最新刊期
卷 47 ， 期 10 ， 2024
- 摘要：Extracellular vesicles (EVs) are secreted by various cells and carry information such as parent cell-derived RNA, DNA, proteins, and lipids. They mediate information exchange between cells and organs, playing a crucial role in disease occurrence and development, diagnosis, treatment, and targeted drug delivery. EVs are also closely associated with traditional Chinese medicine theories and treatments. The qi-blood-fluid and visceral outward manifestation theories are the fundamental theories of traditional Chinese medicine. EVs belong to the fluid category and can reach other viscera through the blood vessels. They regulate the relationship between the viscera or cause imbalances between the viscera, resulting in disease. Chinese materia medica, which primarily includes traditional Chinese patent medicines and simple preparations, and Chinese herbal medicine, can help regulate the quantity and content of endogenous EVs in the body to improve pathological conditions. Additionally, EV-like particles derived from herbal medicines are a major form of pharmacologically active substances that contribute to the therapeutic effects of Chinese medicine in treating diseases. Furthermore, EVs can also be used as carriers to deliver drugs for targeted therapy. Therefore, exploring the relationship between traditional Chinese medicine and EVs will elucidate the modern scientific connotation of traditional Chinese medicine theories and reveal the mechanism of Chinese materia medica. The development of engineered EVs based on Chinese materia medica will provide novel strategies for clinical treatment.关键词：extracellular vesicles;traditional Chinese medicine theories;Chinese materia medica;Chinese herbal medicine-derived EV-like particles
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发布时间：2024-10-29
Expert Commentary
- 摘要：The risk of colorectal cancer is substantially higher in patients with long-term colorectal inflammation than in the general population. Prolonged inflammation is an essential factor that triggers colorectal cancer. The dynamic pathological evolution process of the classic " inflammation-mediated carcinogenesis" in the colorectum is proctocolitis→dysplasia→cancer. Traditional Chinese medicine lacks a systematic consensus on the pathogenesis of colorectal " inflammation-mediated carcinogenesis". This article proposes the theory of " pathogenic factors lurk intestinal collaterals" to explain the development law of pathogenesis in the dynamic evolution of colorectal " inflammation-mediated carcinogenesis". Internal and external factors can trigger the movement of the latent pathogenic factors, thereby damaging the intestinal tissues, when latent pathogenic factors are hidden in the intestinal collaterals, and the healthy qi is unable to expel them. The prolonged course of the disease further weakens the healthy qi, allowing the latent pathogenic factors to accumulate in the intestinal collaterals, intertwine with phlegm-dampness and blood stasis, accelerate accumulation, and lead to cancer. " Latent pathogens trapped in the intestinal collaterals" is the core pathogenesis during inflammation-mediated carcinogenesis. Thus, to prevent colorectal inflammation-mediated carcinogenesis, consideration should be given to the principle of driving away pathogenic factors and dredging the collaterals in clinical practice. The theory regarding " latent pathogens trapped in the intestinal collaterals" can provide a theoretical reference for syndrome differentiation and treating colorectal inflammation-mediated carcinogenesis and offer novel ideas for clinical treatment.关键词：colorectum;inflammation-mediated carcinogenesis;latent pathogens trapped in the intestinal collaterals;intestinal collaterals;driving away pathogenic factors and dredging the collaterals
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发布时间：2024-10-29 - 摘要：As essential concepts of the traditional Chinese medicine theory, " deficiency" and " toxin" have been enriched and developed continuously since Huangdi Neijing. By tracing back and combing " deficiency" and " toxin", this paper sums up their relationship, analyzes and explains their basic connotation, and discusses their extension. The " deficiency-toxin" theory has two meanings: it covers the pathological state of the human body with deficiency of vital qi and excess of pathogenic toxin, and it also refers to the pathological evolutionary process in which " deficiency" and " toxin" promote each other. Based on the connotation and dynamic pathogenesis of the " deficiency-toxin" theory, it is pointed out that this theory can be applied to the prevention and treatment of infectious diseases and chronic debilitating diseases, including the " inflammation-cancer transformation" of inflammatory bowel disease. Taking inflammatory bowel disease as an example and combining its Western medical background, this paper expounds on the pathogenesis and treatment of the " inflammation-cancer transformation" of inflammatory bowel disease, and provides a paradigm of " deficiency-toxin" theory guiding clinical research.关键词：deficiency-toxin;inflammation-cancer transformation;inflammatory bowel disease
