最新刊期
卷 46 ， 期 12 ， 2023
- 摘要：Based on the innovative concept that the pathogenesis of depression may be "deficient qi-induced stagnation", we explore the possibility to treat depression based on the principle of strength origin and unobstruct stagnation. The pathogenesis of "deficient-qi induced stagnation" suggests that "deficient-qi" is the root cause and "stagnation" is the manifestation of depression. "deficient-qi" and "stagnation" constitute a vicious cycle which promotes the occurrence and development of the disease. The treatment of depression should be based on strength origin. According to the primordial qi of the patient, qi must be replenished first, blood must be nourished, yang must be warmed, or yin must be nourished, but patients must always have sufficient primordial qi, be full of spirit, and be energetic. Regarding unobstruct stagnation, according to the degree of stagnation, to resolve depression, qi must be regulated, phlegm must be resolved, blood circulation must be activated, or heat must be cleared; the spirit and emotions should always be at ease, with qi and blood operating smoothly. Strength origin supplements the deficiency and unobstruct stagnation inhibits stagnation. Strength origin and unobstruct stagnation cooperate with each other to reverse the pathological state of deficiency and stagnation, jointly promote the recovery from the disease, and prevent recurrence, providing a new strategy for the prevention and treatment of depression.关键词：depression;deficient-qi induced stagnation;strength origin and unobstruct stagnation;principle of treatment
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发布时间：2024-01-03 - 摘要：This article will explore the connotation of pivot from the perspective of Huangdi Neijing, and elaborate on the relationship between the Shaoyang pivot, the Shaoyin pivot, and depression. Based on the view that the pivots of Shaoyang and Shaoyin are unfavorable, qi is not disordered, and yang is not expressed, which are the key pathogenesis of depression, this article will elaborate on the clinical diagnosis and treatment principles of depression. In addition, it will introduce the main treatment principles of depression, including regulating the pivot to improve spirit, turning the pivot to inspire yang, and warming yang to resolve depression. Based on the clinical application of Shanghan Lun, appropriate prescriptions will be selected for modification. The main formula for regulating yang pivot is Chaihu Guizhi Decoction, while the main formula for regulating yin pivot is Mahuang Fuzi Xixin Decoction. At the same time, attention will be paid to indirectly regulating the pivot based on the development process of the disease, with flexible modification of medication. Finally, it will summarize the treatment ideas of depression, emphasizing on regulating pivot, aiming to alleviate or reduce the further development of the disease and explore new clinical treatment ideas for depression.关键词：Shaoyang pivot;Shaoyin pivot;depression;Chaihu Guizhi Decoction;Mahuang Fuzi Xixin Decoction;adjustment of the pivot
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发布时间：2024-01-03 - 摘要：The normal ascending and descending movements of qi maintain the physiological functions of the human body. If qi rises and falls abnormally or stagnates, this can result in depression. Therefore, the treatment of depression focuses on the regulation of qi movement and restoration of its ascending and descending circulation. Traditional Chinese medicine(TCM) has pharmacological theory based on the correspondence between nature, human, and herbs, which associates the medicinal parts of plants with the characteristics of ascending and descending of medicinal action. This theory has been widely confirmed in clinical practice. In this article, we discuss the special parts of plants, flowers, seeds, stems, and vine, used in the treatment of depression in the context of ascending and descending of qi movement. We analyze the important role of flower drugs, seed drugs, stem drugs, and vine drugs in regulating qi ascending and descending movement and the relationship between viscera in the treatment of depression. We believe that flower drugs are light and clear and have the role of "regulating qi and blood, fragrant and refreshing" ; seed drugs have the effect of "removing pathogenic factors, nourishing and calming the mind" ; and stem and vine drugs have the function of "pivoting to mediate and unblock collaterals." We hope to leverage the theoretical advantages of TCM, broaden the selection of clinical medicinals, and provide new treatment ideas.关键词：the ascending and descending of qi movement;depression;flower drug;seed drug;stem drug;vine drug
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发布时间：2024-01-03
Special Theme: TCM Prevention and Treatment of Depression
