最新刊期
      卷 46 ， 期 4 ， 2023

        Prestigious Forum

      • DING Ying
        Vol. 46, Issue 4, Pages: 445-449(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.001
        摘要：Rheumatic immune diseases in children are difficult to treat, frequently recur, and can seriously affect children’s physical and mental health. At present, treatment of rheumatic immune diseases mainly depends on hormones, biologicals and immunosuppressants. However, these drugs have nonnegligible side effects. Traditional Chinese medicine deems that the side effects of drugs belong to the category of drug "toxicity". Drugs that are toxic are called "toxicity" drugs, with regard to "toxicity" drugs, the theory of "You Gu Wu Yun" in Inner canon of Huangdi considers that although drugs are "toxic, " drugs are used for an explicit "reason, " so the disease itself receives the drug first, which are not harmful to the human body. Based on this theory, we propose "toxicity" drugs’ use principles that "toxicity" drugs are severe; therefore, drugs should not be used until the plight is urgent. "Toxicity" drugs should be stopped when the disease is mostly cured. The "effectiveness" and "toxicity" must be weighed to find a balance between the body and the drugs. Treatment ought to be adapted according to personal condition, because tolerance to "toxicity" drugs varies. Drugs must be used based on disease differentiation and syndrome differentiation, and toxicity must be reduced by compatibility. We also put forward the "toxicity" drugs’ use strategies of precising drugs’ use, taking measures to attenuate toxicity, improving the benefit/risk ratio, which are of great guiding significance to the safe use of drug in pediatric clinics.  
        关键词：You Gu Wu Yun;drug toxicity;toxicity drug;children;rheumatic immune disease   
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        发布时间：2023-05-09

        Special Theme: “You Gu Wu Yun”

      • HAN Shanshan,DAI Yanlin,DING Ying,XING Yaping,GAO Min,SUN Lihui
        Vol. 46, Issue 4, Pages: 450-455(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.002
        摘要：Immunosuppressants are widely used in the treatment of rheumatic immune diseases, but most of them have toxic side effects, causing damage to the immune, digestive, reproductive and other systems, not only reducing patient compliance, but also seriously affecting disease prognosis. At present, Western medicine has no clear solution for the toxic side effects of immunosuppressants. The theory of traditional Chinese medicine(TCM) states that immunosuppressants such as glucocorticoids and cytotoxic drugs are mainly aggressive products. Long-term use of immunosuppressants can damage the lung, spleen and kidney, damage the vital qi of the body, and lead to deficiency symptoms occur. "Treating deficiency with three sources and two systems" is the great method developed by Wang Qishi, a doctor in the late Ming Dynasty, to treat deficiency and fatigue. After continuous enrichment and development in later generations, this has become a classic theory for treating consumption diseases. We studied the toxic side effects of immunosuppressants from the perspective of "treating deficiency with three sources and two systems". We believe that the symptom of consumption caused by immunosuppressants should be treated from the "three sources" of lung, spleen and kidney, and the two types of syndromes of kidney yin deficiency and kidney yang deficiency should be treated from the "two systems" of lung and spleen. In clinical practice, we can determine the corresponding treatment principles according to different system’s injury syndromes, so as to provide a TCM scheme for safe clinical drug use and expand the theoretical system of toxicity reduction based on TCM.  
        关键词：immunosuppressants;toxic side effects;treating deficiency with three sources and two systems   
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        发布时间：2023-05-09
      • DING Ying,ZHAI Wensheng,REN Xianqing,ZHANG Xia,LIU Jianping,HE Liyun,XU Hong,HUANG Wenyan,YU Jian,ZHANG Ying,SUN Li,WU Ying,LYU Xiaoying,XIAO Huijie,SUN Xiangjuan,HE Ping,HAN Shanshan,WANG Long,DAI Yanlin
        Vol. 46, Issue 4, Pages: 456-466(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.003
        摘要：ObjectiveTo investigate the safety and efficacy of a traditional Chinese medicine (TCM) treatment of pediatric Henoch-Schönlein purpura nephritis (HSPN) (proteinuria below the nephrotic level).MethodsThis study was a prospective multicenter stratified randomized controlled trial. In total, 316 children diagnosed with HSPN were divided into the Chinese medicine group (mild: n=132; severe: n=83) and the Western medicine group (mild: n=60; severe: n=41). Patients in the Chinese medicine group were treated with tripterygium wilfordii multiglucoside + sulfotanshinone sodium injection+ Qingre Zhixue Formula, the starting dose of tripterygium wilfordii multiglucoside for the Chinese medicine mild group was 1.5 mg/(kg·d), while that for the Chinese medicine severe group was 2 mg/(kg·d). Patients in the Western medicine mild group were treated with low-molecular-weight heparin calcium + benazepril + dipyridamole + a TCM simulator. In addition, patients in the Western medicine severe group received prednisone. The patients were treated for 12 weeks and followed up for 36 weeks. The urinary protein levels and urinary red blood cell (RBC) count were investigated in the 4th week and the 12th week. In addition, the recurrence rate at the end of 48 weeks of follow-up was calculated, and the incidence of adverse events at the end of 12 weeks of treatment was calculated.ResultsThe urinary protein levels in the Chinese medicine group, the Chinese medicine mild group and the Chinese medicine severe group at the 4th week and the 12th week were significantly lower than in the Western medicine group, the Western medicine mild group and the Western medicine severe group (P<0.01). The urinary RBC counts in the Chinese medicine group, the Chinese medicine mild group and the Chinese medicine severe group at the 4th week and the 12th week were significantly lower than in the Western medicine group, the Western medicine mild group and the Western medicine severe group (P<0.01). No significant difference in recurrence rate was found between the Chinese medicine group and the Western medicine group, between the Chinese medicine mild group and the Western medicine mild group, or between the Chinese medicine severe group and the Western medicine severe group. The incidence of adverse events was lower in the Chinese medicine group than in the Western medicine group, and it was lower in the Chinese medicine severe group than in the Western medicine severe group (P<0.01), but there was no significant difference between the Chinese and Western medicine mild groups.ConclusionChinese medicine alone can be used to reduce urinary protein levels and urinary RBC counts in both mild and severe HSPN. The effect of Chinese medicine on proteinuria was quicker than that of Western medicine, and the incidence of adverse events was significantly lower in the Chinese medicine group than in the Western medicine group. The stepwise Chinese medicine scheme, which is mainly based on tripterygium wilfordii multiglucoside combined with Qingre Zhixue Formula, shows an excellent curative effect and fewer adverse events, indicating it is worthy of clinical promotion.  