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发布时间：2024-10-29 - 摘要：Primary multiple pulmonary nodules have a high incidence, and the size and number of pulmonary nodules on computed tomography images increase with time. Postoperative pathology of multiple pulmonary nodules shows chronic inflammation, adenomatoid change, carcinoma in situ, microinvasive carcinoma, infiltrating carcinoma, and other forms. There is a possibility of " inflammation-cancer transformation" in multiple pulmonary nodules with prolonged time and external irritation. The accumulation of dampness phlegm and blood stasis is the basis of the theory of " inflammation-cancer transformation." Healthy qi deficiency is the key to the " inflammation-cancer transformation." Qi and yang deficiency are the root cause of healthy qi depletion. Emotional depression, dampness, phlegm, and blood stasis transforming into toxins provide the impetus for " inflammation-cancer transformation." There are struggle between healthy qi and evil qi, and waxing and waning of dampness, phlegm and blood stasis in the process of " inflammation-cancer transformation." The dampness phlegm and blood stasis will increase when evil qi increases and healthy qi decreases. In contrast, the size, number, and malignancy of nodules will increase during healthy qi deficiency, showing a dynamic shift from inflammation to atypical adenomatous hyperplasia to cancer. The dampness phlegm and blood stasis will be absorbed as the healthy qi increases and evil qi decreases so that lung cancer can be reversed. External irritation, such as acute inflammatory stimulation, may accelerate the transformation of " inflammation-cancer" in multiple pulmonary nodules.关键词：primary multiple pulmonary nodules;inflammation-cancer transformation;health qi deficiency;emotional depression;dampness phlegm and blood stasis accumulation;preventive treatment of disease
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发布时间：2024-10-29 - 摘要：" State-target-cause-result" is a new clinical theory combining macroscopic and microscopic syndrome differentiation based on the holistic view of traditional Chinese medicine combined with Western medical research. The " inflammation-cancer transformation" of chronic pancreatitis is a complex pathological process that is associated with the interaction between the pancreas and various pathological factors and multiple objects, involving the imbalance of multiple homeostasis. The microscopic process of " inflammation-cancer transformation" in chronic pancreatitis is the " target, " whereas various factors that could induce its occurrence under chronic inflammatory conditions are the " state." The " inflammation-cancer transformation" of chronic pancreatitis is summarized as yin and yang imbalance, qi movement disorder, endogenous dampness, heat, blood stasis, and turbid phlegm stagnation, unresolved congestion resulting in deficiency caused by stagnation, intermingled deficiency and excess, and internal cancer toxin generation. This paper elucidates the pathogenesis and intervention strategies of the " inflammation-cancer transformation" of chronic pancreatitis from a macro perspective of " state, " focusing on reducing the impact of " state" imbalance on the " target" to establish a balanced pancreas-immune-microbiota state. The aim is to broaden the theory for exploring the mechanism and drug development related to chronic pancreatitis " inflammation-cancer transformation" in both traditional Chinese and Western medicine.关键词：state-target-cause-result;chronic pancreatitis;inflammation-cancer transformation;pancreatic cancer;preventive treatment of disease
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发布时间：2024-10-29
Special Theme: TCM Prevention and Treatment of "inflammation-cancer transformation"
- 摘要：The occurrence and development of the pattern stem from the intricate interactions among specific biological molecular networks. Thus, broadening the perspective beyond a single molecular factor and investigating the intricate interconnections among molecular network targets across various levels within complex biological systems is essential when exploring the relationship between prescriptions and their corresponding patterns. This article integrates traditional Chinese image-number thinking with modern quantitative analysis, using qualitative " network image thinking" to innovatively apply numerical method in modular pharmacological analysis. This approach explores the connections between macro-level manifestations of complex biological systems and micro-level molecular network features, aiming to elucidate the correlations between prescriptions and patterns across different levels. An original method system of " network image-number thinking" in traditional Chinese medicine was established to systematically reveal the laws and mechanisms underlying the interaction between prescriptions and the human body. The " network image-number thinking" proposed in this paper has multiple core characteristics: it reflects the dialectical unity of " mutual reliance between image and number" and shows the multi-dimensional hierarchy, sequentiality, self-organization, and the emergence of the network system. This paper also elucidates the fundamental features of functional dynamism—which is characterized by the " ease of constant evolution" —and self-regulation, marked by " harmony and symbiosis" within complex network systems. Furthermore, we promote the practicality and superiority of using " network image-number thinking" to guide the module pharmacology when studying the relationship between prescriptions and their corresponding patterns. This thinking method framework provides a novel perspective for developing module pharmacology, effectively highlighting the leading role of original thinking in modern research on traditional Chinese medicine and moving towards a new unified medical system.关键词：image-number thinking;network image thinking;network number thinking;relationship between prescriptions and patterns;modular pharmacology