- 摘要：Revealing the rules of traditional Chinese medicine (TCM) syndrome differentiation thinking is an important part of researching the original thinking in TCM, which involves brain cognition and neural activity principles. However, traditional research on syndrome differentiation lacks exploration of the cognitive mechanisms of TCM practitioners during syndrome differentiation. In this context of cognitive science, this paper proposes a new paradigm for studying the cognitive neural mechanisms of TCM syndrome differentiation thinking. Firstly, the paper discusses the cognitive shift in syndrome differentiation research and then points out that working memory may be an important window reflecting TCM syndrome differentiation thinking. Based on this, we propose a working hypothesis for the cognitive neural mechanisms of TCM's yin-yang syndrome differentiation and design relevant cognitive neuroscience experimental protocols to explore how the brain engages in yin-yang syndrome differentiation thinking using techniques such as event-related potential and functional magnetic resonance imaging. The implementation of this research pathway can clarify the intrinsic cognitive neural mechanisms of syndrome differentiation thinking, provide evaluation indicators for TCM syndrome differentiation thinking from cognitive neuroscience, and provide cognitive principles to support the cultivation of syndrome differentiation ability of TCM talents.关键词：syndrome differentiation;neural mechanism;expert;event-related potential;functional magnetic resonance imaging;traditional Chinese medicine thinking
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发布时间：2024-01-03 - 摘要：Integrated Chinese and western medicine is a unique medical system in China, which has a strategic position in our country's medical and health care system and is a driving force in the future development of medical science. After nearly 70 years of development, the discipline of integrated Chinese and western medicine has formed a clinical system, a scientific research system, and a talent training system, but there are also shortcomings. In terms of scientific research and disciplinary development, there are relatively few funding projects and corresponding research result in this discipline, and a complete disciplinary system has not been formed. In terms of clinical service, the service scopes urgently need to be expanded, diagnosis and treatment protocols in this discipline need to be increased, and service models need to be improved. In terms of talent cultivation, there is still a serious shortage. One method to solve these problems is crossing innovation between traditional Chinese and western medicine. Clinical evidence is essential for the development of integrated traditional Chinese and western medicine and for improving the accessibility of medical services. Interdisciplinary talent is the foundation for future development. We should strengthen the top-level design of interdisciplinary research between Chinese and western medicine to promote theoretical innovation, obtain high-level clinical evidence to improve the efficacy and expand the scope of clinical services in integrated traditional Chinese and western medicine, and cultivate talent in various subdisciplines of integrated Chinese and western medicine through system and mechanism reform.关键词：Integrated Chinese and Western medicine;crossing innovation;clinical accessibility;diagnosis and treatment model;research;talents
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发布时间：2024-01-03 - 摘要：The relationship between intestinal flora and diseases is currently a hot topic of research, but most studies tend to explain causality and pathogenesis, and there is still a lack of studies of the traditional Chinese medicine (TCM) characteristics of intestinal microecological disorders from the perspective of etiology. The TCM pathogenic characteristics of hybrid flora need to be further clarified. The intestinal flora is an important bridge between the internal and the external environment of body, and plays an important and complex role in the diagnosis, prognosis, and treatment of diseases. Based on the etiology theory of TCM, this paper discusses the scientific connotation of changes of wind, fire, dryness, dampness, and cold caused by intestinal microecological disorder from the aspects of basic concepts, formation causes, and pathogenic nature and characteristics, combined with the nervous system, immune system, gland secretion, and nutritional metabolism, based on clinical manifestations, using the method of examining symptoms and seeking causes. This paper provides a new idea for the study of intestinal flora in TCM, and supplements and enriches the theory of etiology. At the same time, it provides an innovative theoretical basis for the understanding and research that intestinal microecological disorders can promote the occurrence and development of various complex diseases.关键词：intestinal flora;intestinal microecological disorders;dysbacteriosis;etiological theory
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发布时间：2024-01-03
Theoretical Studies
- 摘要：Shanghan Lun is based on "exogenous cold disease, " the change rules of a series of diseases such as superficies tightened by wind-cold and yang deficiency and internal cold, and the rules of treatment based on syndrome differentiation have had a profound impact on traditional Chinese medicine in later generations. Formulae with the name of "Sini" and its variations have the effect of treating deadly cold limbs in Shanghan Lun, for example, Sini Decoction, Tongmai Sini Decoction, Baitong Decoction, Fuling Sini Decoction, Sini Renshen Decoction, Danggui Sini Decoction, and Sini Powder, etc. Their corresponding constitution characteristics, etiology and pathogenesis, changes in disease status, and clinical manifestations have certain commonalities. This paper discusses and analyzes the modifications of the "Sini" formulae, the rules of the formulae, and the principles of application based on the characteristics of yang deficiency constitution, their susceptibility to disease, and the evolutionary pattern of yin excessiveness due to yang deficiency pathogenesis. Our aim is to deepen the knowledge and understanding of the application of the "Sini" formulae from the perspective of yang deficiency constitution and to provide research ideas for the comprehensive study of "constitution-disease-syndrome differentiation" .关键词：yang deficiency constitution;yin excessiveness due to yang deficiency;"Sini" formulae;constitution characteristics;rules of application
