[Differentially expressed proteins in serum among different Chinese medical syndrome types of primary liver cancer in the perioperative period of interventional treatment]

OBJECTIVE

To explore different expressions of serum proteins among different Chinese medical syndrome types of primary liver cancer (PLC) in the perioperative period of interventional treatment, and to explore its significance.

METHODS

Totally 154 PLC patients were assigned to Gan depression syndrome (GDS, 37 cases), Pi deficiency syndrome (PDS, 45 cases), dampness heat syndrome (DHS, 18 cases), blood stasis syndrome (BSS, 28 cases), and yin deficiency syndrome (YDS, 26 cases). The mass spectra of serum proteins were analyzed by using surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS). By combining the features of Chinese medical syndromes, the different expressions of serum proteins among different Chinese medical syndrome types of PLC in the perioperative period of interventional treatment were explored.

RESULTS

One week before interventional treatment, there was statistical difference in the expression of serum protein peak with mass-to-charge ratio (M/Z) being 3,392, 4,970, 5,911, 6,200, and 8,575 Da (P <0.05, P < 0.01). The aforesaid differentially expressed protein peaks occurred simultaneously in PDS and BSS. One week after interventional treatment, the expression of the serum protein peak was down-regulated in YDS syndrome with M/Z being 8,575 Da, showing statistical difference (P <0.01).

CONCLUSION

Different peaks of serum proteins occurred in different Chinese medical syndrome types of PLC in the perioperative period of interventional treatment.

Discrimination of type 2 diabetes mellitus corresponding to different traditional Chinese medicine syndromes based on plasma fatty acid profiles and chemometric methods

AIMS OF THE STUDY

Traditional Chinese medicine (TCM) has a long history and particular advantages in the diagnosis and treatment of type 2 diabetes mellitus (T2DM). Syndrome differentiation is the foundation and essence of TCM theories. The aims of the study are to discriminate T2DM corresponding to different syndromes (Qi-deficiency, Qi and Yin-deficiency and Damp heat) and discover syndrome-related biomarkers using metabolomics technology.

MATERIALS AND METHODS

Plasma fatty acid profiles of 85 clinical samples were established by high performance liquid chromatography (HPLC). Moreover, some of the lipid parameters, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), were obtained through clinical testing methods. Orthogonal signal correction-partial least squares (OSC-PLS) and uncorrelated linear discriminant analysis (ULDA) were employed to establish two-class models for three different syndromes.

RESULTS

Compared with the plasma fatty acid profiles of healthy controls, the characteristic fatty acids of three TCM syndromes were discovered (p<0.01). Totally, the plasma fatty acids of T2DM were up-regulated, while significant differences existed in different syndromes. Results of ULDA indicate that the three TCM syndromes could be effectively separated by the plasma fatty acid profiles and the syndrome-related biomarkers were also screened.

CONCLUSIONS

The fact that three TCM syndromes can be separated indicates certain metabolic differences in different TCM syndromes of T2DM really exist and such differences can be manifested by fatty acids and lipid parameters. The results benefit modern biological interpretation of the three TCM syndromes and in a sense the diagnosis and treatment of diabetes.

[Basic pathogenesis of asthenia of healthy energy and blood stasis in liver cirrhosis studied by serum proteomics]

OBJECTIVE

To study the basic pathogenesis of "asthenia of healthy energy and blood stasis" in liver cirrhosis studied by Chinese syndromes and serum proteomics.

METHODS

The information of four methods of examinations and serum samples were collected from 44 cases of male cirrhotic patients and 17 cases of healthy male volunteers. The different syndrome groups were summarized according to syndrome differentiation and frequency analysis using the patient's information of four methods of examinations. The serum proteins were isolated by magnetic beads and detected by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The proteins expressed differently between cirrhotic patients of different syndrome types and healthy volunteers were analyzed by statistical analysis software (product of Bruker Corporation ClinProTools 2.1 software). The diagnosis model was established by QC algorithm.

RESULTS

The liver cirrhosis syndrome with the appearance frequency of more than 30% was sequenced from high to low as fatigue, listlessness, spider telangiectasia, liver palms, anorexia, bleeding from the nose, the gum or the subcutaneous tissue, the abdominal distention, shortness of breath while moving, dim facial complexion, pricking pain of the flank, weak waist and knees, dull pain in the flank, burning sensation of five centers, or low fever, hectic fever, and night sweat. The cases belonging to Child-Pugh A in the seventeen patients of the Pi-qi asthenia syndrome group accounted for 64.7%. The cases belonging to Child-Pugh C in the twelve patients of the Gan-Shen yin deficiency syndrome group accounted for 66.7%. The cases belonging to Child-Pugh A were similar to the cases belonging to Child-Pugh C in the fifteen patients of the blood stasis syndrome group, being more than 40%. Such syndromes as spider telangiectasia, liver palms, shortness of breath while moving, burning sensation of five centers, or low fever, hectic fever, and night sweat, varicose vein of the abdominal wall, and edema of lower extremities appeared more frequently in Child-Pugh C than in Child-Pugh A (all P < 0.05). The characteristic protein expression peak with mass-to-charge ratio of 4642.81, 4963.91, 5247.8, 5805.95, 6305.27, and 12447.7 in the Pi-qi asthenia syndrome diagnosis model were chosen. The former five peaks could be found in Child-Pugh A and Child-Pugh C. The protein expression peak with mass-to-charge ratio of 9 290. 3 was the characteristic protein expression peak in the Gan-Shen yin deficiency syndrome diagnosis model. The protein expression peak with mass-to-charge ratio of 9290.06 and 7 768. 29 were down-regulated in the Gan-Shen yin deficiency syndrome group compared with the other two syndromes groups. The protein expression peaks 9290.3 and 7768.29 were included in the diagnosis model of hepatitis B cirrhosis. They did not appear in Child-Pugh A, while they were gradually down-regulated in Child-Pugh B and Child-Pugh C. Of the other seventeen protein expression peaks in patients of the Gan-Shen yin deficiency syndrome, eight expressed in Child-Pugh A. The protein expression peaks 4964.55 and 5806.83 that expressed both in Child-Pugh A and Child-Pugh C constituted the characteristic protein peaks of the hepatitis B cirrhosis blood stasis diagnosis model. The diagnosis model of the Pi-qi asthenia syndrome was established with the sensitivity of 100% and the specificity of 82.35%. The diagnosis model of the Gan-Shen yin deficiency syndrome was established with the sensitivity of 100% and the specificity of 94.12%. The diagnosis model of the blood stasis syndrome was established with the sensitivity of 100% and the specificity of 100%.

