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
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
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
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
The"spleen"in traditional Chinese medicine is the"acquired foundation"and the"source of qi and blood biochemistry".Strengthening the"spleen"is one of the important treat‐ment m...The"spleen"in traditional Chinese medicine is the"acquired foundation"and the"source of qi and blood biochemistry".Strengthening the"spleen"is one of the important treat‐ment methods in traditional Chinese medicine;The gut microbiota has been a hot topic in modern scientific research in recent years,and its nutritional and immune functions correspond to some of the functions of the spleen in traditional Chinese medicine.In terms of philosophy,traditional Chinese medicine emphasizes the balance between the spleen and the gut microbiota,emphasizing the importance of supporting the right and eliminating evil,preventing diseases before they occur,seeking the root cause of treat‐ment,and adapting measures to the three causes;Clinically,the treatment of obesity,con‐stipation,diarrhea and other diseases by invigorating the spleen and the treatment mechanism of acupuncture and moxibustion,chiropractic and invigorating the spleen are all related to microecology.This article combines relevant literature on traditional Chinese medicine's"spleen"and"spleen health"to explore the treatment concept,clinical application,and correlation with intestinal microbiota of traditional Chinese medicine's"spleen health".It also elaborates on the latest literature,aiming to exchange ideas with peers and promote research on the microbiota of traditional Chinese medicine's"spleen".展开更多
BACKGROUND Liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function reserve.The size of the spleen inc...BACKGROUND Liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function reserve.The size of the spleen increases due to tissue proliferation,fibrosis,and portal vein congestion,which can indirectly reflect the situation of liver fibrosis/cirrhosis.It was reported that the size of the spleen was related to posthepatectomy liver failure(PHLF).So far,there has been no study combining 2D-SWE measurements of LS with spleen size to predict PHLF.This prospective study aimed to investigate the utility of 2D-SWE assessing LS and spleen area(SPA)for the prediction of PHLF in hepatocellular carcinoma(HCC)patients and to develop a risk prediction model.AIM To investigate the utility of 2D-SWE assessing LS and SPA for the prediction of PHLF in HCC patients and to develop a risk prediction model.METHODS This was a multicenter observational study prospectively analyzing patients who underwent hepatectomy from October 2020 to March 2022.Within 1 wk before partial hepatectomy,ultrasound examination was performed to measure LS and SPA,and blood was drawn to evaluate the patient’s liver function and other conditions.Least absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis was applied to identify independent predictors of PHLF and develop a nomogram.Nomogram performance was validated further.The diagnostic performance of the nomogram was evaluated with receiver operating charac-teristic curve compared with the conventional models,including the model for end-stage liver disease(MELD)score and the albumin-bilirubin(ALBI)score.RESULTS A total of 562 HCC patients undergoing hepatectomy(500 in the training cohort and 62 in the validation cohort)were enrolled in this study.The independent predictors of PHLF were LS,SPA,range of resection,blood loss,international normalized ratio,and total bilirubin.Better diagnostic performance of the nomogram was obtained in the training[area under receiver operating characteristic curve(AUC):0.833;95%confidence interval(95%CI):0.792-0.873;sensitivity:83.1%;specificity:73.5%]and validation(AUC:0.802;95%CI:0.684-0.920;sensitivity:95.5%;specificity:52.5%)cohorts compared with the MELD score and the ALBI score.CONCLUSION This PHLF nomogram,mainly based on LS by 2D-SWE and SPA,was useful in predicting PHLF in HCC patients and presented better than MELD score and ALBI score.展开更多
BACKGROUND According to the theory of traditional Chinese medicine(TCM),the spleen and stomach are the basis of acquired nature and the source of qi and blood biochemistry.After surgery and chemotherapy,patients with ...BACKGROUND According to the theory of traditional Chinese medicine(TCM),the spleen and stomach are the basis of acquired nature and the source of qi and blood biochemistry.After surgery and chemotherapy,patients with colorectal cancer often develop spleen and stomach qi deficiency syndrome,leading to decreased immune function.Buzhong Yiqi decoction,a classic TCM prescription,has the effect of tonifying middle-jiao and invigorating qi,boosting Yang,and suppressing immune-related inflammation.Moreover,it is widely used in the treatment of spleen and stomach qi deficiency syndrome.AIM To investigate the effect of Buzhong Yiqi decoction on spleen and stomach qi deficiency in patients with colorectal cancer.METHODS One hundred patients with colorectal cancer who underwent preoperative chemotherapy and laparoscopy at The First TCM Hospital of Changde from January 2022 to October 2023 were retrospectively analyzed.The patients were divided equally into control and observation groups.Both groups underwent conventional rehabilitation surgery,and the observation group was supplemented with Buzhong Yiqi decoction.SPSS 26.0 was used for statistical analyses.Theχ2 test was used for univariate analysis;independent sample t-tests were used in all cases.RESULTS No significant differences were observed preoperatively in the general characteristics