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Zhongguo Zhen Jiu = Chinese Acupuncture... Mar 2024To explore the rules of acupoint selection and compatibility of acupuncture for Tourette syndrome(TS) in children.
OBJECTIVES
To explore the rules of acupoint selection and compatibility of acupuncture for Tourette syndrome(TS) in children.
METHODS
The relevant literature regarding acupuncture for Tourette syndrome in children included in CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science and Cochrane Library from the establishment of the database to March 31st, 2023 was retrieved.The information of acupuncture prescription, syndrome type, meridian affinity was extracted to set up database. The Microsoft Excel 2019 was used for descriptive statistical analysis, SPSS modeler18.0 was for association rule analysis, lantern5.0 was for latent structure analysis and comprehensive clustering.
RESULTS
①A total of 80 literature was included, and 112 acupuncture prescriptions were extracted, involving 104 acupoints, with a cumulative frequency of 859 times.②The acupoints with high use frequency were Taichong(LR 3), Baihui(GV 20), Fengchi(GB 20), Hegu(LI 4), Sishencong(EX-HN 1), Sanyinjiao(SP 6) and Zusanli(ST 36).③In the treatment of TS with acupuncture, the governor vessel acupoints were the most frequently used, the proportion of acupoints on the head, face, neck and lower limbs was higher. ④The association rule analysis showed that Fengchi(GB 20)-Hegu(LI 4) and Taichong(LR 3)-Hegu(LI 4) had the highest support degree, both were 47.32%.⑤Five comprehensive clustering models were obtained by analyzing the latent structure of high-frequency acupoints, corresponding to deficiency disturbing wind, liver hyperactivity and spleen deficiency, liver transforming into wind, phlegm-heat harassing the interior and stagnation transformed fire.
CONCLUSIONS
Acupuncture for TS in children is based on the principle of soothe the liver and extinguish the wind, regulating and blood, and paying attention to regulating spirit and . The core acupoints are Fengchi(GB 20), Hegu(LI 4), Taichong(LR 3), Baihui(GV 20), Sanyinjiao(SP 6) , Zusanli(ST 36), acupoints should be selected according to different syndrome in clinical.
Topics: Child; Humans; Acupuncture Points; Tourette Syndrome; Acupuncture Therapy; Meridians; Databases, Factual
PubMed: 38467512
DOI: 10.13703/j.0255-2930.20230615-0002 -
Frontiers in Pharmacology 2024Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and...
Tonghua Liyan granules in the treatment of Laryngopharyngeal reflux disease with stagnation of phlegm and qi syndrome: a randomized, double-blind, placebo-controlled study.
Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and concern about LPRD, treatment with proton pump inhibitors (PPIs) is unsatisfactory. Here, LPRD was treated with Tonghua Liyan (THLY) granules in combination with PPIs to evaluate treatment efficacy and possible adverse reactions. Seventy-six LPRD patients with stagnation of phlegm and qi syndrome (SPQS) were randomly divided into an experimental group and a control group. The experimental group received THLY granules combined with rabeprazole capsules. The control group received THLY granule placebo combined with rabeprazole capsules. A parallel, randomized, double-blind, placebo-controlled clinical trial was conducted with these two groups. The treatment cycle was 8 weeks. The reflux symptom index (RSI), clinical symptom score, salivary pepsin content, reflux finding score (RFS) and gastroesophageal reflux disease questionnaire (GerdQ) were used to evaluate clinical efficacy. The final efficacy rate was evaluated according to the RSI and clinical symptom score. Compared with those at baseline, all the indicators in the experimental group and control group significantly improved ( < 0.01). In terms of the RSI, clinical symptom score, and RFS, the experimental group had a higher degree of improvement ( < 0.05), and the overall efficacy rate was higher ( < 0.05). In terms of the salivary pepsin concentration and GerdQ, there was no significant difference between the test group and the control group ( > 0.05). Both groups of safety indicators showed no abnormalities and did not cause any allergic reactions in the body. Compared with PPIs alone, THLY granules combined with PPIs are more effective in the treatment of LPRD patients with SPQS in terms of symptoms and signs. This combination treatment, because of its higher clinical efficacy and lack of obvious adverse reactions, is worthy of clinical promotion and further in-depth study. www.chictr.org.cn, identifier ChiCTR2100046614.