CONCLUSIONS

Asthenia of healthy energy and blood stasis was the basic pathogenesis during the whole process of liver cirrhosis. Asthenia of healthy energy covers Pi-qi asthenia and Gan-Shen yin deficiency. Gan-Shen yin deficiency was obvious in the compensation stage of liver cirrhosis, but it has manifested in this stage. So early treatment was necessary.

[Nourishing-yin effect and mechanism of different parts of Cornu Elaphuri Davidiani in rats]

OBJECTIVE

To investigate nourishing-yin effect and mechanism of different parts of Cornu Elaphuri Davidiani in rats.

METHOD

The model of yin asthenia rats was built by thy roxine. The substance metabolism, pain threshold, hormone levels and biochemical indicators in serum were measured.

RESULTS

The ethanol extract of Cornu Elaphuri Davidiani could regulate the substance metabolism and raise the pain threshold in yin asthenia model rats. Furthermore, it could regulate the hormone levels, biochemical indicators in serum and it could improvte the antioxidant ability.

CONCLUSION

The ethanol extract of Cornu Elaphuri Davidiani showed significant nourishing-yin effect in rats and the possible mechanism is correlated with regulating the neuroendocrine network.

[Experimental study on Qi deficiency and blood stasis induced by muti-factor stimulation in rats]

OBJECTIVE

Animal model of Qi deficiency and blood stasis was established by muti-factor stimulation in rats.

METHOD

Healthy SD rats were chronically stimulated randomly by muti-factor methods (chronic sleep deprivation and feed with moderately high lipid and sugar food). Then the indices of hemorheology, plasma total lipids, vasoactive molecules, blood pressure (BP) and ventricular pressure (VP) were measured.

RESULT

The results as well as the analysis of etiology and pathology suggested that model rats could objectively reflect the clinical characteristics of Qi deficiency and blood stasis syndrome. Blood viscosity at low level, plasma content of angiotensin II (Ang II) and endothelin (ET) significantly increased in model rats, while BP and VP significantly decreased (P < 0.05). On the other hand, Buyang Huanwu decoction could lower down the level of AngII in serum and blood viscosity at low level in rats induced by some stimulus, whereas BP and VP elevated significantly (P < 0.05).

CONCLUSION

Animal model of Qi deficiency and blood stasis induced by muti-factor stimulation including chronic sleep deprivation and feed with moderately high lipid and sugar food could facilitate further study on blood stasis syndrome and screening of Chinese herbal drugs in promoting blood circulation and removing blood stasis.

[Relationship between Chinese medicine pattern with blood levels of sex hormone, lipid and glucose in climacteric women patients with hypertension]

OBJECTIVE

To find the objective indices for traditional Chinese medicine (TCM) pattern identification in women patients with climacteric hypertension (CH) by exploring the relationship between TCM pattern with blood levels of sex hormone, lipid and glucose.

METHODS

TCM syndrome differentiation was made in 75 women CH patients, 43 as yin-deficiency with inner dryness pattern (YDD) and 32 as non-YDD, and correlation analyses were conducted on TCM patterns and blood levels of estradiol (E2), lipids and glucose.

RESULTS

Besides the level of E2 in YDD was lower than that in non-YDD [(112.26 -/+ 66.81) pmol/L vs (146.69 +/- 83.59) pmol/L, P < 0.05), no difference between the two patterns was found in the other indices measured (P > 0.05). Further subunit analysis showed that in patients with CH grade 1, blood levels of total cholesterol (TC), high density lipoprotein (HDL) and apoprotein A-I (ApoA-I) were higher in the 13 patients of YDD than those in the 9 of non-TDD (P < 0.05); in patients with CH grade 2, levels of E2, progesterone (T), HDL and ApoA-I were lower but level of follicle stimulating hormone (FSH) was higher in the 20 YDD than those in the 10 non-YDD (all P < 0.05); while in patients with CH grade, no statistically significant difference was shown between 3 patients of 10 with YDD and 13 with non-YDD in all the indices measured (P > 0.05).

CONCLUSION

Blood level of E2 shows different characteristics between CH patients of YDD and non-YDD patterns, suggesting that it may provide some help to syndrome micro-differentiation, and taking it as an objective index for syndrome typing of climacteric hypertension in female is considerable.

[Expression of TNF-alpha signaling adapter proteins in peripheral blood mononuclear cells in lupus nephritis patients of different TCM asthenia syndromes]

OBJECTIVE

To investigate the mRNA expressions of the TNF adapter proteins, including TNF receptor-associated death domain protein (TRADD), Fas-associated death domain protein (FADD), receptor-interacting protein 1 (RIP-1) and TNF receptor-associated factor-2 (TRAF-2) in peripheral blood mononuclear cells (PBMCs) of lupus nephritis (LN) patients of various TCM asthenia syndromes. Methods Fifty-one inpatients with LN were differentiated according to TCM syndrome differentiation, 13 cases of yin-deficiency with inner heat syndrome (A); 26 cases of both qi-yin deficiency syndrome (B), 12 cases of Pi-Shen yang-deficiency syndrome (C). Peripheral venous blood samples from the 51 LN patients and 17 healthy subjects were collected to separate PBMCs. The mRNA expressions of TNF adapter molecules (TRADD, FADD, RIP-1 and TRAF-2), as well as Caspase-3 and interleukin-1beta (IL-1beta) were analyzed by quantitative real-time PCR and the differences among them were compared.