of the two groups.Fourteen days post-surgery,the abdominal distension,emaciation,loose stool,loss of appetite,and vomiting scores were significantly lower in the observation group than in the control group(P<0.05).Immune function and interleukin(IL)-10 levels in the observation group were significantly higher than those of the control group,whereas IL-6,tumor necrosis factor-α,and C-reactive protein levels,tumor biological indexes,and adverse reactions in the observation group were significantly lower than those of the control group(P<0.05).One month after surgery,the patients’quality of life in the observation group was significantly higher than that of the patients in the control group(P<0.05).CONCLUSION Buzhong Yiqi decoction can regulate inflammatory responses and metabolic processes by enhancing immune function,thereby promoting overall immune nutrition and restoring the body’s balance.展开更多
Over the past decade,medical researchers in China have debated whether the Pi(脾)corresponds to the biomedical spleen or pancreas.This debate exemplifies a broader phenomenon of“anatomical retrofitting”,or the anach...Over the past decade,medical researchers in China have debated whether the Pi(脾)corresponds to the biomedical spleen or pancreas.This debate exemplifies a broader phenomenon of“anatomical retrofitting”,or the anachronistic imposition of contemporary categories onto living historical objects.“Anatomical retrofitting”as a means of rectifying cases of mistranslation further positions the biomedical spleen and pancreas as representing ahistorical,universal truths.This framework gives rise to a conceptual binary:while the biomedical spleen is universalized as what philosophers may describe as“logical”ontology,the Pi connects to a different nature of reality,or“metaphysical”ontology.Far from being an object of imprecision,the Pi was a dynamic vessel that also shared characteristics with the humoral spleen.Given that scholars in China have already subjected Pi to historical scrutiny,this paper urges scholars to do the same with biomedical anatomy.For instance,historically situating the humoral spleen demonstrates that it became less known and less articulated as it transformed into the biomedical spleen.Meanwhile,the pancreas remained an unstable epistemic object that took on the dynamic functions of the humoral spleen in nineteenth-century organotherapy.Through primary source analysis and literature review,this paper contends that the apparent ontological incommensurability between Pi and spleen is neither mutually exclusive nor irreconcilable.Instead,the dynamic nature of internal viscera,their many functions,and their participation in epistemic practices contribute to an ongoing ontological ambivalence that persists despite the forced certainty of anatomical retrofitting.展开更多
BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism...BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.展开更多
Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the ...Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology.This paper clarifies the correlation between the state-target theory,the intestinal flora-gut-brain axis,and liver-depression-spleen-deficiency insomnia.The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored,aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.展开更多
With the growing elderly population,neurodegenerative disorders like Alzheimer's disease(AD)are emerging as a significant public health concern.It is widely acknowledged in the scientific community that the accumu...With the growing elderly population,neurodegenerative disorders like Alzheimer's disease(AD)are emerging as a significant public health concern.It is widely acknowledged in the scientific community that the accumulation of neurotoxic aggregates,such as amyloid beta(Aβ),within the central nervous system is a major factor in the development of these disorders.Furthermore,human genome-wide association studies have identified mutations in microglial receptors that may be linked to a number of neurodegenerative diseases[1].展开更多
BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard t...BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms.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.
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.
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.
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The"spleen"in traditional Chinese medicine is the"acquired foundation"and the"source of qi and blood biochemistry".Strengthening the"spleen"is one of the important treat‐ment methods in traditional Chinese medicine;The gut microbiota has been a hot topic in modern scientific research in recent years,and its nutritional and immune functions correspond to some of the functions of the spleen in traditional Chinese medicine.In terms of philosophy,traditional Chinese medicine emphasizes the balance between the spleen and the gut microbiota,emphasizing the importance of supporting the right and eliminating evil,preventing diseases before they occur,seeking the root cause of treat‐ment,and adapting measures to the three causes;Clinically,the treatment of obesity,con‐stipation,diarrhea and other diseases by invigorating the spleen and the treatment mechanism of acupuncture and moxibustion,chiropractic and invigorating the spleen are all related to microecology.This article combines relevant literature on traditional Chinese medicine's"spleen"and"spleen health"to explore the treatment concept,clinical application,and correlation with intestinal microbiota of traditional Chinese medicine's"spleen health".It also elaborates on the latest literature,aiming to exchange ideas with peers and promote research on the microbiota of traditional Chinese medicine's"spleen".
