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Will partial splenic embolization followed by splenectomy increase intraoperative bleeding?

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 318-330页

作者： Long Huang Qing-Lin Li Qing-Sheng Yu Hui Peng Zhou Zhen Yi Shen Qi Zhang Department of No.1 Surgery The First Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230031Anhui ProvinceChina Anhui University of traditional chinese medicine Anhui University of Traditional Chinese MedicineHefei 230038Anhui ProvinceChina Department of Surgery The Second Hospital Affiliated to Anhui University of Traditional Chinese MedicineHefei 230061Anhui ProvinceChina

BACKGROUND Partial splenic embolization(PSE)has been suggested as an alternative to splenectomy in the treatment of ***,some patients may experience recurrence of hypersplenism after PSE and require ***,there is a lack of evidence-based medical support regarding whether preoperative PSE followed by splenectomy can reduce the incidence of *** To investigate the safety and therapeutic efficacy of preoperative PSE followed by splenectomy in patients with cirrhosis and *** Between January 2010 and December 2021,321 consecutive patients with cirrhosis and hypersplenism underwent splenectomy at our *** on whether PSE was performed prior to splenectomy,the patients were divided into two groups:PSE group(n=40)and non-PSE group(n=281).Patient characteristics,postoperative complications,and follow-up data were compared between *** score matching(PSM)was conducted,and univariable and multivariable analyses were used to establish a nomogram predictive model for intraoperative bleeding(IB).The receiver operating characteristic curve,Hosmer-Lemeshow goodness-of-fit test,and decision curve analysis(DCA)were employed to evaluate the differentiation,calibration,and clinical performance of the *** After PSM,the non-PSE group showed significant reductions in hospital stay,intraoperative blood loss,and operation time(all P=0.00).Multivariate analysis revealed that spleen length,portal vein diameter,splenic vein diameter,and history of PSE were independent predictive factors for IB.A nomogram predictive model of IB was constructed,and DCA demonstrated the clinical utility of this *** groups exhibited similar results in terms of overall survival during the follow-up *** Preoperative PSE followed by splenectomy may increase the incidence of IB and a nomogram-based prediction model can predict the occurrence of IB.

关键词： Partial splenic embolization Splenectomy Hypertension,Portal Liver Cirrhosis Intraoperative bleeding

Yiwei Xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach

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World Journal of Clinical Cases 2024年第13期12卷 2201-2209页

作者： Wan-Qun Chen Qing-Feng Fan Yuan-Jun He Fei Li Xin Wu Yan-Ping Li Xiao-Jun Yang Department of Gastroenterology Chongqing Hospital of Traditional Chinese MedicineChongqing 400000China

BACKGROUND The Correa sequence,initiated by Helicobacter pylori(***),commonly progresses to gastric cancer through the stage of chronic atrophic gastritis(CAG).Although eradication of *** only reduces the risk of gastric cancer,it does not eliminate the risk for neoplastic *** Xiaoyu granules(YWXY)are a commonly used composite preparation in chinese ***,the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional chinese medicine in the treatment of *** To demonstrate the effectiveness of YWXY in patients with CAG and spleenstomach deficiency syndrome(DSSS),by alleviating histological scores,improving response rates for pathological lesions,and achieving clinical efficacy in relieving DSSS *** We designed a double-blind,randomized,controlled *** study enrolled seventy-two ***-negative patients(mean age,52.3 years;38 men)who were randomly allocated to either the treatment group or control group in a 1:1 ratio,and treated with 15 g YWXY or 0.36 g Weifuchun(WFC)tablet combined with the respective dummy for 24 *** pre-randomization phase resulted in the exclusion of 72 patients:50 participants did not meet the inclusion criteria,12 participants declined to participate,and 10 participants were excluded for various other *** visits were conducted during the study,and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh *** also evaluated endoscopic performance scores,total symptom scores,serum pepsinogen and *** Six patients did not complete the trial *** with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)stage,compared with WFC(P<0.05).YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric fun

关键词： Chronic atrophic gastritis Yiwei Xiaoyu granules Randomized clinical trial Weifuchun tablet traditional chinese medicine Helicobacter pylori

Clinical study on the treatment of functional constipation in infants and younger children with pediatric Tuina based on Baliao points