RESULTS

(1) As compared with the healthy subjects, expression of TRADD mRNA in patients of syndrome A, B and C was lowered to 0.54, 0.32, and 0.38-fold, respectively (P < 0.05, P < 0.01), showing insignificant difference among the three syndromes; (2) FADD mRNA lowered to 0.79, 0.62, and 0.72-fold respectively, only with significance shown in syndrome B (P < 0.05); (3) RIP-1 mRNA lowered to 0.79, 0.50, and 0.60-fold respectively with significance shown in syndrome B and C (P < 0.01, P < 0.05), and insignificant difference was shown among the three syndromes; (4) TRAF-2 lowered to 0.70, 0.52, and 0.50-fold respectively (P < 0.01, P < 0.01, P = 0.07), significance shown in syndrome B and C (P < 0.01), but with insignificant difference among the three; (5) Caspase-3 elevated in all patients of the three syndromes (all P < 0.01); (6) IL-1beta in syndrome A was apparently lower ed to the normal range and also lower than that in the other two syndromes (both P < 0.05).

CONCLUSIONS

Expressions of TRADD, FADD, RIP-1 and TRAF-2 mRNA decreased in all the patients of various TCM asthenia syndromes, the decrement in patients of syndrome B and C was lesser than that in syndrome A. These abnormal low expressions of signal proteins might be the substantial bases for asthenia syndromes of LN patients, and the apoptotic signal mediated by them may involve in the formation of asthenia syndrome in LN.

[Thyroid-induced hyperthyroidism Yin-deficiency model of rats]

OBJECTIVE

To establish a rat model of hyperthyroidism Yin-deficiency.

METHODS

SD rats separate male and female were randomly divided into four groups, a total of eight groups, each with six. The first group for the control group, 2 to 4 for the experimental drug-treated group, including thyroid-low, medium and high-dose group. In addition to the first group lavage volume of saline, the other groups were given the concentration of 2. 5, 5, 10 mg/kg-saline suspension of the thyroid. Once a day, 30 days for delivery.

RESULTS

Compared with the control group, with the exception of Group 4 female rats serum T3, T4, FT3, FT4 values were significantly higher (P < 0.01), serum TSH was significantly lower (P < 0.05), the other treatment groups had different values no significant difference (P > 0.05). Group 4 that female rats modeling was success.

CONCLUSION

Administration of thyroid-Suspension 10 mg/ kg for 30 d, female rats hyperthyroidism Yin-deficiency rat model is success.

[The effect of gengnianningshentang on treating 72 patients with female climacteric syndrome of fever due to yin-deficiency]

OBJECTIVE

To observe the clinical effect of gengnianningshentang on the treatment of the climacteric syndrome of fever due to yin-deficiency.

METHODS

108 patients with climacteric syndrome of fever due to yin-deficiency were divided randomly into treatment group (76 cases)and control group (32 cases). Treatment group was treated by gengnianningshentang, and control group was treated by Vitamin E for 3 months. Level of serum E2, LH and FSH were determined, while the variation of symptom scores of climacteric syndrome was observed.

RESULTS

Level of serum E2 in treatment group increased significantly and serum LH and FSH decreased significantly after treatment (p < 0.01). The post treatment total scores of climacteric syndrome in the treament group were significantly improved (p < 0.01).

CONCLUSION

Gengnianningshentang can significantly improve the levels of E2, FSH and LH, and climacteric syndrome in patients of fever due to yin-deficiency. The total effect of gengnianningshentang is much better than western medicine.

[Effect of Ningzhi capsule on blood lipid spectrum in type 2 diabetes mellitus patients complicated with hyperlipidemia]

OBJECTIVE

To observe the effect of Ningzhi Capsule (NZC) on blood lipid spectrum in type 2 diabetes mellitus patients complicated with hyperlipemia (DM-HL).

METHODS

Adopting randomized, parallel and controlled trail method, a total of 70 DM-HL patients of qi-yin deficiency and phlegm-blood stagnant syndrome type were randomized into two groups. The original medication for lowering blood sugar and blood pressure was unchanged, the trial group received oral administration of NZC 5 tablets, 3 times a day, while the control group received Lipanthgl or Simvastatin depending on their different constituents of blood lipids. After 6 months of treatment, sixty subjects completed the trail while two patients dropped out due to side effect and 8 patients lost follow-up (4 in each group). Levels of blood lipids, blood routine, liver and kidney function and symptoms in patients were detected and compared.

RESULTS

After treatment, levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), apoprotein B, and lipoprotein a (LPa) lowered, while levels of high-density lipoprotein (HDL-C) and apoprotein A raised in the trial group as compared with those before treatment (P < 0.05, P < 0.01), but showed no difference between the two groups after treatment except HDL level (P > 0.05). Scores of symptoms were also lowered significantly in the trial group (P < 0.01). In the observation period, no abnormal findings in blood and urine routine examination as well as in liver and renal function were found.

CONCLUSION

NZC could lower the blood lipid spectrum and improve the TCM symptoms in DM-HL patients without any adverse reaction.

[Experimental research about the effect of Rehmannia glutinosa on the drug effect fingerprints of the rabbit's blood serum of Yin deficiency and heat flourishing syndrome]

OBJECTIVE

To study about the effect of Rehmannia glutinosa Libosch on the drug effect fingerprints of the rabbit's blood serum of yin deficiency and heat flourishing syndrome.

METHODS

The infusion of furosemide and escherichia coli endotoxin were used to replicate rabbit' s yin deficiency and heat flourishing syndrome animal model; high performance liquid chromatography gradient elution was adopped to study the change of the rabbit serum drug effect fingerprint in copying between before and after model-making and administration.

RESULTS

Rehmannia glutinosa Libosch mainly affected metabolism level of the inner substance with the function of nourishing yin clearing heat.