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发布时间：2024-10-29 - 摘要：The debate over the governor of spirit is an age-old yet ever-renewing topic in Traditional Chinese Medicine (TCM). The theory primarily revolves around three viewpoints: the heart governs the spirit, the brain governs the spirit, and the heart and brain have a joint role governing the spirit. This article, proceeding from the debate on the dominance of the divine spirit, aims to establish a novel perspective that integrates second-generation cognitive science with the TCM theory of the divine spirit based on their shared concerns regarding cognitive issues. Consciousness is the holistic living organism, and according to the cognitive concepts of second-generation cognitive science, consciousness is an interactive process between the body and the environment. Incorporating the embodied characteristics of the second-generation cognitive science, which emphasizes a return to the human body, behavior, and environment, and its holistic research paradigm into the exploration of the TCM theory of the divine spirit can provide a novel interpretive perspective for the debate on the dominance of the divine spirit. Additionally, conducting an in-depth analysis of the commonalities and differences between second-generation cognitive science and the TCM theory of the divine spirit offers theoretical principles and new research pathways for further developing the TCM theory of the divine spirit. This study has remarkable value in promoting the modernization of the TCM theory of the divine spirit.关键词：traditional Chinese medicine theory of the divine spirit;the second-generation cognitive science;explanatory perspective;theoretical principle;research path
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发布时间：2024-10-29 - 摘要：This article explores the practical situation, construction significance, core points, and enhancement dimensions in constructing the discourse system of traditional Chinese medicine from a macro perspective. It also examines the ways linguistics can help alleviate the challenges in this process. The discourse system of traditional Chinese medicine has gone through three stages. The theory is currently unclear, and the discourse cannot be transmitted without fundamentally solving the problem of " aphasia." The discourse system of traditional Chinese medicine is an inevitable requirement for creating modern and international traditional Chinese medicine models. Its construction must form a subjective understanding of the discourse system, strengthen the advantage of originality, establish an expression paradigm of original system interpretation and new expressions of modern novel quality development, and build an influential international discourse system. The improvement dimension of the discourse system of traditional Chinese medicine should focus on domestic popularization and global dissemination. Strong strategic support should be provided using the epistemological and methodological frameworks of both traditional and modern linguistics.关键词：traditional Chinese medicine;discourse system;discourse power;linguistics;internationalization
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发布时间：2024-10-29 - 摘要：" Metaphysics" is a philosophical perspective different from mechanical materialism, and the Chinese philosophy and traditional Chinese medicine′s view of the human body as " body-qi-spirit" embodies a " metaphysical" cognitive pattern. This paper takes the content of General Treatise on Causes and Manifestations of All Diseases·Wind Diseases as an example to analyze and compare the cognitive evolution process of wind diseases in General Treatise on Causes and Manifestations of All Diseases. It is argued that the General Treatise on Causes and Manifestations of All Diseases constructs a body model characterized by " metaphysics" where the meridian system connects the entire body to facilitate the flow of qi and blood, with the organs serving as the storage places for essence-qi. Through the analysis of the symptoms of stroke, it reveals the specific application of this body model in the theory of disease mechanisms. The meridian tendons, as the subordinate parts of the meridian system, become the physical basis for the explanation of stroke with their substantive existence. It is thus determined that General Treatise on Causes and Manifestations of All Diseases has perfected the two-layer space of " metaphysical-physical" body structure of the theory of disease pathogenesis, laid the foundation for the theory of disease mechanism with the state of qi and blood as the focus of discussion, and constructed a model of disease diagnosis and treatment, which is " disease-symptom-etiology and pathogenesis-treatment" .关键词：metaphysics;General Treatise on Causes and Manifestations of All Diseases;traditional Chinese medicine pathogenesis theory;Synopsis of Golden Chamber;stroke
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发布时间：2024-10-29
Theoretical Study
