BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature...BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature,there has been growing interest in identifying noninvasive alternatives.Transient elastography offers a promising approach for measuring liver stiffness and spleen stiffness,which can help estimate the likelihood of decompensation in patients with chronic liver disease.AIM To investigate the predictive ability of the liver stiffness measurement(LSM)and spleen stiffness measurement(SSM)in conjunction with other noninvasive indicators for clinical decompensation in patients suffering from compensatory cirrhosis and portal hypertension.METHODS This study was a retrospective analysis of the clinical data of 200 patients who were diagnosed with viral cirrhosis and who received computed tomography,transient elastography,ultrasound,and endoscopic examinations at The Second Affiliated Hospital of Xi’an Jiaotong University between March 2020 and November 2022.Patient classification was performed in accordance with the Baveno VI consensus.The area under the curve was used to evaluate and compare the predictive accuracy across different patient groups.The diagnostic effectiveness of several models,including the liver stiffness-spleen diameter-platelet ratio,variceal risk index,aspartate aminotransferase-alanine aminotransferase ratio,Baveno Ⅵ criteria,and newly developed models,was assessed.Additionally,decision curve analysis was carried out across a range of threshold probabilities to evaluate the clinical utility of these predictive factors.RESULTS Univariate and multivariate analyses demonstrated that SSM,LSM,and the spleen length diameter(SLD)were linked to clinical decompensation in individuals with viral cirrhosis.On the basis of these findings,a predictive model was developed via logistic regression:Ln[P/(1-P)]=-4.969-0.279×SSM+0.348×LSM+0.272×SLD.The model exhibited strong performance,with an area under the curve of 0.944.At a cutoff value of 0.56,the sensitivity,specificity,positive predictive value,and negative predictive value for predicting clinical decompensation were 85.29%,88.89%,87.89%,and 86.47%,respectively.The newly developed model demonstrated enhanced accuracy in forecasting clinical decompensation among patients suffering from viral cirrhosis when compared to four previously established models.CONCLUSION Noninvasive models utilizing SSM,LSM,and SLD are effective in predicting clinical decompensation among patients with viral cirrhosis,thereby reducing the need for unnecessary hepatic venous pressure gradient testing.展开更多
OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHO...OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHODS:A single-center,retrospective analysis was conducted on patients diagnosed with IMN who met predefined inclusion and exclusion criteria.Data were collected from the Department of Nephrology at Longhua Hospital,affiliated with Shanghai University of Traditional Chinese Medicine,between January 2007 and December 2011.Clinical parameters including 24-h urinary protein,serum albumin,serum creatinine,and estimated glomerular filtration rate(e GFR,EPI)were assessed at baseline and at 1,3,5,and 10 years of follow-up.The efficacy of the Strengthening Spleen and Draining Dampness therapy was analyzed using repeated measures analysis of variance(ANOVA).Kaplan-Meier survival curves and multivariate proportional hazards model(Cox regression models)were employed to identify factors associated with treatment outcomes.RESULTS:A total of 265 patients were included,with a median follow-up duration of 96 months(36,122).TCM treatment significantly reduced 24-h urinary protein levels(P<0.001),and increased serum albumin levels(P<0.001),while serum creatinine remained stable(P=0.187).Remission rates at 1,3,5,and 10 years were 52.81%,69.71%,68.39%,and 72.36%,respectively,and the rates of avoiding composite outcome events at the same intervals were 98.27%,94.29%,94.19%,and 93.50%.In the subgroup receiving TCM only,remission rates were 56.67%,84.44%,76.32%,and 82.86%.For patients treated initially with Western Medicine followed by TCM,the rates were 52.83%,65.85%,67.47%and 67.75%.In the cohort of patients who received TCM as their first-line therapy,remission rates were 49.23%,62.50%,61.76%,and 69.23%.Multivariate Cox regression analysis revealed that the duration of TCM treatment[hazard ratio(HR)=0.826,95%confidence interval(CI)(0.779,0.876),P<0.001],presence of hypertension[HR=1.912,95%CI(1.181,3.094),P=0.008],baseline serum albumin level[HR=0.930,95%CI(0.894,0.969),P<0.001],and the rate of serum albumin increase within the first year of treatment[HR=0.930,95%CI(0.909,0.957),P<0.001]were significantly associated with clinical outcomes.CONCLUSION:The Strengthening Spleen and Draining Dampness therapy demonstrated robust short-and longterm efficacy in treating IMN,with high rates of remission and renal survival over 10 years.Key factors influencing clinical remission included the duration of TCM treatment,baseline serum albumin levels,the presence of hypertension,and the rate of increase in serum albumin within the first year.These findings suggest that this TCM approach provides a viable long-term treatment option for IMN.展开更多
BACKGROUND Shear wave elastography(SWE)is a non-invasive ultrasound-based technique used to assess tissue stiffness,which reflects underlying pathological changes.While SWE has been widely applied for liver fibrosis e...BACKGROUND Shear wave elastography(SWE)is a non-invasive ultrasound-based technique used to assess tissue stiffness,which reflects underlying pathological changes.While SWE has been widely applied for liver fibrosis evaluation,its application to other abdominal organs,such as the spleen and pancreas,is gaining interest.However,normal stiffness values and inter-system agreement remain poorly defined.AIM To assess the feasibility and agreement of liver,spleen,and pancreas stiffness using three SWE methods.METHODS This single-center observational study enrolled 50 healthy adult volunteers.Liver,spleen,and pancreas stiffness were assessed using three SWE methods:Point-SWE(p-QElaXto)and 2-Dimensional-SWE(2D-QElaXto)with Esaote MyLab 9,and 2D-SWE with SuperSonic Imagine.Feasibility,inter-operator reproducibility,and concordance among systems were evaluated.Stiffness was expressed as median kPa values,and technical reliability was assessed using the interquartile range/median ratio and stability index thresholds.RESULTS Liver and spleen stiffness assessment was feasible in>98%of patients,while pancreas stiffness was measurable in 84%-88%depending on the SWE technique.Mean liver stiffness ranged between 3.9-4.7 kPa across techniques,spleen stiffness ranged from 19.4-23.0 kPa,and pancreas stiffness from 5.2-7.6 kPa.Inter-operator agreement was excellent for liver(intraclass correlation coefficient>0.90)and good to moderate for spleen and pancreas(intraclass correlation coefficient from 0.43 to 0.90).Bland-Altman analysis confirmed good correlation but also systematic differences among devices,especially in pancreas measurements.CONCLUSION This is the first study to establish normal liver,spleen,and pancreas stiffness using MyLab 9 SWE integrated methods as compared to SuperSonic Imagine,with acceptable inter-technique agreement.Liver and spleen values matched existing guidelines;pancreas SWE showed more variability and reduced reproducibility.展开更多
Hyperuricemia(HUA)is a metabolic disorder characterized by elevated levels of uric acid in the blood,resulting from either increased production or decreased excretion of uric acid.This condition has reached epidemic p...Hyperuricemia(HUA)is a metabolic disorder characterized by elevated levels of uric acid in the blood,resulting from either increased production or decreased excretion of uric acid.This condition has reached epidemic proportions.Conventional Western medical treatments often come with a range of adverse effects.According to traditional Chinese medicine(TCM),the root cause of HUA lies in the spleen’s insufficient healthy movement,with phlegm,dampness,turbidity,and stasis being symptomatic manifestations.Research has shown that spleen-strengthening herbal remedies can effectively treat HUA by inhibiting uric acid synthesis enzymes,promoting uric acid excretion,reducing inflammation,providing antioxidant benefits,regulating gut microbiota,and modulating cellular processes.Clinical applications have substantiated these findings.Therefore,from the standpoint of symptomatic treatment of HUA,spleen-strengthening therapies hold significant importance and potential.展开更多