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发布时间：2024-01-03
TCM Constitutions
- 摘要：ObjectiveWe aimed to explore whether Taohongyin (peach seed, safflower, Sichuan lovage rhizome, Chinese angelica root-tip, and Chinese clematis root) treats atherosclerosis by regulating macrophage-mediated lymphangiogenesis.MethodsThe effective components of Taohongyin were identified by UPLC-Q-TOF-MS. RAW264.7 macrophages were transfected with a lentiviral vascular endothelial growth factor C (VEGFC) overexpression construct, a VEGFC knockdown construct (OE-VEGFC), and empty vector (OE-VEHICLE). The atherosclerotic cell model was constructed on RAW264.7 macrophages ( ModelRAW264.7)or on OE-VEGFC (ModelOE-VEGFC) by intervention with human oxidized low density lipoprotein (20 mg/L) and lipopolysaccharide (100 μg/L). The optimal concentration of Taohongyin was determined by the CCK-8 method. A Transwell co-culture model of RAW264.7 macrophages and mouse lymphatic endothelial cells (MLECs) was constructed. Wound healing was assessed by the scratch test. Migration of cells was analyzed by a Transwell assay followed by crystal violet staining. Tube formation was analyzed by the tube formation assay. The contents of VEGFC, interleukin-6 (IL-6), and inducible nitric oxide synthase (iNOS) in the supernatant were determined by ELISA. The VEGFC content was determined by immunofluorescence labeling. The mRNA levels of VEGFC, lymphatic endothelial cell surface receptor (FLT4), podoplanin (PDPN), IL-6, and iNOS were determined by real-time fluorescence quantitative PCR. The protein expression levels of VEGFC, FLT4, HIF-1α, lymphatic vessel endothelial hyaluronic receptor 1 (LYVE-1), homeobox gene transcription factor 1 (Prox-1), IL-6, and iNOS were determined by Western blotting.ResultsUPLC-Q-TOF-MS identified 22 main active components in Taohongyin, in which hydroxysafflor yellow A (23.3%) and D-amygdalin (23.8%) were at the highest levels. A Taohongyin concentration of 20 mg/L was selected as the optimal concentration. The transfection efficiency of OE-VEGFC and OE-VEHICLE was more than 80%, indicating that the RAW264.7 macrophage VEGFC overexpression model was successfully constructed. Compared with the normal control group, the wound healing capacity of MLECs was significantly increased, cell migration and tube formation were enhanced (all P<0.05), VEGFC fluorescence was increased (all P<0.05), the contents of VEGFC, IL-6, and iNOS in the supernatant were increased (all P<0.05), the mRNA expressions of VEGFC, FLT4, PDPN, IL-6, and iNOS were increased (all P<0.05), and the protein expressions of VEGFC, FLT4, HIF-1α, LYVE-1, Prox-1, IL-6, and iNOS were increased ( all P<0.05) in the ModelRAW264.7 group. After intervention with Taohongyin of 20 mg/L, all the indicators were decreased (all P<0.05).Compared with the ModelRAW264.7 group, all the indicators in the ModelOE-VEGFC group were increased(all P<0.05). Compared with the Taohongyin+ ModelRAW264.7 group, all the indicators in the Taohongyin+ ModelOE-VEGFC group were increased(all P<0.05). Compared with the ModelOE-VEGFC group, all the indicators in the Taohongyin+ ModelOE-VEGFC group were decreased(all P<0.05).ConclusionTaohongyin may reduce macrophage-mediated lymphangiogenesis by inhibiting the VEGFC pathway.关键词：Taohongyin;atherosclerosis;RAW264.7 macrophage cell;mouse lymphatic endothelial cells;lymphatic vessels;hydroxysafflower yellow A
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发布时间：2024-01-03 - 摘要：ObjectiveWe aim to investigate the impact of HeiBu Ointment on transforming growth factor-β1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) in human immortalized epidermal cells(HaCaT) and elucidate the mechanism underlying HeiBu Ointment's efficacy in treating chronic skin ulcers with abnormal fibrosis.MethodsWe employed a TGF-β1-induced EMT model using HaCaT. HaCaT cells were categorized into five groups: the blank control group, the model group, and the HeiBu Ointment high-, medium-, and low-dose groups. All the groups were cultured in DMEM high-glucose medium (4.00 mmol/L L-glutamine, 4.5 g/L glucose). The model group was treated with TGF-β1 (0.01 mg/L), while the HeiBu Ointment high-, medium-, and low-dose groups received TGF-β1 (0.01 mg/L) in combination with varying doses of HeiBu Ointment extract (0.5 mg/L, 0.25 mg/L, and 0.125 mg/L). The CCK-8 method was used to detect the effect of HeiBu Ointment on HaCaT cell activity; the effect of HeiBu Ointment on the migration ability of HaCaT cells was determined by scratch test; the effects of HeiBu Ointment on the expression of the epithelial marker protein E-cadherin and the mesenchymal marker proteins N-cadherin and vimentin in HaCaT cells were observed by immuno fluorescence method; the expression of Smad and ERK signaling pathway-related proteins was detected by Western blotting.ResultsHeiBu Ointment below 0.5 mg/L had no effect on HaCaT cell activity. Compared with the model group, HeiBu Ointment significantly inhibited the migration of HaCaT cells after TGF-β1 stimulation (P<0.05), promoted the expression of the epithelial marker protein E-cadherin, inhibited the expression of the mesenchymal marker proteins N-cadherin and vimentin, and inhibited TGF-β1-induced phosphorylation of Smad2, Smad3, and ERK1/2 in HaCaT cells (P<0.05).ConclusionHeiBu Ointment may promote healing of chronic skin ulcers with abnormal fibrosis by inhibiting excessive trausition of epidermal cells to mesenchymal cells through inhibition of the Smad and ERK signaling pathways.关键词：HeiBu Ointment;human immortalized epidermal cells;epithelial-mesenchymal transition;chronic skin ulcer;skin fibrosis