CONCLUSION

The serum HPLC fingerprint established is capable to reflect the function of nourishing yin clearing heat of Rehmannia glutinosa Libosch; the further study on its drug effect fingerprint will help to clarify its activity and metabolism of action.

Correlation between syndromes of posthepatitic cirrhosis and biological parameters: a report of 355 cases

OBJECTIVE

To investigate the pathological factors of syndrome pathomechanism through studying the correlation between syndromes of posthepatitic cirrhosis and biological parameters.

METHODS

Clinical information of three hundred and fifty-five patients with posthepatitic cirrhosis was collected and the database was established. Parameters with statistical significance were analyzed with multi-factor regression analysis to investigate the main influencing factors of the syndromes of posthepatitic cirrhosis.

RESULTS

Formulae of six syndromes, including syndrome of yin deficiency of liver and kidney, syndrome of damp heat, syndrome of stagnated heat smoldering, syndrome of yang deficiency of spleen and kidney, syndrome of stagnation of liver qi and spleen deficiency and syndrome of blood stasis due to qi deficiency, were established with stepwise regression analysis.

CONCLUSIONS

One of the pathophysiological bases of syndrome of blood stasis due to qi deficiency in cirrhosis is synthetic dysfunction of hepatocytes. The pathophysiological basis of syndrome of damp heat is inflammatory injury, which is also syndrome of stagnated heat smoldering in cirrhosis patients. The relationship between syndrome of yin deficiency of liver and kidney and stasis and damp heat may be the pathophysiological basis of the posthepatitic cirrhosis..

[Study on relationship between TCM Syndrome types (Xin-qi and Xin-yang deficiency) and contents of cytokines (tumor necrosis factor-alpha and interleukins) in patients with congestive heart failure]

OBJECTIVE

To explore the relationship between TCM Syndromes types, Xin-qi deficiency (XQD) and Xin-yang deficiency (XYD), and contents of cytokines, including tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta and IL-10 in patients with congestive heart failure (CHF).

METHODS

Sixty-seven CHF in-patients with Xin-qi deficiency or Xin-yang deficiency syndrome were enrolled, their NYHA (New York Heart Association) cardiac function was assessed, ejection fraction (EF) and E peak/A peak (E/A) ratio were determined by Doppler ultrasonic echocardiograph, and serum TNF-alpha, II-6, IL-1beta and IL-10 were measured by double antibody sandwich ELISA assay.

RESULTS

The cardiac function grading in patients of XQD was mostly of I and II grade, while that in patients of XYD was mostly of III and IV grade (by Ridit analysis, P<0.01). The E/A and EF values were higher in patients of XQD than those in patients of XYD (P<0.01). Levels of TNF-alpha, IL-6 and IL-1beta were higher and IL-10 was lower in patients of XYD than those in patients of XQD (P<0.05 or P<0.01) respectively.

CONCLUSION

TNF-alpha, IL-6, IL-1beta and IL-10 probably play an important role in the development process of XQD to XYD, and could be taken as the microcosmic indexes for differentiation of the two syndromes.

[Relationship of plasma endotoxin level with TCM deficiency/excess syndrome and grading/staging of pathologic change of liver in patients with chronic hepatitis]

OBJECTIVE

To explore the relationship of plasma endotoxin level with TCM deficiency/excess Syndrome and the grading/staging of pathologic change of liver in patients with chronic hepatitis B (CHB).

METHODS

Plasma level of endotoxin (ET) was determined using chromogenic limulus amebocyte lysate (LAL) assay in 75 patients with chronic hepatitis B (30 of excess dominance, 45 of deficiency dominance) and also in 15 healthy subjects for control. Moreover, pathological examination on liver biopsy of 20 patients was conducted.

RESULTS

(1) ET level increased in all CHB patients, and the increment was higher in patients of excess dominance than that in patients of deficiency dominance, showing significant difference (P < 0.01). (2) Correlation between ET level and liver pathological grading/staging was shown in CHB patients.

CONCLUSION

Plasma level of ET could be taken as one of the criteria of TCM microcosmic diagnosis in differentiating deficiency/excess syndrome. (2) Endotoxemia plays an important role in pathologic process of liver injury.

[Exploration on essence of spleen-kidney deficiency in middle-aged patients]

OBJECTIVE

To explore the essence of Spleen-Kidney Deficiency in middle-aged patients.

METHODS

Investigation was carried out in 773 cases of 50-69 years old to assay 34 parameters in them, including blood lipid, oxidation and anti-oxidation related substance, sex hormone, liver and renal function, immune function, blood routine, blood pressure and lung vital capacity, etc.

RESULTS

Spleen Deficiency Syndrome is closely related with lipid metabolism disorder; Kidney-Qi Deficiency Syndrome is closely related with hypoimmune function; Kidney-Yin Deficiency Syndrome is closely related with lipid metabolism disorder and hypertension, and Kidney Yang Deficiency is closely related with weakness of anti-oxidation capacity, hypoimmunity, the internal environment disorder of sex hormone and aging, manifested as multiple functions abating.

CONCLUSION

Spleen Deficiency, Kidney-Qi Deficiency and Kidney Yang Deficiency are different layers of a gradually developed and aggravated pathological process, but Kidney-Yin Deficiency could not be listed into this layer.

[Simultaneously analysis of 15 parameters in the patients with the liver-blood deficiency syndrome]

OBJECTIVE

Using HPLC-ED or RIA, we determined simultaneously 15 indexes in 27 patients with the liver-blood deficiency syndrome (LDBD). By means of multivarivate hierarchical cluster analysis and selections of typical variate, the results showed that 15 indexes were classified into 5 groups, and the typical variates of each groups were NE, T3, TXB2, ALD and cGMP. It suggests that LBDS has some pathopysiological characteristics such as decreased functions of sympathetic nerve activation, lower T3 syndrome, imbalance of the active substance regulating cardiovascular function and metabolism of salt and water, and abnormalities second signal substance in cellular membrane.