        关键词：Henoch-Schönlein purpura nephritis;pediatrics;traditional Chinese medicine;tripterygium wilfordii multiglucoside   
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        发布时间：2023-05-09
      • DAI Yanlin,DING Ying,HAN Shanshan,ZHANG Xia
        Vol. 46, Issue 4, Pages: 467-475(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.004
        摘要：ObjectiveWe aimed to (i) observe the effects of Shuangbu Pill (a compound prescription of prepared Rehmannia root and dodder seed) on reproductive damage induced by tripterygium glycosides in rats and (ii) explore its regulatory mechanism by metabolomic analysis.MethodsUsing the random number table method, 21 male 4-week-old Sprague-Dawley rats were randomly divided into the normal group, the tripterygium glycosides group (12.5 mg/kg), and the Shuangbu Pill group (3.125 g/kg) (7 rats per group) and gavaged continuously for 12 weeks. The serum levels of testosterone (T), follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were measured by ELISA; sperm density and sperm motility were measured by an automatic sperm quality analyzer; histopathological changes of the testis and epididymis were observed by HE staining; ultrahigh-performance liquid chromatography coupled with tandem time-of-flight mass spectrometry combined with multivariate statistical method was used to detect and identify testicular tissue metabolites; and the Metabo Analyst platform was used for metabolic pathway analysis.ResultsCompared with the tripterygium glycosides group, the Shuangbu Pill could increase serum T levels (P<0.01), improve the sperm density and sperm motility(P<0.01), increase the number of spermatogenic cells in testicular tissue, reduce spermatogenic cell cavitation, and increase the number of epididymal sperm. According to our metabonomic analysis, after treatment with Shuangbu Pill, the levels of 19 differential metabolites related to reproductive damage caused by tripterygium glycosides could be significantly restored, which are mainly involved in glutathione metabolism and glycerophospholipid metabolism.ConclusionShuangbu Pill can significantly reduce the reproductive damage caused by tripterygium glycosides, possibly through regulating glutathione metabolism and glycerophospholipid metabolism.  
        关键词：Shuangbu Pill;tripterygium glycosides;reproductive damage;metabolomics;glutathione metabolism;glycerophospholipid metabolism;rats   
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        发布时间：2023-05-09
      • WANG Long,DING Ying,XU Shanshan,DAI Yanlin,ZHANG Xia
        Vol. 46, Issue 4, Pages: 476-483(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.005
        摘要：ObjectiveWe aimed to explore the therapeutic mechanism of Qingre Zhixue Formula combined with tripterygium wilfordii multiglucoside in rats with Henoch-Schönlein purpura nephritis (HSPN).MethodsAn HSPN rat model was established by intraperitoneal injection of ovalbumin and complete Freund’s adjuvant. According to the random number table method, 54 rats with successful model were divided into the model group (n=11), the Qingre Zhixue Formula group (3.17 mg/kg, n=11), the tripterygium wilfordii multiglucoside group (4.69 mg/kg, n=11), the combined group (3.17 mg/kg Qingre Zhixue Formula + 4.69 mg/kg tripterygium wilfordii multiglucoside, n=11), the hormone group (prednisone acetate 2.34 mg/kg, n=10), in addition, nine rats in the blank group. Rats in the blank group and the model group were gavaged with the same amount of saline, and rats in the other groups were gavaged with corresponding drugs twice a day for 4 weeks. The urinary red blood cell count and the 24-hour urine protein quantification were determined by urine analyzer. The pathological changes of the mesangial area of rats were observed by transmission electron microscopy. The protein and mRNA expression levels of thioredoxin interacting protein (TXNIP), Nod-like receptor protein 3 (NLRP3), cysteine aspartic protease-1 (Caspase-1) and interleukin-1β (IL-1β) in rat kidney tissue were detected by Western blotting and real-time PCR.ResultsCompared with the model group, the urinary red blood cell count, the 24-hour urine protein quantification, the protein expression levels of TXNIP, NLRP3 and Caspase-1 in the kidney tissues of rats in all treatment groups were reduced (P<0.05). The glomerular thylakoid hyperplasia and basement membrane thickening of rats in each treatment group were improved, among which the most obvious improvement was observed in the combined group. The mRNA expression levels of TXNIP and NLRP3 in the kidney tissues of the rats in the combined group, the tripterygium wilfordii multiglucoside group and the hormone group were decreased (P<0.05), the mRNA expression levels of IL-1β in the kidney tissues of the rats in the combined group and the hormone group were decreased (P<0.05). Compared with the combined group, the urinary red blood cell count, the 24-hour urine protein quantification, the protein expression of TXNIP and NLRP3, and the mRNA expression levels of IL-1β in the kidney tissues of the rats in the remaining treatment groups were all increased (P<0.05). The mRNA expression levels of TXNIP and NLRP3 in the kidney tissues of the rats in the tripterygium wilfordii multiglucoside group were increased (P<0.05), the mRNA expression levels of NLRP3 in the kidney tissues of the rats in the Qingre Zhixue Formula group were increased (P<0.05), the mRNA expression levels of TXNIP, NLRP3 and IL-1β were increased in the kidney tissues of the rats in the hormone group (P<0.05).ConclusionQingre Zhixue Formula combined with tripterygium wilfordii multiglucoside can effectively reduce the urinary red blood cell count and the 24-hour urine protein quantification in HSPN rats, and alleviate kidney injury, which may be related to the inhibition of the TXNIP/NLRP3/Caspase-1 inflammatory pathway.  