Traditional Chinese Medicine(TCM)has been utilized in China for thousands of years to treat and prevent various diseases,with recent research highlighting microRNAs(miRNAs)in herbal decoctions as key bioactive compone...Traditional Chinese Medicine(TCM)has been utilized in China for thousands of years to treat and prevent various diseases,with recent research highlighting microRNAs(miRNAs)in herbal decoctions as key bioactive components.The oral lyophilized powder of the pig spleen extracts(PAT)composed of oligonucleotides and peptides extracted from fresh pig spleen and delivered via a lipid mixture containing neutral cytidinyl lipid DNCA and cationic lipid CLD(Mix),has demonstrated significant antitumor effects against A549 and BCPAP cells,promoting early and late apoptosis by approximately 20%in A549 cells.Intratumoral administration of PAT/Mix in A549-bearing mice significantly reduced both tumor volume and weight.Transcriptomic and proteomic analyses suggested that PAT/Mix exerted its antitumor activity by silencing DEPDC1 mRNA in A549 cells,thereby influencing cellular processes and metabolic pathways.Additionally,PAT/Mix was found to promote the maturation of bone marrow dendritic cells(BMDCs),enhancing antigen processing and presentation.These findings indicated that PAT/Mix held promise as a therapeutic agent with both immunomodulatory and antitumor properties,owing not only to its peptide components but also to miRNAs,which played a critical therapeutic role.展开更多
Spleen-preserving distal pancreatectomy(SPDP)has gained increasing attention as a safe and effective alternative to distal pancreatectomy with splenectomy,particularly for benign and low-grade malignant lesions of the...Spleen-preserving distal pancreatectomy(SPDP)has gained increasing attention as a safe and effective alternative to distal pancreatectomy with splenectomy,particularly for benign and low-grade malignant lesions of the pancreatic body and tail.This narrative review evaluates the current evidence,technical considerations,and disease-specific indications for SPDP.Literature was reviewed using up to date scientific evidence and most recent national and international guidelines.Studies addressing SPDP outcomes,splenectomy complications,and disease-specific oncologic principles were included.Spleen preservation has been associated with reduced rates of postoperative infections,thromboembolic events,and longterm immunologic compromise,without compromising oncologic outcomes in selected patients.Indications favoring SPDP include pancreatic neuroendocrine tumors,intraductal papillary mucinous neoplasms,and solid pseudopapillary neoplasms.Although current guidelines generally recommend splenectomy for pancreatic ductal adenocarcinoma,emerging data suggest that spleen preservation may be feasible in highly selected cases.Technical approaches—primarily the Kimura and Warshaw techniques—enable safe dissection and splenic vessel management,particularly with the support of minimally invasive platforms.In conclusion,SPDP should be considered in appropriately selected patients to reduce morbidity while preserving long-term immune function.Future randomized studies are warranted to define oncologic safety and refine indications across tumor types.展开更多
Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From d...Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From database foundation to January 14,2025,PubMed,Web of Science,Cochrane,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),and China Biomedical Literature Database(CBM)were searched for relevant information.Randomized clinical trials(RCTs)evaluating the efficacy and safety of TSRQ therapy combined with THRT for Hashimoto’s hypothyroidism were eligible for inclusion.Following quality assessment,data were analyzed using Stata 15.1 to conduct a meta-analysis and systematic review.Subgroup analysis was used to identify the sources of heterogeneity.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was adopted to evaluate the certainty of the evidence.Results This study included 30 RCTs,comprising 2687 patients with Hashimoto’s hypothyroidism.Overall methodological quality was acceptable,with no studies exhibiting a high risk of bias.Meta-analysis demonstrated that TSRQ therapy combined with THRT significantly enhanced serum free triiodothyronine(fT3)levels[standardized mean difference(SMD)=0.76,95%confidence interval(CI):0.57 to 0.94,P<0.001]and free thyroxine(fT4)levels(SMD=0.86,95%CI:0.61 to 1.11,P<0.001),while reducing thyroid-stimulating hormone(TSH)levels(SMD=–0.99,95%CI:–1.20 to–0.78,P<0.001)compared with THRT alone.Furthermore,the combination therapy significantly decreased anti-thyroid peroxidase antibody(TPOAb)levels(SMD=–1.46,95%CI:–1.79 to–1.13,P<0.001)and anti-thyroglobulin antibody(TgAb)levels(SMD=–1.46,95%CI:–1.80 to–1.11,P<0.001).TSRQ therapy did not adversely impact the safety profile of THRT.However,while some sources of heterogeneity have been identified(e.g.,specific detection methodologies,I²=0.0%,P=0.938),there remains a portion of unexplained heterogeneity(e.g.,publication year,I²=93.4%,P<0.001),which has undermined confidence in these pooled estimates.The evidence ratings for fT3,fT4,and TSH were limited,and those for TPOAb and TgAb were even more limited.Conclusion TSRQ therapy combined with THRT may strengthen thyroid function and modulate immune dysregulation in patients with Hashimoto’s hypothyroidism without increasing adverse event incidence.展开更多
[Objectives]To investigate the effects of Zuogui Pill on peripheral blood cells,sex hormone levels,interleukin 1β(IL-1β)levels,ovarian follicle number and spleen index in SD rats damaged by ^(60)Coγrays.[Methods]Fi...[Objectives]To investigate the effects of Zuogui Pill on peripheral blood cells,sex hormone levels,interleukin 1β(IL-1β)levels,ovarian follicle number and spleen index in SD rats damaged by ^(60)Coγrays.[Methods]Fifty 8-week-old female SPF SD rats were selected,10 of which were in the normal group and were fed routinely without irradiation;the other 40 rats were irradiated with ^(60)Coγrays(6.0 Gy,LD 40)for 24 h,and then divided into radiation model group,Progynova group,high and low dose of Zuogui Pill groups.Progynova group was treated with 0.09 mg Progynova;high dose Zuogui Pill group was treated with 4.725 g Zuogui Pill crude drug and low dose Zuogui Pill group was treated with 0.945 g Zuogui Pill crude drug;radiation group was treated with 2 mL normal saline by gavage once a day for 21 d.The changes of peripheral blood cells in different time periods were detected;the follicle stimulating hormone(FSH)and estradiol(E 2)in peripheral blood serum were detected by enzyme linked immunosorbent assay(ELISA).The expression levels of E 2,luteinizing hormone(LH)and interleukin 1β(IL-1β)were detected,and the ovarian follicle number and spleen index were measured.[Results]After irradiation,the number of peripheral blood cells decreased,especially the number of white blood cells(P<0.05),the content of hemoglobin increased(P<0.05),the level of E 2 decreased,the number of mature follicles decreased,the spleen index decreased,and the expression level of IL-1βincreased.After the intervention of Zuogui Pill,the serum E 2 level,number of mature follicles and spleen index increased,while the serum IL-1β,FSH and LH levels decreased,especially in the high dose Zuogui Pill group(P<0.05).[Conclusions]Zuogui Pill can promote the repair of ovarian function in rats with radiation injury,which may be related to the promotion of bone marrow hematopoiesis and the improvement of immune function,reflecting the theory of"kidney governing blood vessels".展开更多
BACKGROUND The impact of transjugular intrahepatic portosystemic shunt(TIPS)on liver and spleen stiffness remains unclear,as does the association between preoperative liver and spleen stiffness and prognosis following...BACKGROUND The impact of transjugular intrahepatic portosystemic shunt(TIPS)on liver and spleen stiffness remains unclear,as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.AIM To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.METHODS A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included.Liver and spleen stiffness was assessed using the sound touch quantify(STQ)value,determined via point shear wave elastography in ultrasound imaging.Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.RESULTS The liver STQ value demonstrated a marginally decreasing trend over time(P=0.052),while the spleen STQ value showed a significantly decreasing trend(P=0.025).Spleen STQ was positively correlated with portal pressure gradient(PPG)levels(rs=0.327,P=0.025).Cox regression analysis indicated that older age[hazard ratio(HR)=1.063,95%CI:0.997-1.133,P=0.060]and a higher liver STQ value(HR=1.051,95%CI:1.009-1.095,P=0.018)were associated with an increased mortality risk after TIPS.No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS.The liver STQ value[area under the receiver operating characteristic curve(AUC)=0.724(95%CI:0.563-0.884)]showed superior predictive performance compared to the Child-Pugh score[AUC=0.699(95%CI:0.529-0.870)]and was comparable to the model for end-stage liver disease score[AUC=0.746(95%CI:0.591-0.902)].CONCLUSION Following TIPS,spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG.Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.展开更多