- 摘要：ObjectiveTo explore the pharmacological effects and regulatory mechanisms of Carthami Flos water extract and its main constituent, hydroxysafflower yellow A (HSYA), on primary dysmenorrhea rats with cold coagulation and blood stasis.MethodsForty-two female specific pathogen-free grade rats aged 6-8 weeks were divided into blank, model, HSYA(0.01 g/kg), ibuprofen(0.04 g/kg), and low(0.06 g/kg), medium(0.20 g/kg), and high(0.40 g/kg) Carthami Flos water extract dose groups using the random number table method, with six rats per group. A rat model was established using ice water bath stimulation combined with estradiol benzoate and oxytocin. Continuous gavage was administered for 6 days from the seventh day of modeling. After the intervention, the writhing reaction test was conducted.The rats, uteri, and ovaries were weighed to calculate the organ index. An enzyme-linked immunosorbent assay and radioimmunoassay were used to detect the prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) contents in the uterus, thromboxane B2 (TXB2) and 6-keto-prostaglondin F1α (6-keto-PGF1α) in plasma, and estradiol (E2) in the serum. Hematoxylin and eosin staining were used to detect the pathological changes in uterine tissue. Immunohistochemistry was used to determine cyclooxygenase-2 (COX-2) expression in uterine tissue, whereas immunofluorescence was used to measure follicle-stimulating hormone receptor (FSH-R) expression in ovarian tissue. Western blotting was used to detect gonadotropin-releasing hormone receptor (GnRH-R) and FSH-R expression in uterine tissue.ResultsCompared with the blank group, the rats in the model group exhibited an increase in uterine and ovarian indices and increased PGE2 and PGF2α in the uterus. TXB2 in the plasma and E2 in the serum were also evaluated. Additionally, 6-keto-PGF1α decreased, and COX-2, GnRH-R, and FSH-R expression in the uterus and FSH-R expression in the ovaries also increased(P<0.05). The morphology of the uterine tissue was disordered. Compared with the model group, the low Carthami Flos water extract dose group showed a decrease in uterine index (P<0.05). In the medium and high Carthami Flos water extract dose groups, the writhing response decreased, as did the uterine and ovarian indices and PGE2 and TXB2 contents. The 6-keto-PGF1α content increased, whereas the GnRH-R protein expression in the uterus decreased (P<0.05). The high Carthami Flos water extract dose group also showed a decrease in PGF2α and FSH-R protein expression in the uterus (P<0.05). In the HSYA group, the writhing response decreased, the uterine and ovarian indices decreased, the PGE2, PGF2α, and TXB2 contents decreased, and GnRH-R and FSH-R protein expression decreased in the uterus(P<0.05). The serum E2 levels of the groups that received Carthami Flos water extract at various doses and those of the HSYA group were reduced, and the uterine morphology was improved. COX-2 expression in the uterus and FSH-R protein expression in the ovaries were also reduced (P<0.05).ConclusionCarthami Flos water extract and HSYA can improve the pathological state of primary dysmenorrhea rats with cold coagulation and blood stasis. Its mechanism may be related to regulating the hypothalamic-pituitary-ovary axis.关键词：Carthami Flos;hydroxysafflower yellow A;primary dysmenorrhea;cold coagulation and blood stasis;hypothalamic-pituitary-ovary axis;rats
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发布时间：2024-10-29 - 摘要：ObjectiveTo investigate the mechanism of astragaloside I, the active constituent of milkvetch root, in inhibiting podocyte injury and improving diabetic kidney disease.MethodsAccording to the body weight, 60 male db/db mice were randomly divided into the model group, astragaloside Ⅰ low-dose group (10 mg/kg), astragaloside I medium-dose group (20 mg/kg), astragaloside I high-dose group (40 mg/kg), and valsartan group (10 mg/kg), with 12 mice per group. Twelve db/db littermate control db/m mice were used as the control group. The drug was administered by gavage for 8 weeks. Transmission electron microscope was used to observe the ultrastructure of the kidney; immunohistochemistry and Western blotting were used to detect the expression of nephrotic protein (nephrin), a marker of renal podocytes; enzyme-linked immunosorbent assay was used to detect the contents of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in the serum of mice; Western blotting was used to detect the protein expressions of NOD-like receptor thermoprotein domain-related protein 3 (NLRP3), cysteinyl aspartate specific proteinase 1 (Caspase-1), and Gasdermin D (GSDMD) in kidney tissue.ResultsCompared with the control group, the glomeruli of the model group showed obvious podocyte loss and foot process fusion; the protein expression of nephrin was decreased (P<0.05); the contents of IL-1β and IL-18 in serum were increased (P<0.05); the protein expressions of NLRP3, Cleaved-Caspase-1, and GSDMD-N were increased (P<0.05). Compared with the model group, the renal pathological damage in the astragaloside Ⅰ administration groups were alleviated; the protein expression of nephrin was increased (P<0.05); the contents of IL-1β and IL-18 in serum were decreased (P<0.05); the protein expressions of NLRP3, Cleaved-Caspase-1, and GSDMD-N were decreased (P<0.05).ConclusionAstragaloside I may play a role in intervening diabetic kidney disease by inhibiting pyroptosis and improving podocyte injury.关键词：milkvetch root;astragaloside Ⅰ;diabetic kidney disease;podocytes;pyroptosis;mice