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发布时间：2024-01-03 - 摘要：ObjectiveWe aimed to investigate the mechanism of action of Tianma Gouteng Decoction in the treatment of spontaneously hypertensive rats(SHR) by studying the p38 mitogen-activated protein kinase (p38 MAPK)/heat shock protein 27 (HSP27) pathway.MethodsUsing the random number table method, 30 SHR were divided into the model group, the Valsartan group (0.03 g/kg), and the Tianma Gouteng Decoction group (1 g/kg), 10 rats per group. Additionally, 10 Wistar-Kyoto (WKY) rats were assigned to the normal group. Rats in the Valsartan group and the Tianma Gouteng Decoction group were given corresponding drugs, while rats in the normal group and the model group were administered an equivalent amount of saline orally for 8 consecutive weeks. Blood pressure was recorded on days 0, 14, 28, 42, and 56. Following treatment completion, behavioral changes were observed. Hematoxylin-eosin staining was used to observe the changes in vascular morphology and structure. Masson staining was used to observe the degree of vascular fibrosis. The autophagy ultrastrucure were examined by electron microscopy. An immunofluorescence assay was conducted and the average fluorescence intensities of phosphorylated p38 MAPK (p-p38 MAPK) and phosphorylated HSP27 (p-HSP27) in vascular tissue were calculated. Plasma malondialdehyde (MDA) content, plasma superoxide dismutase (SOD) content, and vascular tissue anti-superoxide anion content were measured by spectrophotometry. Vascular aging was evaluated through a senescence-associated β-galactosidase (SA-β-gal) staining method. The mRNA expression levels of p38 MAPK, MAPK-activated protein kinase-2 (MAPKAPK-2), HSP27, autophagy-associated protein 5 (ATG5), and p62 in vascular tissue were determined by real-time PCR. The protein expression levels of p-p38 MAPK, p-MAPKAPK-2, p-HSP27, ATG5, and p62 in vascular tissue were determined by Western blotting.ResultsCompared with the normal group, the blood pressure and irritability were increased, the rotational tolerance time was decreased, the thickness of vascular media (MT) and the ratio of vascular media thickness to vascular inner diameter (MT/LD) were significantly increased, the number of autophagosomes was decreased, the proportion of SA-β-gal positive cells was increased, the content of MDA was increased, the content of SOD and anti-superoxide anion were decreased, the average fluorescence intensity of p-p38 MAPK was increased, the protein expression levels of p-p38 MAPK and p-MAPKAPK-2 were increased, the mRNA and protein levels of p62 were increased, the average fluorescence intensity of p-HSP27 was decreased, and the mRNA expression level of HSP27 and the protein expression levels of p-HSP27, and the mRNA and protein levels of ATG5 were decreased in the model group (P<0.05). Compared with the model group, the blood pressure and irritability were decreased, the rotational tolerance time was increased, MT and MT/LD were decreased, the number of autophagosomes was increased, the proportion of SA-β-gal positive cells was decreased, the content of MDA was decreased, the content of SOD and anti-superoxide anion were increased, the average fluorescence intensity of p-p38 MAPK was decreased, the protein levels of p-p38 MAPK and p-MAPKAPK-2 were decreased, the mRNA and protein levels of p62 were decreased, and the average fluorescence intensity of p-HSP27, the mRNA expression level of HSP27 and the protein expression levels of p-HSP27, and the mRNA and protein expression levels of ATG5 were increased in the Valsartan group and the Tianma Gouteng Decoction group (P<0.05).ConclusionTianma Gouteng Decoction can delay vascular aging in a spontaneous hypertensive rat model, possibly by regulating autophagy through the p38 MAPK/HSP27 pathway.关键词：Tianma Gouteng Decoction;hypertension;p38 mitogen-activated protein kinase/heat shock protein 27 pathway;autophagy;rats
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发布时间：2024-01-03 - 摘要：ObjectiveTo explore the inhibitory effect of Jianpi Huatan Formula on "inflammation-cancer transformation" in a mouse model of non-alcoholic fatty liver disease based on the lipoprotein lipase (LPL)/carnitine palmitoyltransferase 1 (CPT1)/fatty acid binding protein 4 (FABP4) pathway.MethodsAccording to the random table method, 30 C57BL/6 mice were randomly divided into the control group, model group, Jianpi Huatan Formula low-dose group (19.2 g/kg), Jianpi Huatan Formula high-dose group (38.4 g/kg), and ezetimibe group (10.0 mg/kg), six mice in each group. Except for the control group, mice in the other groups were injected intraperitoneally with diethylnitrosamine (25 mg/kg). After 4 weeks, except for the control group, mice in the other groups were fed with a high-fat and high-cholesterol diet for 26 weeks to establish the non-alcoholic steatohepatitis-related hepatocellular carcinoma (NASH-HCC) model. The treatment was administered once daily for 26 weeks. The number of liver tumors and the maximum tumor surface area were compared among the groups. HE staining and oil red O staining were used to observe liver inflammation, steatosis, and ballooning. The content of tumor necrosis factor-α (TNF-α) in liver was determined by ELISA. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were measured by a biochemical analyzer. The mRNA levels of tumor-related markers such as Birc5, Ly6d, CD44, and Mki67 in liver were determined by real-time PCR. The protein expression levels of LPL, CPT1, and FABP4 in the liver of each group of mice were measured by Western blotting.ResultsCompared with the control group, mice in the model group showed tumors in the liver, elevated mRNA levels of Ly6d, Birc5, CD44, and Mki67, obvious liver damage, severe steatosis and ballooning, large amounts of lipid droplet accumulation in the liver, significantly elevated serum ALT, serum AST, and hepatic TNF-α levels, elevated levels of serum TC, TG, LDL, and HDL, and elevated protein expression levels of LPL, CPT1B, and FABP4 in the liver (P<0.05). Compared with the model group, the mRNA expression of Birc5 was reduced in the Jianpi Huatan Formula low-dose group and the ezetimibe group(P<0.05); liver injury was alleviated to varying degrees in the Jianpi Huatan Formula low- and high-dose groups and the ezetimibe group, as evidenced by a decrease in steatosis and ballooning, a decrease in lipid droplet accumulation, and a decrease in the hepatic inflammatory factor TNF-α (P<0.05). Compared with the model group, serum TC, TG, LDL, and HDL levels were decreased in the Jianpi Huatan Formula low-dose group and the ezetimibe group (P<0.05); and compared with the Jianpi Huatan Formula low-dose group, serum TC, LDL, and HDL levels were significantly decreased in the ezetimibe group (P<0.05). Compared with the model group, the protein expression levels of CPT1B and FABP4 were decreased in the Jianpi Huatan Formula low-dose group, and the protein expression levels of LPL and FABP4 were decreased in the Jianpi Huatan Formula high-dose group (P<0.05).ConclusionJianpi Huatan Formula may exert anti-NASH-HCC effects by regulating the LPL/CPT1/FABP4 lipid metabolism signaling pathway, promoting the breakdown of TC and TG, improving liver tissue steatosis and its inflammatory damage in model mice, and further inhibiting tumor development.关键词：Jianpi Huatan Formula;non-alcoholic steatohepatitis-related hepatocellular carcinoma;lipid metabolism;lipoprotein lipase;carnitine palmitoyltransferase 1;fatty acid binding protein 4;mice
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发布时间：2024-01-03 -
Study on the anti-fatigue effect of modified
Baoyuan Decoction through the AMPK/SIRT1/PGC-1α pathway摘要：ObjectiveWe modified Baoyuan Decoction(ginseng, milkvetch root, liquorice root, cassia bark, and rose-boot) based on the original formula and explored its alleviating effect on physical fatigue.MethodsModified Baoyuan Decoction (MBYD) were analyzed by using HPLC. Altogether 160 ICR mice with SPF grade were divided into 4 parts(n=40 mice per part), in which were divided into the blank control group (purifed water in the same volume), the modified Baoyuan Decoction low-, mid-, and high-dose groups (1.9, 2.1, and 2.3 g/kg). All the groups were administered intragatrically once a day for 30 days. The mice were sacrificed and sampled after the last administration. (1) 40 mice were used to get the behavioral indicators. After 21 days of administration, grip strength, back temperature, times of locomotor activity, and fatigue time of rotating rod was measured; while time of weight-loading swimming was measured at the 30th day. (2) 40 mice were used to get liver/muscle glycogen levels. (3) 40 mice were used to get the content of blood lactic acid (BLA) and its area under the curve (AUC). (4) 40 mice were used to get (ⅰ) the levels of the metabolic products (blood urea nitrogen, BUN; lactate dehydrogenase, LDH; BLA); (ⅱ) activity of the oxidative stress-related enzymes (malondialdehyde, MDA; superoxide dismutase, SOD; catalase, CAT) in the skeletal muscle and the heart; (ⅲ)blood oxygen transport capacity (red blood cell, RBC; hemoglobin, HGB; mean corpuscular hemoglobin concentration, MCHC); (ⅳ) activity of ATP-related enzymes(Na+ -K+ -ATPase; Ca2+ -Mg2+ -ATPase; succinate dehydrogenase, SDH; creatine kinase, CK); (ⅴ) protein expression of phosphorylation alpha-AMP-activated protein kinase (p-AMPK), slient mating type information regulation 2 homolog 1(SIRT1), peroxisome proliferator activated receptor γ coactivator-1α (PGC-1α) and mitochondrial transcription factor A(TFAM).ResultsThe contents of ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, salideoside and calycosin in MBYD were 8.15, 3.82, 1.07, 0.41 and 0.067 g/L. MBYD can significantly improve the activity of Na+ -K+ -ATPase, Ca2+ Mg2+ -ATPase, SDH, CAT, and SOD in the heart and skeletal muscles (all P<0.05); reduce the MDA levels in the heart and skeletal muscles(both P<0.05); reduce the levels of CK and LDH in serum (both P<0.05); increase liver glycogen and muscle glycogen reserves(both P<0.05); reduce the BUN level and the AUC of BLA (all P<0.05); increase the numbers of RBC, HGB, and MCHC in whole blood (all P<0.05); and increase the protein expression levels of p-AMPK, SIRT1, PGC-1α, and TFAM in skeletal muscle and heart (all P<0.05).ConclusionModified Baoyuan Decoction may activate the AMPK/SIRT1/PGC-1α signaling pathway in skeletal muscle and heart, enhance mitochondrial capacity, reduce the accumulation of metabolic products in the body, inhibit oxidative stress, and increase blood oxygen transport capacity, thereby alleviating fatigue.关键词：Baoyuan Decoction;tonify qi;anti-fatigue;Mitochondrion;alpha-AMP-activated protein kinase/slient mating type information regulation 2 homolog 1/peroxisome proliferator activated receptor γ coactivator-1α signal pathway;mice- 103
