Treatment based on syndrome differentiation, as a core of diagnostic and treatment methods in traditional Chinese medicine, now appears to be limited by some of its shortages during the high-speed development of medicine, such as no symptoms for differentiation in some patients, lack of objective standardization and pertinence, and limitations of the four diagnostic methods, etc. Combination of syndrome differentiation and disease differentiation can not only make up the shortages of syndrome differentiation but also expand the scope of diseases treated with traditional Chinese medicine and promote the modernization of traditional Chinese medicine. The author discusses the limitations of treatment based on syndrome differentiation as well as the advantages of combining syndrome differentiation with disease differentiation. It is also stated that this combination can make the system of syndrome differentiation perfect.

This paper has made a distinction between the materialist concept of qi on the medical philosophical level and its substantial existence, and illustrated the materiality and multiplicity of qi. Materiality refers to the objective reality, a summation of various things or phenomena related to humanbeings; while multiplicity refers to diversity of specific substances, each holding its individual essence. Based on two essential conceptions “xiang” and “xiangji”, and combining the theories of traditional Chinese medicine and Western medicine, this paper has also made a preliminary study on the substantial existence of qi at macro- and micro-levels, and on physiological (normal) and pathological (abnormal) aspects. It is the author’s argument that studies of the substantial existence of qi from different aspects, micro-dimension in particular, will push the syndrome differentiation of traditional Chinese medicine to a more subtle sphere.

Molecular immunologic technique gets quick development in recent years, especially the fast development of the immuno-labelling technique, which founds its indispensable status in the study of traditional Chinese medicine (TCM). With the development of the study of TCM, medical immunology connecting TCM with the Western medicine has become one of the most indispensable conjunctive subjects. Scientists can study the theories and prevention or treatment mechanisms of TCM not only at holistic and cell levels, but also at molecular and gene levels. Appropriate application of the molecular immunologic techniques according to their characteristics will play an important role in the study of Chinese integrative medicine.

Objective

To work out a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer.

Methods

Based on the collection and analysis of related medical literature, clinical investigation, and experts’ discussion, a preliminary qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer was formulated. Then it was used in clinic to be verified and revised repeatedly till it was improved to be a satisfied formal criterion.

Results

The basic syndromes listed in the qualitative diagnostic criterion for basic syndromes in patients with primary liver cancer consisted of two parts: excessive syndromes, including the syndromes of stagnation of qi, blood stasis, excess-heat and dampness, and deficient syndromes, including the syndromes of deficiency of qi, deficiency of blood, deficiency of yin and deficiency of yang. Each of the above syndromes could be diagnosed according to specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio was 73.92% between the diagnoses made according to the criterion and the diagnoses acquired from the experts’ experience.

Conclusions

The qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer is coincident with the experts’ clinical practice. However, it needs to be further studied.

Objective

To observe the effect of ginsenosides (GS) and low dose glucocorticoid in preventing and treating the postembolization syndrome following transcatheter arterial chemoembolization (TACE).

Methods

Eighty patients with primary liver carcinoma were randomly divided into 4 double-blinded groups, with 20 patients in each group. Patients in groups A, B, C, D were treated with placebo, dexamethasone (Dex), GS, Dex and GS, respectively. The changes of clinical symptoms and laboratory tests after TACE were observed.

Results

Dex combined with GS markedly decreased the occurrence ratio and lasting time of the symptoms such as nausea, vomiting, fever and pain, and protected the function of liver as compared with the placebo (P<0.05). Single use of Dex or GS improved some symptoms as compared with the placebo, but it was not as good as the combination of Dex and GS.

Conclusion

ex combined with GS can effectively prevent and treat the postembolization syndrome following TACE.

Objective

To evaluate the immuno-modulatory effect of short course administration of somatostatin (stilamin) continuously at early stage in patients with severe acute pancreatitis (SAP).

