1.Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine:Aural Vertigo
Yingdi GONG ; Zhanfeng YAN ; Wei FENG ; Daxin LIU ; Jiaxi WANG ; Jianhua LIU ; Yu ZHANG ; Shusheng GONG ; Guopeng WANG ; Chunying XU ; Xin MA ; Bo LI ; Shuzhen GUO ; Mingxia ZHANG ; Jinfeng LIU ; Jihua GUO ; Zhengkui CAO ; Xiaoxiao ZHANG ; Zhonghai XIN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):215-222
Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine (TCM) mainly involves peripheral vestibular diseases of Western medicine, such as Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis, and vestibular migraine, being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo, aural vertigo affecting the quality of life, aural vertigo not relieved after surgery, aural vertigo with complex causes, and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM: Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo, the control and mitigation of the symptoms, and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.
2.Research status of clinical application of recombinant human urokinase
Zixing LI ; Liqi YI ; Zhanfeng GAO
International Journal of Surgery 2024;51(3):212-216
In recent years, recombinant human urokinase (rhPro-UK) has been widely used in the treatment of a variety of thromboembolic diseases, with significant efficacy and no obvious adverse reactions. In addition, it has a wide range of applications in many new technology fields. This article focuses on the application of rhPro-UK in the treatment of acute myocardial infarction, cerebrovascular disease, lower extremity deep vein thrombosis, arterial thrombosis and other diseases. rhPro-UK has demonstrated good thrombolytic efficacy and safety in these diseases, especially in patients with acute myocardial infarction, and adjuvant PCI therapy can significantly increase myocardial reperfusion, improve cardiac function, and do not increase the risk of bleeding. For cerebrovascular disease, rhPro-UK can significantly improve the degree of neurological deficit and has a high safety profile. In the treatment of lower extremity deep vein thrombosis, rhPro-UK has shown superior thrombolytic efficacy and safety compared with urokinase. For arterial thrombosis and biological stents, the use of rhPro-UK has also achieved some efficacy, but more research is needed to confirm its efficacy and safety. In addition, ultrasound-mediated drug-loaded thrombolysis systems also have potential applications in rhPro-UK therapy. Future research on rhPro-UK will focus more on the development of new technologies.
3.Clinical Effectiveness and Safety of Bairui Granules (百蕊颗粒) in Treating Patients with Acute Pharyngitis with Wind-Heat Syndrome: A Multi-Center, Double-Blind, Double-Simulation, Randomized Controlled Trial
Siming LIU ; Hui ZHOU ; Qiang LI ; Min ZHOU ; Qixiang WU ; Shanjun YANG ; Jun WANG ; Jingjing YUAN ; Ying ZHANG ; Ziqi ZHU ; Jingyi HU ; Shuang WU ; Mengting LI ; Zhanfeng YAN
Journal of Traditional Chinese Medicine 2024;65(11):1139-1145
ObjectiveTo evaluate the clinical effectiveness and safety of Bairui Granules (百蕊颗粒) in the treatment of acute pharyngitis with wind-heat syndrome. MethodsA multicenter, double-blind, double-simulation, randomised controlled trial was conducted, in which 162 patients with acute pharyngitis and wind-heat syndrome from 7 centers were recruited, and each center was divided into trial group and control group on the ratio of 2∶1. In the trial group, 108 cases were orally administered with Bairui Granules plus Reyanning Granules (热炎宁颗粒) simulant, and in the control group, 54 cases were orally administered with Reyanning Granules plus Bairui Granules simulant for 5 days, with a follow-up visit on the 6th day. Full analysis set (FAS) analysis and per protocol set (PPS) were used for analysis, respectively. The primary efficacy index was the disappearance rate of sore throat after 5-day treatment; the secondary efficacy indexes were the disappearance rate of sore throat after 3-day treatment, as well as the visual analogue score (VAS) of sore throat before treatment, every day during the treatment, and follow-up on day 6, and the traditional Chinese medicine (TCM) syndrome score was