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Journal of Acupuncture and Tuina Science 2024年第5期22卷 417-422页

作者： CHEN Li WU Xijun Wuxi hospital of traditional chinese medicine Jiangsu ProvinceWuxi 214071China

Objective:To observe the clinical efficacy of Tuina(chinese therapeutic massage),basically Yi Zhi Chan pushing at Baliao points in the treatment of functional constipation in infants and children aged 1-3 years ***:Seventy kids were randomly divided into an observation group and a control group,with 35 cases in each *** control group was treated with conventional Tuina manipulation,while the observation group was treated with Tuina manipulation based on Yi Zhi Chan pushing at Baliao *** groups were treated once every other day,with 10 times as 1 course of *** score on the self-developed constipation rating scale and clinical efficacy were compared after 1 course of ***:The total effective rate was 90.6%in the observation group and 76.7%in the control group,and the difference between the two groups was statistically significant(P<0.05).The degree of defecation difficulty in the children in the observation group was milder than that in the control group(P<0.01).Conclusion:Tuina manipulation based on Yi Zhi Chan pushing at Baliao points can significantly improve the degree of defecation difficulty in children,and the total effective rate is better than that of conventional Tuina manipulation.

关键词： Tuina Massage Pediatric Tuina Yi Zhi Chan Pushing Points,Baliao Constipation Randomized Controlled Trial

Jianpi Gushen Huayu decoction ameliorated diabetic nephropathy through modulating metabolites in kidney,and inhibiting TLR4/NF-κB/NLRP3 and JNK/P38 pathways

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World Journal of Diabetes 2024年第3期15卷 502-518页

作者： Zi-Ang Ma Li-Xin Wang Hui Zhang Han-Zhou Li Li Dong Qing-Hai Wang Yuan-Song Wang Bao-ChaoPan Shu-Fang Zhang Huan-Tian Cui Shu-Quan Lv Graduate School Hebei University of Chinese MedicineShijiazhuang 050000Hebei ProvinceChina Department of Endocrinology Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine of Hebei Province Affiliated to Hebei University of Chinese MedicineCangzhou 061000Hebei ProvinceChina School of Integrative medicine Tianjin University of Traditional Chinese MedicineTianjin 300000China The First School of Clinical medicine Yunnan University of Traditional Chinese MedicineKunming 065000Yunnan ProvinceChina Department of Endocrinology Hebei Cangzhou Hospital of Integrative MedicineCangzhou 061000Hebei ProvinceChina

BACKGROUND Jianpi Gushen Huayu Decoction(JPGS)has been used to clinically treat diabetic nephropathy(DN)for many ***,the protective mechanism of JPGS in treating DN remains *** To evaluate the therapeutic effects and the possible mechanism of JPGS on *** We first evaluated the therapeutic potential of JPGS on a DN mouse *** then investigated the effect of JPGS on the renal metabolite levels of DN mice using non-targeted ***,we examined the effects of JPGS on c-Jun N-terminal kinase(JNK)/P38-mediated apoptosis and the inflammatory responses mediated by toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)/NOD-like receptor family pyrin domain containing 3(NLRP3).RESULTS The ameliorative effects of JPGS on DN mice included the alleviation of renal injury and the control of inflammation and oxidative *** metabolomic analysis revealed that JPGS altered the metabolites of the kidneys in DN mice.A total of 51 differential metabolites were *** analysis results indicated that nine pathways significantly changed between the control and model groups,while six pathways significantly altered between the model and JPGS *** related to cysteine and methionine metabolism;alanine,tryptophan metabolism;aspartate and glutamate metabolism;and riboflavin metabolism were identified as the key pathways through which JPGS affects *** experimental validation showed that JPGS treatment reduced the expression of TLR4/NF-κB/NLRP3 pathways and JNK/P38 pathway-mediated apoptosis related *** JPGS could markedly treat mice with streptozotocin(STZ)-induced DN,which is possibly related to the regulation of several metabolic pathways found in ***,JPGS could improve kidney inflammatory responses and ameliorate kidney injuries in DN mice via the TLR4/NF-κB/NLRP3 pathway and inhibit JNK/P38 pathwaymediated apoptosis in DN mice.