Methods

Thirty-nine patients with SAP (22 men, 17 women; the middle age was 49 years)were randomly allocated into control group (20 patients treated with non-surgical integrated traditional Chinese and Western medicine) and treatment group (19 patients treated with somatostatin administered intravenously at a dosage of 250 μg/h for consecutive 72 hours as well as the treatment for the control group). Laboratory parameters, including the expressions of CD3, CD4 and CD8 in lymphocytes (tested by flow cytometry) and C reactive protein (CRP), and indexes of therapeutic effect, including the occurrence of organic dysfunction, local complication and mortality between the two groups were compared. Another group of 30 healthy volunteers (19 men, 11 women; the middle age was 47 years) were recruited for testing the normal levels of CD3, CD4 and CD8.

Results

(1) The levels of CD3, CD4 and CD4/CD8 in lymphocytes before treatment in both groups were significantly lower than those in the healthy subjects (P<0.05), but there were no statistical differences between the two groups. At the 4th day, CD3, CD4 and CD4/CD8 increased significantly in the treatment group (P< 0.05) while no changes in the control group; the levels of CD4 and CD4/CD8 in the treatment group were also higher than those in the control group (P< 0.05). (2) The CRP levels of the 2 groups showed no statistical difference before and 4 days after the treatment, but the CRP level in the treatment group was significantly lower than that in the control group at the 7th day (P< 0.05). WBC count, serum levels of amylase, lipase, lactate dehydrogenase, aspartate aminotransferase, as well as the score of APACHE II in the treatment group recovered more quickly than those in the control group (P<0.05). (3) The occurrences of organic dysfunctions, local complications and mortality in both groups were not statistically different.

Conclusion

The short course administration of somatostatin continuously at early stage can reduce the inflammatory response, up-regulate the cell immune function and improve the conditions of the patients with SAP, but its effect on mortality and morbidity needs further study.

Objective

To investigate the clinical effectiveness of Toubiao Qingfei (expelling exterior evil and clearing lung) Decoction (TBQFD) on wind-warm and pulmonary heat syndrome.

Methods

Forty-six subjects were randomized into treatment group and control group. Patients in the control group were treated with Western medicines, while patients in the treatment group were treated with Western medicines and TBQFD. The therapeutic effects and improvement of symptoms in both groups were observed.

Results

The durations of fever, cough and absorption of pulmonary inflammatory focus in the treatment group were 1.52, 3.52 and 6.25 days respectively, which were significantly shorter than those in the control group (P<0.05).

Conclusion

TBQFD can improve the symptoms, such as fever and cough, and can promote the absorption of infection and shorten the clinical course of wind-warm and pulmonary heat syndrome.

Objective

To study the effects of Yiqi Huayu Recipe on the gene expression pattern in normal and apoptotic chondrocytes in the cervical intervertebral disc of rats.

Methods

The intervertebral disc endplates of rats were digested enzymatically. The apoptosis of the chondrocytes was induced by anti-Fas antibody. BiostarR-40s microarray chips were used to investigate the gene expression pattern in chondrocytes in the normal control, apoptosis and Yiqi Huayu Recipe groups. The results were scanned with Scan Array 4000 and analyzed with GenePix Pro 3.0, and then subjected to standardization and ratio analysis.

Results

In the apoptosis group, 30 kinds of genes expressed in cervical intervertebral disc chondrocytes were screened out, in which 10 were up-regulated (ratio>2) and 20 down-regulated (ratio<0.5) as compared with the normal control group. On the other hand, in the Yiqi Huayu Recipe group, 97 kinds of genes expressed in cervical intervertebral disc chondrocytes were screened out, in which 44 were up-regulated (ratio>2) and 53 down-regulated (ratio<0.5) as compared with the apoptosis group.

Conclusion

There are some signal transduction pathways that control the apoptosis of the intervertebral disc chondrocytes. Yiqi Huayu Recipe regulates the gene express of the apoptotic chondrocytes in intervertebral disc. The study gives a further understanding to the mechanism of the cervical spondylosis and enriches the theories of qi and blood of traditional Chinese medicine.

Objective

To investigate the effect of Niupo Zhibao Pellet (NPZBP) on the expression of neuronal nitric oxide synthase (nNOS) in the brain of endotoxin-induced shock rats.