        关键词：Henoch-Schönlein purpura nephritis;tripterygium wilfordii multiglucoside;Qingre Zhixue Formula;TXNIP/NLRP3/Caspase-1 pathway;rats   
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        发布时间：2023-05-09

        Theoretical Studies

      • LI Yanjie,LIU Hongyan
        Vol. 46, Issue 4, Pages: 484-490(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.006
        摘要：In the Song, Jin, and Yuan Dynasties, Neo-Confucianism was the main philosophical school of the time and profoundly affected the development of medicine. The influence of Neo-Confucianism on medicine began with the physicians, and then expanded to specific medical theories. This influence led to profound and comprehensive changes in medicine in the Song, Jin, and Yuan Dynasties. At the ideological and theoretical level, the influence of Neo-Confucianism on traditional Chinese medicine (TCM) is mainly manifested in (i) the theoretical integration of the two; (ii) the effects of the concept of heaven and man in Neo-Confucianism on the development of the theory of " five movements and six qi" in medicine; and (iii) the effects of the cognitive method of seeking knowledge from nature on the study of medical theory by physicians. While affirming the positive effects of Neo-Confucianism on the development of medicine, it must be clearly recognized that under different historical conditions, Neo-Confucianism also had an inhibitory effect on the development of medicine. With the increasing influence of " Neo-Confucianism", the inhibitory effect of Neo-Confucianism on medicine began with the physicians, and then expanded to specific medical theories. A profound understanding of the specific manifestations and negative effects of Neo-Confucianism on TCM can provide inspiration for an objective understanding of the formation of TCM theory, as well as for the inheritance and development of modern TCM.  
        关键词：Neo-Confucianism;investigate things is to attain knowledge;Song Jin Yuan Dynasties;physicians of the Jin and Yuan Dynasties   
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        发布时间：2023-05-09
      • XU Rui,LU Mingyuan
        Vol. 46, Issue 4, Pages: 491-495(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.007
        摘要：As an important concept in traditional Chinese medicine, the concept of the vital gate has led to many misunderstandings and disputes in later generations because of its multiple connotations. In this article, the concept of the vital gate is considered from the perspective of yin and yang and based on the Taoist idea of "bearing with yin and taking in yang". It is clearly put forward that the "right kidney vital gate" theory in the Nan Jing is the inheritance of the core of the "eye is the vital gate" theory in the Huangdi Neijing. Although the right kidney and the eye part have different functions, they both have the characteristics of "bearing with yin and taking in yang" and are related to the essence of life; that is, based on yin essence and yang qi, the two blend and merge, so as to evolve a complete life activity. Yin and yang are combined, their roots promote each other, and the vitality is inexhaustible, so the place of "bearing with yin and taking in yang" is the door of life generation and the secret of life manifestation; hence, it is called the vital gate. The true meaning of the term vital gate fully reflects the important role played by yin and yang in the construction and formation of relevant theories of traditional Chinese medicine.  
        关键词：Huangdi Neijing;Nan Jing;true meaning of the vital gate;bearing with yin and taking in yang   
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        发布时间：2023-05-09
      • XIE Weijian,ZHU Xiaolin,WANG Tairan,XUE Ye,ZHANG Yunsong
        Vol. 46, Issue 4, Pages: 496-501(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.008
        摘要：Stomach excess and spleen deficiency is a chronic and knotty pattern of the system of spleen and stomach, which is based on deficiency of the spleen and hyperfunction of the stomach. When this pattern occurs, the relationship between the spleen and stomach is disordered, and their complex function of providing nutrition for the whole body is reduced; then, the other viscera are damaged and dysfunctional, affecting all parts of the body. Based on five elements theory, we explored and interpreted the pathogenesis of stomach excess and spleen deficiency pattern, and put forward that stomach excess and spleen deficiency is a pattern of abnormal function and a disordered relationship of the five elements at the center of the earth. Then, we established the four basic classifications of the pattern of stomach excess and spleen deficiency and the related method of convergence therapy, regulating the other four functions comprehensively on the basis of treating the earth function. In clinical practice, combining convergence therapy with the traditional therapy of invigorating the spleen and regulating the stomach can improve the curative effect, which provides a new idea for related theoretical research and clinical practice.  