[Effects of di-zhen granules on catecholamine transmitter and gonadotropin of clamacteric rats with deficiency of yin brings about the interior heat-syndrome]

Fifteen-month-old Sprague-Dawley rats were given with some kinds of hot property of herb to produce model of Deficiency of yin brings about the interior heat-syndrome. The weight, water drinking volume, and body temperature of model rats were observed at the process of producing model and the treatment of di-zhen granules. Hypothalamic NE, DA and plasma NE, E concentration were determined by high-performance liquid chromatography, and serum E2, FSH, LH levels were determined by radioimmunoassay. The results were that after having been given the hot property of herbs for 2 weeks, the model rats increased water drinking volume and body temperature, which is similar to the appearance of patients with Deficiency of yin brings about the interior heat syndrome, and after having been treated with di-zhen granules, the water drinking volume and temperature of model rats decreased significantly (P < 0.01). The hypothalamic NE, DA, plasma NE, E, and the serum FSH, LH of the group treated with di-zhen granules were significantly lower than that of the model group and the normal group(P < 0.01). The results show that our model mentioned above possesses some characteristic features of the human climacteric syndrome which exhibits Deficiency of yin brings about the interior heat-syndrome. Di-zhen granules may regulate the function of GnRH neurons and other neurotic nucleus in hypothalamus, and then rectify the endocrine disorders of climacteric.

[Effect of yiqi yangyin huoxue recipe on endothelin and nitric oxide of type 2 diabetic patients with deficiency of both Qi-Yin and blood stasis syndrome]

OBJECTIVE

To study the effect of Yiqi Yangyin Huoxue recipe (YQYYHX) in treating type 2 diabetes mellitus (DM) patients with deficiency of both Qi-Yin (DQY) and blood stasis Syndrome.

METHODS

Forty-one type 2 DM patients compared with those in the control group were observed.

RESULTS

After treatment, the endothelin (ET) level of the treated group reduced significantly, and the total effective rate of blood sugar lowering were as follows: Fasting blood glucose (FBG) 87.80%, 2 hours postprandial plasma blood glucose (PBG) 90.24%.

CONCLUSION

YQYYHX is effective in improving the patient's vascular endothelia cell functions by reducing the plasma ET level, clinical symptoms and blood sugar lowering.

[Study on molecular mechanism of ganyang shangkang syndrome in hypertension]

OBJECTIVE

To investigate the molecular mechanism of Ganyang Shangkang (Liver Yang ascending, GYSK) syndrome in hypertension.

METHODS

The plasma norepinephrine (NE), epinephrine (E) contents in patients with GYSK syndrome or Ganshen Yinxu (Liver and Kidney Yin Deficiency, GSYX) syndrome who were suffered from hypertension, and normal controls were determined by high performance liquid chromatography-electrochemical detector (HPLC-ECD). The polymorphism of tyrosine hydroxylase (TH) gene in the three groups were analyzed by Southern Blot assay. The polymorphism of TH and MAOA, MAOB gene microsatellite in these groups were analyzed by polymerase chain reaction (PCR)-SSCP; meanwhile, the GYSK model by administration of single TCM preparation, Radix Aconiti preparate (RAP) in spontaneous hypertension rats (SHR). The adrenal gland medulla were examined for their TH expression at the protein level after ABC immuno histochemical staining with the TH monoclonal antibody (McAb). The adrenal TH gene mRNA expression was demonstrated by in situ hybridization with the synthesized TH oligonucleic acid probe. The results of immunohistochemistry and in situ hybridization were analyzed with the image analysis system (IAS).

RESULTS

The plasma NE, E contents in patients with GYSK were more significantly increased than that in GSYX and normal controls. The TH gene amplified and the type A1 TH microsatellite D11S4046 was increased more remarkably than other groups. The TH mRNA protein expression in their adrenal tissue of the single TCM preparation RAP induced GYSK model in SHR were elevated.

CONCLUSIONS

The GYSK syndrome of hypertension possesses the character as amplified TH gene and increased TH mRNA and protein. It suggested that the hyperexpression of TH is probably the mechanism of GYSK syndrome in hypertension.

[Influence of qi-gong on plasma TXB2 and 6-keto-PGF1 alpha in two TCM types of essential hypertension]

Forty-five patients of essential hypertension differentiated into two TCM types, i.e. Gan Yang Shang Kang Zheng (GYSK) and Yin Xu Yang Kang Zheng (YXYK) were randomly selected. Among them, the 31 patients received qi-gong therapy including 12 GYSK cases (group b) and 19 YXYK cases (group c) and 14 patients (group d) received nifedipine therapy. It was found that the plasma 6-K-PGF1 alpha was increased and TXB2 as well as TXB2/6-K-PGF1 alpha ratio were decreased after the therapy (P < 0.05) in group b, c and d. No statistical significant difference was found between group b and group c (P > 0.05). The results suggest that qi-gong is regulatory on TXB2 and 6-K-PGF1 alpha in patients with essential hypertension and is identical in the two different TCM Zheng types.

[Preliminary study on pathophysiological basis of liver-blood deficiency syndrome]

By ways of HPLC and RIA, multiple laboratory parameters were determined simultaneously in 84 patients of iron--deficiency anemia (IDA) or chronic aplastic anemia (CAA) with Liver-Blood Deficiency Syndrome (LBDS) diagnosed by differentiation of TCM. The results showed that LBDS had some pathophysiological characteristics such as decreased function of sympathicus and adrenal medulla axis, increasing of L-EK, lower energy metabolism of erythrocyte, lower rate of body metabolism, sodium and water imbalance, and abnormalities in hemorrheology and erythrocyte deformability. It is suggested that the patients with LBDS are in a state of protective compensation in blood volume regulation.

[Effects of Chinese herbs xianzhen tablet on the deformability of erythrocyte in non-insulin-dependent diabetes mellitus patients with deficiency of both qi and yin and deficiency of kidney with blood stasis]

OBJECTIVE

To explore the effects of Xianzhen Tablet (XZT) on the hemorheology of type 2 diabetes (NIDDM) on the basis of previous studies in XZT, that have indicated its ability to deplete fasting blood glucose, to reduce the injury of free radical to the body, to improve the Na(+)-K(+)-ATPase in the erythrocyte membrane of NIDDM.