Food allergy has become a global concern.Spleen tyrosine kinase(SYK)inhibitors are promising therapeutics against allergic disorders.In this study,a total of 300 natural phenolic compounds were firstly subjected to vi...Food allergy has become a global concern.Spleen tyrosine kinase(SYK)inhibitors are promising therapeutics against allergic disorders.In this study,a total of 300 natural phenolic compounds were firstly subjected to virtual screening.Sesamin and its metabolites,sesamin monocatechol(SC-1)and sesamin dicatechol(SC-2),were identified as potential SYK inhibitors,showing high binding affinity and inhibition efficiency towards SYK.Compared with R406(a traditional SYK inhibitor),sesamin,SC-1,and SC-2 had lower binding energy and inhibition constant(Ki)during molecular docking,exhibited higher bioavailability,safety,metabolism/clearance rate,and distribution uniformity ADMET predictions,and showed high stability in occupying the ATP-binding pocket of SYK during molecular dynamics simulations.In anti-dinitrophenyl-immunoglobulin E(Anti-DNP-Ig E)/dinitrophenyl-human serum albumin(DNP-HSA)-stimulated rat basophilic leukemia(RBL-2H3)cells,sesamin in the concentration range of 5-80μmol/L influenced significantly the degranulation and cytokine release,with 54.00%inhibition againstβ-hexosaminidase release and 58.45%decrease in histamine.In BALB/c mice,sesamin could ameliorate Anti-DNP-Ig E/DNP-HSA-induced passive cutaneous anaphylaxis(PCA)and ovalbumin(OVA)-induced active systemic anaphylaxis(ASA)reactions,reduce the levels of allergic mediators(immunoglobulins and pro-inflammatory cytokines),partially correct the imbalance of T helper(Th)cells differentiation in the spleen,and inhibit the phosphorylation of SYK and its downstream signaling proteins,including p38 mitogen-activated protein kinases(p38 MAPK),extracellular signalregulated kinases(ERK),and p65 nuclear factor-κB(p65 NF-κB)in the spleen.Thus,sesamin may be a safe and versatile SYK inhibitor that can alleviate Ig E-mediated food allergies.展开更多
Mass mortality of mandarin fish(Siniperca chuatsi)due to infectious spleen and kidney necrosis virus(ISKNV)infection occurs frequently.Since there are no effective drug treatments available,prevention relies heavily o...Mass mortality of mandarin fish(Siniperca chuatsi)due to infectious spleen and kidney necrosis virus(ISKNV)infection occurs frequently.Since there are no effective drug treatments available,prevention relies heavily on detection.Effective and rapid on-site detection methods are needed for early diagnosis of ISKNV.In this study,a rapid and simple colloidal gold test strip method,specific for the antibody against major capsid protein(MCP),was developed and systematically evaluated for the detection of ISKNV.The limit of detection of the test strip is a 1꞉100 dilution of a positive standard serum and the antibody level in the fish could be estimated from the depth of color of the test line.The strips were tested against serum samples of cyprinid herpesvirus-2(CyHV-2),grass carp reovirus(GCRV),largemouth bass ranavirus(LMBV),large yellow croaker iridovirus(LYCIV),and spring viremia of carp virus(SVCV),yielding no cross-reactivity.In addition,10 mandarin fish artificially infected with ISKNV were tested using the current industry standard PCR method(SC/T 7211-2011)on their splenorenal tissues.The results from the test strips showed a high degree of concordance with PCR testing,achieving a Kappa value of 0.737.All the results indicated that the colloidal gold test strips prepared in this study could be used as a simple,rapid,and highly sensitive and specific method for ISKNV diagnosis.展开更多
Objective:To explore the effects of acupoint catgut embedding combined with auricular point pressing with beans on symptom management self-efficacy and quality of life in patients with nonalcoholic steatohepatitis(NAS...Objective:To explore the effects of acupoint catgut embedding combined with auricular point pressing with beans on symptom management self-efficacy and quality of life in patients with nonalcoholic steatohepatitis(NASH)of liver depression and spleen deficiency type.Methods:Sixty patients with NASH of liver depression and spleen deficiency type admitted to our hospital from January 2021 to December 2023 were selected and divided into an acupoint catgut embedding group(n=30)and a combined group(n=30)using the envelope lottery method.The acupoint catgut embedding group received acupoint catgut embedding intervention,while the combined group received auricular point pressing with beans on the basis of the acupoint catgut embedding group.The two groups were compared in terms of TCM syndrome scores,symptom management self-efficacy[Chronic Disease Self-Efficacy Scale(CDSES)],and quality of life[Chronic Liver Disease Questionnaire(CLDQ)].Results:After intervention,the combined group had lower TCM syndrome scores for both primary and secondary symptoms compared to the acupoint catgut embedding group(P<0.05).The combined group also had higher scores in all dimensions and total score of the CDSES compared to the acupoint catgut embedding group(P<0.05).Similarly,the combined group had higher scores in all dimensions and total score of the CLDQ compared to the acupoint catgut embedding group(P<0.05).Conclusion:Acupoint catgut embedding combined with auricular point pressing with beans can effectively improve TCM symptoms,enhance symptom management self-efficacy,and improve quality of life in patients with NASH of liver depression and spleen deficiency type.展开更多
Objective:To observe the clinical efficacy of the method of softening the liver,harmonizing the spleen,and unblocking the orifices in the treatment of Xiaoke Neizhang with Qi and Yin deficiency type.Methods:Seventy-tw...Objective:To observe the clinical efficacy of the method of softening the liver,harmonizing the spleen,and unblocking the orifices in the treatment of Xiaoke Neizhang with Qi and Yin deficiency type.Methods:Seventy-two patients with Xiaoke Neizhang of qi and yin deficiency type were selected from March 2024 to May 2025 and divided into a treatment group and a control group with 36 cases each according to the random number table method.The treatment group was treated with the method of softening the liver,harmonizing the spleen,and unblocking the orifices,which included oral administration of Softening the Liver and Harmonizing the Spleen Pills combined with iontophoresis of Xuesaitong Injection.The control group was treated with oral administration of calcium dobesilate capsules.Both groups were treated for 2 courses,and multiple indicators such as visual acuity,fundus condition,and TCM syndrome scores were compared between the two groups.Results:The total effective rate of the treatment group was higher than that of the control group.There were significant differences in visual acuity,fundus condition,and TCM syndrome scores between and within the groups(P<0.05).Conclusion:The method of softening the liver,harmonizing the spleen,and unblocking the orifices has a definite clinical effect in the treatment of Xiaoke Neizhang with Qi and Yin deficiency type.It has a direct effect,is painless,easy for patients to accept,and has high clinical application value.展开更多
Objective:To evaluate the therapeutic effect of Shu Gan Jian Pi Yi Qi prescription combined with grain-sized moxibustion on diarrhea-predominant irritable bowel syndrome(IBS-D)with liver depression and spleen deficien...Objective:To evaluate the therapeutic effect of Shu Gan Jian Pi Yi Qi prescription combined with grain-sized moxibustion on diarrhea-predominant irritable bowel syndrome(IBS-D)with liver depression and spleen deficiency syndrome.Methods:60 patients with IBS-D(liver depression and spleen deficiency syndrome)treated in the outpatient clinic from January 2021 to December 2023 were selected and randomly divided into two groups using a random number table.The combined group was treated with Shu Gan Jian Pi Yi Qi prescription and grain-sized moxibustion,while the reference group was treated with western medication.The total effective rate,IBS symptom severity score(IBS-SSS),Bristol stool scale score,and IBS-specific quality of life questionnaire(IBSQOL)were compared between the two groups.Results:The total effective rate of the combined group was higher than that of the reference group(P<0.05).Before treatment,there were no differences in IBS-SSS score,Bristol stool scale score,and IBSQOL score between the two groups(P>0.05).After treatment,the IBS-SSS score and Bristol stool scale score of the combined group were lower than those of the reference group,while the IBSQOL score was higher(P<0.05).Conclusion:Shu Gan Jian Pi Yi Qi prescription combined with grain-sized moxibustion can improve the symptoms of IBS-D patients,including stool characteristics,and enhance their quality of life.展开更多
