最新刊期
卷 47 ， 期 3 ， 2024
- 摘要：The pathogenesis of varicocele infertility is complex, and currently, there is no specific drug for clinical treatment, traditional Chinese medicine (TCM) has certain advantages in improving clinical symptoms of patients and improving sperm quality. Based on the theory of deficiency and stasis in TCM and modern related research, we believe that static blood blocking collaterals is the initiating factor of this disease, and kidney essence deficiency is the immanent trend of this disease. The pathogenesis and treatment method of this disease are studied on the basis of " soil theory". Guilu Tongqu Decoction is a formula developed by our team based on " soil theory" for the treatment of varicocele infertility. It is a modified version of the classic formula Zuogui Pill, which has the effects of tonifying the kidney, nourishing essence, and promoting blood circulation for removing blood stasis. Its clinical efficacy is good. At the same time, based on our team′s extensive clinical practice, we propose three treatment strategies for varicocele infertility, namely, the combination of systemic and local treatment, the combination of radial and symptomatic treatment, and the combination of TCM and surgical procedures. These methods can effectively improve the overall therapeutic effect and provide a reference for the treatment of varicocele infertility with TCM.关键词：varicocele;male infertility;kidney deficiency and blood stasis;Guilu Tongqu Decoction;soil theory
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发布时间：2024-05-20 - 摘要：Male lower urinary tract symptoms is a collective term for a group of symptoms associated with lower urinary tract disorders characterized by frequent urination, urgent urination, and difficulty of urination, of which the common causes are benign prostatic hyperplasia or overactive bladder. With the aging of the global population, the incidence of male lower urinary tract symptoms is increasing year by year. Based on the theoretical connotation of " zang-fu extraordinary connection", the relationship between the lungs and the bladder, the spleen and the small intestine, and the kidneys and the sanjiao with the formation of male lower urinary tract symptoms is explained from three perspectives. It is believed that lung qi depression and closure, disturbance of qi transformation in bladder, and insufficient spleen transport occur, the small intestine is dysfunctional, kidney yang is exhausted, and obstruction of the sanjiao waterway are the basic pathogenesis of male lower urinary tract symptoms. It is emphasized that the location of the disease should be identified. If it is related to the lungs and the bladder, then the disease should be treated by lifting the pot to lift the lid and diffusing the lung qi to benefit the bladder with Wuling Powder plus perilla leaf and bitter apricot seed; if it is related to the spleen and the small intestines, then the disease should be treated by raising the clear and directing the turbid downward and improving the spleen qi in order to support the small intestines with Shenling Baizhu Powder; if it is related to the kidneys and the sanjiao, then the disease should be treated by seeking the yang within the yin and warming and tonifying the kidney qi in order to dredge up the sanjiao with Bawei Shenqi Pill. According to the patient′s condition, treatment can be combined with acupuncture, exercise, and other therapies. This paper can provide reference for clinical treatment of male lower urinary tract symptoms.关键词：zang-fu extraordinary connection;male lower urinary tract symptoms;benign prostatic hyperplasia;overactive bladder;treatment based on syndrome differentiation
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发布时间：2024-05-20 - 摘要：Our team created the pathogenesis theory of cancer toxin in traditional Chinese medicine on the basis of inheriting the academic thought of "cancer toxins" of ZHOU Zhongying, a Chinese medical master.The pathogenesis theory of cancer toxin suggests that cancer toxins is the key factor leading to the occurrence and development of malignant tumors, the basic pathogenesis of malignant tumor is accumulation of evil and toxins, deficiency of vital qi. This paper proposes that the main pathological factors of carcinoma of prostate are deficiency, dampness, heat, stasis and toxins. The core pathogenesis was spleen and kidney deficiency, dampness-heat stasis toxin accumulation in essence chamber. The disease is located in the essence chamber, closely related to kidney and bladder, and involves liver and spleen. Clinical treatment is based on anti-cancer and detoxification, strengthening vital qi to eliminate pathogenic factor as the basic treatment principles, treatment with anti-cancer detoxification as the core, tonifying the spleen and kidney as the fundamental, clearing heat and removing dampness, removing blood stasis and dispersing is key, accompanied by dispersing liver and regulating qi, the whole syndrome differentiation, to maintain a stable period of time. Strengthening vital qi does not leave evil, eliminating evil does not harm vital qi. Guided by the pathogenesis theory of cancer toxin, this paper expounds the treatment of carcinoma of prostate based on syndrome differentiation and highlights the key role of the pathogenesis theory of cancer toxin in the treatment of this disease, providing reference for the differentiation and treatment of carcinoma of prostate.关键词：cancer toxin;pathogenesis theory;carcinoma of prostate;treatment based on syndrome differentiation;therapeutic principles and methods
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发布时间：2024-05-20
Special Theme: TCM Prevention and Treatment of Male Diseases