METHODS

Erythrocyte deformability and aggregation were studied with Ektacytometer in a total of 60 type 2 diabetes who were randomly divided into two groups. One was ZXT treated group, another was placebo group.

RESULTS

(1) The erythrocyte deformability of type 2 diabetes was lower than that in normal subjects (P < 0.001), but the erythrocyte aggregation increased abnormally than that of health people (P < 0.001). The correlation test indicated there were negative correlation with plasma fibronogen and positive correlation with blood cholesterol (P < 0.05). (2) The erythrocyte deformability in the ZXT treated group with 30 patients improved after 8 weeks treatment (P < 0.01), with the decreased fasting blood glucose and plasma fibrinogen (P < 0.05). Compared with placebo group, there was significant statistical difference (P < 0.01).

CONCLUSIONS

XZT could improve the erythrocyte deformability in the type 2 diabetes.

A study on plasma norepinephrine and epinephrine levels in TCM liver syndromes

The levels of plasma norepinephrine (NE) and epinephrine (E) were determined by HPLC in 220 patients with various TCM liver syndromes, and in 96 healthy subjects as controls. The plasma NE and E contents were higher in patients with liver excess syndromes, including Ganqi Yujie (GQYJ [symbol: see text]) syndrome, Ganyang Shangkang (GYSK [symbol: see text]) syndrome, Ganhuo Shangyan (GHSY [symbol: see text]) syndrome, and Ganyang Huafeng (GYHF [symbol: see text]) syndrome; while they were lower in patients with liver deficiency syndromes, including Ganqixu (GQX [symbol: see text]) syndrome, Ganxuexu (GXX [symbol: see text]) syndrome, and Ganyinxu (GYX [symbol: see text]) syndrome. Futhermore, when Ganshen Yinxu (GSYX [symbol: see text]) syndrome was turned into GYSK and then into GYHF, the plasma NE and E contents increased in order of precedence; while when GQYJ was turned into Ganyu Pixu (GYPX [symbol: see text]) syndrome, both NE and E contents decreased. The results suggest that the plasma NE and E contents are reliable objective parameters for the study of pathophysiological basis of the liver excess and liver deficiency syndromes, and the liver-kidney and liver-spleen interrelated syndromes.

[Clinical observation on relationship of antioxidation criteria and immune function of erythrocyte in patients with asthenia syndrome]

Results of observation on 31 patients of Qi-Yin Deficiency Syndrome showed that as compared with normal person, the superoxide dismutase (SOD) activity of erythrocyte in patients was lowered, the content of serum lipid peroxide (LPO) increased, the rosette rate of red cell C3b receptor (RC3 bRR) lowered but that of red cell immune complex was elevated significantly (P < 0.01). There were a positive correlation between erythrocyte SOD activity and RC3bRR (r = 0.381, P < 0.05), and a negative correlation between serum LPO level and RC3bRR (r = -0.395, P < 0.05).

[Relations of regulatory polypeptide and syndrome differentiation of traditional Chinese medicine of angina pectoris patients]

Ninety cases of angina pectoris patients with the Deficiency of Heart Qi Syndrome (DHQS), Deficiency of Heart-Yin Syndrome (DHYS) and blood stasis in Heart vessels Syndrome (BSHVS) were studied. The number of patients were 30 for each group. Their regulatory polypeptides:atrial natri-uretic polypeptide (ANP), beta-Endorphine (beta-EP), Endothelin (ET), Angiotensin (A-II) were tested. Results showed that in comparing with normal level, P < 0.05 or < 0.01, ANP and beta-EP of them: DHQS > BSHVS > normal group > DHYS. ET and A-II of them: DHYS > BSHVS > normal group > DHQS. And the comparison between groups revealed that P < 0.05 or < 0.01. So ANP, beta-EP, ET and A-II were the principal material basis, and they could be the specific objective parameters of the Syndrome Differentiation.

[Study on relation of kidney-deficiency with hearing damage and serum trace elements in patients with chronic nephropathy]

The hearing and serum trace element of 73 cases of chronic nephropathy were measured. Results showed that the incidence of hearing damage in high frequency was 68.5% with a mean hypoacusis of 35.1 +/- 6.1 dB, while in 55 patients of Kidney Deficiency type, the incidence of hearing damage in high frequency was 83.6%, it was significantly higher than that in patients without Kidney Deficiency. The serum levels of trace elements (iron and zinc) in patients with Kidney Deficiency were lower than that of normal level and in patients without Kidney Deficiency, and the decrease of serum iron was directly proportional to the degree of hearing damage. There were close relationship between the Kidney Deficiency with the hearing damage as well as the serum levels of iron and zinc.

[Diphasic regulatory effect of lishen injection on sex hormones in senile female patients with coronary heart disease of kidney deficiency type]

Effects of Lishen injection on serum estradiol (E2), testosterone (T) and the E2/T ratio in 30 cases of postmenopausal patients with coronary heart disease and of Kidney Deficiency type were observed. Results showed that: (1) Serum E2 and the E2/T ratio were lower (P < 0.01) in the group of Kidney-Yin Deficiency type and higher (P < 0.01) in the group of Kidney-Yang Deficiency type as compared with normal control. (2) After treatment with Lishen injection the levels of serum E2 and the E2/T ratio were elevated in the former (P < 0.01) and lowered in the later (P < 0.01). Both were approaching to normal level (P > 0.05). (3) The levels of T in both groups were unaffected (P > 0.05) before and after treatment. These results suggested the imbalance of Kidney-Yin and Kidney-Yang is related to the disturbance of sex hormones and Lishen injection could not only regulate the Kidney-Yin and Kidney-Yang, improve the symptoms of Kidney Deficiency, but also could convert the abnormal change of sex hormone, it has a good diphasic regulatory effect on E2, and is beneficial on balance of sex hormones of both sex in the inner environment of human body.

