最新刊期
      卷 45 ， 期 10 ， 2022

        Special Theme: Clinical Practice of TCM Pharmacovigilance

      • SHI Lin,ZHANG Bing
        Vol. 45, Issue 10, Pages: 973-978(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.001
        摘要：Medication safety has been drawing much attention from medical staff and the public as drug therapy still prevails nowadays. However, the increasing demand of medication safety failed to be met due to problems such as the shortage of specialists and insufficient approaches. To further achieve the efficacy and safety of drug therapy, a medication safety strategy of "clinical medication notice" mechanism was proposed innovatively based on the academic idea of medicine and medication synergy. Clinical practice has proved it effective to improve medication safety. The present study systematically introduces the medication safety strategy, including its theories, contents, and method. Specifically, the strategy aims to bridge the gap between clinical medicine and medication administration. With its roots deep in medicine and medication in traditional Chinese medicine (TCM), it integrates the TCM theory of properties with modern pharmacovigilance. In addition to guiding medication, the strategy combines knowledge of diseases, characteristics of drugs, administration, safety information, lifestyle modification, and medication monitoring from the prospective of medicine and medication synergy with patients as the center. After decades of clinical practice, the pathways and approaches of clinical medication notice have been gradually improved with clinical standardization formed, which will improve medication compliance, reduce adverse drug events, promote rational medication, and ensue clinical efficacy.  
        关键词：medicine and pharmacy synergy;medication safety strategy;clinical medicine notice;traditional Chinese meteria medica   
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      • ZHANG Bing,WU Hao,ZHANG Xiaomeng,LIN Zhijian
        Vol. 45, Issue 10, Pages: 979-984(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.002
        摘要：The "warnings" section in medicine instructions is an important part that all national drug regulatory agencies use to ensure drug safety. This paper sorted out 12 laws, regulations and guidelines related to the "warnings" of drug instructions in 6 representative countries in Europe, America, Oceania, and Asia, and compared their expression and format requirements to provide reference for the improvement of the "warning" terms in the instructions of Chinese patent medicines. Technical Specification for Revision of Safety Information in the Marketed Chinese Patent Medicine Instructions-Warnings (T/CACM 1370.6-2021) provided enlightenment for revising and improving the instructions in terms of the problems such as incomplete labelling of the "warnings" . We explored the strategy of clinical pharmaceutical service based on "warning" terms, and proposed to carry out the whole process of clinical pharmaceutical service based on the principles of "monitoring, follow-up research, and international reference" , and provide the most direct medication guidance for physicians, pharmacists, nurses, and patients to ensure the safe and rational medication in clinical practices, and to improve the quality of clinical pharmaceutical care.  
        关键词：Chinese patent medicine instructions;warnings;pharmaceutical care   
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      • LIN Zhijian,HUANG Zhengkai,ZHANG Xiaomeng,ZHANG Bing
        Vol. 45, Issue 10, Pages: 985-989(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.003
        摘要：The section of "adverse drug reactions" in Chinese patent medicine instructions contains the critical information of the potential risk of Chinese patent medicine, which can provide strong guidance for safe and rational application of Chinese patent medicine. This paper is derived from the Technical Specifications for Revising Safe Information Items in the Marketed Chinese Patent Medicine Instructions-Adverse Drug Reaction (T/CACM 1370.2-2021)of China Association of Chinese Medicine. The section of "adverse drug reactions" can be improved by expanding the information source of adverse reactions of Chinese patent medicine, following up the information of adverse reactions and standardizing the writing form in view of lack of content, untimely updates and vague statements. The pharmaceutical care of Chinese patent medicine should follow the principles of "theoretical guidance of traditional Chinese medicine" and "rational drug use" , which refers to a pharmaceutical care path focusing on the prevention of adverse reactions, and carrying out risk monitoring, assessment, prevention, and treatment with Chinese patent medicine. The improvement of the section of the "adverse drug reactions" in Chinese patent medicine instructions and the strategics of providing clinical pharmaceutical care is conducive to the clinical use of Chinese patent medicine and thus improves the safety of Chinese patent medicine.  