performed before treatment and at the follow-up on day 6. The effectiveness on TCM syndrome was evaluated at the follow-up on day 6, and the changes of vital signs, blood routine, urine routine, liver functions, kidney function, the adverse events before and after the treatment were recorded, and safety analysis set (SS) was analysed. Results162 patients entered the FAS and SS analyses, and 158 cases (105 cases in the trial group and 53 cases in the control group) entered the PPS analysis. FAS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.56% (87/108) in the trial group and 64.81% (35/54) in the control group, and the difference between groups was statistically significant (χ2 = 5.10, P = 0.0239). PPS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.00% (84/105) in the trial group and 64.15% (34/53) in the control group, and the difference between groups was statistically significant (χ2 =4.85, P = 0.0277). FAS and SS analyses both showed that the difference in disappearance rate of sore throat between groups on 3-day treatment was not statistically significant (P>0.05). Compared with those before treatment, the VAS scores of sore throat were lower in both groups during treatment on day 2, 3, 4, 5, and follow-up on day 6 (P<0.01), but the difference between groups at each time point was not statistically significant (P>0.05). TCM syndrome scores of both groups at the follow-up were lower than that before treatment, and those of the trial group were lower than those of the control group (P<0.01). The cure rate and effective rate of TCM syndrome of the trial group were significantly higher than those of the control group (P<0.01). There was no significant difference in blood routine, urine routine, liver function, kidney function between groups before and after treatment (P>0.05), and no serious adverse events occured in both groups. ConclusionBairui Granules showed clinical effectiveness in the treatment of acute pharyngitis of wind-heat syndrome, and it could significantly improve the clinical symptoms, accelerate the disappearance time of sore throat with good safety.
4.Concentrated growth factor and collagen as barrier materials in alveolar ridge preservation for posterior teeth:a prospective cohort study with one-year follow-up
Zhanfeng ZHU ; Tingting YANG ; Qinyi CHEN ; Weien QIU ; Yongshan LI ; Yilan LIN ; Yu BAN
West China Journal of Stomatology 2024;42(3):346-352
Objective This study aims to evaluate the efficacy of concentrated growth factor(CGF)membrane and collagen as barrier materials in sealing the alveolar socket in alveolar ridge preservation(ARP)in the posterior region during a one-year follow-up.Methods A total of 24 pa-tients who underwent ARP in the posterior region were selected for inclusion and randomly assigned to the CGF group(12 cases)and Collagen group(12 cases).The pa-tients in both groups underwent extraction of posterior teeth.The extraction sockets were filled with a bone sub-stitute to the level of the pre-extraction buccal and lingual or palatal alveolar bone plates.The wounds in the CGF group were closed with a fabricated CGF overlaying the upper edge of the bone substitute material,whereas those in the Colla-gen group were closed with Bio-Oss Collagen.The implants were placed after 6 months.The evaluation was based on implant retention,re-grafting rate,and vertical and horizontal alveolar ridge bone volume changes measured by cone beam computed tomography(CBCT).Data were statistically analyzed using SPSS 28.0 software.Results No patient withdrew throughout the follow-up period.No implant failure and no severe peri-implant or mucosal soft tissue compli-cations were observed.Six months after the operation,the degree of vertical alveolar ridge height resorption in the CGF group was lower than that in the Collagen group(P<0.05).There were no statistically difference between the groups at 1 year after the operation(P>0.05).The amount of bone reduction in horizontal alveolar ridge width showed no difference between the groups at 6 months and 1 year after surgery(P>0.05).Conclusion CGF membrane and Bio-Oss Collagen as barrier materials for posterior ARP inhibited reduction in alveolar ridge bone mass.