The high incidence of hand,foot,and mouth disease(HFMD)in children,coupled with improper management,can lead to complications,causing significant distress to both patients and their parents.This article reports on the...The high incidence of hand,foot,and mouth disease(HFMD)in children,coupled with improper management,can lead to complications,causing significant distress to both patients and their parents.This article reports on the successful treatment of a case of HFMD with dampness-heat accumulation in the spleen type using a therapeutic approach of applying herbal patches to acupoints to disperse dampness,promote heat dissipation,and unblock the fu organs.The herbs selected primarily include honeysuckle,Forsythia,and mint to relieve the exterior and promote heat dissipation;Agastache and magnolia bark to transform and dry dampness;Scutellaria,blackberry lily,and licorice to clear heat,detoxify,and benefit the throat;and magnolia bark and bitter orange to unblock the fu organs and purge heat.The flexible combination of these herbs with acupoints such as Shenque,Zhongwan,Tiantu,and Feishu fully leverages the synergistic effects of both the herbs and acupoints,resulting in a significant therapeutic effect.This approach provides valuable insights and methodologies for the prevention and treatment of HFMD in children.展开更多
Objective:To evaluate the therapeutic efficacy of the umbilical acupuncture’s“Wind-Thunder Interaction Method”in treating schizophrenia(SCH)patients with liver stagnation and spleen deficiency.Methods:A total of 12...Objective:To evaluate the therapeutic efficacy of the umbilical acupuncture’s“Wind-Thunder Interaction Method”in treating schizophrenia(SCH)patients with liver stagnation and spleen deficiency.Methods:A total of 120 SCH patients with liver stagnation and spleen deficiency were selected and evenly divided by ball drawing.The umbilical acupuncture group received the“Wind-Thunder Interaction Method”,while the Western medicine group received pure Western medicine treatment.The outcomes were compared in terms of efficacy and other indicators.Results:The umbilical acupuncture group showed a higher total effective rate,a decrease in disease symptom scores,lower scores on the side effect rating scale,improved cognitive function scores,and excellent laboratory indicators,with p<0.05 between the groups.Conclusion:The“Wind-Thunder Interaction Method”of umbilical acupuncture demonstrated a relatively high effectiveness in treating SCH patients with liver stagnation and spleen deficiency,alleviating symptoms,reducing side effects,improving cognitive function,and facilitating the recovery of neuro-vascular regulatory peptide groups.展开更多
AIM： To study the liver and spleen volume variations in hepatic fibrosis patients at different histopathological stages. METHODS： Multidetector computed tomography （MDCT） scan was performed in 85 hepatic fibrosis ...AIM： To study the liver and spleen volume variations in hepatic fibrosis patients at different histopathological stages. METHODS： Multidetector computed tomography （MDCT） scan was performed in 85 hepatic fibrosis patients. Liver volume （LV） and spleen volume （SV） were measured. Fifteen healthy individuals served as a control group （SO）. The patients were divided into stage 1 （S1） group （n = 34）, stage 2 （S2） group （n = 25）, stage 3 （S3） group （n = 16）, and stage 4 （S4） group （n = 10） according to their histopathological stage of liver fibrosis. RESULTS： The LV and standard LV （SLV） had a tendency to increase with the severity of fibrosis, but no statistical difference was observed in the 5 groups （LV： F = 0.245, P = 0.912; SLV： F = 1.902, P = 0.116）. The SV was gradually increased with the severity of fibrosis, and a statistically significant difference in SV was observed among the 5 groups （P 〈 0.01）. The LV/SV ratio and SLV/SV ratio were gradually decreased with the aggravation of hepatic fibrosis, and statistically significant differences in both LV/SV and SLV/SV were found among the 5 groups （P 〈 0.01）.CONCLUSION： The absence of obvious LV reduction in patients with chronic liver disease may be a morphological index of patients without liver cirrhosis. The SV is related to the severity of fibrosis, and the spleen of patients with advanced fibrosis is enlarged evidently. The LV/SV ratio and SLV/SV ratio are of a significant clinical value in the diagnosis of advanced liver fibrosis.展开更多
The spleen and stomach are the foundation of acquired constitution, and the source of qi and blood production. Therefore, harmonizing the spleen and stomach is of great importance in treatment of diseases. In this pap...The spleen and stomach are the foundation of acquired constitution, and the source of qi and blood production. Therefore, harmonizing the spleen and stomach is of great importance in treatment of diseases. In this paper, based on GAO＇s academic ideas of acupuncture and moxibustion, the different rules of harmonizing the spleen and stomach for internal miscellaneous diseases and carefully supplementing spleen and stomach for externally-contracted diseases were elaborated by starting with the acupoint selection prescriptions and harmonizing the spleen and stomach. In addition, time acupuncture and pattern differentiation moxibustion application and other treatment characteristics were put forward. The experience of professor GAO Yu-chun in acupuncture manipulation of ＂harmonizing the spleen and stomach＂ was summarized in detail from five aspects for learning and reference.展开更多
Under the influence of academic theories of numerous physicians of TCM such as Li Gao and Li Zhong-zi in antient China, Professor Jia Chun-sheng proposed the academic thought of tonifying spleen and kidney in combinat...Under the influence of academic theories of numerous physicians of TCM such as Li Gao and Li Zhong-zi in antient China, Professor Jia Chun-sheng proposed the academic thought of tonifying spleen and kidney in combination with acupuncture based on his clinical experience for decades. In clinical practice of acupuncture, Zhongwan （中脘 CV 12）, bilateral Tianshu （天枢 ST 25）, Qihai （气海 CV 6）, Guanyuan （关元 CV4） are often selected to invigorate spleen so as to nourish original qi and to treat both spleen and kidney. The above-mentioned five acupoints form a pattern similar to a star according to their location distribution, so it is called the starlike selection method of acupoints, which attaches importance to spleen and kidney （original qi）. Many diseases, especially internal injuries, are often treated with the starlike acupuncture manipulation combined with acupuncture at other acupoints, which achieves good clinical efficacy.展开更多
OBJECTIVE: To investigate the expression of and interleukin-12(IL-12) and interferon-γ(IFN-γ) in relation to the pathology of damp-heat of spleen-stomach syndrome(DHSS) induced by Helicobacter pylori(H. pylori) infe...OBJECTIVE: To investigate the expression of and interleukin-12(IL-12) and interferon-γ(IFN-γ) in relation to the pathology of damp-heat of spleen-stomach syndrome(DHSS) induced by Helicobacter pylori(H. pylori) infection.METHODS: In total, 114 individual gastric mucosal specimens including 83 DHSS, 19 spleen-qi deficiency syndrome(SQD) and 12 from healthy volunteers(CON) were collected by gastroscopy. To explore the relationship between the two syndromes and H. pylori infection, individual samples were tested using rapid urease and methylene blue tests. Hematoxylin and eosin stained sections were examined to grade for the degree of inflammation and inflammatory activity, and expression of IL-12 and IFN-γ was investigated by immunohistochemistry.RESULTS: Statistically significant differences in the degree of inflammation and inflammatory activity were observed between the groups of specimens:DHSS, SQD and CON(P < 0.05). Additionally, greater intestinal metaplasia(IM) and dysplasia were observed in the DHSS group, especially those with H.pylori infection. Expression of both IFN-γ and IL-12 was higher in DHSS samples infected with H. pylori than in uninfected samples and in the CON(P <0.05) but not in the SQD(P > 0.05) groups. Intriguingly, in gastric specimens exhibiting IM and dysplasia, IL-12 translocated from the nucleus into the cytoplasm.CONCLUSION: Our findings suggest that IL-12 and IFN-γ are involved in DHSS pathology, but not in SQD, acting as healthy-Qi. DHSS is not just the consequence of those two cytokines but results from the cross-talk between a number of cytokines and/or other proteins, which may warrant further investigation in DHSS patients infected with H. pylori.展开更多
基金Supported by Xi’an Science and Technology Plan,No.23YXYJ0172.