        关键词：Chinese patent medicine instructions;adverse drug reactions;pharmaceutical care   
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      • ZHANG Bing,LI Yaolei,ZHANG Xiaomeng,LIN Zhijian
        Vol. 45, Issue 10, Pages: 990-993(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.004
        摘要：The "contraindication" section in the instructions of Chinese patent medicine is crucial in guiding pharmaceutical care and rational clinical use of medicines. This paper was derived from Technical Specification for Revision of Safety Information of Listed Proprietary Chinese patent medicines (T/CACM 1370.3-2021). After systematically combing the contents of "contraindications" in the instructions of Chinese patent medicine, we found that there are problems such as lack of information, unclear scope, and inconsistent expressions of the same varieties. We then advised on how to improve "contraindications" in the instructions of Chinese patent medicine based on expert interview, demonstration and analysis, on the basis of which we explored the strategies for improving clinical pharmaceutical services. The strategies are based on the principle of combining tradition and modernity, and include the discovery, avoidance, and application of contraindications with doctors, pharmacists, patients and their families, and pharmaceutical marketing authorization holders as the main subjects to guide and improve the development of pharmaceutical care. The improved pharmaceutical care strategy based on the "contraindication" in the instructions of Chinese patent medicine embodies inheritance and innovation of Chinese patent medicine use in the actual clinical use, and promotes the rational clinical medication.  
        关键词：Chinese patent medicine instructions;contraindications;pharmaceutical care   
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      • SA Ri′na,ZHANG Xiaomeng,ZHANG Bing,LIN Zhijian,XU Huizhe
        Vol. 45, Issue 10, Pages: 994-998(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.005
        摘要：A complete set of precautions in Chinese patent medicine (CPM) instructions is an important reference for physicians to select and use medicines. It also provides solid support for pharmacists to provide comprehensive pharmaceutical care, including counseling and monitoring of drug use, medication education, medication reconciliation, prescription review, and other activities that can help patients use medications safely and sensibly. By researching the item of precautions in CPM instructions and taking into account the association standard of Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions-Precautions (T/CACM 1370.4-2021), it was found that there were problems such as a lack of precautions and limited implications for the clinical use of medications. By combining the result of expert interviews and questionnaires, this paper presented the strategies for clinical pharmaceutical care based on the improvement of precautions in CPM instructions from three factors affecting medication safety, including medicines, patients, and clinical use of medications. The strategies follow the principle of "adopting traditional Chinese medicine theories throughout the entire process" , take the subjects of pharmaceutical care as the objects, and suggest various routes for implementing different pharmaceutical services based on the precautions in CPM instructions to create the contents of pharmaceutical care. Establishing strategies for clinical pharmaceutical care based on improving precautions in CPM instructions could enhance pharmaceutical services and promote rational use of medications.  
        关键词：Chinese patent medicine instructions;precautions;pharmaceutical care   
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      • ZHANG Bing,LYU Jintao,ZHANG Xiaomeng,LIN Zhijian
        Vol. 45, Issue 10, Pages: 999-1004(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.006
        摘要：The information on the application for special populations in Chinese patent medicine (CPM) instructions provides a direct reference for the clinical implementation of pharmaceutical care for special populations. This paper was inspired by the Technical Specifications for Revision of Safety Information in Marketed Chinese Patent Medicine Instructions-Application for Special Populations (T/CACM 1370.5-2021), an association standard released by the China Association of Chinese Medicine. The ideas for improving the instructions were put forward, aiming at the major problems in the application for special populations in CPM instructions, including missing or incomplete information, ambiguous definitions, and limited implications. In the light of physiological and pathological characteristics and the properties of drugs in special populations, the strategies for clinical pharmaceutical care of special populations were proposed. The principle of "targeted information, subdivided content, and personalized service" should be followed to implement special population-based pharmaceutical care, including the introduction of pharmaceutical characteristics, risk assessment, medication formulation or reconciliation, pharmaceutical monitoring and medication education, which will promote rational use of medications and reduce medication risks in special populations.  