Methods

SD rats were randomly divided into normal control group, endotoxin-induced shock model group and NPZBP-treated group. Lipopolysaccharide (LPS) (1.5 mg/kg i.v.) and D-galactosamine (D-GalN) (100 mg/kg i.p.) were administered to the rats in endotoxin-induced shock model group, as well as to the rats in NPZBP-treated group after seven-day treatment, to induce the shock. The expression of nNOS in the brain of the rats in each of the 3 groups was measured by immunohistochemical methods.

Results

In the 3 groups, nNOS immuno-positive cells distributed widely in layer Ⅱ, Ⅲ, Ⅳ of the cerebral cortex, the molecular layer of hippocampus, the polymorphic layer of the dentate gyrus, the reticular formation of brain stem, and the molecular, granular and Purkinje cell layer of the cerebellar cortex. The number of immuno-positive cells in the NPZBP-treated group was slightly higher than that of the normal control group, and signifficantly lower than that of the model group (P<0.05) in many regions of the brain, including cerebral cortex, hippocampus, brain stem and cerebellar cortex.

Conclusion

NPZBP can inhibit the over-expression of nNOS in wide area of the brain in endotoxin-induced shock rats.

Objective

To study the role of nuclear factor-kappa B (NF-κB) and cycloxygenase-2 (COX-2) in the onset of phlegm obstruction due to lung-deficiency in rats and the therapeutic mechanism of Huatan Recipe.

Methods

Twenty-four SD rats were randomly divided into normal group, model group and treatment group, with 8 rats in each group. The rats in the model group and treatment group were exposed to sulfur dioxide and cold wind to establish the rat model of phlegm obstruction due to lung-deficiency, and the rats in the treatment group were also treated with Huatan Recipe, a compound traditional Chinese medicine. The expression of NF-κB in the bronchial epithelial cells of the rats was tested with the method of immunohistochemistry, and the COX-2 mRNA in the lung tissues of the rats was measured by using reverse transcription-polymerase chain reaction.

Results

The expressions of NF-κB and COX-2 mRNA in rats of the model group were higher than those of the normal group (P<0.01), and the expressions of NF-κB and COX-2 mRNA in rats of the treatment group were obviously lower than those of the model group (P<0.01).

Conclusion

The NF-κB and COX-2 play an important role in the onset of phlegm obstruction in rats. Huatan Recipe may prevent the development of phlegm obstruction by down-regulating the expressions of NF-κB and COX-2 mRNA.

Objective

To study the apoptosis-promoting effect of the serum from Panax notoginseng extracts-fed dog on precancerous gastric cells by means of flow cytometry.

Methods

In the experiment, we adopted eternalized human gastric mucosa epithelium GES-1 cells transformed by N-methyl-N’-nitro-N-nitroso-guanidine (MNNG) (MC cells) as the model of precancerous lesions for study in vitro. We took the serum of a dog before and at two different points of time (2 and 6 hours) after feeding the dog with Panax notoginseng extracts for experiment. The MC cells were cultured in mediums with different concentrations of the medicated serum at 2- or 6-hour point of time for 72 hours. By means of flow cytometry, we examined the apoptosis-promoting effects of the serums on the MC cells.

Results

The medicated serums at these 2 points of time had significant effects in promoting MC cell apoptosis. The proportions of apoptotic cells in culture mediums with medicated serums had a significant increase as compared with those in culture mediums with non-medicated serums (serum obtained before administration of extracts to the dog) under the same conditions (P<0.05). The number of MC cells in G₀/G₁ phase was decreased (P<0.05) and that in G₂/M phase increased (P<0.05), while no consistent changes were observed in S phase.

Conclusion

The medicated serums obtained at the two different points of time have significant apoptosis-promoting effects on MC cells. They decrease the number of MC cells in G₀/G₁ phase and increase the number of MC cells in G₂/M phase. This is probably responsible for the effects of Panax notoginseng extracts in inhibiting the proliferation of MC cells and promoting its apoptosis.

Objective

To investigate the effects of low-level laser irradiation on acupuncture points combined with iontophoresis against brain damage after middle cerebral artery occlusion (MCAO) in rats.