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发布时间：2024-01-03 - 摘要：ObjectiveTo elucidate the metabolomic mechanisms for the clinical phenomes of spleen deficiency and dampness-heat syndrome (PXSR) and the dampness-heat accumulation syndrome (SRYJ) associated with colorectal cancer (CRC).MethodsFrom March 2021 to October 2021, A total of 68 patients with spleen deficiency and dampness-heat syndrome and 58 patients with dampness-heat accumulation syndrome of colorectal cancer were recruited in the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, and 62 healthy control with balanced constitution personnel who underwent physical examination here. Cohorts were established for PXSR phenome (PXSRP), SRYJ phenome (SRYJP), and healthy control with balanced constitution (BC). Serum metabolites were isolated and identified by non-targeted metabolomics and ultra-high liquid chromatography and mass spectrometry (UHPLC-QE-MS); the results were further analyzed by principal component analysis (PCA), Orthogonal partial least squares discriminant analysis (OLPS-DA) analysis and bioinformatics analysis.ResultsCompared with Group BC, Group PXSRP had 12 metabolite differences, including downregulation of guanidoacetic acid, and upregulation of formiminoglat-amic acid, imidazoleacetic acid, deoxyuridine, cytidine, pseudouridine, ornithine, N-acetylornithine, 5-hydroxyindoleacetic acid, porphobilinogen, succinic acid semialdehyde, and galactitol.7 metabolic pathways were involved, mainly involving abnormal energy metabolism. Group SRYJP had 17 metabolite differences, including upregulation of deoxyuridine, cytidine, porphobilinogen, arachidonic acid, prostaglandin B2, isocitric acid, L-gulonolactone, and downregulation of guanidoacetic acid, uridine, hydroxyproline, pyrrole-2-carboxylic acid, adenosine, 5, 6-DHET, 8, 9-DiHETrE, 9, 10-DHOME, bovinic acid, and hydroxypyruvic acid. Nine metabolic pathways were involved, mainly with lipid metabolism and tricarboxylic acid cycle abnormality. There were 4 identical characteristic metabolite differences(guanidoacetic acid, deoxyuridine, cytidine, porphobilinogen) between group PXSRP and group SRYJP.ConclusionThese results reveal the metabolomic mechanism of the formation of the clinical phenomes of PXSR and SRYJ associated with CRC and provide objective metabolomic evidence for the precise diagnosis of CRC clinical phenomes.关键词：colorectal cancer;spleen deficiency and dampness-heat syndrome;dampness-heat accumulation syndrome;phenomics of TCM;phenomics;metabolomics
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发布时间：2024-01-03
Experimental Studies
- 摘要：ObjectiveWe aimed to explore the discrepancies in clinical features and outcomes between damp-heat stasis jaundice syndrome and qi-deficiency stasis jaundice syndrome in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF).MethodsWe performed an analysis including 111 HBV-ACLF patients recruited from December 2017 to December 2021 in the Fifth Medical Center of Chinese PLA General Hospital. According to traditional Chinese medicine syndromes, these patients were divided into the dampness-heat stasis jaundice syndrome group(n=90) and the qi-deficiency stasis jaundice syndrome group(n=21). All patients adopt the standard internal medicine treatment plan. Baseline data, laboratory indicators, complications, and disease scores, including the model for end-stage liver disease (MELD), MELD-Na, and Acute-on-Chronic Liver Failure(ACLF)Research Consortium (AARC) scores, were recorded. All patients were followed up to 90 days after enrollment. We compared the baseline demographic characteristics, 90 d mortality, and complications of HBV-ACLF patients with different syndromes. The confounding factors were adjusted through Cox analysis to evaluate the impact of dampness-heat stasis jaundice syndrome and qi-deficiency stasis jaundice syndrome on the prognosis and the development of complications.ResultsThere were differences in age, clinical indicators, and outcomes between HBV-ACLF patients with dampness-heat stasis jaundice syndrome group and the qi-deficiency stasis jaundice syndrome group. The patients with qi-deficiency stasis jaundice syndrome group had higher MELD scores, MELD-Na scores, and AARC scores. Compared to patients with dampness-heat stasis jaundice syndrome group, patients with qi-deficiency stasis jaundice syndrome group were older, had worse liver synthesis and reserve function of the liver, and had a milder inflammatory response, and the proportion of patients with cirrhosis was higher (P<0.05). Patients with qi-deficiency stasis jaundice syndrome group had a higher cumulative mortality rate within 90 days than patients with dampness-heat stasis jaundice syndrome group(P=0.013). Qi-deficiency stasis jaundice syndrome was dependently associated with a higher mortality risk than dampness-heat stasis jaundice syndrome (HR=1.57, P=0.014). Multivariate analysis showed that older age (HR=1.06, P=0.006), elevated total bilirubin levels (HR=1.11, P=0.003), hyponatremia (HR=1.86, P=0.004), renal dysfunction (HR=3.27, P=0.027), and a basis of cirrhosis (HR=2.12, P=0.024) were risk factors for 90-day mortality, and elevated prothrombin activity (HR=0.94, P=0.007) was a protective factor for 90-day mortality in HBV-ACLF patients. Additionally, patients with qi-deficiency stasis jaundice syndrome group had higher rates of new-onset spontaneous bacterial peritonitis, hepatic encephalopathy, and renal insufficiency than those with dampness-heat stasis jaundice syndrome group within 90 days(P<0.05).ConclusionOur study suggested that qi-deficiency stasis jaundice syndrome is more serious than damp-heat stasis jaundice syndrome. Our multivariate analysis indicated that patients with qi-deficiency stasis jaundice syndrome had higher rates of mortality, new-onset spontaneous bacterial peritonitis, hepatic encephalopathy, and kidney dysfunction than patients with damp-heat stasis jaundice syndrome. This study preliminarily demonstrated that dampness-heat stasis jaundice syndrome and qi-deficiency stasis jaundice syndrome may hold significant value for disease conditions and prognosis prediction for HBV-ACLF patients.关键词：acute-on-chronic liver failure;hepatitis B virus;stasis jaundice syndrome;clinical features and outcomes