文摘BACKGROUND The hepatic venous pressure gradient serves as a crucial parameter for assessing portal hypertension and predicting clinical decompensation in individuals with cirrhosis.However,owing to its invasive nature,there has been growing interest in identifying noninvasive alternatives.Transient elastography offers a promising approach for measuring liver stiffness and spleen stiffness,which can help estimate the likelihood of decompensation in patients with chronic liver disease.AIM To investigate the predictive ability of the liver stiffness measurement(LSM)and spleen stiffness measurement(SSM)in conjunction with other noninvasive indicators for clinical decompensation in patients suffering from compensatory cirrhosis and portal hypertension.METHODS This study was a retrospective analysis of the clinical data of 200 patients who were diagnosed with viral cirrhosis and who received computed tomography,transient elastography,ultrasound,and endoscopic examinations at The Second Affiliated Hospital of Xi’an Jiaotong University between March 2020 and November 2022.Patient classification was performed in accordance with the Baveno VI consensus.The area under the curve was used to evaluate and compare the predictive accuracy across different patient groups.The diagnostic effectiveness of several models,including the liver stiffness-spleen diameter-platelet ratio,variceal risk index,aspartate aminotransferase-alanine aminotransferase ratio,Baveno Ⅵ criteria,and newly developed models,was assessed.Additionally,decision curve analysis was carried out across a range of threshold probabilities to evaluate the clinical utility of these predictive factors.RESULTS Univariate and multivariate analyses demonstrated that SSM,LSM,and the spleen length diameter(SLD)were linked to clinical decompensation in individuals with viral cirrhosis.On the basis of these findings,a predictive model was developed via logistic regression:Ln[P/(1-P)]=-4.969-0.279×SSM+0.348×LSM+0.272×SLD.The model exhibited strong performance,with an area under the curve of 0.944.At a cutoff value of 0.56,the sensitivity,specificity,positive predictive value,and negative predictive value for predicting clinical decompensation were 85.29%,88.89%,87.89%,and 86.47%,respectively.The newly developed model demonstrated enhanced accuracy in forecasting clinical decompensation among patients suffering from viral cirrhosis when compared to four previously established models.CONCLUSION Noninvasive models utilizing SSM,LSM,and SLD are effective in predicting clinical decompensation among patients with viral cirrhosis,thereby reducing the need for unnecessary hepatic venous pressure gradient testing.
基金Supported by the National Key Research and Development Project,Clinical Study on the Treatment of Refractory Membranous Nephropathy with the Treatment of Strengthening Spleen and Draining Dampness in Method using Single Group Target Value Method(No.2019YFC1709403)Systematic Study on the Diagnosis and Treatment Rules of Membranous Nephropathy in Traditional Chinese Medicine(No.2023YFC35033501,No.2023YFC35033503)。
文摘OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHODS:A single-center,retrospective analysis was conducted on patients diagnosed with IMN who met predefined inclusion and exclusion criteria.Data were collected from the Department of Nephrology at Longhua Hospital,affiliated with Shanghai University of Traditional Chinese Medicine,between January 2007 and December 2011.Clinical parameters including 24-h urinary protein,serum albumin,serum creatinine,and estimated glomerular filtration rate(e GFR,EPI)were assessed at baseline and at 1,3,5,and 10 years of follow-up.The efficacy of the Strengthening Spleen and Draining Dampness therapy was analyzed using repeated measures analysis of variance(ANOVA).Kaplan-Meier survival curves and multivariate proportional hazards model(Cox regression models)were employed to identify factors associated with treatment outcomes.RESULTS:A total of 265 patients were included,with a median follow-up duration of 96 months(36,122).TCM treatment significantly reduced 24-h urinary protein levels(P<0.001),and increased serum albumin levels(P<0.001),while serum creatinine remained stable(P=0.187).Remission rates at 1,3,5,and 10 years were 52.81%,69.71%,68.39%,and 72.36%,respectively,and the rates of avoiding composite outcome events at the same intervals were 98.27%,94.29%,94.19%,and 93.50%.In the subgroup receiving TCM only,remission rates were 56.67%,84.44%,76.32%,and 82.86%.For patients treated initially with Western Medicine followed by TCM,the rates were 52.83%,65.85%,67.47%and 67.75%.In the cohort of patients who received TCM as their first-line therapy,remission rates were 49.23%,62.50%,61.76%,and 69.23%.Multivariate Cox regression analysis revealed that the duration of TCM treatment[hazard ratio(HR)=0.826,95%confidence interval(CI)(0.779,0.876),P<0.001],presence of hypertension[HR=1.912,95%CI(1.181,3.094),P=0.008],baseline serum albumin level[HR=0.930,95%CI(0.894,0.969),P<0.001],and the rate of serum albumin increase within the first year of treatment[HR=0.930,95%CI(0.909,0.957),P<0.001]were significantly associated with clinical outcomes.CONCLUSION:The Strengthening Spleen and Draining Dampness therapy demonstrated robust short-and longterm efficacy in treating IMN,with high rates of remission and renal survival over 10 years.Key factors influencing clinical remission included the duration of TCM treatment,baseline serum albumin levels,the presence of hypertension,and the rate of increase in serum albumin within the first year.These findings suggest that this TCM approach provides a viable long-term treatment option for IMN.
文摘BACKGROUND Shear wave elastography(SWE)is a non-invasive ultrasound-based technique used to assess tissue stiffness,which reflects underlying pathological changes.While SWE has been widely applied for liver fibrosis evaluation,its application to other abdominal organs,such as the spleen and pancreas,is gaining interest.However,normal stiffness values and inter-system agreement remain poorly defined.AIM To assess the feasibility and agreement of liver,spleen,and pancreas stiffness using three SWE methods.METHODS This single-center observational study enrolled 50 healthy adult volunteers.Liver,spleen,and pancreas stiffness were assessed using three SWE methods:Point-SWE(p-QElaXto)and 2-Dimensional-SWE(2D-QElaXto)with Esaote MyLab 9,and 2D-SWE with SuperSonic Imagine.Feasibility,inter-operator reproducibility,and concordance among systems were evaluated.Stiffness was expressed as median kPa values,and technical reliability was assessed using the interquartile range/median ratio and stability index thresholds.RESULTS Liver and spleen stiffness assessment was feasible in>98%of patients,while pancreas stiffness was measurable in 84%-88%depending on the SWE technique.Mean liver stiffness ranged between 3.9-4.7 kPa across techniques,spleen stiffness ranged from 19.4-23.0 kPa,and pancreas stiffness from 5.2-7.6 kPa.Inter-operator agreement was excellent for liver(intraclass correlation coefficient>0.90)and good to moderate for spleen and pancreas(intraclass correlation coefficient from 0.43 to 0.90).Bland-Altman analysis confirmed good correlation but also systematic differences among devices,especially in pancreas measurements.CONCLUSION This is the first study to establish normal liver,spleen,and pancreas stiffness using MyLab 9 SWE integrated methods as compared to SuperSonic Imagine,with acceptable inter-technique agreement.Liver and spleen values matched existing guidelines;pancreas SWE showed more variability and reduced reproducibility.
基金National Natural Science Foundations of China(Grant No.81960863)the Education Department of Yunnan Province(Grant No.2023Y0463 and 2024Y380)Yunnan Clinical Research Center for rheumatism in Traditional Chinese Medicine(Grant No.202405AJ310004).
文摘Hyperuricemia(HUA)is a metabolic disorder characterized by elevated levels of uric acid in the blood,resulting from either increased production or decreased excretion of uric acid.This condition has reached epidemic proportions.Conventional Western medical treatments often come with a range of adverse effects.According to traditional Chinese medicine(TCM),the root cause of HUA lies in the spleen’s insufficient healthy movement,with phlegm,dampness,turbidity,and stasis being symptomatic manifestations.Research has shown that spleen-strengthening herbal remedies can effectively treat HUA by inhibiting uric acid synthesis enzymes,promoting uric acid excretion,reducing inflammation,providing antioxidant benefits,regulating gut microbiota,and modulating cellular processes.Clinical applications have substantiated these findings.Therefore,from the standpoint of symptomatic treatment of HUA,spleen-strengthening therapies hold significant importance and potential.