关键词： Diabetic nephropathy Jianpi Gushen Huayu Decoction Oxidative stress Inflammation Untargeted metabolomics Toll-like receptor 4/nuclear factor-kappa B/NOD-like receptor family pyrin domain containing 3 pathway c-Jun N-terminal kinase/P38-mediated apoptosis

Acupuncture reduces sedative and anaesthetic consumption and improves pain tolerance in patients undergoing colonoscopy: aMeta-analysis

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Journal of traditional chinese medicine 2024年

作者： WANG Bingyu JIN Fangfang GAO Jiawei YANG Liuxin ZHANG Yali YUAN Xingxing ZHANG Yang School of Graduate Studies，Heilongjiang University of chinese medicine Department of Gastroenterology， Heilongjiang Academy of traditional chinese medicine Department of Zhang Yali Senior traditional chinese medicine Expert Studio， Heilongjiang Academy of traditional chinese medicine Department of Gastroenterology， the First Affiliated hospital of Heilongjiang University of chinese medicine

OBJECTIVE: To evaluate the effects of acupuncture anesthesia on the consumption of sedatives and anesthetics， pain， and time consumption in patients undergoing colonoscopy， thus providing evidence that acupuncture anesthesia should be extended to endoscopists and ***: Four English and four chinese databases were searched for randomised controlled trials of acupuncture anaesthesia in patients undergoing colonoscopy， published from database inception to 1 March 2023. Outcomes were consumption of sedatives and anaesthetics， pain tolerance， visual analog scale(VAS) score， the meantime consumption of examination， satisfaction， and adverse reactions. RESULTS: Thirty-one randomized controlled trials with a total of 4790 participants were included. Results showed that acupuncture anaesthesia significantly reduced consumption of sedatives and anaesthetics[9 studies， n = 944， standardized mean difference (SMD)= -0.82， 95% CI(-1.31， -0.33)， P = 0.001]， VAS score [9 studies， n = 1790， mean difference (MD)= -1.13， 95% CI(-1.70， -0.57)， P＜0.001]， meantime consumption [21 studies， n= 3799， MD = -2.09， 95% CI(-3.15， -1.03)， P＜0.001]and adverse reactions of colonoscopy [7 studies， n = 738， odds ratio (OR) = 0.17， 95% CI (0.10， 0.28)， P＜0.001]. Acupuncture also significantly improved pain tolerance [14 studies， n= 1661， OR = 7.05， 95% CI(3.79， 13.12)， P＜0.001]， while no beneficial effects were found for satisfaction[7 studies， n = 843， SMD = 0.02， 95% CI(-0.38， 0.43)， P = 0.91]. CONCLUSION: Acupuncture has beneficial effects on patients undergoing colonoscopy， particularly in reducing consumption of sedatives and anaesthetics， alleviating pain， shorteningthe time consumption of examination and preventing adverse events. As an alternative， effective， inexpensive， and accessible approach， acupuncture anaesthesia should be extended to endoscopists and anaesthesiologists.

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Huangqin Decoction Delays Progress of Colitis-Associated Carcinogenesis by Regulating Nrf2/HO-1 Antioxidant Signal Pathwayin Mice

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chinese Journal of Integrative medicine 2024年第2期30卷 135-142页

作者： GU Li-mei LI He-zhong GAO Lei LI Hui WEI Lan-fu PAN Cheng-yu WU Ke-xuan TIAN Yao-zhou Department of Gastrointestinal Endoscopy Affiliated Hospital of Nanjing University of Chinese MedicineNanjing(210029)China Department of Gastroenterology Affiliated Hospital of Integrated Traditional Chinese and Western MedicineNanjing University of Chinese MedicineNanjing(210028)China School of Integrated chinese and Western medicine Nanjing University of Chinese MedicineNanjing(210023)China