        关键词：Chinese patent medicine instructions;application for special populations;pharmaceutical care   
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        发布时间：2022-11-04

        Prestigious Forum

      • WANG Linyuan
        Vol. 45, Issue 10, Pages: 1005-1017(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.007
        摘要：The emergence of foreign-introducing traditional Chinese medicinals (FITCM) or exotic Chinese medicinals is of historical inevitability in the development of traditional Chinese medicine (TCM). It has become a new field and development direction in the TCM discipline construction under the new situation, and an indispensable part of traditional Chinese medicine. With the deepening of reform and opening up policy, the implementation of the " Belt and Road" initiative and the development of China's economy, its role has become more and more important. The development of FITCM is a practical process of the inheritance and innovation of traditional Chinese medicine theory. Through combing the historical development, it is shown that the key to the research of new FITCM is to endow exotic traditional medicinals with TCM properties. This paper has defined the concept and research content of FITCM, summarized the steps and method of the research on the medicinal properties of FITCM, expounded the " four steps" to explore the medicinal properties of FITCM, constructed the new research paradigm of FITCM, summarized the development status and the current catalogue of new FITCM. This paper also discusses the position and role of FITCM in the construction of traditional Chinese medicine from five aspects: the new direction of discipline development, the new platform of innovative development, the new measures of talent training, the new impetus of social development and the new approaches to international exchange. The research and development of FITCM will inevitably become the new impetus and highlight of the development of traditional Chinese medicine.  
        关键词：foreign-introducing traditional Chinese medicinals;foreign medicinal plant resources;properties of traditional Chinese medicine;the Belt and Road initiative;discipline of Chinese materia medica;discipline construction   
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        Expert Commentaries

      • LIU Cunzhi
        Vol. 45, Issue 10, Pages: 1018-1023(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.008
        摘要：As a representative external therapy of traditional Chinese medicine, acupuncture is considered a valuable treasure with a history of thousands of years and it has been playing an important role in the process of disease prevention and treatment. In this paper, advices was given in order to improve the reliability of clinical evidence of acupuncture. The author summarized existing contradictions and issues by reviewing the status quo of evidence of acupuncture clinical trials. With the expansion of acupuncture disease spectrum, and emerging of high-quality clinical trials, promoting acupuncture clinical research evidence reliability would serve as the breakthrough point. Currently reliability of evidence in acupuncture clinical research has gained increasing international recognition. However, there remains room for improvement in the setting of sham acupuncture standard, attainment of practical evidence, and translation studies of clinical research result. In the future, it is advised to standardize sham acupuncture, achieve international consensus on operating standards, strengthen real world studies, as well as translate clinical trials result of acupuncture from multiple disciplinary perspectives, to further improve the influence of acupuncture in the process of internationalization.  
        关键词：acupuncture;clinical application;clinical evidence;research review;sham acupuncture   
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        Theoretical Studies

      • WANG Yongyan,LIAO Xing,WANG Zhong
        Vol. 45, Issue 10, Pages: 1024-1028(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.009
        摘要：Qi and qi transformation are the essence of the principles in traditional Chinese medicine (TCM). TCM takes 'qi’ as the origin of everything and the combination of 'zhen qi (genuine qi)’ and 'ling qi (spiritual qi)’ as the vitality of the human body, which is the expression of the natural connection between physical and mental health. It also takes 'chong qi (clashing qi)’ as harmony and dialectical unity in clinical practice. Qi is Xiang (manifestation), a kind of systematic information. Qi should be understood based on its original creativity and the original Xiang of Taixu (the great void). This paper theoretically explored qi from different dimensions: the interpretation and extension of the essence of qi, the treatment of physical and mental diseases with emphasis on qi regulation, and the way to maintain health by paying attention to the harmony between the genuine qi and spiritual qi. In particular, this paper expounded in detail the key points of diagnosis and treatment of the five zang organs injured by abnormal emotions and the regulation of emotional diseases with emphasis on treating the liver and unblocking the qi movement, aiming to provide a reference for TCM clinicians and researchers to fully understand the theory and application value of qi.  