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发布时间：2024-10-29 - 摘要：ObjectiveTo explore the effect and mechanism of Shenqi Jieyu Formula (SQJYF) on depression and anxiety-like behavior in adult offspring rats after maternal separation (MS). This was done by observing the levels of metabolites in the hippocampus and prefrontal cortex of the Papez circuit through magnetic resonance spectroscopy (MRS).MethodsTwenty-four Sprague-Dawley rats at 16 days of pregnancy were divided into the normal, model, SQJYF, and fluoxetine groups using the random number table method, with six rats per group. MS was performed 4 h a day from the first to the 21st day after birth. Starting from the 15th day, the corresponding medications(SQJYF group: 12.5 g/kg, fluxetine group: 2.33 mg/kg) were administered to mother rats once a day for 7 consecutive days. Normal breastfeeding was performed during the gavage. The offspring rats were weaned on the 22nd day. According to the experimental grouping of mother rats, one male and one female offspring rat of each mother rat were randomly selected using the random number table method, with six rats per group. They were divided into normal, model, SQJYF, and fluoxetine female and male rat groups, respectively. After 8 weeks of feeding, the offspring rats in each group were subjected to forced swimming test(FST), the sucrose water consumption test, and open field tests (OFT), and the elevated plus maze (EPM) test was conducted. The relative values of N-acetyl-aspartate (NAA), choline (Cho), glutamic acid (Glu), myo-inositol (mI), and creatine (Cr) in the hippocampus and prefrontal cortex were detected using MRS.ResultsCompared with that of the normal female and male rat groups, the weight of the rats in the model group was decreased as well as sucrose water consumption and the horizontal and vertical scores of OFT, whereas the immobility time of FST increased. Compared with the normal female and male rat group, the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of the female and male rats in the model group decreased (all P<0.01). The proportion of rats entering the open arm and open arm residence time of the model female rat group in the EPM test decreased, whereas the Cho/Cr value of the right hippocampus of the female rats in the model group increased (P<0.05). Compared with the model female and male rat group, the weight of the rats in the SQJYF and fluoxetine groups increased, the immobility time of FST decreased, but the sucrose water consumption and the horizontal and vertical OFT scores increased (P<0.01). The proportion of rats entering the open arm and open arm residence time in the EPM increased in the SQJYF and fluoxetine female rat groups compared to those of the model female rat group (P<0.01). Compared with the model female rat group, the NAA/Cr and Glu/Cr values in the bilateral hippocampus and prefrontal cortex of female rats in the SQJYF and fluoxetine groups increased. The NAA/Cr and Glu/Cr values in the right hippocampus and prefrontal cortex of male rats in the SQJYF and fluoxetine groups were higher than those in the model group (P<0.05), whereas the Cho/Cr value in the right hippocampus of female and male rats in the SQJYF and fluoxetine groups decreased (P<0.05).ConclusionMS in early life can lead to depression and anxiety-like behavior in adult offspring. However, SQJYF may exert antidepressant and anti-anxiety effects by regulating the metabolite levels in related brain regions of the Papez circuit.关键词：maternal separation;magnetic resonance spectroscopy;Papez circuit;offspring;Shenqi Jieyu Formula;rats
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发布时间：2024-10-29 - 摘要：ObjectiveTo investigate the effect and mechanism of Jiawei Ditan Decoction on cardiomyocyte ferroptosis in rats with chronic intermittent hypoxia based on the phosphoinositide 3-kinase(PI3K)/protein kinase B (Akt) signaling pathway.MethodsThirty 8-week-old male Sprague-Dawley rats were randomly divided into normal control, low-oxygen intervention, and Jiawei Ditan Decoction intervention groups using the random number table method, with 10 rats per group. The low-oxygen and Jiawei Ditan Decoction intervention groups were treated with intermittent hypoxia chamber for modeling, with 8 h of intervention daily. Gavage administration was performed before and after daily intervention. The intervention group received a dosage of 16.38 g/kg Jiawei Ditan Decoction, whereas the other two groups received normal saline. The experimental intervention period was 12 weeks. Hematoxylin and eosin staining was used to observe the morphology of myocardial tissue. Transmission electron microscope was used to observe the mitochondrial ultrastructure in cardiomyocytes. Biochemical detection was used to measure the Fe2+ and malondialdehyde (MDA) content in myocardial tissue. Phosphorylated-phosphoinositide 3-kinase (p-PI3K), PI3K, phosphorylated-protein kinase B (p-Akt), Akt, solute carrier family 7 member 11 (SLC7A11), glutathione peroxidase 4 (GPX4), nuclear factor erythroid 2-related factor 2 (Nrf2), and acyl-coenzyme A synthetase long-chain family member 4 (ACSL4) protein expression in myocardial tissue were measured using western blotting. The rat cardiomyocyte cell line, H9c2, was cultured in high glucose Dulbecco′s Modified Eagle Medium, and the ultra-high-performance liquid chromatography was used to detect drug components in Jiawei Ditan