PubMed: 38464723
DOI: 10.3389/fphar.2024.1275740 -
Chest Mar 2024A 49-year-old man, a farmer, had been experiencing coughing, phlegm, and difficulty breathing for 2 months. He underwent a CT scan at a local hospital that showed a...
A 49-year-old man, a farmer, had been experiencing coughing, phlegm, and difficulty breathing for 2 months. He underwent a CT scan at a local hospital that showed a mediastinal mass. Bronchoscopy showed no obstruction in the tracheal lumen, and an endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) biopsy was performed on the mediastinal mass. The cytologic smear of the mediastinal mass showed a few atypical epithelial cells; the possibility of a tumor could not be ruled out. The patient visited our thoracic surgery outpatient department; based on the advice of the thoracic surgeon, the patient underwent another endobronchial ultrasound-guided transbronchial fine needle aspiration biopsy of the mediastinal mass 4 days before this admission. The patient went home and waited for the results. Two days later, the patient experienced a fever and palpitations accompanied by chills, yellow phlegm, and orthopnea. The patient visited our ED, underwent tracheal intubation, and was admitted to our ICU. The patient had had occasional coughing and phlegm for the past 10 years, which were not taken seriously or investigated. The patient does not smoke or drink alcohol, and there is no history of cancer in the family.
Topics: Male; Humans; Middle Aged; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Bronchoscopy; Mediastinal Diseases; Dyspnea; Cough; Lung Neoplasms; Lymph Nodes; Mediastinum
PubMed: 38461020
DOI: 10.1016/j.chest.2023.08.018 -
Biomedical Chromatography : BMC Jun 2024Xixin-Ganjiang herb pair (XGHP) is a classic combination for warming the lungs to dissolve phlegm and is often used to treat a variety of chronic lung diseases; it can...
Protective effect of Xixin-Ganjiang herb pair for warming the lungs to dissolve phlegm in chronic obstructive pulmonary disease rats based on integrated network pharmacology and metabolomics.
Xixin-Ganjiang herb pair (XGHP) is a classic combination for warming the lungs to dissolve phlegm and is often used to treat a variety of chronic lung diseases; it can treat the syndrome of cold phlegm obstruction of lungs. First, ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to examine the composition of XGHP, and network pharmacology was used to predict its potential core targets and signaling pathways in the current study. Second, a rat model of chronic obstructive pulmonary disease (COPD) was established for assessing the anti-COPD activity of XGHP, and metabolomics was used to explore the biomarkers and metabolic pathways. Finally, the sample was validated using molecular docking and Western blotting. The integration of metabolomics and network pharmacology results identified 11 targets, 3 biomarkers, 3 pathways, and 2 metabolic pathways. Western blotting showed that XGHP effectively regulated the expression of core proteins via multiple signaling pathways (downregulation of toll-like receptor 4 [TLR4] and upregulation of serine/threonine-protein kinase 1 [p-AKT1] and nitric oxide synthase 3 [NOS3]). Molecular docking results showed that the 10 potentially active components of XGHP have good affinity with tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), matrix metalloproteinase 9 (MMP-9), TLR4, p-AKT1, and NOS3. Our findings suggest that XGHP may regulate glucolipid metabolism, improve energy supply, and inhibit inflammatory responses (TNF-α, IL-6, and MMP-9) via the PI3K-Akt signaling pathway and HIF-1 signaling pathway in the management of COPD.
Topics: Animals; Pulmonary Disease, Chronic Obstructive; Rats; Drugs, Chinese Herbal; Metabolomics; Male; Network Pharmacology; Rats, Sprague-Dawley; Molecular Docking Simulation; Chromatography, High Pressure Liquid; Tandem Mass Spectrometry; Lung; Disease Models, Animal; Signal Transduction
PubMed: 38449348
DOI: 10.1002/bmc.5851 -
Journal of Cardiothoracic Surgery Mar 2024Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date,... (Review)
Review
BACKGROUND
Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date, fewer than 30 cases of pulmonary PNET have been reported. In this case report, we present the clinical details of a 12-year-old girl with pulmonary PNET who underwent surgical treatment. We also conducted an analysis and summary of other relevant studies and the surgical outcomes.