        关键词：qi;qi movement;qi transformation;diagnosis and treatment   
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        TCM Pharmacology

      • YANG Luping,SUN Hongmei,GAI Cong,CHENG Cuicui,WANG Xu,MA Haojie,ZHANG Yuxin,ZHANG Jinkun
        Vol. 45, Issue 10, Pages: 1029-1036(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.010
        摘要：ObjectiveTo establish a rat model of ischemic stroke with the pattern of qi deficiency and blood stasis to observe the effects of Buyang Huanwu Tang (Yang-Supplementing and Five-Returning Decoction, BYHWT) and its disassembled prescription on cerebral blood flow and lipid metabolism in rats with ischemic stroke of qi deficiency and blood stasis pattern and explore the mechanism of compound prescriptions of traditional Chinese medicine.MethodsThe model of qi deficiency and blood stasis pattern was simulated by multiple factors. Then the rat model of ischemic stroke was prepared using the suture-occluded method. Male SD rats were randomly divided into normal group, model group, Buqi (supplementing qi, BQ) group (10.8 g/kg), Huoxue (circulating blood, HX) group (2.2 g/kg), BYHWT group (13.1 g/kg) and simvastatin (SV) group (10 mg/kg). Each treatment group was given the corresponding medication via gavage, and the normal and model groups were given the equal amounts of distilled water. After continuous intragastric administration for seven days, the samples were collected and the indexes were tested. Qi deficiency pattern, blood stasis pattern and neurological function score were used to evaluate the success of the combined model of disease and pattern. The cerebral blood flow was evaluated by a laser speckle flow imaging system. Blood cholesterol (CHO), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were detected by an automatic biochemical analyzer. The expression of adenosine monophosphate-activated protein kinase (AMPK) and phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK) in brain tissue was observed by Western blotting.ResultsCompared with the normal group, the cerebral blood flow ratio and the HDL-C level were decreased (P<0.05); the CHO, TG and LDL-C levels were increased (P<0.01); the protein expression of AMPK and p-AMPK was decreased (P<0.01) in the model group. After seven days of the administration, compared with the model group, qi-deficiency pattern, blood stasis pattern and neurological function scores in the BYHWT group and BQ group were decreased (P<0.05). The cerebral blood flow ratio and the protein expression of AMPK and p-AMPK were increased (P<0.01) while the TG level decreased (P<0.01) in all treatment groups. The HDL-C level was increased (P<0.05) while the CHO and the LDL-C levels decreased (P<0.05 or P<0.01) in the BYHWT group and SV group. The p-AMPK/AMPK ratio was increased (P<0.05) in the BYHWT, BQ, and SV groups.ConclusionBYHWT may prevent and treat ischemic stroke with the pattern of qi deficiency and blood stasis by improving lipid metabolism and regulating cerebral blood flow. The qi supplementing and blood circulating medicinals in the formula seems to have synergistic effects.  
        关键词：Buyang Huanwu Decoction;divided formula;ischemic stroke;qi deficiency and blood stasis pattern;cerebral blood flow;lipid metabolism;rats   
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      • LOU Pengfei,QIAO Jiajun,WANG Yuezhu,XIA Zhongyuan
        Vol. 45, Issue 10, Pages: 1037-1043(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.011
        摘要：ObjectiveTo observe the effects of Buzhong Yiqi Tang (Center-supplementing and Qi-boosting Decoction, BZYQT) on thyroid antibody, Th-related cytokines and histopathological morphology of experimental autoimmune thyroiditis (EAT) model rats.MethodsThe EAT rat model was replicated using a mixed immunoinjection method of pig thyroglobulin and Fredrin's adjuvant combined with high iodine feeding method, and the rats were randomly divided into the model group, selenium yeast group, BZYQT group, and blank group, with nine rats in each group. Selenium yeast group was given selenium yeast (20.67 μg/kg), while BZYQT group was given Buzhong Yiqi Granules (0.93 g/kg), and the blank and model groups were given equal volums of drinking water. After 56 days of the intervention, free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), thyroperoxidase antibody (TPOAb), thyroglobulin antibody (TGAb), interleukin-4 (IL-4), interleukin-38 (IL-38), interferon-γ (IFN-γ) were detected in the peripheral blood of rats by enzyme-linked immunosorbent (ELISA) determination, and the histopathological changes of rat thyroid were observed under light microscope by HE staining.ResultsCompared with the blank group, FT3, FT4, T3, T4, TPOAb, TGAb, IFN-γ and IFN-γ/IL-4 increased (P<0.05), while IL-4 and IL-38 decreased (P<0.05), and a large number of lymphocytes were infiltrated in thyroid tissue in the model group. Compared with the model group, FT3, FT4, T3, T4, TGAb, TPOAb, IFN-γ and IFN-γ/IL-4 in BZYQT group and selenium yeast group decreased (P<0.05), while IL-4 and IL-38 increased (P<0.05). Compared with selenium yeast group, TGAb and TPOAb in BZYQT group decreased (P<0.05). Under light microscope, the degree of lymphocyte infiltration in the thyroid tissue of rats in the two groups significantly reduced compared with that in the model group, and the improvement of infiltration in the BZYQT group was better than that in the selenium yeast group.ConclusionBZYQT can improve the thyroid function of EAT rats by regulating the autoimmune function, reduce the levels of TGAb and TPOAb, and alleviate the lymphocyte infiltration in thyroid tissues. Both selenium yeast and BZYQD can improve EAT by regulating Th1/Th2 balance and IL-38 level, and the effect of BZYQD is slightly better than that of selenium yeast.  