Decoction. The CCK-8 assay was used to detect the cell survival rate of cells treated with different concentrations of Jiawei Ditan Decoction. The cells were divided into the normoxic, erastin, and erastin + Jiawei Ditan Decoction intervention groups, and p-Akt and GPX4 protein expression was measured using western blotting. p-PI3K and GPX4 protein expression were detected in the normoxic, low-oxygen intervention 12 h, and low-oxygen intervention 12 h + 740Y-P groups. The p-PI3K, PI3K, p-Akt, Akt, and GPX4 protein expression was detected in the normoxic, low-oxygen intervention 6 h, low-oxygen intervention 12 h, low-oxygen intervention 12 h + Jiawei Ditan Decoction low-dose, low-oxygen intervention 12 h + Jiawei Ditan Decoction medium-dose, and low-oxygen intervention 12 h + Jiawei Ditan Decoction high-dose groups (drug concentrations of 5, 10, and 20 g/L, respectively).ResultsThe myocardial cells in the low-oxygen intervention group were disordered and swollen and the mitochondrial arrangement of myocardial cells was disordered, with increased mitochondrial membrane density, ruptured cristae, and vacudar degeneration compared with those in the normal control group. The myocardial cells in the Jiawei Ditan Decoction intervention group were arranged neater, and the morphology of mitochondria was relatively regular than those in the low-oxygen intervention group, and no apparent swelling was observed. Compared with the normal control group, the low-oxygen intervention group showed an increase in the MDA and Fe2+ content, a decrease in the p-PI3K/PI3K and p-Akt/Akt values, decreased SLC7A11, GPX4, and Nrf2 expression, and increased ACSL4 expression (P<0.05). Compared with the low-oxygen intervention group, the Jiawei Ditan Decoction intervention group showed a decrease in MDA and Fe2+ content, an increase in the p-PI3K/PI3K and p-Akt/Akt values, increased SLC7A11, GPX4, and Nrf2 expression, and decreased ACSL4 expression (P<0.05). Jiawei Ditan Decoction contained DL-stachydrine, D-(+ )-malicacid, adenosine, etc.The cell survival rate of the 10.00 g/L group increased (P<0.05) compared to that of the Jiawei Ditan Decoction 0, 1.25, 2.50, 5.00, and 20.00 g/L groups. Compared with the normoxic group, p-Akt and GPX4 expression decreased in the erastin group (P<0.05); compared with the erastin group, the erastin + Jiawei Ditan Decoction intervention group showed increased p-Akt and GPX4 expression (P<0.05). Compared with the normoxic group, p-PI3K and GPX4 expression decreased in the low-oxygen intervention 12 h group (P<0.01); compared with the low-oxygen intervention 12 h group, the low-oxygen intervention 12 h + 740Y-P group showed increased p-PI3K and GPX4 expression (P<0.05). Compared with the normoxic group, GPX4 expression and the p-Akt/Akt and p-PI3K/PI3K were reduced in the low-oxygen intervention 6 and 12 h groups (P<0.05); compared with the low-oxygen intervention 6 h and 12 h groups, the p-PI3K/PI3K and p-Akt/Akt values increased in the low-oxygen intervention 12 h + Jiawei Ditan Decoction low, medium, and high-dose groups (P<0.05). GPX4 expression was also increased (P<0.05).ConclusionJiawei Ditan Decoction may improve cardiomyocyte ferroptosis in rats by regulating the PI3K/Akt signaling pathway, thereby playing a protective role against chronic intermittent hypoxia-induced cardiac injury in rats.关键词：Jiawei Ditan Decoction;phosphoinositide 3-kinase/protein kinase B;chronic intermittent hypoxia;myocardium;ferroptosis;rats
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发布时间：2024-10-29
Experimental Study
- 摘要：ObjectiveThe study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine (TCM) and TCM syndrome elements in different chronic stages of psoriasis vulgaris.MethodsA database was constructed using electronic medical records collected from July 2019 to March 2024 from 1, 049 patients with psoriasis vulgaris. The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages: initial diagnosis, progressive stage (Week 2-3), progressive stage (Week 4-5), skin lesion improvement stage (Week 6-7), and remission stage. The syndrome elements network was constructed using community detection algorithms, and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis. In the syndrome differentiation of local skin lesions, blood heat syndrome was the most common (79.79%); among the disease location of TCM syndrome elements (called "disease location" ), liver was the most prevalent (35.62%); and among the pathological factors of TCM syndrome elements (called "pathological factors" ), fire (heat) was the most common (75.48%). (ⅱ) Active stage (Week 2-3). In the syndrome differentiation of local skin lesions, blood heat syndrome remained the most prevalent (73.13%); among the disease location, liver was still the most prevalent (31.71%); and among the pathological factors, fire (heat) continued to be the most common (82.11%), while dampness (22.26%) and qi stagnation (8.39%) began to increase. (ⅲ) Active stage (Week 4-5). The syndrome differentiation of local skin lesions was dominated by blood heat syndrome (45.91%) and blood dryness syndrome (37.19%); among disease location, the interior was the most prevalent (15.25%); and among the pathological factors, fire (heat) remained the most common (50.66%), with an increase in yin deficiency (34.26%). (ⅳ) Skin lesion improvement stage (Week 6-7). In the syndrome differentiation of local skin lesions, both blood dryness syndrome (49.44%) and blood stasis syndrome (33.33%) increased; among the disease location, meridians increased most significantly and became the most prevalent (13.44%); and among the pathological factors, blood stasis increased most significantly and became the most prevalent (28.20%). (ⅴ) Remission stage. In the syndrome differentiation of local skin lesions, blood stasis syndrome became the primary (55.69%), while the percentage of blood dryness syndrome decreased (21.16%); meridians (25.71%) and blood stasis(62.34%) remained the most predominant syndrome elements related to disease location or pathological factors.ConclusionThe overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency. From the initial diagnosis to the active phase (Week 2-3), heat syndrome dominated; during the active phase (Week 4-5), heat syndrome coexisted with damp syndrome or yin deficiency syndrome; changes in the syndrome element network were the most significant during the lesion improvement phase, with blood stasis gradually increasing and peaking during the remission phase. Blood stasis, dampness, and qi stagnation were pervasive throughout psoriasis vulgaris; qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.关键词：psoriasis vulgaris;real-world study;evolution rules;association network;elements of syndrome of traditonal Chinese medicine;retrospective study
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发布时间：2024-10-29 - 摘要：ObjectiveTo discuss the evaluation basis of the clinical rational use of Dahuang Zhechong Capsule and to establish its rationality evaluation criterion to promote the sensible use of Dahuang Zhechong Capsule.MethodsThe rationality evaluation criterion for Dahuang Zhechong Capsule was formulated by referring to the package insert, treatment guidelines, and other literature. According to the criterion, 270 outpatient prescriptions using Dahuang Zhechong Capsule in Xiyuan Hospital, China Academy of Chinese Medical Sciences were reviewed from January to June 2020. The indication, usage and dosage, drug combination, and repeated administration were analyzed. The pharmaceutical intervention was performed to address the problems found in the prescription reviews, and 328 outpatient prescriptions using Dahuang Zhechong Capsule in October 2020 were reevaluated.ResultsThe irrational use rate of Dahuang Zhechong Capsule from January to June 2020 was 42.22% (114 cases), including 108 (40%) cases of inappropriate indications, five (1.85%) cases of improper usage and dosage, and one (0.37%) case of inappropriate administration route. However, the pharmaceutical intervention in October 2020 remarkably reduced the irrational use rate of Dahuang Zhechong Capsule (4.27%, 14 cases), all of which were inappropriate indications.ConclusionDahuang Zhechong Capsule is being used irrationally; therefore, establishing an evaluation criterion is required. The specific situation of irrational drug use can be identified by prescription review according to its rationality evaluation criterion to manage its clinical use better and promote its rational use.关键词：Dahuang Zhechong Capsule;rational use of drug;evaluation criterion;outpatient prescription;indication
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发布时间：2024-10-29
Clinical Study
- 摘要：ObjectiveTo explore the mediating effect of sleep duration on the relationship between qi stagnation constitution and anxiety/depression in junior high school students.MethodsFrom March 20 to March 31, 2020, a total of 10, 325 students from 6 junior high schools in Henan, Liaoning, Shaanxi, Shandong, and Fujian provinces were sampled by cluster sampling. Firstly, the general conditions (age, gender, grade, hometown, whether they are an only child) and sleep duration were collected, and their qi stagnation constitution, depression and anxiety status were evaluated by using the Qi Stagnation Subscale in the " TCM Constitution Classification and Judgment Scale", the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7). Secondly, Spearman correlation analysis was used to explore the correlation between qi stagnation constitution, sleep duration, and anxiety/depression. Then, linear regression analysis and mediating effect test were used to explore the relationship between qi stagnation constitution and anxiety/depression in junior high school students, and the mediating effect of sleep duration was analyzed, and the results were verified.Results(i) The detection rate of anxiety in non-only children was higher than that of only children (χ2=11.198, P=0.001); The detection rate of anxiety (χ2=106.967, P<0.001) or depression (χ2=84.692, P<0.001) was higher among senior students than those in lower grades, while those of girls with anxiety (χ2=100.441, P<0.001) or depression (χ2=71.418, P<0.001) were higher than those of boys. The detection rates of anxiety (χ2=1 092.298, P<0.001) and depression (χ2=866.740, P<0.001) in qi stagnation constitution students were higher than those of non-qi stagnation constitution students, and the detection rates of anxiety (χ2=1 076.716, P<0.001) and depression (χ2=1 099.725, P<0.001) in students whose sleep duration less than 8 h were higher than those of whose sleep duration more than 8 h, and the shorter the sleep duration, the higher the detection rate. (ii) Qi stagnation constitution positively predicted anxiety/depression (β=0.679, P<0.001; β=0.718, P<0.001), and sleep duration had a negative predictive effect on anxiety/depression (β= -0.403, P<0.001; β= -0.439, P<0.001). (iii) Sleep duration played a partial mediating role in the relationship between qi stagnation constitution and anxiety/depression in junior high school students, and the mediating effect accounted for 13.40% and 13.79% of the total effect, respectively.ConclusionAlthough qi stagnation constitution mainly affects anxiety/depression through direct effect, it can still be partially indirectly realized through the mediating variable of sleep duration, that is, the shorter the sleep duration, the higher the risk of anxiety/depression in junior high school students. Therefore, the mental health problems of junior high school students can be prevented and improved by regulating qi stagnation constitution and ensuring adequate sleep duration.