基金Supported by the National Natural Science Foundations of China,No.81873897 and No.82102050Shanghai Science and Technology Development Foundation,No.22Y11911500Shanghai Municipal Health Commission of Science and Research Fund,No.202140378.
文摘BACKGROUND Liver stiffness(LS)measurement with two-dimensional shear wave elastography(2D-SWE)correlates with the degree of liver fibrosis and thus indirectly reflects liver function reserve.The size of the spleen increases due to tissue proliferation,fibrosis,and portal vein congestion,which can indirectly reflect the situation of liver fibrosis/cirrhosis.It was reported that the size of the spleen was related to posthepatectomy liver failure(PHLF).So far,there has been no study combining 2D-SWE measurements of LS with spleen size to predict PHLF.This prospective study aimed to investigate the utility of 2D-SWE assessing LS and spleen area(SPA)for the prediction of PHLF in hepatocellular carcinoma(HCC)patients and to develop a risk prediction model.AIM To investigate the utility of 2D-SWE assessing LS and SPA for the prediction of PHLF in HCC patients and to develop a risk prediction model.METHODS This was a multicenter observational study prospectively analyzing patients who underwent hepatectomy from October 2020 to March 2022.Within 1 wk before partial hepatectomy,ultrasound examination was performed to measure LS and SPA,and blood was drawn to evaluate the patient’s liver function and other conditions.Least absolute shrinkage and selection operator logistic regression and multivariate logistic regression analysis was applied to identify independent predictors of PHLF and develop a nomogram.Nomogram performance was validated further.The diagnostic performance of the nomogram was evaluated with receiver operating charac-teristic curve compared with the conventional models,including the model for end-stage liver disease(MELD)score and the albumin-bilirubin(ALBI)score.RESULTS A total of 562 HCC patients undergoing hepatectomy(500 in the training cohort and 62 in the validation cohort)were enrolled in this study.The independent predictors of PHLF were LS,SPA,range of resection,blood loss,international normalized ratio,and total bilirubin.Better diagnostic performance of the nomogram was obtained in the training[area under receiver operating characteristic curve(AUC):0.833;95%confidence interval(95%CI):0.792-0.873;sensitivity:83.1%;specificity:73.5%]and validation(AUC:0.802;95%CI:0.684-0.920;sensitivity:95.5%;specificity:52.5%)cohorts compared with the MELD score and the ALBI score.CONCLUSION This PHLF nomogram,mainly based on LS by 2D-SWE and SPA,was useful in predicting PHLF in HCC patients and presented better than MELD score and ALBI score.
文摘BACKGROUND According to the theory of traditional Chinese medicine(TCM),the spleen and stomach are the basis of acquired nature and the source of qi and blood biochemistry.After surgery and chemotherapy,patients with colorectal cancer often develop spleen and stomach qi deficiency syndrome,leading to decreased immune function.Buzhong Yiqi decoction,a classic TCM prescription,has the effect of tonifying middle-jiao and invigorating qi,boosting Yang,and suppressing immune-related inflammation.Moreover,it is widely used in the treatment of spleen and stomach qi deficiency syndrome.AIM To investigate the effect of Buzhong Yiqi decoction on spleen and stomach qi deficiency in patients with colorectal cancer.METHODS One hundred patients with colorectal cancer who underwent preoperative chemotherapy and laparoscopy at The First TCM Hospital of Changde from January 2022 to October 2023 were retrospectively analyzed.The patients were divided equally into control and observation groups.Both groups underwent conventional rehabilitation surgery,and the observation group was supplemented with Buzhong Yiqi decoction.SPSS 26.0 was used for statistical analyses.Theχ2 test was used for univariate analysis;independent sample t-tests were used in all cases.RESULTS No significant differences were observed preoperatively in the general characteristics of the two groups.Fourteen days post-surgery,the abdominal distension,emaciation,loose stool,loss of appetite,and vomiting scores were significantly lower in the observation group than in the control group(P<0.05).Immune function and interleukin(IL)-10 levels in the observation group were significantly higher than those of the control group,whereas IL-6,tumor necrosis factor-α,and C-reactive protein levels,tumor biological indexes,and adverse reactions in the observation group were significantly lower than those of the control group(P<0.05).One month after surgery,the patients’quality of life in the observation group was significantly higher than that of the patients in the control group(P<0.05).CONCLUSION Buzhong Yiqi decoction can regulate inflammatory responses and metabolic processes by enhancing immune function,thereby promoting overall immune nutrition and restoring the body’s balance.