CASE PRESENTATION
In May 2018, a 12-year-old girl was admitted with symptoms of cough and blood-tinged phlegm. A computed tomography scan revealed a large mass, measuring 12.9 cm × 8.1 cm, in the right middle and lower lungs. A percutaneous lung biopsy confirmed poorly differentiated tumor cells with a nested growth pattern. Immunohistochemical staining demonstrated positive expression of CD99, CD56, Vimentin, and Synaptophysin. The patient was diagnosed with pulmonary PNET. Following three cycles of neoadjuvant chemotherapy, a substantial reduction in tumor volume was observed. Subsequently, the patient underwent a surgical procedure involving pneumonectomy and partial resection of the left atrium with the assistance of cardiopulmonary bypass. The patient was discharged 37 days after surgery. During a three-year follow-up period, she exhibited no signs of tumor recurrence and has successfully returned to school.
CONCLUSIONS
This case highlights the successful management of an advanced PNET with neoadjuvant chemotherapy, pneumonectomy, and partial resection of the left atrium employing cardiopulmonary bypass. The patient remained disease-free after three years. Our analysis of surgically treated cases indicates that neoadjuvant chemotherapy can contribute to improved prognoses for PNET patients. It is crucial to emphasize that complete surgical excision remains the cornerstone of treatment, underscoring the importance of surgeons considering radical surgical approaches whenever feasible for patients with pulmonary PNETs.
Topics: Female; Humans; Child; Neoplasm Recurrence, Local; Pneumonectomy; Neoadjuvant Therapy; Lung; Neuroectodermal Tumors, Primitive
PubMed: 38443970
DOI: 10.1186/s13019-024-02563-8 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Oct 2023Insomnia is a common disease and its impact on human health cannot be ignored. At present, there are 3 main clinical treatments for insomnia, including traditional...
Insomnia is a common disease and its impact on human health cannot be ignored. At present, there are 3 main clinical treatments for insomnia, including traditional Chinese medicine treatment, sedative hypnotic drug therapy, and cognitive behavioral therapy. Traditional Chinese medicine (TCM) treatment for insomnia is widely used due to its advantages of low side effects, good efficacy, and no drug dependence. This paper summarizes the pathogenesis of insomnia in the theories of traditional Chinese and Western medicine. Modern medical research generally believes that sleep-wake disorder is the main pathological mechanism of insomnia, involving many factors such as monoamine neurotransmitter disorder, cytokine imbalance and intestinal flora imbalance. TCM mainly divides the pathogenesis of insomnia into 9 kinds of syndrome types: Liver depression transforming into fire, hyperactivity of fire due to yin deficiency, phlegm-heat attacking internally, disharmony between heart and kidney, deficiency of both heart and spleen, qi deficiency of both heart and gallbaldder, stomach qi disharmony, exuberance of heart fire, and internal blockade of static blood. According to these 9 kinds of pathogenesis of insomnia, the corresponding classical prescriptions such as Longdanxiegan decoction, Suanzaoren decoction, Huanglian-Wendan decoction, Jiaotai pill and Guipi decoction were analyzed and summarized. There is evidence that traditional Chinese medicine could treat insomnia mainly by increasing the level of 5-hydroxytryptamine, reducing the levels of dopamine, noradrenaline, tumor necrosis factor α, and interlukin-6, decreasing the ratio of glutamic acid to γ-aminobutyric acid, and inhibiting the hypothalamic-pituitary-adrenal axis.
Topics: Humans; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Sleep Initiation and Maintenance Disorders; Medicine, Chinese Traditional; Amines
PubMed: 38432879
DOI: 10.11817/j.issn.1672-7347.2023.230200 -
Medicine Mar 2024Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm... (Review)
Review
RATIONALE
Botrychium ternatum ((Thunb.) Sw.), a traditional Chinese medicine, is known for its therapeutic properties in clearing heat, detoxifying, cough suppression, and phlegm elimination. It has been extensively used in clinics for the treatment of many inflammation-related diseases. Currently, there are no documented cases of rhabdomyolysis resulting from Botrychium ternatum intoxication.
PATIENT CONCERNS
A 57-year-old male presented with a complaint of low back discomfort accompanied by tea-colored urine lasting for 4 days. The patient also exhibited markedly increased creatine phosphate kinase and myoglobin levels. Prior to the onset of symptoms, the patient consumed 50 g of Botrychium ternatum to alleviate pharyngodynia.