Methods

Sixty-nine SD rats were randomly divided into five groups, including normal group, sham operation group, model group, electro-acupuncture group and low-level laser irradiation on acupuncture points combined with iontophoresis group (LLLI group). The cerebral ischemia-reperfusion (I/R) model was established by thread embolism of middle cerebral artery. The rats in the LLLI group, as well as the electro-acupuncture group were given treatment as soon as the occlusion finished (0 hour) and 12, 24 hours after the occlusion. We observed the changes of neurological deficit scores and the body weight of the rats at different time. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in the rat’s brain tissue were tested.

Results

The neurological deficit score of the LLLI group was significantly lower than that of the model group. The body weight and the activity of SOD of the rats decreased slightly, and the content of MDA decreased significantly after the treatment.

Conclusion

The low-level laser irradiation on acupuncture points combined with iontophoresis can prevent focal cerebral ischemia-reperfusion injury. One of its mechanisms may be increasing the activity of SOD and decreasing the damage of the oxidation products to the body.

Objective

To study the therapeutic effect of Bushen Rougan Recipe (BSRGR) on hepatic fibrosis in rats.

Methods

Forty male Wistar rats were randomly divided into normal control group (n=10), model group (n=15), and BSRGR-treated group (n=15). Rats in the model and BSRGR-treated groups were administered intraperitoneally with 0.5% dimethylnitrosamine (DMN),10 ml·kg ^-1·d ^-1 , successive 3 days per week for 4 weeks to induce hepatic fibrosis. Then rats in the above 2 groups were given normal saline and BSRGR (10 ml·kg ^-1·d ^-1, ig) for another 4 weeks, respectively. Rats in the 3 groups were all executed at the end of the 8th week. The serum total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (A) and globulin (G) were determined and the serum hyaluronic acid (HA), laminin (LN) and collagen Ⅳ (Ⅳ-C) were measured. 

Results

The rat model of liver fibrosis was successfully induced by DMN. It was found that the serum TBIL, AST and ALT and the liver fibrosis marks were declined in BSRGR-treated group as compared with those in the model group (P<0.01). The content of total serum protein and the A/G in BSRGR-treated group were both increased as compared with those in the model group (P<0.05).

Conclusion

BSRGR can be used to treat hepatic fibrosis in rats.

Objective

To establish a staging standard for a transplanted hepatoma model in rats, which may be equivalent to the human primary liver cancer.

Methods

A transplanted hepatoma model was made in SD rats by implantation of histologically intact Walker-256 tumor fragment into the left lateral lobe of the liver. The body weight, tumor volume and serum albumin level of the rats were measured and assayed in different periods. Pathological sections were also fabricated to detect the invasion and metastasis of the neighboring tissues.

Results

The body weight loss and ascites occurred at the 12th and 18th day separately. The serum albumin level was (35.32±2.45) g/L at the 11th day, which showed no statistical difference as compared with the healthy rats (P>0.05), and the albumin level at the 18th day was significantly lower than that at the 11th day (P<0.05). At the 23rd day, 56.25％ of the rats developed bloody ascites.

Conclusion

The period between 5-11 days in the model rats may be correspondent to the early stage of human primary liver cancer, and the biological behavior of the model rats at the18th day may be correspondent to the late stage of human primary liver cancer. This staging standard might be the guideline for model selection in experimental study of primary liver cancer.

The problem on study of the active and toxic constituents of Chinese materia medica is the core of the problems in the field of modern research of Chinese materia medica. But approved methods for ascertaining the active and toxic constituents in Chinese materia medica have not been developed yet and are in developing phases. In combination with the characteristics of Chinese materia medica in clinical use and the achievements of modern pharmaceutical research, series model may be a finer approach to make certain of the active and toxic constituents from Chinese materia medica, which includes the parent compound biotransformation by human intestinal bacteria to make biotransformation products, and the absorption and further biotransformation in intestinal wall, the metabolization in the liver, and the secretion by the kidney of the parent compounds and biotransformation products. This method is also an important research assignment in the field of experimental medicine study of Chinese materia medica.