文摘Over the past decade,medical researchers in China have debated whether the Pi(脾)corresponds to the biomedical spleen or pancreas.This debate exemplifies a broader phenomenon of“anatomical retrofitting”,or the anachronistic imposition of contemporary categories onto living historical objects.“Anatomical retrofitting”as a means of rectifying cases of mistranslation further positions the biomedical spleen and pancreas as representing ahistorical,universal truths.This framework gives rise to a conceptual binary:while the biomedical spleen is universalized as what philosophers may describe as“logical”ontology,the Pi connects to a different nature of reality,or“metaphysical”ontology.Far from being an object of imprecision,the Pi was a dynamic vessel that also shared characteristics with the humoral spleen.Given that scholars in China have already subjected Pi to historical scrutiny,this paper urges scholars to do the same with biomedical anatomy.For instance,historically situating the humoral spleen demonstrates that it became less known and less articulated as it transformed into the biomedical spleen.Meanwhile,the pancreas remained an unstable epistemic object that took on the dynamic functions of the humoral spleen in nineteenth-century organotherapy.Through primary source analysis and literature review,this paper contends that the apparent ontological incommensurability between Pi and spleen is neither mutually exclusive nor irreconcilable.Instead,the dynamic nature of internal viscera,their many functions,and their participation in epistemic practices contribute to an ongoing ontological ambivalence that persists despite the forced certainty of anatomical retrofitting.
基金Supported by 2021 Shenyang Science and Technology Program-Public Health R&D Special Project(Joint Project)of Shenyang Municipal Science and Technology Bureau,No.21-174-9-04.
文摘BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.
文摘Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology.This paper clarifies the correlation between the state-target theory,the intestinal flora-gut-brain axis,and liver-depression-spleen-deficiency insomnia.The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored,aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.
基金supported by the National Natural Science Foundation of China(82071392)Science and Technology Innovation Enhancement Project of Army Medical University,China(2019CXJSB021).
文摘With the growing elderly population,neurodegenerative disorders like Alzheimer's disease(AD)are emerging as a significant public health concern.It is widely acknowledged in the scientific community that the accumulation of neurotoxic aggregates,such as amyloid beta(Aβ),within the central nervous system is a major factor in the development of these disorders.Furthermore,human genome-wide association studies have identified mutations in microglial receptors that may be linked to a number of neurodegenerative diseases[1].
文摘BACKGROUND The spleen is the most commonly injured solid organ in blunt abdominal trauma,and splenic pseudoaneurysm rupture is associated with a high risk of mortality.Nonoperative management has become the standard treatment for hemodynam-ically stable patients with splenic injuries.On the other hand,delayed splenic pseudoaneurysms can develop in any patient,and at present,there are no known risk factors that may reliably predict their occurrence.Furthermore,there is a lack of consensus regarding the most appropriate strategies for monitoring and mana-ging splenic injuries,especially lower-grade(I-III).AIM To determine the predictors of pseudo-aneurysm formation following splenic injury and develop follow-up strategies for early detection of pseudoaneurysms.METHODS We retrospectively analyzed patients who visited the Level I Trauma Center bet-ween January 2013 and December 2022 and were diagnosed with spleen injuries after blunt abdominal trauma.RESULTS Using the American Association for the Surgery of Trauma spleen injury scale,the splenic injuries were categorized into the following order based on severity:Grade I(n=57,17.6%),grade II(n=114,35.3%),grade III(n=89,27.6%),grade IV(n=50,15.5%),and grade V(n=13,4.0%).Of a total of 323 patients,35 underwent splenectomy and 126 underwent angioembolization.19 underwent delayed angioembolization,and 5 under-went both initial and delayed angioem-bolization.In 14 patients who had undergone delayed angioembolization,no extravasation or pseudoaneurysm was observed on the initial computed tomography scan.There are no particular patient-related risk factors for the formation of a delayed splenic pseudoaneurysm,which can occur even in a grade I spleen injury or even 21 days after the injury.The mean detection time for a delayed pseudoaneurysm was 6.26±5.4(1-21,median:6,inter-quartile range:2-9)days.CONCLUSION We recommend regular follow-up computed tomography scans,including an arterial and portal venous phase,at least 1 week and 1 month after injury in any grade of blunt traumatic spleen injury for the timely detection of delayed pseudoaneurysms.