DIAGNOSES
The patient was diagnosed with rhabdomyolysis due to Botrychium ternatum intoxication.
INTERVENTIONS
The patient underwent a substantial volume of fluid resuscitation, diuresis, and alkalization of urine, as well as correction of the acid-base balance and electrolyte disruption.
OUTCOMES
Following a 10-day treatment plan involving massive fluid resuscitation, diuresis, and alkalization of urine, the patient showed notable improvement in his lower back pain and reported the absence of any discomfort. Following reexamination, the levels of creatine phosphate kinase and myoglobin were restored to within the normal ranges. Additionally, no abnormalities were detected in liver or renal function. As a result, the patient was considered eligible for discharge and was monitored.
CONCLUSIONS
Botrychium ternatum intoxication was associated with the development of rhabdomyolysis. To manage this condition, it is recommended that patients provide massive fluid resuscitation, diuresis, alkalization of urine, and other appropriate therapeutic interventions.
LESSON
Currently, there are no known cases of rhabdomyolysis resulting from Botrychium ternatum intoxication. However, it is important to consider the potential occurrence of rhabdomyolysis resulting from Botrychium ternatum intoxication when there is a correlation between the administration of Botrychium ternatum and the presence of muscular discomfort in the waist or throughout the body, along with tea-colored urine. Considering the levels of creatine phosphate kinase and myoglobin, the diagnosis or exclusion of rhabdomyolysis caused by Botrychium ternatum intoxication should be made, and suitable treatment should be administered accordingly.
Topics: Male; Humans; Middle Aged; Myoglobin; Phosphocreatine; Rhabdomyolysis; Fluid Therapy; Creatine Kinase; Tea
PubMed: 38428852
DOI: 10.1097/MD.0000000000037304 -
Journal of Thoracic Disease Jan 2024Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such...
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide, and therefore the identification of the modifiable risk factors [such as exposure to vapors, gases, dust and fumes (VGDF)] for accelerate disease progression has important significance.
METHODS
We conducted COPD surveillance in six cities of southern China between 2014 and 2019. We recorded the diagnosis of chronic bronchitis, respiratory symptoms, occupational exposure to VGDF and other covariates by using a structured questionnaire. Logistic regression and multivariate linear regression model were adopted for analysis. We performed sensitivity analyses based on two methods of propensity score (PS) methods to evaluate the robustness of our results.
RESULTS
A total of 7,418 participants were included. Cough [odds ratios (ORs): 1.60, 95% confidence interval (CI): 1.22 to 2.08] and phlegm (OR: 1.49, 95% CI: 1.19 to 1.85) correlated significantly with exposure to dust. There was an increased risk of cough (OR: 1.53, 95% CI: 1.11 to 2.07) for occupational exposure to gas/vapor/fume. Dual exposure to dust and gas/vapor/fume was associated with a significantly increased risk of chronic bronchitis (OR: 1.74, 95% CI: 1.20 to 2.52), cough (OR: 1.43, 95% CI: 1.15 to 1.79) and phlegm (OR: 1.49, 95% CI: 1.24 to 1.79). In 5,249 participants with complete data of spirometry, gas/vapor/fume was associated with a decreased ratio of forced expiratory volume in one second and forced vital capacity (FEV/FVC) (β: -1.05, 95% CI: -1.85 to -0.26) and maximal mid-expiratory flow (MMEF) (β: -0.15, 95% CI: -0.23 to -0.07). Dual exposure to dust and gas/vapor/fume was significantly associated with decreased FEV/FVC (β: -0.74, 95% CI: -1.28 to -0.20) and MMEF (β: -0.06, 95% CI: -0.12 to -0.01). Results of sensitivity analysis were not materially changed.
CONCLUSIONS
VGDF exposure is associated with chronic bronchitis, respiratory symptoms and decreased lung function, suggesting that VGDF contributes to the pathogenesis and progression of COPD.
PubMed: 38410603
DOI: 10.21037/jtd-23-646 -
Respirology (Carlton, Vic.) Jun 2024Prognostic indices have been developed to predict various outcomes, including mortality. These indices and hazard ratios may be difficult for patients to understand. We...