Objective:To investigate the effect of Huangqin Decoction(HQD)on nuclear factor erythroid 2 related-factor 2(Nrf2)/heme oxygenase(HO-1)signaling pathway by inducing the colitis-associated carcinogenesis(CAC)model mice with azoxymethane(AOM)/dextran sodium sulfate(DSS).Methods:The chemical components of HQD were analyzed by liquid chromatography-quadrupole-time-of-flight mass spectrometry(LC-Q-TOF-MS/MS)to determine the molecular constituents of *** 48 C57BL/6J mice were randomly divided into 6 groups by a random number table,including control,model(AOM/DSS),mesalazine(MS),low-,medium-,and high-dose HQD(HQD-L,HQD-M,and HQD-H)groups,8 mice in each *** for the control group,the mice in the other groups were intraperitoneally injected with AOM(10 mg/kg)and administrated with 2.5%DSS orally for 1 week every two weeks(totally 3 rounds of DSS)to construct a colitis-associated carcinogenesis mouse *** mice in the HQD-L,HQD-M and HQD-H groups were given HQD by gavage at doses of 2.925,5.85,and 11.7 g/kg,respectively;the mice in the MS group was given a suspension of MS at a dose of 0.043 g/kg(totally 11 weeks).The serum levels of malondialdehyde(MDA)and superoxide dismutase(SOD)were measured by enzyme-linked immunosorbent *** mRNA and protein expression levels of Nrf2,HO-1,and inhibitory KELCH like ECH-related protein 1(Keap1)in colon tissue were detected by quantitative real-time PCR,immunohistochemistry,and Westem blot,***:LC-Q-TOF-MS/MS analysis revealed that the chemical constituents of HQD include baicalin,paeoniflorin,and glycyrrhizic *** to the control group,significantly higher MDA levels and lower SOD levels were observed in the model group(P<0.05),whereas the expressions of Nrf2 and HO-1 were significantly decreased,and the expression of Keap1 increased(P<0.01).Compared with the model group,serum MDA level was decreased and SOD level was increased in the HQD-M,HQD-H and MS groups(P<0.05).Higher expressions of

关键词： Huangqin Decoction colitis-associated carcinogenesis nuclear factor erythroid 2 related-factor 2/heme oxygenase signaling pathway oxidative stress chinese medicine

Causal role of immune cells in obstructive sleep apnea hypopnea syndrome:Mendelian randomization study

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World Journal of Clinical Cases 2024年第7期12卷 1227-1234页

作者： Huang-Hong Zhao Zhen Ma Dong-Sheng Guan Department of Encephalopathy Henan Provincial Hospital of Traditional Chinese MedicineZhengzhou 450000Henan ProvinceChina Department of Personnel The First Affiliated Hospital of Henan University of Traditional Chinese MedicineZhengzhou 450000Henan ProvinceChina Department of Neurology Henan Provincial Hospital of Traditional Chinese MedicineZhengzhou 450000Henan ProvinceChina

BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic *** immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies(GWAS)and genotyping techniques using highdensity genetic markers(e.g.,SNP or CNVs).But this tactic hasn't yet been applied to *** a Mendelian randomization analysis,we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of *** To investigate the immune cells'association with OSAHS via genetic methods,guiding future clinical *** A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and *** statistics for each immune cell feature were obtained from the GWAS *** on 731 immune cell properties,such as morphologic parameters,median fluorescence intensity,absolute cellular,and relative cellular,was compiled using publicly available genetic *** results'robustness,heterogeneity,and horizontal pleiotropy were confirmed using extensive sensitivity *** Following false discovery rate(FDR)correction,no statistically significant effect of OSAHS on immunophenotypes was ***,two lymphocyte subsets were found to have a significant association with the risk of OSAHS:Basophil%CD33dim HLA DR-CD66b-(OR=1.03,95%CI=1.01-1.03,P<0.001);CD38 on IgD+CD24-B cell(OR=1.04,95%CI=1.02-1.04,P=0.019).CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach,thus offering direction for potential future medical research.

关键词： Obstructive sleep apnea hypopnea syndrome Immunity Causal inference MR analysis Sensitivity

Promotion and Mechanism of Acupotomy on Chondrocyte Autophagy in Knee Osteoarthritis Rabbits

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chinese Journal of Integrative medicine 2024年第9期30卷 809-817页

作者： LU Man MENG De-hong SHE Ze-yu WU Xian XIA Shuai YANG Kai-ning LIU Cun-bin LI Tao YANG Yong-hui The First Affiliated hospital of Anhui University of chinese medicine Hefei230031China The Second Affiliated hospital of Anhui University of chinese medicine Hefei230038China Department of Acupotomy Rehabilitation Anhui Provincial Hospital of Integrated Traditional Chinese and Western MedicineHefei230031China