        关键词：five elements theory;stomach excess and spleen deficiency;knotty pattern;convergence therapeutic method   
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        发布时间：2023-05-09

        Experimental Studies

      • YANG Xiupeng,XU Yonggang,MA Rou,DU Yu,PENG Qing,WANG Hongzhi,CAI Xiaoqing,WEI Diu,LI Rui,WANG Dexiu,LI Liu
        Vol. 46, Issue 4, Pages: 502-508(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.009
        摘要：ObjectiveTo explore the therapeutic effect of Yiqi Tongyang Granule in the treatment of immune thrombocytopenia mice and the underlying mechanism.MethodsBALB/c mice were treated with anti-mouse platelet serum from guinea pig to establish an immune thrombocytopenia mouse model. Model mice were randomly devided into the model group, the prednisone group, the Yiqi Tongyang Granule group, and the Jinshuye group; 10 unmodeled mice as the control group. The mice were treated with Yiqi Tongyang Granule(17.4 g/kg), prednisone(9.1 mg/kg), and Jinshuye Styptic Mixture(3.9 mL/kg) by gavage for 11 days, and the platelets (PLT), white blood cells (WBC), and hemoglobin (Hb) counts in the mice were measured. Bone marrow megakaryocyte counts were compared by bone marrow smears and bone marrow pathology, and the proportions of different types of megakaryocytes in bone marrow were analyzed. The organ coefficients and pathological changes of the spleen and thymus were observed in mice. Lymphocyte subsets were detected using a flow cytometer.ResultsCompared with the control group, the number of PLT in immune thrombocytopenia mice was reduced (P<0.05), and after treatment with Yiqi Tongyang Granule, prednisone, and Jinshuye Styptic Mixture, the number of PLT was increased (P<0.05). Compared with the control group, the number of bone marrow megakaryocytes was increased and the proportion of PLT-producing megakaryocytes was decreased in immune thrombocytopenia mice (P<0.05). The number of megakaryocytes was decreased after treatment with Yiqi Tongyang Granule (P<0.05), the ratio of primitive and naive megakaryocytes was decreased, and the proportion of PLT-producing megakaryocytes was increased in the immune thrombocytopenia mice (P<0.05). The spleen was observed to be enlarged in the immune thrombocytopenia mice based on the spleen organ coefficient and pathology, and extramedullary hematopoiesis was found to be common in the spleens of immune thrombocytopenia mice. Thymus atrophy was very obvious in immune thrombocytopenia mice treated with prednisone based on the thymus organ coefficient and pathology. The percentages of Tc, Th, and Treg cells of immune thrombocytopenia mice were reduced, and these percentages were increased after treatment with Yiqi Tongyang granules (P<0.05).ConclusionYiqi Tongyang Granule could regulate the immune state of immune thrombocytopenia mice by regulating the lymphocyte subpopulations and increase the PLT levels in peripheral blood by affecting the number of bone marrow PLT-producing megakaryocytes. The therapeutic effect of Yiqi Tongyang Granule was similar to that of prednisone and clearly superior to that of Jinshuye Styptic Mixture.  
        关键词：immune thrombocytopenia;Yiqi Tongyang Granule;lymphocyte subsets;mice   
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        发布时间：2023-05-09
      • HONG Yaonan,WU Dijiong,SHEN Yingying,LI Hangchao,XU Linglong,YE Baodong,SHAO Keding
        Vol. 46, Issue 4, Pages: 509-519(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.010
        摘要：ObjectiveWe aimed to investigate the effects and the underlying mechanism of Bushen Huoxue Formula (BSHXF)on the adipogenic differentiation function of an iron overload (IO) mouse preadipocyte strain (3T3-L1 cells) and the underlying mechanism.MethodsIn total, 45 Sprague-Dawley rats were given BSHXF(15 g/kg) by gavage for 7 days to prepare the medicated serum of BSHXF. 3T3-L1 cells were divided into the normal group, the shCtrl group, the model group, the BSHXF+ IO shCtrl group and the BSHXF+ IO shNrf2 group. 3T3-L1 cells were transfected with lentivirus particles to construct nuclear factor E2 related factor-2 (Nrf2) silenced 3T3-L1 cells (3T3-L1 shNrf2) and empty vector control 3T3-L1 cells (3T3-L1 shCtrl). Ferric ammonium citrate (FAC) was used to establish the 3T3-L1 IO cell model, and the optimal FAC concentration was determined. The normal group and the shCtrl group were not treated. The model group was given FAC, the BSHXF + IO shCtrl group and the BSHXF + IO shNrf2 group were given FAC+ BSHXF medicated serum. The cell survival rate and lipid deposition of each group were detected by the CCK-8 assay and Oil red O staining. The mRNA expression levels of peroxisome proliferator-activated receptor gamma (PPARγ), hormone-sensitive triglyceride lipase (HSL) and adipose triglyceride lipase (ATGL) were detected by real-time PCR. The levels of glutathione reduced (GSH) and lipid peroxidation (LPO) in cell supernatant were detected by ELISA. The protein expression levels of transferrin receptor (TFR), ferritin light chain (FTL), ferritin heavy chain (FTH), iron regulatory protein (IRP), glutathione peroxidase 4 (GPX4), cystine/glutamate antiporter system (XCT), heme oxygenase 1 (HO-1) and Nrf2 were detected by Western blotting.ResultsCompared with the shCtrl group, the expression level of Nrf2 in the 3T3-L1 cells in the shNrf2 group was decreased (P<0.01), indicating that the establishment was successful. The optimal concentration of FAC was determined to be 15 μmol/L. Compared with the shCtrl group, the cell survival rate of the model group was decreased (P<0.01), the relative content of triglyceride was increased (P<0.01), intracellular lipid deposition was increased, the mRNA expression levels of PPARγ, HSL and ATGL were decreased (P<0.01), the levels of GSH and LPO were decreased (P<0.01), the protein expression levels of Nrf2 and IRP were increased (P<0.05, P<0.01), and the protein expression levels of TFR, FTL, GPX4, XCT, FTH and HO-1 were decreased (P<0.01). Compared with the model group, the cell survival rate of the BSHXF+ IO shCtrl group was increased (P<0.05), the relative content of triglyceride was decreased (P<0.01), intracellular lipid deposition was decreased, the mRNA expression levels of PPARγ, HSL and ATGL were increased (P<0.05), the levels of GSH and LPO were increased (P<0.05), the protein expression level of IRP was decreased (P<0.05) and the protein expression levels of Nrf2, TFR, FTL, GPX4, XCT, FTH and HO-1 were increased (P<0.05, P<0.01). Compared with the BSHXF+ IO shCtrl group, the cell survival rate of the BSHXF+ IO shNrf2 group was decreased (P<0.05), the relative content of triglyceride was increased (P<0.05), intracellular lipid deposition was increased, the mRNA expression levels of PPARγ, HSL and ATGL were decreased (P<0.05), the levels of GSH and LPO were decreased (P<0.05), the protein expression level of IRP was increased (P<0.05), and the protein expression levels of Nrf2, TFR, FTL, GPX4, XCT, FTH and HO-1 were decreased (P<0.05, P<0.01).ConclusionBSHXF can effectively protect 3T3-L1 cells from oxygen free radical damage and ferroptosis induced by IO, which benefits the proliferation of adipocytes, and can inhibit terminal maturation.  
