Study of electroacupuncture with different frequencies for the treatment of headache and anxiety-depression symptoms in patients with migraine: A randomized clinical trial: 不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

ObjectiveTo observe the effects of electroacupuncture (EA) with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patients with such conditions.DesignSingle-center, randomized, controlled clinical trial was designed, and the outcome assessors and statisticians were blinded. The patients with migraine were randomized into 2 Hz EA group, 100 Hz EA group and sham-stimulation group. In each group, the changes in migraine attacks, days with headache, the scores of visual analogy scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and migraine-specific quality-of-life questionnaire (MSQ), as well as the dosage of analgesics were observed at the baseline, during treatment, in 1, 2 and 3 months of follow-up separately.SettingPatients were enrolled in the Third Affiliated Hospital of Zhejiang Chinese Medical University, between 1^st August 2018 and 31^st July 2021.ParticipantsSixty-five migraine patients with or without aura.InterventionsIn the EA groups, the acupoints were bilateral Fengchi (GB20), Gongxue (Extra), Sizhukong (TE23), Taiyang (EX-HN5), Shuaigu (GB8), Waiguan (TE5) and Yanglingquan (GB34). Electric stimulation was exerted at GB20 and Gongxue (Extra), with 2 Hz and 100 Hz separately. In the sham-stimulation group, the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue (Extra), and on the radial side of TE5 and GB34. The output wires were cut off after attached to the acupoints. The patients in each group received the treatment 3 times weekly, once every two days, for consecutive 4 weeks. The complete intervention was composed of 12 treatments.Main outcome measuresChanges in numbers of migraine attacks at treatment phase (week 1 to week 4) from the baseline(week -4 to week 0) in patients of each groupResults(1) Changes in migraine attacks and days with headache: In the 2 Hz EA and 100 Hz EA groups, the changes for migraine attacks and days of headache were higher significantly when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (2) Changes of VAS score: In the 2 Hz EA and 100 Hz EA groups, the changes of VAS score were significantly higher when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (3) Assessment of anxiety and depression: The differences in the changes of SAS and SDS scores had no statistical significance in patients of each group at each assessment stage (P > 0.05). (4) Assessment on the quality of life: Compared with the sham-stimulation group at the same time stage, the improvement in MSQ score was increased significantly during treatment in patients of the 2 Hz EA and 100 Hz groups (P < 0.05). There was no statistical difference between two EA groups. (5) Assessment on safety and compliance: The patients of each group had sound compliance. There was no adverse events during trial, suggesting promising safety of treatment.ConclusionEA may effectively reduce the migraine attacks, and the days and intensity of headache, presenting promising safety. However, there was no significant improvement on anxiety-depression symptoms, and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine.Trial registrationChiCTR1800017259     

Carvedilol can attenuate histamine-induced paw edema and formaldehyde-induced arthritis in rats without risk of gastric irritation

Background and aimRheumatoid arthritis treatment aims to control joint damage and any associated complications such as cardiovascular disease. Most anti-inflammatory drugs have a high tendency to cause gastro-intestinal irritation. The present study is designed to investigate the anti-inflammatory effect of carvedilol and to study its effect on gastric mucosa.Experimental approachLornoxicam (1.3 mg/kg) or carvedilol (10 mg/kg) was administrated orally 1 h before histamine injection into animals of a histamine-induced paw edema model and orally daily for 11 days into animals of a formaldehyde-induced arthritis model. Tumor necrosis factor-α and prostaglandin E₂ were measured in animals of the formaldehyde-induced arthritis model. The effect of lornoxicam and carvedilol on gastric mucosa was assessed in normal rats and after induction of cold stress ulcer.ResultsCarvedilol succeeded in reducing hind paw edema in both histamine-induced paw edema and formaldehyde-induced arthritis and in reducing the elevated level of tumor necrosis factor-α and prostaglandin E₂ nearly with near equal efficacy compared with lornoxicam. Carvedilol did not show any ulcerative effect on the gastric mucosa of normal rats, and its use was associated with an improvement of both the gross and histopathological pictures of gastric ulcers in animals of the cold stress ulcer model compared with lornoxicam treated rats.ConclusionThe current findings support the use of carvedilol both in the management of inflammation as well as the prevention of cardiovascular complications in rheumatoid arthritis patients. The use of carvedilol was not associated with any gastro-intestinal tract irritation.     