基金The Contract Grant from Zhejiang Fengan Biopharmaceutical Co.,Ltd,Zhejiang Province,China。
文摘Traditional Chinese Medicine(TCM)has been utilized in China for thousands of years to treat and prevent various diseases,with recent research highlighting microRNAs(miRNAs)in herbal decoctions as key bioactive components.The oral lyophilized powder of the pig spleen extracts(PAT)composed of oligonucleotides and peptides extracted from fresh pig spleen and delivered via a lipid mixture containing neutral cytidinyl lipid DNCA and cationic lipid CLD(Mix),has demonstrated significant antitumor effects against A549 and BCPAP cells,promoting early and late apoptosis by approximately 20%in A549 cells.Intratumoral administration of PAT/Mix in A549-bearing mice significantly reduced both tumor volume and weight.Transcriptomic and proteomic analyses suggested that PAT/Mix exerted its antitumor activity by silencing DEPDC1 mRNA in A549 cells,thereby influencing cellular processes and metabolic pathways.Additionally,PAT/Mix was found to promote the maturation of bone marrow dendritic cells(BMDCs),enhancing antigen processing and presentation.These findings indicated that PAT/Mix held promise as a therapeutic agent with both immunomodulatory and antitumor properties,owing not only to its peptide components but also to miRNAs,which played a critical therapeutic role.
文摘Spleen-preserving distal pancreatectomy(SPDP)has gained increasing attention as a safe and effective alternative to distal pancreatectomy with splenectomy,particularly for benign and low-grade malignant lesions of the pancreatic body and tail.This narrative review evaluates the current evidence,technical considerations,and disease-specific indications for SPDP.Literature was reviewed using up to date scientific evidence and most recent national and international guidelines.Studies addressing SPDP outcomes,splenectomy complications,and disease-specific oncologic principles were included.Spleen preservation has been associated with reduced rates of postoperative infections,thromboembolic events,and longterm immunologic compromise,without compromising oncologic outcomes in selected patients.Indications favoring SPDP include pancreatic neuroendocrine tumors,intraductal papillary mucinous neoplasms,and solid pseudopapillary neoplasms.Although current guidelines generally recommend splenectomy for pancreatic ductal adenocarcinoma,emerging data suggest that spleen preservation may be feasible in highly selected cases.Technical approaches—primarily the Kimura and Warshaw techniques—enable safe dissection and splenic vessel management,particularly with the support of minimally invasive platforms.In conclusion,SPDP should be considered in appropriately selected patients to reduce morbidity while preserving long-term immune function.Future randomized studies are warranted to define oncologic safety and refine indications across tumor types.
基金National Natural Science Foundation of China(82305090)Shanghai Municipal Health Commission(20234Y0168)National Key Research and Development Program of China(2017YFC1703301)。
文摘Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From database foundation to January 14,2025,PubMed,Web of Science,Cochrane,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),and China Biomedical Literature Database(CBM)were searched for relevant information.Randomized clinical trials(RCTs)evaluating the efficacy and safety of TSRQ therapy combined with THRT for Hashimoto’s hypothyroidism were eligible for inclusion.Following quality assessment,data were analyzed using Stata 15.1 to conduct a meta-analysis and systematic review.Subgroup analysis was used to identify the sources of heterogeneity.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was adopted to evaluate the certainty of the evidence.Results This study included 30 RCTs,comprising 2687 patients with Hashimoto’s hypothyroidism.Overall methodological quality was acceptable,with no studies exhibiting a high risk of bias.Meta-analysis demonstrated that TSRQ therapy combined with THRT significantly enhanced serum free triiodothyronine(fT3)levels[standardized mean difference(SMD)=0.76,95%confidence interval(CI):0.57 to 0.94,P<0.001]and free thyroxine(fT4)levels(SMD=0.86,95%CI:0.61 to 1.11,P<0.001),while reducing thyroid-stimulating hormone(TSH)levels(SMD=–0.99,95%CI:–1.20 to–0.78,P<0.001)compared with THRT alone.Furthermore,the combination therapy significantly decreased anti-thyroid peroxidase antibody(TPOAb)levels(SMD=–1.46,95%CI:–1.79 to–1.13,P<0.001)and anti-thyroglobulin antibody(TgAb)levels(SMD=–1.46,95%CI:–1.80 to–1.11,P<0.001).TSRQ therapy did not adversely impact the safety profile of THRT.However,while some sources of heterogeneity have been identified(e.g.,specific detection methodologies,I²=0.0%,P=0.938),there remains a portion of unexplained heterogeneity(e.g.,publication year,I²=93.4%,P<0.001),which has undermined confidence in these pooled estimates.The evidence ratings for fT3,fT4,and TSH were limited,and those for TPOAb and TgAb were even more limited.Conclusion TSRQ therapy combined with THRT may strengthen thyroid function and modulate immune dysregulation in patients with Hashimoto’s hypothyroidism without increasing adverse event incidence.
基金Supported by National Natural Science Foundation of China(81760806&82360877)Natural Science Foundation of Gansu Province(24JRRA1027)Gansu Provincial Higher Education Innovation Ability Improvement Project of Gansu Provincial Department of Education(2022A-076).
文摘[Objectives]To investigate the effects of Zuogui Pill on peripheral blood cells,sex hormone levels,interleukin 1β(IL-1β)levels,ovarian follicle number and spleen index in SD rats damaged by ^(60)Coγrays.[Methods]Fifty 8-week-old female SPF SD rats were selected,10 of which were in the normal group and were fed routinely without irradiation;the other 40 rats were irradiated with ^(60)Coγrays(6.0 Gy,LD 40)for 24 h,and then divided into radiation model group,Progynova group,high and low dose of Zuogui Pill groups.Progynova group was treated with 0.09 mg Progynova;high dose Zuogui Pill group was treated with 4.725 g Zuogui Pill crude drug and low dose Zuogui Pill group was treated with 0.945 g Zuogui Pill crude drug;radiation group was treated with 2 mL normal saline by gavage once a day for 21 d.The changes of peripheral blood cells in different time periods were detected;the follicle stimulating hormone(FSH)and estradiol(E 2)in peripheral blood serum were detected by enzyme linked immunosorbent assay(ELISA).The expression levels of E 2,luteinizing hormone(LH)and interleukin 1β(IL-1β)were detected,and the ovarian follicle number and spleen index were measured.[Results]After irradiation,the number of peripheral blood cells decreased,especially the number of white blood cells(P<0.05),the content of hemoglobin increased(P<0.05),the level of E 2 decreased,the number of mature follicles decreased,the spleen index decreased,and the expression level of IL-1βincreased.After the intervention of Zuogui Pill,the serum E 2 level,number of mature follicles and spleen index increased,while the serum IL-1β,FSH and LH levels decreased,especially in the high dose Zuogui Pill group(P<0.05).[Conclusions]Zuogui Pill can promote the repair of ovarian function in rats with radiation injury,which may be related to the promotion of bone marrow hematopoiesis and the improvement of immune function,reflecting the theory of"kidney governing blood vessels".
基金Supported by National Natural Science Foundation of China,No.82200650Shanxi Provincial Clinical Research Center for Interventional Medicine,No.202204010501004+3 种基金the Precision Interventional Diagnosis and Treatment Technology Innovation Base for Cirrhosis and Portal Hypertension,No.YDZJSX20231B010the Natural Science Foundation of Shanxi Province,No.20210302124282 and No.202203021212046the Shanxi Province Higher Education“Billion Project Science and Technology Guidance Project”,No.2C622024120the National Natural Science Foundation of China Supporting Fund,No.Y82200650.