        关键词：iron overload;adipogenic differentiation;ferroptosis;preadipocytes;in vitro   
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        发布时间：2023-05-09
      • CHAN Liujia,WANG Wenjing,PANG Yuheng,ZOU Xin,YI Bing,WANG Yuji,ZHAO Lichun
        Vol. 46, Issue 4, Pages: 520-527(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.011
        摘要：ObjectiveWe aimed to study the effect of genistein on mitochondrial damage and G2/M cell cycle arrest in breast cancer cell strain.MethodsThe Cell Counting Kit-8 (CCK-8) assay was used to determine the proliferation of MDA-MB-231 and MCF-7 cells after administration of genistein(12.5, 25, 50, 100, 150, and 200 μmol/L) for 48 h. The effects of genistein (50, 100, and 150 μmol/L for 48 h) on the cell cycle were detected by PI staining of MDA-MB-231 and MCF-7 cells. JC-1, MitoTracker Orange CMTMRos, and Hoechst 33342 staining assays were used to detect the effects of genistein (50, 100, and 150 μmol/L for 48 h) on mitochondrial function and apoptosis in MDA-MB-231 and MCF-7 cells.ResultsCompared with the control group, the cell proliferation activity was decreased in genistein groups, genistein could inhibit the proliferation of cells in each concentration(P<0.05, P<0.01). Genistein induced nuclear chromatin agglutination in MDA-MB-231 and MCF-7 cells, which indicated that apoptosis was promoted. Genistein arrested the cell cycle of MDA-MB-231 and MCF-7 cells in the G2/M phase (P<0.05, P<0.01).Genistein decreased the mitochondrial membrane potential and mitochondrial activity in MDA-MB-231 and MCF-7 cells (P<0.05, P<0.01).ConclusionGenistein could inhibit the proliferation of MDA-MB-231 and MCF-7 cells, induce cell cycle arrest in the G2/M phase, and induce apoptosis. The underlying mechanisms could be related with mitochondrial function modulation.  
        关键词：genistein;breast cancer cell strain;mitochondria;cell cycle   
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        发布时间：2023-05-09

        Chinese Medical Informatics

      • WANG Xuehui,CHEN Yunru,ZHENG Youyou,WANG Xinyue,SUN Huiyi,WANG Jianyun,LI Junxiang,SONG Zhenmei,LIU Fang,BU Zhijun,LIU Jianping,LIU Zhaolan
        Vol. 46, Issue 4, Pages: 528-535(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.012
        摘要：ObjectiveBased on the data of patients with ulcerative colitis treated with Five-Flavor Sophora Flavescens Radix Enteric-coated Capsules, we discuss the feasibility and methodology of constructing a prediction model of the efficacy of traditional Chinese medicine.MethodsBased on phase Ⅲ clinical trial data of Five-Flavor Sophora Flavescens Radix Enteric-coated Capsules, a total of 274 patients with active ulcerative colitis with complete population data after 8 weeks of treatment in the experimental group (Five-Flavor Sophora Flavescens Radix Enteric-coated Capsules) were selected. R 4.1.0 was used for statistical analysis. First, all the variables to be screened were included to construct a multivariate Logistic regression model. Then, variables with P<0.05 were screened for inclusion in the final model. The nomogram was plotted. The bootstrap method was used to resample 1 000 times for internal validation of the model, the C index was calculated, and the calibration chart was plotted to evaluate the discrimination and calibration of the model. The model was evaluated by the Hosmer-Lemeshow goodness of fit test and external validation. The overall evaluation of the model was performed by the above methods.ResultsThe prognostic factors for complete remission of ulcerative colitis were younger age (15-65 years old) (OR=0.96, 95%CI: 0.94-0.99, P=0.002), non-chronic persistent (compared with primary type) (OR=0.36, 95%CI: 0.18-0.74, P =0.005), no microscopic bleeding (OR=0.42, 95%CI: 0.22-0.82, P=0.011), and decreased erythrocyte sedimentation rate (OR=0.97, 95%CI: 0.95-0.99, P=0.006). We used the above variables to construct the final model and drew a nomogram. The corrected C index was 0.735 (95%CI: 0.672-0.797), indicating that the model’s discrimination was acceptable. The calibration diagram shows that the calibration curve and the standard line roughly fit, indicating the calibration model is acceptable. The Hosmer-Lemeshow goodness of fit test (χ2=7.07, P=0.53) showed that the model was well fitted. We conducted an external test of the prediction model. The C index and confidence interval were 0.54(95%CI: 0.44-0.65).ConclusionIt is feasible to construct a prediction model by using data from randomized controlled trials. A prediction model based on the study data may provide an effective evaluation tool for clinical monitoring and targeted therapy after large sample validation.  