5.Correlation between serum OPN, BMP2, RBP4 and renal function and bone mineral density in diabetes nephropathy patients
Xiaofen MA ; Shiqi ZHANG ; Dandan XUE ; Yiming ZHANG ; Zhanfeng JIAO ; Chengqiang JIN ; Xiang LI
Journal of Chinese Physician 2024;26(6):876-880
Objective:To investigate the relationship between serum osteopontin (OPN), bone morphogenetic protein 2 (BMP2), retinol binding protein 4 (RBP4) and renal function and bone mineral density in patients with diabetes nephropathy (DN).Methods:A total of 120 patients with DN diagnosed in the Affiliated Hospital of Jining Medical University from January 2020 to December 2021 were selected as the DN group, 60 patients with simple diabetes as the type 2 diabetes mellitus (T2DM) group, and 60 subjects with normal glucose tolerance test as the control group. The serum OPN, BMP2, RBP4, low bone mineral density (LBMD), femoral neck bone density (FNBMD) and renal function indicators of the three groups were compared. According to the urinary albumin excretion rate (UAER) of DN patients, the patients were divided into microalbuminuria DN group (71 cases) and massive albuminuria DN group (49 cases), and stratified comparison was made. The simple linear correlation analysis was used to analyze the OPN of DN patients. BMP2, RBP4, renal function and bone mineral density.Results:The fasting blood glucose (FPG), glycated hemoglobin (HbA 1c), serum creatinine (Scr), UAER, and cystatin (CysC) levels of DN group patients were significantly higher than those of T2DM group and control group, and the differences were statistically significant (all P<0.05); The FPG and HbA 1c in the T2DM group were higher than those in the control group, and the differences were statistically significant (all P<0.05); The OPN and BMP2 of DN group patients were higher than those of T2DM group and control group, while the RBP4, LBMD, FNBMD of DN group were lower than those of T2DM group and control group, and the differences were statistically significant (all P<0.05); The OPN and BMP2 of the T2DM group were higher than those of the control group, while RBP4 was lower than that of the control group, and the differences were statistically significant (all P<0.05); The levels of FPG, HbA 1c, Scr, UAER, and CysC in patients with macroalbuminuria DN were significantly higher than those in patients with microalbuminuria DN, and the differences were statistically significant (all P<0.05); The OPN and BMP2 of patients in the large albuminuria DN group were higher than those in the microalbuminuria DN group, while the RBP4, LBMD, and FNBMD of patients in the large albuminuria DN group were lower than those in the microalbuminuria DN group, and the differences were statistically significant (all P<0.05). The OPN of DN group patients was positively correlated with Scr, UAER, and CysC (all P<0.05), while BMP2 was positively correlated with UAER and CysC (all P<0.05); The OPN and BMP2 of DN group patients were negatively correlated with LBMD and FNBMD (all P<0.05), while RBP4 was positively correlated with LBMD and FNBMD (all P<0.05). Conclusions:OPN, BMP2, RBP4 are closely related to the degree of renal function impairment and bone loss in DN patients, and can to some extent reflect the degree of bone metabolism and osteoporosis in T2DM patients.
6.Correlation between initial estimated glomerular filtration rate and all-cause mortality in patients with urgent-start peritoneal dialysis
Xiang LI ; Lingling NIU ; Nana LUO ; Zhanfeng JIAO ; Xia WANG ; Yiming ZHANG
Chinese Journal of Postgraduates of Medicine 2024;47(7):589-594