        关键词：Buzhong Yiqi Tang;experimental autoimmune thyroiditis;thyroid antibodies;Th cytokines;pathological morphology;rats   
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      • LIU Shuangqiao,LI Li,SHAO Zixuan,GAO Jing,JIA Lan,LIU Jiaqi,HU Jinxi,WANG Jingxia
        Vol. 45, Issue 10, Pages: 1044-1051(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.012
        摘要：ObjectiveTo investigate the effect of Complanatoside A on triglyceride (TG) transport pathway regulated by hepatocyte nuclear factor 4α (HNF4α) in steatotic L02 cells during lipid metabolism.MethodsL02 cells were cultured in vitro, and 1 mmol/L free fatty acid (FFA) was prepared with a ratio of sodium oleate: sodium palmitate=2∶1, and a cellular steatosis model was established after 24 h of intervention in L02 cells. The experiment included the blank group, model group (0 μmol/L), low mass concentration group of Complanatoside A (25 μmol/L), middle mass concentration group of Complanatoside A (50 μmol/L) and high mass concentration group of Complanatoside A (100 μmol/L). After the cells were cultured for 24 h, the blank group was cultured for 48 h in high glucose DMEM medium (complete medium) containing 10% fetal bovine serum; the model group was cultured in complete medium for 24 h, and then cultured for 24 h in complete medium containing 1 mmol/L FFA; each mass concentration group of Complanatoside A was pretreated with the corresponding concentration of Complanatoside A for 24 h, and then L02 cells were cultured for 24 h in complete medium containing 1 mmol/L FFA and different concentrations of Complanatoside A. TG, total cholesterol (TC), glutamic-pyruvic transaminase (ALT) and glutamic oxaloacetic transaminase (AST) in each group were measured with the microplate method. Leptin (LEP), adiponectin (ADPN), resistin (Retn), interleukin-2 (IL-2), interleukin-10 (IL-10) and apolipoprotein B100 (ApoB100) in each group were measured with the ELISA method. The expression of HNF4α and nuclear factor kappa-B(NF-κB)/p65 proteins in each group were measured with the Western blotting method.ResultsCompared with the model group, TC and Retn in the low mass concentration group of Complanatoside A decreased (P<0.05), and IL-10 increased (P<0.05); TC, ALT, and Retn in the middle mass concentration group of Complanatoside A decreased (P<0.05), and ADPN and IL-10 increased (P<0.05); TG, TC, ALT, AST, Retn and ApoB100 in the high mass concentration group of Complanatoside A decreased (P<0.05), while ADPN and IL-10 increased (P<0.05); LEP and IL-2 in the low, middle and high mass concentration group of Complanatoside A decreased, but the differences were not statistically significant (P>0.05). Compared with the model group, the expression of HNF4α protein in the high mass concentration group of Complanatoside A up-regulated (P<0.05), and the expression of NF-κB/p65 protein down-regulated (P<0.05).ConclusionRegarding the effects on TG transport pathway, Complanatoside A may stimulate the transcription of HNF4α to regulate the assembly and secretion of ApoB100, activate adipokines to promote fatty acid oxidation, and then accelerate lipid transport and inhibit lipid production, which could describe the role of Astragali complanati semen in maintaining lipid metabolism homeostasis and reducing inflammatory injury of hepatocytes.  