BACKGROUND AND OBJECTIVE
Prognostic indices have been developed to predict various outcomes, including mortality. These indices and hazard ratios may be difficult for patients to understand. We investigated the association between smoking, respiratory symptoms and lung function with remaining life expectancy (LE) in older adults.
METHODS
Data were from the 2004/05 English Longitudinal Study of Ageing (ELSA) (n = 8930), participants aged ≥50-years, with mortality data until 2012. Respiratory symptoms included were chronic phlegm and shortness of breath (SOB). The association between smoking, respiratory symptoms and FEV/FVC, and remaining LE was estimated using a parametric survival function and adjusted for covariates including age at baseline and sex.
RESULTS
The extent to which symptoms and FEV/FVC predicted differences in remaining LE varied by smoking. Compared to asymptomatic never smokers with normal lung function (the reference group), in never smokers, only those with SOB had a significant reduction in remaining LE. In former and current smokers, those with respiratory symptoms had significantly lower remaining LE compared to the reference group if they had FEV/FVC <0.70 compared to those with FEV/FVC ≥0.70. Males aged 50-years, current smokers with SOB and FEV/FVC <0.70, had a remaining LE of 19.2 (95%CI: 16.5-22.2) years, a decrease of 8.1 (5.3-10.8) years, compared to the reference group.
CONCLUSION
Smoking, respiratory symptoms and FEV/FVC are strongly associated with remaining LE in older people. The use of remaining LE to communicate mortality risk to patients needs further investigation.
Topics: Humans; Male; Female; Middle Aged; Longitudinal Studies; Smoking; Life Expectancy; Aged; Aging; Forced Expiratory Volume; Lung; Dyspnea; Vital Capacity; Respiratory Function Tests
PubMed: 38403987
DOI: 10.1111/resp.14683 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Jan 2024This study aimed at investigating the mechanism of Trichosanthis Fructus-Allii Macrostemonis Bulbus(GX) in treating cardiovascular diseases in rats with the syndrome of...
[Mechanism of "Trichosanthis Fructus-Allii Macrostemonis Bulbus" in treating cardiovascular diseases with syndrome of combined phlegm and stasis based on serum metabolomics].
This study aimed at investigating the mechanism of Trichosanthis Fructus-Allii Macrostemonis Bulbus(GX) in treating cardiovascular diseases in rats with the syndrome of combined phlegm and stasis. The rat model was established by a high-fat diet, ice-water bath combined with subcutaneous injection of adrenalin hydrochloride, and the syndrome score was determined. The serum samples of rats in the control, model, and GX groups were collected. Ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was employed to analyze the metabolic profiles of the serum samples. The differential metabolites were screened and identified by partial least squares-discriminant analysis(PLS-DA) and orthogonal partial least squares-discriminant analysis(OPLS-DA). The intervention targets of GX-regulated metabolites and their metabolic pathways were searched against MetaboAnalyst. Gene Ontology enrichment was carried out to predict the biological pathways associated with the intervention targets of metabolic pathways. A total of 129 potential biomarkers were detected in the rat model with the syndrome of combined phlegm and stasis via metabolomics, and GX regulated 54 metabolites in several metabolic pathways such as linoleic acid metabolism, sphingolipid metabolism, and tricarboxylic acid cycle. The further screening against MetaboAnalyst showed that GX recovered the levels of nine metabolites associated with cardiovascular diseases with the syndrome of combined phlegm and stasis, which involved 69 targets in the pathways regarding cholesterol metabolism, fatty acid metabolism, inflammatory response, and glucose homeostasis and metabolism. The above-mentioned results suggested that GX can alleviate the symptoms of the rat model of cardiovascular diseases with the syndrome of combined phlegm and stasis by regulating the metabolism of linoleic acid, sphingosine, docosahexaenoic acid, rosemary acid, succinic acid, adenine, L-phenylalanine, L-valine and modulating the biological pathways such as cholesterol metabolism, fatty acid metabolism, inflammatory response, and glucose homeostasis and metabolism.
Topics: Rats; Animals; Cardiovascular Diseases; Linoleic Acid; Chromatography, High Pressure Liquid; Metabolomics; Biomarkers; Cholesterol; Glucose; Drugs, Chinese Herbal; Chive
PubMed: 38403356
DOI: 10.19540/j.cnki.cjcmm.20230914.706