        关键词：ulcerative colitis;Five-Flavor Sophora Flavescens Radix Enteric-coated Capsules;nomogram;Bootstrap method   
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        Thought and Method

      • LIU Zhenzhu,LIU Xiuchao,TIAN Dong,WANG Weiguang,ZHAI Shuangqing
        Vol. 46, Issue 4, Pages: 536-540(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.013
        摘要：As a common pediatric disease, attention deficit disorder (ADHD) is hardly differentiated in patterns, both because of its various syndromes, and the main symptoms are mental and spiritual disorders. Based on the core concept of Huangdi Neijing, we discuss the clinical diagnosis and treatment of ADHD based on images. ADHD is studied using both physical and functional images, which mainly represent clinical symptoms of hyperactivity, unstable emotions, distractibility, and poor comprehension. We summarize the characteristics of ADHD as "excess in wind and fire image, deficiency in earth and water image", considering that "excess in wind and fire image" is responsible for the symptoms of hyperactivity and unstable emotions, while "deficiency in earth and water image" is responsible for distractibility. Further, the symptoms of poor comprehension and difficulties in communication indicate a disability of "renwu" (cognition of world) in the heart. We suggest corresponding therapies and prescriptions based on our clinical experience in order to provide a reference for the clinical diagnosis and treatment of hyperkinetic diseases in children.  
        关键词：Huangdi Neijing;core concept;image;five elements;attention deficit hyperactivity disorder   
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      • SONG Wei,ZHANG Zhongyi,WANG Kai,SHEN Tao,CHEN Mingling,XIAO Min
        Vol. 46, Issue 4, Pages: 541-545(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.014
        摘要：Image thinking in traditional Chinese medicine (TCM) is a way of thinking to establish connections with corresponding "images" and to explore the links between the essential laws of TCM and the material attributes, laws, and properties known in nature. Based on traditional image thinking, we compare hair to trees and combine TCM with the modern understanding of androgenetic alopecia to describe its pathogenesis. It is believed that plants and trees wither in dry conditions. This is similar to a lack of kidney essence; when blood can’t be transformed into essence, resulting in damage to emptiness of hair follicles, hair shrivels and falls off. Similarly, plants and trees can die due to excessive water over a long period of time, which is analogous to steaming on the parietal bone due to dampness-heat; the hair root is soaked, becomes soft, and dies. In other cases, because of soil hardening and poor permeability, the root cannot grow, which is analogous to blood stasis in the hair follicle; the flow of qi in the meridians is not smooth and the hair roots are not moistened, resulting in hair loss. The treatment of androgenic alopecia is therefore analogous to the treatment of natural plants and trees. Plants and trees need to be fertilized and irrigated; in analogy, the kidney should be nourished to secure the root so as to replenish yin and grow hair. Plants and trees need water drainage; similarly, turbidity and the fat should be transformed and reduced to strengthen the roots. Plants and trees need loose soil; in analogy, in the scalp, blood stasis should be removed to improve the blood supply of hair follicles. Furthermore, new hairs are like seedlings; therefore, we should pay attention to disease aftercare. This article discusses the treatment of androgenic alopecia based on image thinking in order to provide a new perspective for the clinical treatment of androgenic alopecia.  
        关键词：androgenic alopecia;image thinking;analogy;yin deficiency;dampness-heat;blood stasis   
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      • SUN Zhiqi,WANG Chao,ZHAO Haibin,HOU Jiqiu,SHI Jinyu,DING Wanli
        Vol. 46, Issue 4, Pages: 546-550(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.015
        摘要：Psycho-cardiological disease has many symptoms and a complex pathogenesis, so it is difficult to treat with syndrome differentiation in clinical practice. The combination of disease and syndrome is based on syndrome differentiation, starting from syndrome differentiation and combining disease differentiation with syndrome differentiation. By focusing on the main symptoms and summarizing the common symptoms of different diseases, precise positioning, and treatment based on syndrome differentiation are achieved. Using the diagnosis and treatment approach of "combining disease and syndrome to unify diseases" to treat Psycho-cardiological disease, that is, first extract the common pathogenesis behind various symptoms, then consider the particularity of the disease, and consider concurrent symptoms. Finally, treat the extracted syndrome based on syndrome differentiation. The diagnosis and treatment approach of "combining disease and syndrome to unify diseases" provides a reference for more precise treatment of Psycho-cardiological diseases and improving therapeutic effects in clinical practice.  
