In the present study it was proved first that human recombinant interleukin-6(HrIL-6) significantly augmented natural killer(NK) cell activity derived from human fetal spleens against K562 target cells in a 4 hours 51...In the present study it was proved first that human recombinant interleukin-6(HrIL-6) significantly augmented natural killer(NK) cell activity derived from human fetal spleens against K562 target cells in a 4 hours 51Cr release assay. The enhancement of NK activity with 24 hours preincubation in HrlL-6 was dose-dependent, and significantly higher than that of fresh NK cells and controls cultured with RPMI-1640 medium alone (P<0.001). We also found that IL-6 was able to augment NK activity from different fetal spleens at 20 to 40 weeks of gestation (up to 2.24 to 2.78 times), and no difference of NK activity of fetal splenocytes treated by HrIL-6 was observed between different fetal age (32.3% to 45.4%, P>0.05). Furthermore, IL-6-augmented NK activity of fetal splenocytes was very similar to adult levels (P>0.05). These finding strongly indicated that IL-6 plays an important role in the development of NK cell function during the gestational period, suggesting that IL-6 may be of importance in the regulation of host defense mechanisms against malignancies and viral diseases.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 Acute mesenteric ischemia is a life-threatening disease.Intrasplenic gas is an extremely rare finding in such cases.CASE SUMMARY We report a case of a 79-year-old woman with a history of end-stage renal dis...BACKGROUND Acute mesenteric ischemia is a life-threatening disease.Intrasplenic gas is an extremely rare finding in such cases.CASE SUMMARY We report a case of a 79-year-old woman with a history of end-stage renal disease on hemodialysis for approximately 20 years,type 2 diabetes mellitus,and atrial fibrillation who presented with two days of epigastric pain.A computed tomography scan of the abdomen revealed intraperitoneal free air and significant intrasplenic gas.Laparoscopy revealed diffuse intestinal gangrene,and acute superior mesenteric ischemia was diagnosed.The patient died within 24 hours owing to profound shock.CONCLUSION Intrasplenic gas is an extremely rare finding on computed tomography imaging in cases of acute mesenteric ischemia.展开更多
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
BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant ...BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant lesions,splenic hamartomas,and angiosarcomas may exhibit overlapping features,making diagnosis challenging.This report presents a case of splenic hamartoma suspected to be an angiosarcoma based on preoperative imaging.Splenic hamartomas that mimic angiosarcomas are exceedingly rare.CASE SUMMARY A 33-year-old male presented to the Department of Emergency with frank red blood hematemesis and a 1-week history of epigastric pain.On arrival,he was alert and hemodynamically stable.Contrast-enhanced abdominal computed tomography revealed splenomegaly with significant engorgement of the portal and splenic veins,along with a diffuse nodular splenic lesion measuring 8.2 cm×6.2 cm.Following esophageal varix ligation,abdominal magnetic resonance imaging demonstrated iso-to high-signal intensity within the splenic mass and multiple hypervascular lesions in the right hepatic lobe,raising suspicion for splenic an-giosarcoma with hepatic metastases.18F-fluorodeoxyglucose positron emission tomography-computed tomography showed diffusely mild increased metabolic activity in the spleen.The patient subsequently underwent splenectomy and liver biopsy.Histopathological examination revealed chronic inflammation in the liver,and the splenic lesion was confirmed to be a splenic hamartoma.The patient successfully returned to work and remains in good health.CONCLUSION This rare case of splenic hamartoma mimicking angiosarcoma highlights the importance of differential diagnosis in managing splenic tumors.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
Thousands of years ago,the concept of Jiu Zuo Shang Rou(久坐伤肉long-time sitting damages muscles)was introduced in traditional Chinese medicine(TCM).It was clearly recorded in ancient books,that prolonged sitting dis...Thousands of years ago,the concept of Jiu Zuo Shang Rou(久坐伤肉long-time sitting damages muscles)was introduced in traditional Chinese medicine(TCM).It was clearly recorded in ancient books,that prolonged sitting disrupts the circulation of qi and blood,damages muscles,impairs spleen function,and ultimately leads to diseases.Modern biomedical evidence shows that sedentary behavior,including prolonged sitting,affects endocrine,metabolic,and physiological functions,increasing the risk of chronic diseases.This article systematically reviews TCM records of the health impacts of long-time sitting and biomedical findings,to explore the pathophysiological mechanisms underlying the health risks of prolonged sitting.By integrating TCM's preventative philosophy,namely Zhi Wei Bing(治未病preventing a disease before it arises),with modern preventive medicine,this study offers insights into strategies for mitigating the health risks associated with sedentary behavior.展开更多