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发布时间：2024-01-03 - 摘要：The "theory of imbalance of the essence and tendon" is an innovative theory proposed by our team that is based on the academic ideas of Chinese medicine master Tang Youzhi and famous master Zhuang Zengyuan and combines years of clinical experience. "Essence" includes both innate essence and the essence of the five zang-organs and six fu-organs required for postnatal growth and development, respectively. "Tendon" refers to a complex of nerves, soft tissue, and connective tissue, which not only has characteristic features but also functions such as connection, support, nutrition, and protection. The reason why the eye can see things is that essence is its material foundation, and tendon is the functional guarantee. During the occurrence and development of myopia, the "imbalance of the essence and tendon" runs through the entire process and is the core link in the occurrence and development of myopia. The word "imbalance" not only includes the disruption of the steady state of the essence and tendon, but also carries the connotation of biological rhythm imbalance. Modern research suggests that biological rhythms play an important role in the occurrence and development of myopia. This article explores the relationship between the imbalance of essence and tendon and biological rhythms based on the "theory of imbalance of essence and tendon" and preliminarily proposes that the main treatment method for treating myopia is to replenish essence, soften tendon, benefit the head, and regulate the rhythm. Guiding the treatment of myopia with the "theory of imbalance of essence and tendon" helps to deeply understand the etiology and pathogenesis of myopia and broaden clinical diagnosis and treatment ideas.关键词：myopia;theory of imbalance of the essence and tendon;biological rhythm;core pathogenesis;method of treatment
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发布时间：2024-01-03 - 摘要：ObjectiveTo observe the clinical efficacy of hip joint rotative extending manupilation in the treatment of primary and early knee osteoarthritis (KOA).MethodsFrom September 2022 to May 2023, a total of 148 patients with primary and early KOA were recruited from The First Affiliated Hospital of Hebei University of Chinese Medicine. According to the random numbers generated from computer, the patients were randomly divided into the experimental group (74 cases, including eight dropouts) and the control group (74 cases, including 11 dropouts). Both groups received health education, while the experimental group additionally underwent hip joint rotative extending manupilation every two days, the control group received oral diclofenac sodium sustained-release tablets (75 mg/d). Both groups were treated for 2 weeks. The visual analogue scale (VAS) score and the Western Ontario and McMaster University (WOMAC) osteoarthritis index score were compared between the two groups at three time points: before treatment, after treatment, and at follow-up (2 weeks after treatment). The 36-item Short-Form (SF-36) scale score was compared between the two groups at two time points: before treatment and at follow-up. The clinical efficacy was evaluated.ResultsThe VAS score and WOMAC osteoarthritis index score of the two groups after treatment and at follow-up were lower than those before treatment, and the VAS score and WOMAC osteoarthritis index score of the experimental group were lower than those of the control group (P<0.05). The SF-36 scale score was higher in the experimental group than that in the control group at follow-up(P<0.05). The total effective rate was 90.9% in the experimental group, which was higher than 79.3% in the control group (P<0.05).ConclusionHip joint rotative extending manupilation is effective for relieving pain, alleviating clinical symptoms, and improving joint function in patients with primary and early KOA. It is more effective than oral diclofenac sodium sustained-release tablets and has greater clinical application value. This may be attributed to manual adjustment of the femur rotation status and the relative position between the femoral head and the acetabulum, correcting the abnormal force line of the lower limbs, and balancing the weight-bearing state of the knee joint, so as to achieve the effect of treating KOA.关键词：knee osteoarthritis;knee arthralgia;holism;manipulation;hip joint rotative extending manupilation