        关键词：Astragali complanati semen;Complanatoside A;L02 cells;steatosis;lipid metabolism;triglyceride transport;hepatocyte nuclear factor 4α   
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        Clinical Studies

      • ZHANG Zhongmian,HUANG Jiaqin,HE Baixiang,LIN Jiaying,YE Wangyu,CAO yun,ZHANG Xiyan,CHEN JiaQIn,LI Zhihong
        Vol. 45, Issue 10, Pages: 1052-1059(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.013
        摘要：ObjectiveTo investigate the mechanism of Shenbai granule modulating phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway to interfere with gastric mucosal epithelial cell autophagy in patients with gastric precancerous lesions (GPL).MethodsAccording to relevant criteria, 30 patients with pathological diagnosis of GPL and TCM syndromes in accordance with the syndrome of liver and stomach stagnation heat and stomach collateral stasis were included. After continuous intervention with Shenbai granule for 12 weeks, gastroscopy was re-examined, and pathological tissues were collected. HE staining was used to observe the pathological changes of gastric mucosa before and after intervention with Shenbai granule. The expressions of PI3K, B-lymphoblastoma/leukemia-2 (Bcl-2), epidermal growth factor receptor (ERBB4), phosphatase tensin homolog (PTEN), P53 and Akt in gastric mucosa were detected by polychromatic immunofluorescence assay. The expressions of Beclin-1, microtubule-associated protein light chain 3-Ⅱ (LC3-Ⅱ), P62 and mTOR were detected by immunohistochemistry.ResultsAfter Shenbai granule treatment, compared with before treatment, the number, distribution range and density of dysplastic cells in gastric mucosa were significantly reduced, the thickness of lamina propria was increased, and the glandular lumen structure tended to be normal. After treatment, the scores of pathological manifestations of atrophy, intestinal metaplasia and dysplasia decreased, and the difference of atrophy and dysplasia decreased was statistically significant (P<0.05). The expressions of apoptosis-related proteins were down-regulated to varying degrees, among which the expressions of PI3K, Akt and Bcl-2 proteins were significantly down-regulated (P<0.05). The expression levels of Beclin-1 and LC3-Ⅱ proteins in autophagy related proteins were up-regulated to varying degrees, and the up-regulation of Beclin-1 protein expression was statistically significant (P<0.05); The protein levels of mTOR and P62 were down-regulated to varying degrees, and the down-regulation of mTOR protein expression was statistically significant (P<0.05).ConclusionThe protective effect of Shenbai granule on gastric mucosal injury in GPL may be related to its role in regulating cell autophagy and apoptosis through PI3K/Akt/mTOR pathway.  
        关键词：gastric precancerous lesions;Shenbai Granule;PI3K/Akt/mTOR pathway;autophagy;apoptosis   
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      • HUO Chaoyue,LIU Yanfeng,LIN Taoxiu,ZHANG Yuejian,SUN Xinhui,HE Xiangyu,HE Tiantian,ZHANG Wenjuan,MA Xiaona
        Vol. 45, Issue 10, Pages: 1060-1065(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.014
        摘要：ObjectiveTo observe the clinical effect of Zishui Qinggan Lichong granule (ZQLG) on perimenopausal syndrome (PMS) patients with the pattern of liver stagnation and kidney deficiency.MethodsA total of 60 patients with PMS identified as liver stagnation and kidney deficiency pattern who were treated in Beijing University of Chinese Medicine Third Affiliated Hospital from July 2020 to January 2022 were collected and divided into the observation group (n = 30) and control group (n = 30) by using the random number table method. In the observation group, ZQLG was used, and the control group was set as a blank control. The trial lasted 3 months. After 3 months, the modified Kupperman score, levels of sex hormones in serum and quality of life scale (QOL-BREF) and adverse reactions were evaluated and compared between the two groups.ResultsAfter 3 months, indexes mentioned above in the control group were worsened to varying degrees. The modified Kupperman score and follicle-stimulating hormone (FSH) level were significantly increased (P<0.05). The indexes in the observation group were significantly improved. The total therapeutic effectiveness rate was 90% without adverse events. The modified Kupperman score, the levels of FSH and luteinizing hormone (LH) were significantly decreased, and estradiol (E2) level was increased. The scores of physical, psychological, environment, and self-assessment area of the QOL-BREF were significantly increased (P<0.05). Compared with the control group, besides improvement of Kupperman score and serum sex hormones, the score of social area in the QOL-BREF was also significantly increased (P<0.05).ConclusionZQLG can ameliorate the characteristic symptoms such as hot flashes, sweating, insomnia, emotional agitation, depression, and lassitude, but also improve the sex hormone levels and QOL in patients with PMS, which demonstrates its efficacy in treating PMS with the pattern of liver stagnation and kidney deficiency.  