Clinically significant Portal hypertension(PH),defined by a hepatic venous pressure gradient(HVPG)greater than 10 mmHg,is a key predictor of decompensation events in cirrhosis,leading to variceal hemorrhage,ascites,an...Clinically significant Portal hypertension(PH),defined by a hepatic venous pressure gradient(HVPG)greater than 10 mmHg,is a key predictor of decompensation events in cirrhosis,leading to variceal hemorrhage,ascites,and hepatic encephalopathy.This narrative review explores the pathophysiology of PH in cirrhosis,evaluates diagnostic methods for identifying clinically significant PH(CSPH),and discusses guideline-driven strategies to prevent initial and further decompensation.While HVPG remains the gold standard for diagnosing CSPH,non-invasive tools such as liver stiffness measurement and spleen stiffness measurement are increasingly used for initial risk stratification.The combined use of these tools reduces the proportion of patients in the diagnostic"grey zone".Endoscopic ultrasound-guided portal pressure gradient is an emerging diagnostic tool that requires further validation.Non-selective beta-blockers are the cornerstone of primary prophylaxis for decompensation,and their combination with endoscopic variceal ligation is the first-line therapy for secondary prophylaxis of recurrent esophageal variceal bleeding.Statins show promise in reducing PH and preventing decompensation while further studies are still needed.This review also discusses the indications for preemptive transjugular intrahepatic portosystemic shunt and its role in managing refractory ascites and variceal bleeding.展开更多
This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-inva...This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-invasive method to measure LS,which correlates with the degree of liver fibrosis,and SPA,an indicator of portal hypertension,2D-SWE offers a comprehensive evaluation of a patient’s hepatic status.These advancements are particularly crucial in hepatic surgery,where accurate preoperative assessments are essential for optimizing surgical outcomes and minimizing complications.This letter highlights the prac-tical implications of integrating 2D-SWE into clinical practice,emphasizing its potential to improve patient safety and surgical precision by enhancing the ability to predict PHLF and tailor surgical approaches accordingly.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
BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to era...BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to eradicate esophageal varices completely,and a control endoscopy after 2-4 weeks is required to assess eradication and/or the need for another band ligation.Liver stiffness measurement(LSM)is being increasingly used as a screening non-invasive tool to predict varices according to Baveno VII criteria.However,to date,there are no instruments able to non-invasively predict the outcome of EVBL.AIM To identify non-invasive predictors of varices eradication(VE)after EVBL through multiparametric ultrasound(US).Secondary aim was to develop a prediction model of successful variceal eradication based on non-invasive parameters.METHODS We prospectively enrolled consecutive cirrhotic patients intolerant or with contraindications to beta-blockers undergoing EVBL for bleeding prophylaxis.Patients underwent multiparametric US with LSM,spleen stiffness measurement(SSM)and dynamic contrastenhanced US(DCE-US)on liver parenchyma and portal vein,at baseline(T0)and one month(T1)after EVBL.Each US parameter and their variations from baseline were correlated with VE evaluated by control endoscopy performed at T1.RESULTS We enrolled 41 patients(median age 64 years,75.6%males).At T128 patients(68.3%)reached VE,whereas 13(31.7%)required a second EVBL.Patients who achieved VE showed a significant decrease in SSM(P=0.018),and a significant increase in peak enhancement,area under the curve and wash-in rate of both liver parenchyma and portal vein after treatment(P<0.001).Statistically significant differences between the two groups of patients were incorporated in a multivariate analysis and used to develop three prediction models.CONCLUSION A multimodal US approach based on DCE-US parameters,LSM and SSM might become a reliable predictor of VE and a useful non-invasive alternative to endoscopy.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
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
文摘In the present study it was proved first that human recombinant interleukin-6(HrIL-6) significantly augmented natural killer(NK) cell activity derived from human fetal spleens against K562 target cells in a 4 hours 51Cr release assay. The enhancement of NK activity with 24 hours preincubation in HrlL-6 was dose-dependent, and significantly higher than that of fresh NK cells and controls cultured with RPMI-1640 medium alone (P<0.001). We also found that IL-6 was able to augment NK activity from different fetal spleens at 20 to 40 weeks of gestation (up to 2.24 to 2.78 times), and no difference of NK activity of fetal splenocytes treated by HrIL-6 was observed between different fetal age (32.3% to 45.4%, P>0.05). Furthermore, IL-6-augmented NK activity of fetal splenocytes was very similar to adult levels (P>0.05). These finding strongly indicated that IL-6 plays an important role in the development of NK cell function during the gestational period, suggesting that IL-6 may be of importance in the regulation of host defense mechanisms against malignancies and viral diseases.