Objective:To explore the correlation between the initial estimated glomerular filtration rate (eGFR) and all-cause mortality in end-stage renal disease (ESRD) patients undergoing urgent-start peritoneal dialysis (USPD).Methods:The clinical data of 380 ESRD patients undergoing USPD from January 2013 to June 2023 in Affiliated Hospital of Jining Medical University were retrospective analyzed. According to the median initial eGFR of 6.25 ml/(min·1.73 m 2), the patients were divided into low eGFR group with eGFR<6.25 ml/(min·1.73 m 2) and high eGFR group with eGFR ≥6.25 ml/(min·1.73 m 2), with 190 patients in each group. The baseline characteristics and hematological indexes within 48 h before USPD were compared between the two groups. The patients were followed up until death or until June 30, 2023, and all-cause mortality was recorded. The Kaplan-Meier survival curve was used to evaluate the accumulated survival rate. Multivariate Cox regression analyses were used to identify the independent risk factors for all-cause mortality in ESRD patients undergoing USPD, with subgroup analyses based on age, gender and diabetes. Results:The median follow-up time was 40.7 (21.7, 59.0) months, 112 patients died, with a total mortality rate of 29.5% (112/380). The blood potassium, blood phosphorus, urea nitrogen, uric acid, parathyroid hormone and dialysis age in high eGFR group were significantly lower than those in low eGFR group: (4.1 ± 0.7) mmol/L vs. (4.5 ± 0.8) mmol/L, (1.6 ± 0.4) mmol/L vs. (1.9 ± 0.6) mmol/L, (21.8 ± 7.2) mmol/L vs. (29.7 ± 11.0) mmol/L, (359.8 ± 99.4) μmol/L vs. (429.4 ± 116.9) μmol/L, 242.2 (151.5, 398.3) ng/L vs. 281.7 (189.1, 487.2) ng/L and 36.1 (18.8, 54.0) months vs. 43.7 (28.8, 68.2) months, the diabetes rate, hemoglobin, platelet count, blood chloride, fasting blood glucose and mortality rate were significantly higher than those in low eGFR group: 20.0% (38/190) vs. 11.6% (22/190), (100.6 ± 18.2) g/L vs. (96.1 ± 20.0) g/L, (207.7 ± 72.6) × 10 9/L vs. (192.4 ± 65.6) × 10 9/L, (100.6 ± 4.1) mmol/L vs. (99.4 ± 4.7) mmol/L, (5.9 ± 2.3) mmol/L vs. (5.5 ± 1.9) mmol/L and 34.2% (65/190) vs. 24.7% (47/190), and there were statistical differences ( P<0.01 or< 0.05). Kaplan-Meier survival curve analysis result showed that the all-cause mortality rate in high eGFR group was significantly higher than that in low eGFR group, and there was statistical difference (log-rank χ2 = 6.64, P<0.01). After adjusting for gender, age and confounding factors, multivariate Cox regression analysis result showed that elevated eGFR, increased mean corpuscular volume and elevated fasting blood glucose were independent risk factors for all-cause mortality in ESRD patients undergoing USPD ( HR = 1.14, 1.04 and 1.15; 95% CI 1.04 to 1.26, 1.01 to 1.08 and 1.03 to 1.29; P<0.01 or<0.05), while female was an independent protective factor ( HR = 0.59, 95% CI 0.38 to 0.92, P<0.05). Subgroup analysis result showed a consistent effect of eGFR on mortality in ESRD patients undergoing USPD. Conclusions:Higher initial eGFR in ESRD patients undergoing USPD is associated with an increased risk of all-cause mortality.
7.Clinical Predominance Disease of Traditional Chinese Medicine: Gastroesophageal Reflux Disease
Ping WANG ; Fengyun WANG ; Yu LAN ; Lingyun ZHANG ; Xiaoqing LI ; Kun WANG ; Xiujing SUN ; Zhanfeng YAN ; Xiulan ZHANG ; Demin LI ; Hongmei WU ; Xiaohong LI ; Xiaoke LI ; Jianqin YANG ; Dawei ZOU ; Xiaoxiao ZHANG ; Xudong TANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(12):199-208
Gastroesophageal reflux disease (GERD) is a frequently and commonly occurring disease in clinic. In recent decades, with the development in pathophysiology and drug researches, modern medicine has achieved remarkable progress and results in diagnosis and treatment. However, the treatments for non-erosive reflux disease, refractory gastroesophageal reflux disease, proton pump inhibitor resistance, overlap of disease symptoms, and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine (TCM) was widely used in clinical practice, which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine (CACM) and undertaken by the Spleen and Stomach Disease Branch of CACM, "the 12th Youth Salon of Clinical Predominance Disease Series (GERD)" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions, improvement and maintenance of symptoms, response to overlapping disease symptoms, reduction and withdrawal of acid suppressors, and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths, combing the difficulties of modern medical diagnosis and treatment, which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.