        关键词：combination of disease and syndrome;syndrome-based disease;psycho-cardiological disease   
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        Clinical Studies

      • LI Mengqian,ZHANG Xiaomei,LI Baozhong,CHE Likun,HU Jiarui,LI Rui,YU Xiaolin,XU Qiuwen,JIN Ying,LAI Yuxin,JIANG Liangduo
        Vol. 46, Issue 4, Pages: 551-556(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.016
        摘要：ObjectiveWe aimed to observe the clinical efficacy of treating medium-risk solid pulmonary nodules based on patient’s pathogenesis state.MethodsA prospective randomized controlled study was conducted to select patients with medium-risk solid pulmonary nodules who were admitted to either Dongfang Hospital of Beijing University of Chinese Medicine or Beijing Shijitan Hospital Affiliated to Capital Medical University from September 2020 to July 2022 (128 cases in total). The patients were randomly divided using the random number table method into the experimental group (85 cases) and the blank control group (43 cases) at a 2: 1 ratio. We diagnosed patients with (ⅰ) single state: qi deficiency, yin deficiency, yang deficiency, qi stagnation, and dampness-heat state, (ⅱ) combined state, or (ⅲ) a general state: if the patients did not meet any of the diagnosis criteria. Patients in the experimental group were treated with additional Sanjie basic prescription (Processed pinellia, Arisaema with bile, Balloon flower, Tuckahoe, Raw oyster, Radix notoginseng) according to the state at the time of consultation, while patients in the blank control group were not treated. Each course took 3 months, and patients received one or two courses. Lung CT scans were carried out after 3 and 6 months, and treatment efficacy was evaluated based on the reduction rate of the maximum diameter area of pulmonary nodules combined with the density and morphological changes.ResultsIn total, 115 patients completed the study (77 patients in the experimental group and 38 patients in the blank control group). The total clinical effective rates for the experimental group at 3 and 6 months were 51.95% and 49.02%, respectively, which were higher compared to 7.89% and 8.57%, respectively for the blank control group (P<0.01). The maximum diameter of solid pulmonary nodules in the experimental group decreased compared with the baseline value, while it increased in the blank control group.ConclusionUnder the condition of limited traditional syndrome differentiation and treatment, the treatment of medium-risk solid pulmonary nodules based on overall pathogenesis state received certain clinical efficacy.  
        关键词：treatment based on pathogenesis state;medium-risk pulmonary nodules;solid pulmonary nodules;randomized controlled clinical study   
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      • LAN Tianyi,WANG Zihan,YAN Zeran,YAO Chuanhui,YU Hongwei,MA Ensen,ZHANG Liubo,ZHANG Yuqiao,XU Caiqin,WANG Jinping,ZHANG Nan,TAO Qingwen,XU Yuan
        Vol. 46, Issue 4, Pages: 557-563(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.017
        摘要：ObjectiveWe aimed to explore the delaying effect of Bushen Zhiwang Decoction (a compound prescription for tonifying the kidney and treating arthritis) on bone destruction in rheumatoid arthritis (RA) patients with a pattern of deficiency of both liver and kidney based on the modified total Sharp score (mTSS).MethodsA total of 170 RA patients with a pattern of deficiency of both liver and kidney attending the Department of TCM Rheumatism of the China-Japan Friendship Hospital from September 2020 to September 2021 were prospectively enrolled in this randomized controlled trial. A stochastic grouping method was used to assign patients to the experimental group or the control group. Patients in the experimental group were treated with Bushen Zhiwang Decoction combined with regular doses of conventional synthetic disease-modifying antirheumatic drugs (cDMARDs), and patients in the control group were treated only with regular doses of cDMARDs. The observation period was 12 months. The mTSS was used as the main index to observe the degree of bone destruction in both groups after treatment.ResultsA total of 153 patients completed the final observation (76 in the experimental group and 77 in the control group). There were no significant differences in baseline characteristics between the two groups. After 12 months of treatment, patients in the experimental group showed a more significant improvement in erythrocyte sedimentation rate and traditional Chinese medicine syndrome score compared to patients in the control group (P<0.05). Radiographic evaluation revealed an increase in mTSS in both groups, but the increase in mTSS was significantly smaller (P<0.01) in the experimental group. Radiological progression of bone destruction occurred in 59 patients (77.6%) in the experimental group, a much lower proportion than in the control group (75 patients, 97.4%) (P<0.01). Visualization of the proportional distribution showed that mTSS growth values were consistently lower in the experimental group than in the control group.ConclusionTreatment with Bushen Zhiwang Decoction combined with cDMARDs can effectively delay the progression of bone destruction in RA patients with a pattern of deficiency of liver and kidney.  
        关键词：rheumatoid arthritis;bone destruction;Bushen Zhiwang Decoction;modified total Sharp score;randomized controlled trial   
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      • HUANG Jinchang,ZHANG Chunguang
        Vol. 46, Issue 4, Pages: 564-571(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.018
        摘要：The triple-jiao is considered "the envoy of original qi, " but there is no documentation on what is "the ambassador" in ancient books. By combining prior literature and clinical thinking, we put forward the idea that "governor conception and thoroughfare vessels are the ambassador of original qi". The original qi is the root of ascending, descending, exiting, and entering of visceral meridians and collaterals. "Governor conception and thoroughfare vessels" is the main channel of the upward, downward, inward and outward movement of original qi. Meridian collaterals, zang-fu organs, four extremities and limbs are the branches of the ascending, descending, exiting, and entering of original qi. "Governor conception and thoroughfare vessels" and the triple-jiao constitute a complex network of original qi distribution and jointly maintain the basic activities of life. In accordance with "governor conception and thoroughfare vessels is the ambassador of original qi" combined with clinical practice, in the treatment of spinal cord malignant tumors, it is necessary to regulate the governor vessel to release the exterior to regulate the exiting and entering of qi. In persistent disease, the exterior should be released to regulate the exiting and entering of qi, which is beneficial to ascending and descending of qi. For emergencies and severe diseases illness, it is necessary to tonify the original qi to facilitate the ascending, descending, exiting, and entering of qi. Therefore, we put forward the view that in the treatment of malignant tumors of the spinal cord, attention should be paid to the access of qi. In persistent disease, one should not forget the use of wind-dispelling Chinese medicinals to relieve the extenor. In emergencies and severe diseases, moxibustion should be applied to the Dantian district acupoints. The aim of the present study is to provide a reference for clinical workers in the treatment of persistent disease and acute critical illness.  