论中医“症状性病名”的合理性

症状性病名是病名演变过程中的必然阶段,也是以症状为纲目编撰医籍的需要,虽然症状性病名因症病概念混淆饱受诟病,但基于症状性病名仍有其存在的合理性和必要性,当前临床的关键问题是如何在继续继承及发展症状性病名同时,综合应用中医诊断基本要素、西医病名诊断与客观检查指标,弥补症状性病名应用短板。     

绝经后骨质疏松症肾阴虚证关联LincRNA uc431 +的表达研究

目的探讨lincRNA uc431+与绝经后骨质疏松症(postmenopausal osteoporosis,POP)肾阴虚证的关系及其二级结构特征。方法在前期研究证实了CLCF1是POP肾阴虚证的重要关联基因,并在血液lncRNA芯片检测中筛选了POP肾阴虚证的特异lincRNAs,本文采用blat软件对靶基因为CLCF1的lncRNA进行分析;采用分析软件RNAfold对lncRNA及其二级结构进行预测;随机选择绝经后骨质疏松症患者,中医辨证分型为肾阴虚证组25例,健康绝经后妇女25例设为正常对照组。用定量PCR技术检测绝经后骨质疏松症肾阴虚证组、对照组外周血lincRNA uc431+及CLCF1的表达水平。结果 blat软件预测lincRNA uc431+的靶基因为CLCF1,相关系数为-0.8192(P=0.0069);RNAfold软件预测发现lincRNA uc431+有多个茎环结构;实时荧光定量PCR结果表明,POP肾阴虚证组CLCF1 mRNA表达水平明显低于对照组(P0.01),lincRNA uc431+在POP肾阴虚证组中表达出现降低,与对照组相比,差异具有统计学意义(P0.01)。结论 lincRNA uc431+的表达下调可能与绝经后骨质疏松症肾阴虚证相关联。     

续苓健骨颗粒治疗肾虚血瘀型绝经后骨质疏松症的疗效及转录机制研究

探讨续苓健骨颗粒治疗肾虚血瘀型绝经后骨质疏松症的临床疗效及转录组机制。方法 选取肾虚血瘀型绝经后骨质疏松症患者,随机分为续苓健骨颗粒试验组及骨化三醇对照组。观察两组中医证候积分、骨密度及安全性指标。取6例试验组患者治疗前、后的外周血进行转录组测序,另选6例健康组作为对照,筛选差异表达基因并行KEGG分析。结果 完成病例：试验组27例,对照组27例。试验组中医证候疗效总有效率为96.30 %,显著优于对照组的77.78 %（P?0.05）。治疗后两组中医证候积分、腰脊刺痛、下肢痿软等临床症状评分较治疗前均下降（P<0.05）,但组间比较差异无统计学意义（P>0.05）。两组治疗前后骨密度比较差异无统计学意义（P>0.05）,但均保持稳定或呈现上升趋势。两组均未出现严重不良反应。转录组测序：试验组治疗前、后有319个差异基因;试验组治疗前与健康组有598个差异基因,其中19个差异基因（包括FOSB、H4C2、RAMP3等）在治疗后其表达显著改变。KEGG分析结果表明,FOSB参与破骨细胞分化、IL-17信号通路。结论 续苓健骨颗粒治疗绝经后骨质疏松症,能够显著改善临床症状,中医证候疗效优于骨化三醇,其作用机制可能与FOSB、RAMP3、H4C2基因及FOSB参与的破骨细胞分化、IL-17信号通路相关。     

Reliability and validity of dermatology life quality index： assess- ment of quality of life in human immunodeficiency virus/acquired immunodeficiency syndrome patients with pruritic papular erup- tion

OBJECTIVE： To test the reliability and validity of dermatology life quality index（DLQI） in simplified Chinese language by assessing the quality of life（QoL） in HIV（human immunodeficiency virus）/AIDS（Acquired immunodeficiency syndrome） patients with pruritic papular eruption（PPE）. METHODS： A study of simplified-Chinese-versiond from10 questions with the principal component analysis and the contribution rate of the 3 common factors was 59.95%. CONCLUSION： The simplified-Chinese-version DIQL is an acceptable and valid scale for HIV/AIDS patients with PPE. It can be used to evaluate the QoL of HIV/AIDS patients with PPE in China.     

Characterization of brusatol self-microemulsifying drug delivery system and its therapeutic effect against dextran sodium sulfate-induced ulcerative colitis in mice