8.Clinical Dominant Diseases in Traditional Chinese Medicine: A Series of Youth Salon Seminars for Clinical Dominant Diseases Held by China Association of Chinese Medicine
Zhanfeng YAN ; Lingbo KONG ; Jingshang WANG ; Baoli LIU ; Yuan XU ; Yingke LIU ; Ping WANG ; Cang ZHANG ; Weijing LIU ; Dawei ZOU ; Guowang YANG ; Demin LI ; Jiang CHEN ; Mei MO ; Yong ZHU ; Bin WANG ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(1):202-208
The discussion and research on the clinical dominant diseases of traditional Chinese medicine (TCM) have attracted increasing attention. Through approaches including modern technology, evidence-based medical methods, and multi-disciplinary treatment, we should construct a sound TCM inheritance and innovation system, establish a collaborative innovation mechanism, and integrate major research projects, striving to make breakthroughs in TCM theory, methodology, standards, and regulation system, promoting the scientific and technological progress of TCM, and thereby improving its curative effect. The China Association of Chinese Medicine (CACM) carried out a series of youth salon seminars for clinical dominant diseases in TCM, discussing and sorting out the advantages of the dominant diseases in clinical diagnosis and treatment of TCM and integrated traditional Chinese and western medicine in specific diseases or fields. Authoritative experts in the industry were invited to give comment and guidance to form a report. Centering on clinical research of dominant diseases, thematic research was carried out in the aspects of practice, human experience-based evidence, and transformation path. Through the systematic study of the dominant diseases, the advantages of TCM in different stages of disease treatment were excavated to constantly improve the prevention and treatment ability of TCM and carry forward the advancement of TCM theory and practice. At the same time, the communication and understanding between traditional Chinese and western medicine were improved, laying the foundation for the further formation of industry guidelines or consensus and comprehensive promotion. These seminars are expected to provide references for the development of policy planning, clinical diagnosis and treatment, health economy, and social services in TCM and lay the foundation for the formation of a new modern diagnosis and treatment system with Chinese characteristics.
9.Advantages of Traditional Chinese Medicine in Treating Dominant Disease: Allergic Rhinitis
Lili LIU ; Daxin LIU ; Jinfeng LIU ; Shuzhen GUO ; Zhonghai XIN ; Renzhong WANG ; Li TIAN ; Kuiji WANG ; Mingxia ZHANG ; Shirui YANG ; Shufan GUO ; Yonggang LIU ; Wei ZHANG ; Lingyan JIANG ; Hui CHEN ; Xing LIAO ; Geng LI ; Chenyu CHI ; Xiaoxiao ZHANG ; Zhanfeng YAN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(2):203-211
In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance, Innovation, and Development of traditional Chinese medicine(TCM) and the spirit of the National Conference on TCM, Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis (AR) and they reached a basic consensus. In recent years, the prevalence of AR has been on the rise, threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society. AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity, and the imbalance is similar to the Yin-yang disharmony in TCM. In the treatment of this disease, western medicine features rapid onset. However, it is cost-intensive and causes severe surgical trauma, and the recurrence is common. TCM boasts diverse methods for AR, which can be used in all stages of this disease. It has advantages in controlling symptoms such as nasal congestion, runny nose, or dysosmia in the attack stage, preventing recurrence in the remission stage, and treating refractory AR or steroid-resistant AR. In particular, acupuncture enjoys a reputation in treatment of AR, which has been supported by evidence-based medicine and recommended by guidelines. While treating local symptoms of AR, TCM regulates the psychosomatic conditions, which facilitates chronic disease management and long-term follow-up. We should integrate the advantages of TCM and western medicine, give full play to the unique nonnegligible and irreplaceable advantages of TCM, formulate a comprehensive diagnosis and treatment scheme for learning and promotion, and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.
10.Research progress on the role of pyroptosis in the occurrence and development of peritoneal fibrosis
Dandan XUE ; Xiang LI ; Xiaofen MA ; Zhanfeng JIAO ; Yiming ZHANG
Journal of Chinese Physician 2023;25(6):958-960,F3
Peritoneal dialysis is a recognized renal replacement therapy. Long term peritoneal dialysis will lead to changes in the morphology and function of the peritoneum, that is, peritoneal fibrosis, which is a known cause of the loss of peritoneal ultrafiltration capacity. Pyroptosis is a special type of soluble programmed cell death, characterized by cell swelling, rupture, secretion of cell contents and significant proinflammatory effect. The pyroptosis can be divided into typical and atypical pathways, and the inflammatory body of NOD like receptor heat protein domain related protein 3 (NLRP3) is the most important initiator. Current evidence shows that high glucose peritoneal dialysis fluid can induce peritoneal Mesothelium to scorch, and the inflammation and cell damage caused by it can aggravate the progress of peritoneal fibrosis. Different signal pathways have been proved to regulate the occurrence of pyroptosis. The latest research has proved that some potential targeted methods to inhibit pyroptosis can effectively inhibit the inflammation of peritoneal mesothelium and alleviate peritoneal fibrosis. This article mainly discusses the molecular mechanism of pyroptosis and the relationship between pyroptosis and peritoneal fibrosis.

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