        关键词：Governor conception and thoroughfare vessels;the ambassador of original qi;upward, downward, inward and outward movement;clinical application based on syndrome differentiation   
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      • ZHOU Shaofeng,WANG Yaoxian,ZHENG Huijuan,CHEN Huixi,SUN Weiwei,LIU Weijing
        Vol. 46, Issue 4, Pages: 572-576(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.019
        摘要："Bitterness firming kidney" is a therapeutic principle proposed in the Huangdi Neijing in accordance with the physiological characteristics of kidney storing essence. Based on the understanding of physicians in past dynasties on "bitterness firming kidney, " this paper summarizes the specific connotation of "bitterness firming kidney, " which includes medicinals bitter in taste strengthening kidney yin, bitter and cold medicinals subduing hyperactivity of liver yang, slightly bitter medicinals nourishing yin, and corresponding representative prescriptions and clinical application. The core of the treatment is to take care of the kidney essence and qi, including bitter and cold medicinals eliminating pathogenic factors to strengthen kidney yin or subduing hyperactivity of liver yang cross kidney to solidify yin, or to use slightly bitter medicinals to nourish the kidney yin essence. Then, taking kidney diseases as an example, a specific "bitterness firming kidney" formula is applied to treat urinary tract infection, diabetic nephropathy, and chronic kidney disease to alleviate the side effects of hormone therapy, so as to improve clinical diagnosis and treatment of kidney diseases through classical traditional Chinese medicine.  
        关键词：bitterness firming kidney;kidney storing essence;traditional Chinese medicine;kidney disease   
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        Hematology and Oncology

      • WANG Jinhuan,SHI Wenxuan,SUN Weizheng
        Vol. 46, Issue 4, Pages: 577-583(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.021
        摘要：Through the analysis of relevant literatures, the characteristics and advantages of traditional Chinese medicine (TCM) and Western medicine in the clinical treatment of IgA vasculitis are reviewed. Studies published between January 1, 2012, and November 10, 2022, were retrieved from the China National Knowledge Infrastructure database and the PubMed database to summarize and evaluate the key challenges in the clinical treatment of IgA vasculitis: recurrent and not easy to cure, gastrointestinal symptoms which are difficult to resolve, inevitable and protracted kidney damage. With improvement in IgA vasculitis treatment, these key difficulties have become urgent problems. TCM has unique advantages in the treatment of this disease, but there are still major problems in TCM-based treatment: the lack of guidelines for diagnosis and treatment of IgA vasculitis in adults and children, hormone use norms, and high-quality clinical studies. This article discusses the clinical treatment of IgA vasculitis based on either TCM alone or integrated traditional Chinese and western medicine to further improve the clinical treatment of this disease.  
        关键词：IgA vasculitis;recurrence;abdominal;nephritis;treatment   
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      • LUO Mei,TIAN Shaodan,HOU Li,ZHANG Dingdan,FAN Qiuyue,CHEN Xinyi
        Vol. 46, Issue 4, Pages: 584-592(2023) DOI: 10.3969/j.issn.1006-2157.2023.04.020
        摘要：ObjectiveTo investigate the distribution rule of traditional Chinese medicine (TCM) syndromes and symptoms of pancreatic cancer, and to analyze its correlation with various factors, such as gender, age, the course of disease, lesion sites, clinical stage, presence of lymph node or distant metastasis, and previous treatment.MethodsWe retrospectively analyzed the medical records of 319 patients with pancreatic cancer. The basic information and syndromes were analyzed. Six common clinical basic syndromes (syndrome of stagnation of qi and blood stasis, syndrome of dampness-heat amassment, syndrome of damp retention due to spleen deficiency, syndrome of yin deficiency of liver and kidney, syndrome of deficiency of both qi and blood, and syndrome of heat-toxin amassment and blood stasis) were selected for syndrome differentiation according to the relevant TCM syndrome diagnosis standards. The distribution rules of TCM syndromes and symptoms were statistically described. A multinomial logistic regression model was used to assess the correlation between TCM syndromes and various factors such as gender, age, the course of disease, lesion sites, clinical stage, lymph node and distant metastasis, and previous treatment.ResultsPatients with pancreatic cancer experienced abdominal pain and abdominal distension as the first symptom, and the primary clinical symptoms were anorexia, fatigue, and abdominal pain. The distribution of TCM syndromes from high to low was: syndrome of damp retention due to spleen deficiency, syndrome of dampness-heat amassment, syndrome of yin deficiency of liver and kidney, syndrome of stagnation of qi and blood stasis, syndrome of deficiency of both qi and blood, and syndrome of heat-toxin amassment and blood stasis. The distribution of TCM syndromes in patients with pancreatic cancer with regard to differences in gender, age, disease course, lesion sites, presence of lymphatic metastasis, and surgery or chemotherapy was significantly different (P<0.05, P<0.01). Syndrome of qi stagnation and blood stasis was positively associated with age and negatively associated with the course of disease. Chemotherapy was a risk factor for syndrome of yin deficiency of liver and kidney. Male was a protective factor for syndrome of deficiency of both qi and blood.ConclusionThe primary TCM syndromes in patients with pancreatic cancer were syndrome of damp retention due to spleen deficiency and syndrome of dampness-heat amassment. Clinical characteristics, such as gender, age, the course of disease, lesion sites, presence of lymph node metastasis, and chemotherapy were influencing factors for TCM syndromes.  
        关键词：pancreatic cancer;traditional Chinese medicine;syndrome;symptom;prognosis   
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