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发布时间：2024-01-03 - 摘要：Grassroots TCM talents are an important force in promoting the revitalization and development of TCM. The author summarizes the practical experience in participating in the " Beijing Famous Traditional Chinese Medicine Master Service Project" and proposes the concept of " community-oriented TCM talents". " Community-oriented TCM talents" are rooted in the grassroots, mainly focus on clinical practice, and have a high level of medical treatment. They have characteristics such as love for Chinese medicine, solid professional skills, good medical ethics, and adaptability to the grassroots. Drawing on the SWOT analysis method, the author analyzed the strengths, weaknesses, opportunities, and threats faced by cultivating " community-oriented TCM talents". The main strength lies in the good development of grassroots TCM services, while the main weakness lies in the lack of grassroots TCM talents. The opportunity lies in policy support and environmental improvement, while the challenge lies in the difficulties in retaining grassroots TCM talents. Suggestions for cultivating grassroots TCM talents are proposed from the perspectives of seizing policy opportunities, cultivating scarce talents, improving service capabilities, and improving the development environment.关键词：Chinese medicine;talents cultivation;SWOT analysis;community-oriented Chinese medicine talents
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发布时间：2024-01-03
Clinical Studies
- 摘要：The hypercoagulable state, which is common in lung cancer patients, especially in patients with middle and advanced stage, not only triggers thromboembolic events, but also promotes the growth and spread of tumor cells. Thus, it is of great significance to improve the hypercoagulable state. Based on the theory of "deficient qi leading to stasis", we discuss the basic pathogenesis of the hypercoagulable state of lung cancer and its treatment based on traditional Chinese medicine. It is believed that "deficient qi" (deficiency of lung qi) is the internal pathological basis for the formation of the hypercoagulable state of lung cancer, and "stasis" (blood stasis) is an important pathogenic link. "Deficient qi" is the basis of pathogenesis and runs through the whole process. "Stasis" is the standard of pathogenesis and worsens the disease. Deficiency and stasis are the cause and effect of each other, and the evil flourishes and the vital qi declines, which constitutes a vicious circle. Treatment should follow the principle of replenishing the deficiency and promoting stasis, replenishing lung qi, harmonizing yin and yang to replenish the deficiency, activating blood circulation and removing blood stasis, and resolving phlegm to promote stagnation. Treating the hypercoagulable state of lung cancer from the theory of "deficient qi leading to stasis" can support vital qi, regulate yin and yang, dissolve phlegm, and remove stasis, thus slowing down disease progression and lowering the risk of coagulation complications, which can provide certain ideas for the clinical diagnosis and treatment of the hypercoagulable state and tumor-associated thromboembolism.关键词：deficient qi leading to stasis;lung cancer;hypercoagulable state;pathogenesis;treatment method
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发布时间：2024-01-03 - 摘要：In order to summarize the academic thoughts and clinical experience of prestigious traditional Chinese medicine (TCM) hematological experts, China Association of Chinese Medicine Blood Disease Branch and the Hematological Diseases' Innovative Research and Transformation Platform of China Association of Chinese Medicine have summarized the academic thoughts and clinical experience of 15 TCM and integrated TCM and western medicine experts such as ZHOU Aixiang. Investigators summarized the clinical diagnosis and treatment experience and academic thoughts of Professors KE Weijun, DAI Ximeng, CHEN Anmin, MA Rou, LI Jianhua, and JIANG Hongyu. Among them, Professor KE Weijun treats hematological diseases with TCM and western medicine and emphasizes the relationship between healthy qi and pathogenic qi based on the evolution rule of disease and syndrome. Professor DAI Ximeng establishes the treatment principle with kidney deficiency as the core in the treatment of aplastic anemia, and takes the lead in the application of Liushen Pill in the treatment of leukemia. Professor CHEN Anmin puts forward the theory of "four-dimensional blood production" and "six-in-one co-treatment" in the treatment of hematological diseases. Professor MA Rou adopts a combination of TCM and western medicine to treat hematological diseases based on syndrome differentiation, and is the first to apply Qinghuang Powder to treat myelodysplastic syndrome. Professor LI Jianhua puts forward a new hypothesis of "the pathogenesis of enzyme injury first" in aplastic anemia, and constructs a more mature diagnosis and treatment model of integrated TCM and western medicine. Professor JIANG Hongyu proposes a new model of treating aplastic anemia in Chinese medicine, which is a combination of disease, syndrome, and concurrent differentiation and treatment, "triple diagnosis and treatment", and tertiary prevention of morbidity and recurrence. The purpose of this initiative is to create a co-prosperity body to summarize and build on the experience of experts in TCM for the treatment of hematological disorders, to further enrich and improve the system of inheritance and innovation, and to cultivate and improve the diagnosis and treatment of hematological diseases.关键词：hematological diseases;prestigious traditional Chinese medicine practitioner;academic thought;experience of diagnosis and treatment;inheritance
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发布时间：2024-01-03
Hematology and Oncology
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