        关键词：Zishui Qinggan Lichong granule;perimenopausal syndrome;syndrome of liver constraint and kidney deficiency;Modified Kupperman score;serum sex hormones;quality of life;ovarian function   
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        发布时间：2022-11-04
      • XU Minjie,CHANG Jingling
        Vol. 45, Issue 10, Pages: 1066-1070(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.015
        摘要：Stroke is the most common cause of death and disability in adults. About 80% of the surviving patients have different degrees of functional impairment, which brings a heavy burden to the family and society. It is of important practical significance to give timely and effective rehabilitation treatment to stroke patients under the guidance of a scientific theory. In traditional Chinese medicine, the heart and the brain co-govern the spirit, which is proposed based on the theory of " heart governing the spirit" and " brain being the house of the original spirit" , and essence, blood and marrow are mutually generated and transformed, which is based on " heart governing blood" and " brain being the sea of marrow" , reflecting the correlation between heart and brain. Modern medicine has discovered that atherosclerosis and vascular endothelial dysfunction are the important pathological basis of " heart-brain comorbidity" in stroke, and it is reflected in various pathological mechanisms, such as neuroendocrine-vascularization and intestinal flora. Based on " heart-brain relation" and " heart-brain comorbidity" , the paper further proposes " brain-heart co-treatment" , and applys this theory to various rehabilitation treatments, such as acupuncture and traditional Chinese medicine, which have good guiding value.  
        关键词：brain-heart co-treatment;stroke;rehabilitation of traditional Chinese medicine;acupuncture;Chinese herbal medicine;therapy   
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        发布时间：2022-11-04
      • NAN Mengdie,LI Xiao,XIE Meiwen,HUANG Xiaoling,SI Kuangzhong,HOU Li
        Vol. 45, Issue 10, Pages: 1071-1076(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.016
        摘要：Traditional Chinese medicine (TCM) differential treatment of advanced gastric cancer is based on the theory of different pathogeneses at different location with different indicated prescriptions. Advanced gastric cancer can be categorized by primary site into cardia cancer, gastric body cancer, and gastric antrum cancer. Differentiating treatment of gastric cancer by different primary sites corresponds to Traditional Chinese Medicine diseases, such as dysphagia, stomachache, haematemesis and regurgitation according to different symptoms of different primary sites. The basic pathogeneses of cardia cancer, gastric body cancer, and gastric antrum cancer are the pattern of intermingled phlegm, qi stagnation and blood stasis, pattern of stomach heat injuring yin and the pattern of stagnation of cold and qi. Based on the general therapeutic principle, "strengthening the body resistance to eliminate pathogenic factors" , gastric cancer, advanced gastric cancer originated in cardia, gastric body, and gastric antrum can be treated by attaching different importance to therapeutic principle such as the method of dispersing stagnation and descending stomach qi, the method of nourishing stomach yin and the method of warming stomach yang. The idea of differentiating treatment by site provides a certain reference for the TCM treatment of advanced gastric cancer.  
        关键词：advanced gastric cancer;differentiation and treatment by tumor location;traditional Chinese medicine;cardia;gastric body;gastric antrum   
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        发布时间：2022-11-04
      • XIE Quan,LI Yanqing,CHEN Junli,ZHANG Xiaoyun,LI Yipeng,LEI Xue
        Vol. 45, Issue 10, Pages: 1077-1080(2022) DOI: 10.3969/j.issn.1006-2157.2022.10.017
        摘要：It will be more conducive to obtain curative effect and improve prognosis to treat cognitive impairment after stroke (PSCI) early. PSCI corresponds to the disorders of " dementia" , " amnesia" and " loss of brain marrow" in traditional Chinese medicine (TCM). We summarized the TCM pathogenesis characteristics of PSCI as " phlegm, stasis, deficiency and stagnation" . The phlegm and stasis are both causes and effects in the continuous development of the disease. The deficiency includes congenital qi deficiency and acquired deficiency of spleen and stomach qi, which are the key links in the development of PSCI. The stagnation refers to liver qi stagnation, or qi stagnation transforming into fire and fire generating wind, which plays an important role in the occurrence and development of PSCI. Phlegm, stasis, deficiency and stagnation lead to damage of brain marrow and dysfunction of cognition. In depth analysis of TCM pathogenesis of PSCI is of great significance to expound the disease evolution process and to guide clinical treatment.  
        关键词：post stroke cognitive impairment;stroke;dementia;TCM pathogenesis;phlegm, stasis, deficiency and stagnation   
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