[Study on relationship of lipid peroxide in coronary heart disease with and without diabetes]

Activity of erythrocyte superoxide dismutase (RBC-SOD), levels of serum malondialdehyde (MDA), plasma 6-keto-prostaglandin F 1 alpha (6-keto-PGF 1 alpha) and thromboxane B2(TXB2) were measured in 30 healthy subjects and 57 coronary heart desease (CHD) patients inoluding 21 cases complicated with diabetes and 36 without. Their characteristics of Syndrome Differentiation and typing were observed. The results showed that the activity of RBC-SOD, 6-keto-PGF 1 alpha in CHD patients were significantly lower than those in the healthy subjects, but the levels of TXB2, MDA were significantly higher. The levels of TXB2 in CHD patients with diabetes were significantly higher than tose without, but the activity of RBC-SOD were significantly lower. There were remarkably positive correlations between the levels of serum MDA and that of blood sugar, TXB2, TG and BMI in CHD patients with diabetes. There were remarkably negative correlations between the levels of serum MDA and plasma 6-keto-PGF 1 alpha. The results suggested that the metabolic abnormality of lipoperoxides was more serious in CHD patients with diabetes than without. The main Syndrome of CHD with diabetes was Qi-Yin Deficiency with Blood Stasis, while that of without diabetes was Qi Deficiency with Blood Stasis.

[Clinical and experimental study on codonopsis pilosula oral liquor in treating coronary heart disease with blood stasis]

The effects of Codonopsis pilosula oral liquor (CPOL) on tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) in the plasma of 25 patients of coronary heart disease with blood stasis were studied. It has been shown that those patients had a significant decrease in t-PA activity (P < 0.01) compared to healthy subjects. After 4 weeks of CPOL therapy, platelet aggregation significantly decreased (P < 0.05), there was no significant difference in t-PA and PAI. From the results shown above, it suggested that one of the effects of CPOL in influencing blood coagulation was its inhibition on platelet aggregation, but not through the elevating of fibrinolytic activity.

[Study on motilin and spleen-yin deficiency]

The Plasma motilin level in 44 cases patients with Spleen-Yin deficiency (SYD) was observed and compared with Spleen-Qi Insufficiency (SQI), the normal control group. SYD patients were treated using self-made Shen Rou Yang Zhen Tang oral liquor. The results showed that plasma motilin level was higher significantly than that of the control group (P < 0.01), but was remarkably lower than that of SQI. The difference was significant among the three groups (P < 0.01). The abnormal incidence of positive plasma motilin was 65.91% and 75.00% respectively. It is conjectured that the plasma motilin level in SYD was related to excitability of vagus nerve, disturbance of gastro-intestinal internal environment, indigestion and malabsorption of GI tract.

[Relationship between local effect of cortisol used by chronic bronchitis patients and syndrome differentiation in TCM]

Serum cortisol levels and bronchoalveolar lavage fluid (BALF) from 105 patients with chronic obstructive pulmonary disease (COPD) and 36 normal subjects were examined and the relationship between cortisol inhibiting the TXB2 secreted by alveolar macrophage (AM) and the theory of Syndrome Differentiation in TCM was explored. Results showed: (1) No significant differences were found between chronic bronchitis and normal subjects on cortisol levels in serum, but in BALF, cortisol levels was significantly lower in Lung Qi Deficiency when compared with that in normal subjects. (2) the levels of cortisol inhibiting the TXB2 secreted by AM which were significantly lower in chronic bronchitis when compared with that in control. In short, the amount and function of cortisol in BALF were significantly different in various syndromes in TCM of chronic bronchitis.

[Gastric motility in patients with spleen-deficiency symptoms]

By using a method for synchronously-detecting gastric myoelectric activity and intraluminal pressure and a radioimmunoassay of plasmic motilin, gastric motility, plasmic level of motilin and their relationship in 12 normal individuals and in the patients with a variety of Spleen-Deficiency (SD) Syndromes, i.e. 12 SD with Cold type (H type), 7 SD with Stomach-Yin-Deficiency type(I type), 38 SD with Heat type (R type) and 6 SD with Liver-Qi-Stagnation type (U Type) were investigated. The results showed: degree of myoelectric dysrhythmia and rate of electro-mechanical decouple in all patients (except for I type) were much higher than those in the normals (P < 0.01 or P < 0.05); both mean frequency and amplitude of contraction in the patients were decreased; percentage of contractive action in the patients (except for I type) was lower than that in the normals (P < 0.05); plasmic level of motilin in the patients (except for I type) had a tendency to increase and had a linear correlation to degree of myoelectric dysrhythmia (r = 0.33, P < 0.01). It was suggested that some significant disorders of gastric motility exist in different SD patients and there might be an intrinsic cause effect relationship among increased plasmic motilin, myoelectric dysrhythmia and abnormal mechanical motion. The similar changes suggested that there is pathophysiological mechanism of SD syndrome. Furthermore, this synchronously-detecting method was useful to discover intrinsic relationship between gastric myoelectric activity and mechanical motion.

[Changes in serum zinc level of periodontitis with kidney deficiency]

The study is to explore the possible relationship between the level of trace element zinc in serum and periodontitis with Kidney deficiency. The level of serum zinc in 40 cases of periodontitis and in 19 normal controls was examined by atomic absorption spectrum analysis. The results indicated that there was only a descending trend of serum zinc in periodontitis group as compared with normal group. But further analysis revealed that according to the severity of periodontitis and the theory of Syndrome differentiation in TCM, it showed that the drop of serum zinc had not only a negative correlation with the severity of periodontitis, but also was co-related to whether there was Kidney deficiency or not. Serum zinc of periodontitis with Kidney Deficiency group was significantly lower than that of normal control group as well as the group of periodontitis without Kidney deficiency (P < 0.05). The data suggested that the decline of serum zinc level is closely related to the occurring and development of periodontitis with Kidney Deficiency.