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 Acute mesenteric ischemia is a life-threatening disease.Intrasplenic gas is an extremely rare finding in such cases.CASE SUMMARY We report a case of a 79-year-old woman with a history of end-stage renal disease on hemodialysis for approximately 20 years,type 2 diabetes mellitus,and atrial fibrillation who presented with two days of epigastric pain.A computed tomography scan of the abdomen revealed intraperitoneal free air and significant intrasplenic gas.Laparoscopy revealed diffuse intestinal gangrene,and acute superior mesenteric ischemia was diagnosed.The patient died within 24 hours owing to profound shock.CONCLUSION Intrasplenic gas is an extremely rare finding on computed tomography imaging in cases of acute mesenteric ischemia.
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 Clinical Research Grant from Pusan National University Hospital in 2024.
文摘BACKGROUND Primary splenic lesions are rare and often detected incidentally through imaging,biopsy,or autopsy,typically without distinct clinical symptoms.Although imaging can help differentiate benign from malignant lesions,splenic hamartomas,and angiosarcomas may exhibit overlapping features,making diagnosis challenging.This report presents a case of splenic hamartoma suspected to be an angiosarcoma based on preoperative imaging.Splenic hamartomas that mimic angiosarcomas are exceedingly rare.CASE SUMMARY A 33-year-old male presented to the Department of Emergency with frank red blood hematemesis and a 1-week history of epigastric pain.On arrival,he was alert and hemodynamically stable.Contrast-enhanced abdominal computed tomography revealed splenomegaly with significant engorgement of the portal and splenic veins,along with a diffuse nodular splenic lesion measuring 8.2 cm×6.2 cm.Following esophageal varix ligation,abdominal magnetic resonance imaging demonstrated iso-to high-signal intensity within the splenic mass and multiple hypervascular lesions in the right hepatic lobe,raising suspicion for splenic an-giosarcoma with hepatic metastases.18F-fluorodeoxyglucose positron emission tomography-computed tomography showed diffusely mild increased metabolic activity in the spleen.The patient subsequently underwent splenectomy and liver biopsy.Histopathological examination revealed chronic inflammation in the liver,and the splenic lesion was confirmed to be a splenic hamartoma.The patient successfully returned to work and remains in good health.CONCLUSION This rare case of splenic hamartoma mimicking angiosarcoma highlights the importance of differential diagnosis in managing splenic tumors.
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financed by the grants from the Zhejiang Province Higher Education Research Fund Program(NO.JG20220766)National Natural Science Foundation of China(No.71774147)Innovation and Entrepreneurship Training Program for College Students in Zhejiang Province(No.S202010344012)。
文摘Thousands of years ago,the concept of Jiu Zuo Shang Rou(久坐伤肉long-time sitting damages muscles)was introduced in traditional Chinese medicine(TCM).It was clearly recorded in ancient books,that prolonged sitting disrupts the circulation of qi and blood,damages muscles,impairs spleen function,and ultimately leads to diseases.Modern biomedical evidence shows that sedentary behavior,including prolonged sitting,affects endocrine,metabolic,and physiological functions,increasing the risk of chronic diseases.This article systematically reviews TCM records of the health impacts of long-time sitting and biomedical findings,to explore the pathophysiological mechanisms underlying the health risks of prolonged sitting.By integrating TCM's preventative philosophy,namely Zhi Wei Bing(治未病preventing a disease before it arises),with modern preventive medicine,this study offers insights into strategies for mitigating the health risks associated with sedentary behavior.