Brusatol (BR) is one of the main bioactive components derived from Brucea javanica, a medicinal herb historically used in the treatment of dysenteric disorders (also known as ulcerative colitis(UC)). Due to its poor aqueous solubility, a novel brusatol self-microemulsifying drug delivery system (BR-SMEDDS) nanoformulation with smaller size, higher negative zeta potential and drug content, and excellent stability was developed. The appearance of BR-SMEDDS remained clear and transparent, and transmission electron microscopy showed microemulsion droplets to be spherical with homogeneous distribution. Pharmacokinetic parameters indicated that oral bioavailability was greatly improved by BR-SMEDDS as compared with aqueous suspension. Meanwhile, the anti-colitis activity of BR-SMEDDS was evaluated on dextran sodium sulfate (DSS)-induced colitis mice model. The result illustrated that the nano-formation significantly reduced the body weight loss, recovered colon length, decreased disease activity index and microscopic score, regulated immune-inflammatory cytokines, diminished oxidative stress and repressed the colonic expression of myeloid differentiation factor 88 (MyD88), toll-like receptor 4 (TLR4) and nuclear factor kappa B p65 (NF-κB p65) proteins. Our findings demonstrated for the first time that BR could effectively attenuate colonic inflammation in mice, at least partially, via favorable regulation of anti-oxidative and anti-inflammatory status and inhibition of the TLR4-linked NF-κB signaling pathway. The BR nano-formulation was superior to BR suspension and sulphasalazine, in treating experimental UC, and exhibited similar effect with azathioprine, with much smaller dosage. The enhanced anti-UC effect of BR might be intimately associated with the improved pharmacokinetic property by SMEDDS. The developed nano-delivery system might thus be a promising candidate for colitis treatment.     

基于计算机技术的中医面色诊信息采集与识别研究

目的:探索中医面色诊的规范化采集环境和客观识别方法,实现中医面色诊的计算机自动识别。方法:在中医理论指导下,比较各种人造光源,建立面色诊采集环境和临床面色判读量表;采集典型面色样本,结合图像处理、模式识别、人工智能等多种信息处理方法对面部颜色信息进行识别。结果:①研制了符合中医特点的以LED光源为照明光源的面色诊采集暗箱;②确定了符合中医理论的,临床专家认可的中医面部五色分类判读量表;③建立了面色诊颜色客观自动识别的方法,确定各类面色在色彩空间中的范围,初步研制中医面色识别分析系统。结论:该方法实现了中医面色诊的计算机自动识别,克服了传统中医望面色无客观量化标准和存在主观性的不足,增强了中医临床信息采集的规范化和准确性,提高了辨证诊断的科学性。     

Contribution of DNA methylation profiling to the reclassification of a variant of uncertain significance in the KDM5C gene

KDM5C encodes a demethylase of the histone H3 lysine 4 residue, involved in chromatin regulation and gene expression. Hemizygous KDM5C pathogenic variants cause X-linked intellectual disability of Claes-Jensen type. Because of its mode of inheritance and the low specificity of the clinical phenotype, interpretation of variants can be difficult, hence the need for functional studies and biomarkers specific to this disorder. We present the case of a male patient with intellectual disability, behavioral abnormalities and subtle dysmorphic features, in which genetic investigation identified a hemizygous novel missense KDM5C variant of uncertain significance (VUS), inherited from his asymptomatic mother and present in his paucisymptomatic sister. We assessed the global genomic DNA methylation status from a whole blood sample of the proband. Global DNA methylation profiling specifically identified the recently discovered epi-signature of Claes-Jensen syndrome. This result served as a biomarker which independently highlighted KDM5C as the cause of the disorder in this patient. Because of the X-linked mode of inheritance, variant reclassification had a high impact on genetic counseling in this family. This example highlights the value of global methylome profiling in situations of variants of uncertain significance in genes with a known specific epi-signature.     

基于文献计量分析的数据挖掘在中医诊断学领域的应用研究

为系统探索数据挖掘在中医诊断学领域应用的科研产出、研究主体及研究主题演化路径和前沿热点问题,研究以中国知网(CNKI)期刊数据库为数据源,收集自建库以来至2019年该领域相关文献,并利用CiteSpace和VOSviewer科学计量软件进行可视化知识图谱绘制。该研究领域的成长依次经历了起源阶段、探索阶段、发展阶段、平台阶段及新的发展阶段,学者们对该领域研究的关注度总体上呈上升趋势。目前,该领域高产作者共有35位,发文期刊主要为中医领域的核心期刊,机构以上海中医药大学、北京中医药大学、湖南中医药大学科研产出最多。研究主题主要形成四大聚类:计算机与中医辨证论治、数据挖掘与疾病用药规律、中医计量诊断、人工智能与中医四诊。主要研究主题从较早的计算机辅助诊断、数学模型、计量诊断、证素辨证等在中医诊断的应用发展至近年来的数据挖掘、关联规则、中医药、模糊数学、用药规律、聚类算法、大数据、状态辨识、名老中医等。特别是在现今互联网+及“健康中国”的时代背景下,中医诊断有了新的内涵,充分发挥数据挖掘优势,立足中医思维与名医经验,挖掘中医药真实世界的健康大数据规律成为新兴热点。