[Effect of liuwei dihuang granules, pills and decoction on contents of cAMP, E2, T, Zn and Cu in plasma of renal yin deficient patients]

Experiments showed that in patients of renal yin deficiency who took orally Liuwei Dihuang granules for 4 weeks, the contents of cAMP, E2, Zn and Cu were found mankedly lower, but the contents of T mankedly higher than before using the drugs. This indicates that the granules are equally effective as pills and decoction.

[Therapeutic changes in nephrotic syndrome treated with yiqi huoxue jiedu decoction and corticosteroid]

Plasmic and urinary TXB2 and 6-Keto-PGF1 alpha of 87 patients of nephrotic syndrome (NS) and 25 healthy subjects were measured by RIA, and the influence of Yiqi Huoxue Jiedu decoction (YHJ) and corticosteroid on above-mentioned parameters was investigated.

RESULTS

Plasmic and urinary TXB2 as well as the ratio of TXB2/6-K-PGF1 alpha of both types of NS increased (P < 0.01-0.05). The plasmic TXB2 of II type was higher than that of I type of NS (P < 0.01), 6-K-PGF1 alpha increased as well (P < 0.05). After treatment, plasmic and urinary TXB2 of both types of NS were remarkably lower (P < 0.01), while urinary 6-K-PGF1 alpha increased significantly (P < 0.05). In comparing with pre-treatment investigation, the plasmic 6-K-PGF1 alpha of II type was reduced (P < 0.05). It was shown that YHJ would inhibit the synthesis of TXA2 and regulate the TXA2-PGI2 balance. YHJ was markedly effective in producing TXB2 and 6-K-PGF1 alpha increase, its therapeutical effects was better to patients with Yin Deficiency and both Qi-Yin Deficiency, but not so well with Yang Deficiency Syndrome.

[Clinical study of qianxining in the treatment of 60 cases of yang hyperactivity due to yin deficiency type of hypertension]

60 cases with Yang Hyperactivity due to Yin Deficiency type of hypertension were randomly divided into two groups. One was treated with TCM and the other with WM as control. The results showed that: (1) there were no significant differences in the total effective rate and the amplitude of lowering of blood pressure between two groups; (2) the improvement of symptoms and disturbance of autonomic nerve was significant in TCM group in comparison with control; (3) there were some changes in HR, SV, plasma PRA, TXB2 and 6-keto-PGF1 alpha level in both groups, but the decrease of TXB2/6-keto-PGF1 alpha ratio was significant in TCM group only (P < 0.05); (4) TC and TG in patients with hyperlipemia showed a remarkable drop in TCM group (P < 0.02; P < 0.005). All these revealed that Qianxining was a satisfactory hypotensive remedy and a further exploration of its mechanism is suggested.

[Relation between treatment with traditional Chinese medicine for recurrent aphthous ulcer and human zinc and copper]

The purpose of the study is to explore the relation between general condition of patients with recurrent aphthous ulcer (RAU) and human zinc and copper with TCM conception of the organism as a whole, and adjustment effect of human body zinc and copper by TCM treatment. Results showed that the average value of serum zinc of 75 cases of RAU was on lower level within normal range, serum copper was normal, the rate of copper to zinc was higher than normal value. Analysis using the TCM theory showed serum zinc of patients of deficiency symptom-complex was lower than excessiveness symptom-complex, the rate of copper to zinc of patients of deficiency symptom-complex was higher than normal range. The zinc content of serum and the rate of copper to zinc were different in patients of various symptom-complexes of RAU. The zinc and copper contents of serum were adjusted, the rate of copper to zinc was normalized and the immune function of T-cell increased distinctly by TCM treatment according to an overall differentiation of symptoms and signs. Thus the therapeutic effect of TCM was better than zinc preparation.

[Nourishing yin action of the prepared rhizoma Rehmanniae]

The results of the experiment show that the prepared Rhizomae Rehmanniae can obviously improve the change of weight, quality of drinking water, urine and serum level of T3, T4 and AD of the hyperthyroid Yin deficient rats, and thus administers to the nourishing of Yin. The action of nourishing the kidney Yin is related with improving the serum level of AD in the body.

[Preliminary study on the treatment of diabetic retinopathy utilizing with nourishing yin, tonifying kidney and blood-activating herbs]

23 cases including 45 eyes of diabetic retinopathy treated with nourishing Yin, tonifying Kidney and blood-activating herbs were presented. The results showed that the serum viscosity and cholesterol were markedly decreased (P less than 0.01), and the implicit times of a-wave and b-wave in flash electroretinogram(F-ERG) were significantly advanced than those of themselves before treatment (P less than 0.01 and P less than 0.05 respectively). The visual acuity in most cases was improved and the effective rate was 64.44%. The therapeutical mechanism for diabetic retinopathy used by nourishing Yin, tonifying Kidney and blood-activating herbs were discussed. The authors suggested that the Chinese herbs probably could change the chemical and physical properties of blood, promote the ocular circulation and the absorption of sludged blood and decrease the retinal ischemia.

[Plasma cortisol concentration and blood leukocyte content of glucocorticoid receptors in patients with deficiency-cold vs deficiency-heat syndromes]

Plasma cortisol concentration and blood leukocyte content of glucocorticoid receptors (GCR) were assayed in 20 patients with deficiency syndromes, 10 cold in property (deficiency-cold), the other 10 hot in property (deficiency-heat), and also in 10 healthy individuals as normal control for the purpose of investigating the nature of cold and heat syndromes. As a result, the cases of deficiency-cold syndrome (DCS) had a normal concentration of plasma cortisol but a lowered content of GCR in leukocytes when compared with the normal control (P less than 0.05); the cases of deficiency-heat syndrome (DHS) had a higher concentration of plasma cortisol than the normal control (P less than 0.05) and a slightly higher content of GCR in leukocytes. It was concluded that the DCS is characterized by diminished biological effects of adrenocortical activity, while the DHS, by augmented biological effects of adrenocortical activity.