文摘BACKGROUND The impact of transjugular intrahepatic portosystemic shunt(TIPS)on liver and spleen stiffness remains unclear,as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.AIM To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.METHODS A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included.Liver and spleen stiffness was assessed using the sound touch quantify(STQ)value,determined via point shear wave elastography in ultrasound imaging.Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.RESULTS The liver STQ value demonstrated a marginally decreasing trend over time(P=0.052),while the spleen STQ value showed a significantly decreasing trend(P=0.025).Spleen STQ was positively correlated with portal pressure gradient(PPG)levels(rs=0.327,P=0.025).Cox regression analysis indicated that older age[hazard ratio(HR)=1.063,95%CI:0.997-1.133,P=0.060]and a higher liver STQ value(HR=1.051,95%CI:1.009-1.095,P=0.018)were associated with an increased mortality risk after TIPS.No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS.The liver STQ value[area under the receiver operating characteristic curve(AUC)=0.724(95%CI:0.563-0.884)]showed superior predictive performance compared to the Child-Pugh score[AUC=0.699(95%CI:0.529-0.870)]and was comparable to the model for end-stage liver disease score[AUC=0.746(95%CI:0.591-0.902)].CONCLUSION Following TIPS,spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG.Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.
基金Incubation Program of Youth Innovation in Shandong ProvinceKey Research and Development Program of Shandong Province(2021TZXD007)。
文摘Food allergy has become a global concern.Spleen tyrosine kinase(SYK)inhibitors are promising therapeutics against allergic disorders.In this study,a total of 300 natural phenolic compounds were firstly subjected to virtual screening.Sesamin and its metabolites,sesamin monocatechol(SC-1)and sesamin dicatechol(SC-2),were identified as potential SYK inhibitors,showing high binding affinity and inhibition efficiency towards SYK.Compared with R406(a traditional SYK inhibitor),sesamin,SC-1,and SC-2 had lower binding energy and inhibition constant(Ki)during molecular docking,exhibited higher bioavailability,safety,metabolism/clearance rate,and distribution uniformity ADMET predictions,and showed high stability in occupying the ATP-binding pocket of SYK during molecular dynamics simulations.In anti-dinitrophenyl-immunoglobulin E(Anti-DNP-Ig E)/dinitrophenyl-human serum albumin(DNP-HSA)-stimulated rat basophilic leukemia(RBL-2H3)cells,sesamin in the concentration range of 5-80μmol/L influenced significantly the degranulation and cytokine release,with 54.00%inhibition againstβ-hexosaminidase release and 58.45%decrease in histamine.In BALB/c mice,sesamin could ameliorate Anti-DNP-Ig E/DNP-HSA-induced passive cutaneous anaphylaxis(PCA)and ovalbumin(OVA)-induced active systemic anaphylaxis(ASA)reactions,reduce the levels of allergic mediators(immunoglobulins and pro-inflammatory cytokines),partially correct the imbalance of T helper(Th)cells differentiation in the spleen,and inhibit the phosphorylation of SYK and its downstream signaling proteins,including p38 mitogen-activated protein kinases(p38 MAPK),extracellular signalregulated kinases(ERK),and p65 nuclear factor-κB(p65 NF-κB)in the spleen.Thus,sesamin may be a safe and versatile SYK inhibitor that can alleviate Ig E-mediated food allergies.
基金Supported by the Earmarked Fund for China Agricultural Research System(No.CARS-45-16)the Key Research and Development Plan of Jiangsu Province(No.BE2021369)。
文摘Mass mortality of mandarin fish(Siniperca chuatsi)due to infectious spleen and kidney necrosis virus(ISKNV)infection occurs frequently.Since there are no effective drug treatments available,prevention relies heavily on detection.Effective and rapid on-site detection methods are needed for early diagnosis of ISKNV.In this study,a rapid and simple colloidal gold test strip method,specific for the antibody against major capsid protein(MCP),was developed and systematically evaluated for the detection of ISKNV.The limit of detection of the test strip is a 1꞉100 dilution of a positive standard serum and the antibody level in the fish could be estimated from the depth of color of the test line.The strips were tested against serum samples of cyprinid herpesvirus-2(CyHV-2),grass carp reovirus(GCRV),largemouth bass ranavirus(LMBV),large yellow croaker iridovirus(LYCIV),and spring viremia of carp virus(SVCV),yielding no cross-reactivity.In addition,10 mandarin fish artificially infected with ISKNV were tested using the current industry standard PCR method(SC/T 7211-2011)on their splenorenal tissues.The results from the test strips showed a high degree of concordance with PCR testing,achieving a Kappa value of 0.737.All the results indicated that the colloidal gold test strips prepared in this study could be used as a simple,rapid,and highly sensitive and specific method for ISKNV diagnosis.
文摘Objective:To explore the effects of acupoint catgut embedding combined with auricular point pressing with beans on symptom management self-efficacy and quality of life in patients with nonalcoholic steatohepatitis(NASH)of liver depression and spleen deficiency type.Methods:Sixty patients with NASH of liver depression and spleen deficiency type admitted to our hospital from January 2021 to December 2023 were selected and divided into an acupoint catgut embedding group(n=30)and a combined group(n=30)using the envelope lottery method.The acupoint catgut embedding group received acupoint catgut embedding intervention,while the combined group received auricular point pressing with beans on the basis of the acupoint catgut embedding group.The two groups were compared in terms of TCM syndrome scores,symptom management self-efficacy[Chronic Disease Self-Efficacy Scale(CDSES)],and quality of life[Chronic Liver Disease Questionnaire(CLDQ)].Results:After intervention,the combined group had lower TCM syndrome scores for both primary and secondary symptoms compared to the acupoint catgut embedding group(P<0.05).The combined group also had higher scores in all dimensions and total score of the CDSES compared to the acupoint catgut embedding group(P<0.05).Similarly,the combined group had higher scores in all dimensions and total score of the CLDQ compared to the acupoint catgut embedding group(P<0.05).Conclusion:Acupoint catgut embedding combined with auricular point pressing with beans can effectively improve TCM symptoms,enhance symptom management self-efficacy,and improve quality of life in patients with NASH of liver depression and spleen deficiency type.
基金2024 Scientific Research Project of Jilin Provincial Administration of Traditional Chinese Medicine(Project No.:2024139)。
文摘Objective:To observe the clinical efficacy of the method of softening the liver,harmonizing the spleen,and unblocking the orifices in the treatment of Xiaoke Neizhang with Qi and Yin deficiency type.Methods:Seventy-two patients with Xiaoke Neizhang of qi and yin deficiency type were selected from March 2024 to May 2025 and divided into a treatment group and a control group with 36 cases each according to the random number table method.The treatment group was treated with the method of softening the liver,harmonizing the spleen,and unblocking the orifices,which included oral administration of Softening the Liver and Harmonizing the Spleen Pills combined with iontophoresis of Xuesaitong Injection.The control group was treated with oral administration of calcium dobesilate capsules.Both groups were treated for 2 courses,and multiple indicators such as visual acuity,fundus condition,and TCM syndrome scores were compared between the two groups.Results:The total effective rate of the treatment group was higher than that of the control group.There were significant differences in visual acuity,fundus condition,and TCM syndrome scores between and within the groups(P<0.05).Conclusion:The method of softening the liver,harmonizing the spleen,and unblocking the orifices has a definite clinical effect in the treatment of Xiaoke Neizhang with Qi and Yin deficiency type.It has a direct effect,is painless,easy for patients to accept,and has high clinical application value.
基金Inner Mongolia Autonomous Region Education Science 14th Five-Year Planning Project(Project No.:NGJGH2023467)Inner Mongolia Medical University Higher Education Teaching Reform Research Project(Project No.:NYJXGG2022054)。
文摘Objective:To evaluate the therapeutic effect of Shu Gan Jian Pi Yi Qi prescription combined with grain-sized moxibustion on diarrhea-predominant irritable bowel syndrome(IBS-D)with liver depression and spleen deficiency syndrome.Methods:60 patients with IBS-D(liver depression and spleen deficiency syndrome)treated in the outpatient clinic from January 2021 to December 2023 were selected and randomly divided into two groups using a random number table.The combined group was treated with Shu Gan Jian Pi Yi Qi prescription and grain-sized moxibustion,while the reference group was treated with western medication.The total effective rate,IBS symptom severity score(IBS-SSS),Bristol stool scale score,and IBS-specific quality of life questionnaire(IBSQOL)were compared between the two groups.Results:The total effective rate of the combined group was higher than that of the reference group(P<0.05).Before treatment,there were no differences in IBS-SSS score,Bristol stool scale score,and IBSQOL score between the two groups(P>0.05).After treatment,the IBS-SSS score and Bristol stool scale score of the combined group were lower than those of the reference group,while the IBSQOL score was higher(P<0.05).Conclusion:Shu Gan Jian Pi Yi Qi prescription combined with grain-sized moxibustion can improve the symptoms of IBS-D patients,including stool characteristics,and enhance their quality of life.
