.05).Immunofluorescence staining and Western blotting results showed that,compared with control group,in model group the number of TH-positive cells,average fluorescence intensity of Nrf2,and HO-1 levels decreased(P<0.01),while the Keap-1 protein level increased(P<0.01),and the number of Nrf2 expression on NeuN neurons decreased(P<0.001).Compared with model group,the number of TH-positive cells,average fluorescence intensity of Nrf2,HO-1 level,and the number of Nrf2 expression on NeuN neurons in the brain tissue of mice in WYP group increased(P<0.05),while Keap-1 protein level decreased(P<0.05).Conclusions WYP could alleviate the motor dysfunction and protect dopaminergic neurons in PD mice.The underlying mechanism may be related to the regulation of Keap-1/Nrf2/HO-1 pathway to inhibit oxidative stress response.

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