基金Supported by Quebec Health Research Fund Clinician Research Scholars Junior 1,No.350546.
文摘Clinically significant Portal hypertension(PH),defined by a hepatic venous pressure gradient(HVPG)greater than 10 mmHg,is a key predictor of decompensation events in cirrhosis,leading to variceal hemorrhage,ascites,and hepatic encephalopathy.This narrative review explores the pathophysiology of PH in cirrhosis,evaluates diagnostic methods for identifying clinically significant PH(CSPH),and discusses guideline-driven strategies to prevent initial and further decompensation.While HVPG remains the gold standard for diagnosing CSPH,non-invasive tools such as liver stiffness measurement and spleen stiffness measurement are increasingly used for initial risk stratification.The combined use of these tools reduces the proportion of patients in the diagnostic"grey zone".Endoscopic ultrasound-guided portal pressure gradient is an emerging diagnostic tool that requires further validation.Non-selective beta-blockers are the cornerstone of primary prophylaxis for decompensation,and their combination with endoscopic variceal ligation is the first-line therapy for secondary prophylaxis of recurrent esophageal variceal bleeding.Statins show promise in reducing PH and preventing decompensation while further studies are still needed.This review also discusses the indications for preemptive transjugular intrahepatic portosystemic shunt and its role in managing refractory ascites and variceal bleeding.
基金Supported by Guangdong Medical Science and Technology Research Fund Project,No.A2024475.
文摘This study explores the significance of using two-dimensional shear wave elastography(2D-SWE)to assess liver stiffness(LS)and spleen area(SPA)for predicting post-hepatectomy liver failure(PHLF).By providing a non-invasive method to measure LS,which correlates with the degree of liver fibrosis,and SPA,an indicator of portal hypertension,2D-SWE offers a comprehensive evaluation of a patient’s hepatic status.These advancements are particularly crucial in hepatic surgery,where accurate preoperative assessments are essential for optimizing surgical outcomes and minimizing complications.This letter highlights the prac-tical implications of integrating 2D-SWE into clinical practice,emphasizing its potential to improve patient safety and surgical precision by enhancing the ability to predict PHLF and tailor surgical approaches accordingly.
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.
文摘BACKGROUND Endoscopic variceal band ligation(EVBL)represents a pivotal treatment in the prophylaxis of esophageal varices bleeding in patients with cirrhosis,but in some cases a single session of EVBL is unable to eradicate esophageal varices completely,and a control endoscopy after 2-4 weeks is required to assess eradication and/or the need for another band ligation.Liver stiffness measurement(LSM)is being increasingly used as a screening non-invasive tool to predict varices according to Baveno VII criteria.However,to date,there are no instruments able to non-invasively predict the outcome of EVBL.AIM To identify non-invasive predictors of varices eradication(VE)after EVBL through multiparametric ultrasound(US).Secondary aim was to develop a prediction model of successful variceal eradication based on non-invasive parameters.METHODS We prospectively enrolled consecutive cirrhotic patients intolerant or with contraindications to beta-blockers undergoing EVBL for bleeding prophylaxis.Patients underwent multiparametric US with LSM,spleen stiffness measurement(SSM)and dynamic contrastenhanced US(DCE-US)on liver parenchyma and portal vein,at baseline(T0)and one month(T1)after EVBL.Each US parameter and their variations from baseline were correlated with VE evaluated by control endoscopy performed at T1.RESULTS We enrolled 41 patients(median age 64 years,75.6%males).At T128 patients(68.3%)reached VE,whereas 13(31.7%)required a second EVBL.Patients who achieved VE showed a significant decrease in SSM(P=0.018),and a significant increase in peak enhancement,area under the curve and wash-in rate of both liver parenchyma and portal vein after treatment(P<0.001).Statistically significant differences between the two groups of patients were incorporated in a multivariate analysis and used to develop three prediction models.CONCLUSION A multimodal US approach based on DCE-US parameters,LSM and SSM might become a reliable predictor of VE and a useful non-invasive alternative to endoscopy.
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.
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.