关键词：sleep duration;qi stagnation constitution;junior high school students;anxiety;depression;mediating role
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发布时间：2024-10-29
TCM Constitution
- 摘要：ObjectiveTo investigate the effects of electroacupuncture on the intestinal NIMA-related kinase 7(NEK7)/NOD-like receptor thermal protein domain associated protein 3 (NLRP3) signaling pathway in mice with Parkinson′s disease.MethodsAccording to the randomized number table method, 36 C57BL/6 mice were randomly divided into the control group, the model group, and the electroacupuncture group, with 12 mice per group. The Parkinson′s disease mouse model was established by gavage of rotenone solution (10 mg/kg) for 28 d. After molding, the electroacupuncture group was stimulated with " Fengfu" (DU17), " Taichong" (LR3), and " Zusanli" (ST36) for 14 d, while the control group and the model group were only treated with immobilization. The motor ability of mice was detected by pole climbing test and hindlimb rating score, the positive expressions of nigral tyrosine hydroxylase (TH) and colon occludin were detected by immunohistochemistry, the histological morphology of colon was observed by hematoxylin-eosin staining, and Western blotting was used to detect the protein expressions of NEK7, NLRP3, Caspase-1, and interleukin-1β (IL-1β).ResultsCompared with the control group, mice in the model group had lower score on the pole climbing test and a higher hindlimb rating score (P<0.01); the average optical densities of nigral TH and colon occludin were decreased(P<0.01); significant inflammatory infiltration was observed in the colonic tissue, and the muscularis propria was thinned; and the protein expressions of NEK7, NLRP3, Caspase-1, and IL-1β in the colonic tissue were elevated (P<0.01). Compared with the model group, mice in the electroacupuncture group had higher score on the pole climbing test and a lower hindlimb rating score (P<0.01); the average optical densities of nigral TH and colon occludin were increased (P<0.01); the degree of inflammatory infiltration of colonic tissues decreased, and the muscularis propria was thickened; and the protein expressions of NEK7, NLRP3, Caspase-1, and IL-1β of colonic tissues were decreased (P<0.01).ConclusionElectroacupuncture at " Fengfu" (DU17), " Taichong" (LR3), and " Zusanli" (ST36) can improve motor functional impairments in mice with Parkinson′s disease, and the mechanism may be through the inhibition of intestinal NEK7/NLRP3 pathway, improving the intestinal barrier damage, relieving the intestinal inflammation, and improving the dopaminergic neuron injury.关键词：Parkinson′s disease;electroacupuncture;intestinal inflammation;NIMA-related kinase 7;NOD-like receptor thermal protein domain associated protein 3;mice
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发布时间：2024-10-29
Acupuncture Moxibustion and Tuina
- 摘要：With the increasing incidence of cardiovascular diseases, Professor WANG Yongyan has adhered to the traditional principles while embracing innovation, proposing to apply the theory of " the heart governing the spirit" to the prevention and treatment of cardiovascular diseases. He emphasized that it is crucial to preserve the spirit before the onset of disease, which includes maintaining a balanced diet, regular lifestyle, avoiding excessive labor, maintaining a serene and unfettered mind, and nurturing the spirit within. For those already suffering from disease, preventing progression and deterioration requires adjusting the spirit, and skilled practitioners should first inspect the patient′s spirit by examining the eyes, tongue, facial complexion, and overall physical condition. In treatment, adjusting the spirit involves distinguishing between different imbalances of qi, blood, yin, yang, cold, heat, deficiency, and excess, and employing appropriate method to calm and nourish the spirit accordingly. After the illness, nurturing the spirit is essential, including spiritual nourishment through exercise, dietary therapy, emotional therapy, and external treatments. By applying the theory of " the heart governing the spirit" throughout the prevention, treatment, and rehabilitation of cardiovascular diseases, Professor WANG Yongyan′s approach effectively prevents the occurrence of cardiovascular diseases, controls their progression, inhibits deterioration, and improves the prognosis of patients.关键词：heart governing the spirit;cardiovascular diseases;preventive treatment of disease
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发布时间：2024-10-29
Health Preservation and Active Aging
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