Objective:To explore the effect of acupotomy intervention on autophagy of chondrocytes in rabbits with knee osteoarthritis(KOA),and to determine the possible mechanisms of acupotomy to alleviate cartilage ***:The modified Videman method was used to construct a KOA rabbit *** modeling,40 rabbits were randomly divided into 4 groups by a random number table:control;KOA(model);KOA+acupotomy(acupotomy),and KOA+sham acupotomy(sham),10 in each *** a 3-week treatment course,the knee joint activity was determined by the modified Lequesne MG ***-eosin staining staining was used to examine the morphological changes of *** of chondrocytes was observed by transmission electron *** surface morphology of cartilage tissue was observed by scanning electron *** mRNA and protein levels of AMP kinase/mammalian target of rapamycin/Unc-51(AMPK/mTOR/ULK1)signal pathway key proteins,autophagy-related factor Beclin-1 and microtubule-associated protein 1A/1B light chain 3(LC3)in rabbit knee cartilage were assessed by real-time fluorescence quantitative polymerase chain reaction and Western blot,***:The modified Lequesne MG score of acupotomy group was significantly lower than that of model group(P<0.05).Pathological results showed that chondrocyte autophagy decreased and cartilage surface was rough in the model group,which recovered after acupotomy *** mRNA expressions of AMPK,ULK1,Beclin-1 and the protein levels of p-AMPK,p-ULK1,Beclin-1,and LC3Ⅱ/LC3Ⅰwere decreased in the model group,while the mRNA and protein expressions of mTOR were increased(P<0.01).However,acupotomy treatment reversed these abnormal changes(P<0.05).Conclusions:Acupotomy could effectively up-regulate the expressions of AMPK,ULK1 and Beclin1,reduce the expression of mTOR,promote autophagy,and alleviate joint *** is a promising complementary and alternative therapy for KOA.

关键词： acupotomy knee asteoarthritis autophagy AMPK/mTOR/ULK1 signaling pathway rabbit

Kuicolong-yu enema decoction retains traditional chinese medicine enema attenuates inflammatory response ulcerative colitis through TLR4/NF-κB signaling pathway

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1149-1154页

作者： Li Han Kun Tang Xiao-Li Fang Jing-Xi Xu Xi-Yun Mao Ming Li Department of Anorectal Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Anhui HospitalHefei 230001Anhui ProvinceChina Anorectal Center The First Affiliated Hospital of Anhui University of Traditional Chinese MedicineHefei 230001Anhui ProvinceChina Department of Spleen and Stomach Diseases Department of GastroenterologyAffiliated Wuhu Hospital of Traditional Chinese Medicine of Anhui College of Traditional Chinese MedicineWuhu 241000Anhui ProvinceChina

BACKGROUND Ulcer colitis(UC)is a chronic,nonspecific,and noninfectious inflammatory bowel ***,Toll-like receptors(TLRs)have been found to be closely associated with clinical inflammatory *** complete remission in patients with intermittent periods of activity followed by dormancy is ***,no study has explored the mechanism by which Kuicolong-yu enema decoction retains traditional chinese medicine enemas to attenuate the inflammatory response in *** To explore the mechanism by which Kuicolong-yu enema decoction retains traditional chinese medicine enemas to attenuate the inflammatory response in *** This prospective clinical study included patients who met the exclusion criteria in 2020 and *** patients with UC were divided into two groups(control and experimental).The peripheral blood of the experimental and control groups were collected under aseptic *** expression of TLR4 protein,NF-κB,IL-6,and IL-17 was detected in the peripheral blood of patients in the experimental group and control group before and 1 month after taking the *** co rrelation analysis was used to analyze the relationship between the expression level of TLR4 protein and the expression levels of downstream signal NF-κB and inflammatory factors IL-6 and IL-17,and P<0.05 was considered statistically *** There were no significant differences in the patient characteristics between the control and experimental *** results showed that the expression levels of TLR4 and NF-κB in the experimental group were significantly lower than those in the control group(P<0.05).The levels of IL-6 and IL-17 in the experimental group were significantly lower than those in the control group(P<0.05).The TLR4 protein expression in the experimental group was positively correlated with the expression level of downstream signal NF-κB and was positively correlated with the levels of downstream inflammatory cytokines IL-6 and IL-

关键词： Ulcerative colitis TLR4 NF-κB signaling pathway Kuicolong-yu enema