文摘The high incidence of hand,foot,and mouth disease(HFMD)in children,coupled with improper management,can lead to complications,causing significant distress to both patients and their parents.This article reports on the successful treatment of a case of HFMD with dampness-heat accumulation in the spleen type using a therapeutic approach of applying herbal patches to acupoints to disperse dampness,promote heat dissipation,and unblock the fu organs.The herbs selected primarily include honeysuckle,Forsythia,and mint to relieve the exterior and promote heat dissipation;Agastache and magnolia bark to transform and dry dampness;Scutellaria,blackberry lily,and licorice to clear heat,detoxify,and benefit the throat;and magnolia bark and bitter orange to unblock the fu organs and purge heat.The flexible combination of these herbs with acupoints such as Shenque,Zhongwan,Tiantu,and Feishu fully leverages the synergistic effects of both the herbs and acupoints,resulting in a significant therapeutic effect.This approach provides valuable insights and methodologies for the prevention and treatment of HFMD in children.
文摘Objective:To evaluate the therapeutic efficacy of the umbilical acupuncture’s“Wind-Thunder Interaction Method”in treating schizophrenia(SCH)patients with liver stagnation and spleen deficiency.Methods:A total of 120 SCH patients with liver stagnation and spleen deficiency were selected and evenly divided by ball drawing.The umbilical acupuncture group received the“Wind-Thunder Interaction Method”,while the Western medicine group received pure Western medicine treatment.The outcomes were compared in terms of efficacy and other indicators.Results:The umbilical acupuncture group showed a higher total effective rate,a decrease in disease symptom scores,lower scores on the side effect rating scale,improved cognitive function scores,and excellent laboratory indicators,with p<0.05 between the groups.Conclusion:The“Wind-Thunder Interaction Method”of umbilical acupuncture demonstrated a relatively high effectiveness in treating SCH patients with liver stagnation and spleen deficiency,alleviating symptoms,reducing side effects,improving cognitive function,and facilitating the recovery of neuro-vascular regulatory peptide groups.
基金Supported by Science and Technology Program of Beijing Education Committee,No.KM200810025002
文摘AIM： To study the liver and spleen volume variations in hepatic fibrosis patients at different histopathological stages. METHODS： Multidetector computed tomography （MDCT） scan was performed in 85 hepatic fibrosis patients. Liver volume （LV） and spleen volume （SV） were measured. Fifteen healthy individuals served as a control group （SO）. The patients were divided into stage 1 （S1） group （n = 34）, stage 2 （S2） group （n = 25）, stage 3 （S3） group （n = 16）, and stage 4 （S4） group （n = 10） according to their histopathological stage of liver fibrosis. RESULTS： The LV and standard LV （SLV） had a tendency to increase with the severity of fibrosis, but no statistical difference was observed in the 5 groups （LV： F = 0.245, P = 0.912; SLV： F = 1.902, P = 0.116）. The SV was gradually increased with the severity of fibrosis, and a statistically significant difference in SV was observed among the 5 groups （P 〈 0.01）. The LV/SV ratio and SLV/SV ratio were gradually decreased with the aggravation of hepatic fibrosis, and statistically significant differences in both LV/SV and SLV/SV were found among the 5 groups （P 〈 0.01）.CONCLUSION： The absence of obvious LV reduction in patients with chronic liver disease may be a morphological index of patients without liver cirrhosis. The SV is related to the severity of fibrosis, and the spleen of patients with advanced fibrosis is enlarged evidently. The LV/SV ratio and SLV/SV ratio are of a significant clinical value in the diagnosis of advanced liver fibrosis.
基金Supported by Project of Hebei Provincial Science and Technology Department:“Clinical study of the acupuncture manipulation of regulating governor vessel and unblocking brain in treatment of dominant diseases of acupuncture-moxibustion”:14277706D2014 project of scientific research on traditional Chinese medicine of Hebei Provincial Administration of Traditional Chinese Medicine“Study of GAO’s academic ideas of acupuncture and moxibustion”:2014038
文摘The spleen and stomach are the foundation of acquired constitution, and the source of qi and blood production. Therefore, harmonizing the spleen and stomach is of great importance in treatment of diseases. In this paper, based on GAO＇s academic ideas of acupuncture and moxibustion, the different rules of harmonizing the spleen and stomach for internal miscellaneous diseases and carefully supplementing spleen and stomach for externally-contracted diseases were elaborated by starting with the acupoint selection prescriptions and harmonizing the spleen and stomach. In addition, time acupuncture and pattern differentiation moxibustion application and other treatment characteristics were put forward. The experience of professor GAO Yu-chun in acupuncture manipulation of ＂harmonizing the spleen and stomach＂ was summarized in detail from five aspects for learning and reference.
文摘Under the influence of academic theories of numerous physicians of TCM such as Li Gao and Li Zhong-zi in antient China, Professor Jia Chun-sheng proposed the academic thought of tonifying spleen and kidney in combination with acupuncture based on his clinical experience for decades. In clinical practice of acupuncture, Zhongwan （中脘 CV 12）, bilateral Tianshu （天枢 ST 25）, Qihai （气海 CV 6）, Guanyuan （关元 CV4） are often selected to invigorate spleen so as to nourish original qi and to treat both spleen and kidney. The above-mentioned five acupoints form a pattern similar to a star according to their location distribution, so it is called the starlike selection method of acupoints, which attaches importance to spleen and kidney （original qi）. Many diseases, especially internal injuries, are often treated with the starlike acupuncture manipulation combined with acupuncture at other acupoints, which achieves good clinical efficacy.
基金Supported by Natural Science Foundation-funded Project:Research on the NF-KB Pathway and Micro-ecology Alteration Based on Helicobacter Pylori Correlated Gastric Disease(No.30772689)Natural Science Foundation-funded Project:Progression of Diverse Syndromes on Mi RNAs and Gene Polymorphism of Inflammatory Cytokines in Helicobacter Pylori Correlated Gastric Disease Based on Pathogenic Toxin(No.81373563)
文摘OBJECTIVE: To investigate the expression of and interleukin-12(IL-12) and interferon-γ(IFN-γ) in relation to the pathology of damp-heat of spleen-stomach syndrome(DHSS) induced by Helicobacter pylori(H. pylori) infection.METHODS: In total, 114 individual gastric mucosal specimens including 83 DHSS, 19 spleen-qi deficiency syndrome(SQD) and 12 from healthy volunteers(CON) were collected by gastroscopy. To explore the relationship between the two syndromes and H. pylori infection, individual samples were tested using rapid urease and methylene blue tests. Hematoxylin and eosin stained sections were examined to grade for the degree of inflammation and inflammatory activity, and expression of IL-12 and IFN-γ was investigated by immunohistochemistry.RESULTS: Statistically significant differences in the degree of inflammation and inflammatory activity were observed between the groups of specimens:DHSS, SQD and CON(P < 0.05). Additionally, greater intestinal metaplasia(IM) and dysplasia were observed in the DHSS group, especially those with H.pylori infection. Expression of both IFN-γ and IL-12 was higher in DHSS samples infected with H. pylori than in uninfected samples and in the CON(P <0.05) but not in the SQD(P > 0.05) groups. Intriguingly, in gastric specimens exhibiting IM and dysplasia, IL-12 translocated from the nucleus into the cytoplasm.CONCLUSION: Our findings suggest that IL-12 and IFN-γ are involved in DHSS pathology, but not in SQD, acting as healthy-Qi. DHSS is not just the consequence of those two cytokines but results from the cross-talk between a number of cytokines and/or other proteins, which may warrant further investigation in DHSS patients infected with H. pylori.