- 摘要：The " pre-disease" theory of traditional Chinese medicine focuses on the dynamic and continuous evolution from health to disease, and emphasizes early identification and intervention in the complex and gradual process of evolution from health to disease. The " pre-disease" theory and complexity science share the same perspective on health and disease from the standpoint of features of the dynamic evolution and holism, i. e., life is considered as a complex system with ongoing dynamic changes, which exhibit the nonlinear features of " homeostasis-destabilization-phase transition-another homeostasis". In this paper, from the perspective of nonlinear dynamics in complexity science, we explain the scientific connotation of the evolution law of " pre-disease" -disease based on the theory of critical slowing down in traditional Chinese medicine. Based on the theory of critical slowing down and the dynamic network biomarker method generated by its development, combined with the macro signs of comprehensive analysis of data gained by four diagnostic method and the micro features including transcriptomics and the microbiomics, this paper proposes to integrate macro and micro multi-hierarchy information to construct a " pre-disease" critical slowing down identification model with the characteristics of traditional Chinese medicine diagnosis and treatment, which provides a new perspective and method for the early warning of complex diseases.关键词：pre-disease;traditional Chinese medicine;critical slowing down;complex system;model framework;dynamic network biomarkers
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发布时间：2024-05-20 -
Brief interpretation on the disease′s name and pathogenesis of " drinking little but urinating much" AI导读
摘要：First recorded in Huangdi Neijing, " drinking little but urinating much" is the main symptom of " Feixiao", of which the pathogenesis is heart transferring cold to lung. Many later traditional Chinese medicine doctors have worked and brought different expositions on the disease′s name, " Shangxiao", " Xiaxiao", " Feixiao" or " Shenxiao" are used respectively. In regard to the pathogenesis, dryness-fire, simultaneous occurrence of cold and heat or deficiency-cold are supposed to be the main properties of the disease, while heart, lung, liver, and kidney are the core disease locations. For example, YU Jiayan emphasized " dryness-heat in heart and lung", ZHENG Qin′an advocated " wind-fire of Jueyin", ZHANG Congzheng expounded " cold with heat in the heart and lung", LOU Ying revealed " cold with heat in the lung and kidney", and HUANG Yuanyu proposed " cold in kidney with dampness in spleen". By analyzing the theories of different schools of traditional Chinese medicine and related prescriptions or herbs and medical records, " drinking little but urinating much" could be attributed to " Shenxiao", and " deficiency-cold in lung and kidney" could be its basic pathogenesis, and meanwhile the cross-transmission of zang-fu viscera, intermingled deficiency and excess as well as inter-transformation between cold and heat should be considered adequately. This paper summarizes and sorts out the theories of " Xiao" disease in ancient literature, so as to provide new ideas for the modern prevention and treatment of diabetes.关键词：drinking little but urinating much;disease′s name;pathogenesis;Huangdi Neijing- 355
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发布时间：2024-05-20 - 摘要：Inspired by ZHU Danxi′s theory of " excessive qi inducing fire" to articulate " yin fire", Ke Yunbo created the theory of " rising qi generating water". The author′s team takes " excessive qi inducing fire" as the starting point, and through the perspective of " qi stagnation is fire" and " six climatic exopathogens generating from fire", and elucidate the idea " rising qi generating water". Unlike the " excessive qi inducing fire" that leads to excess fire and strong fire, the yin fire discussed in " rising qi generating water" should be the deficiency fire and stagnant fire caused by the excess of life fire and stagnation in the body. The treatment focuses on ascending and dispersing the middle qi of the liver and kidney, so it requires a shorter course of disease and no significant loss of kidney yin and kidney yang. However, the fundamental principle is to mediate the qi of the spleen and stomach. Using Chinese thorowax root, largetrifoliolious bugbane rhizome, and other herbs to lift the middle qi and restore the ascending and descending qi of the spleen and stomach can clear deficient heat, just like the principle of water suppressing fire. This article elaborates on the connotation of " rising qi generating water", aiming to broaden clinical diagnosis and treatment ideas, address some erroneous cognitive biases of " excessive qi inducing fire", and provide a theoretical basis for the philosophical concepts between " qi", " water", and " fire" .关键词：rising qi generating water;excessive qi inducing fire;yin fire;six climatic exopathogens generating from fire;fire is incompatible with primordial qi
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发布时间：2024-05-20 - 摘要：Taking " harmony of body and spirit" as the theoretical core in Huangdi Neijing and the functional nature and executive structure of the five emotions system as clues, this paper explores and analyzes the relevant theories of the five emotions system in ancient Chinese medicine literature. It is found that the five emotions system is a highly ordered and integrated collection of five functional states. It often resides in the five zang viscera, it operates between the meridians and the xuanfu through the elevation and movement of the qi, and it is the pivotal point for the operation of the qi and blood of the organism, the interactive conduction of information, and the unity of form, emotion, and qi. Therefore, this paper starts from the point of view of system science. It is proposed that the primordial spirit exercises control over the five emotions and the five emotions provide nutrition to the primordial spirit, and that the two are not " islands of information" but have a dynamic and hierarchical internal connection. The executive structure of the five emotions system, namely, the meridians, the xuanfu, and the five zang viscera, is the pivot, and it is recognized that the operation of the five emotions system is a process with self-organizing characteristics and orderly and eternal motion. We think of the qi, blood, ying, and essence as the basis of occurrence, the meridian as the execution channel, and the xuanfu as the place for the spiritual mechanism to enter and exit; the five zang viscera serve as a dwelling place, and ministerial fire serves as the source of energy. This paper serves as reference for future research related to the executive structure of the five emotions system of traditional Chinese medicine.关键词：harmony of body and spirit;five emotions;executive structure;Xuanfu;meridian;five zang viscera
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发布时间：2024-05-20
Theoretical Studies
- 摘要：YOU Zaijing, a doctor of Wumen region, and a famous expert of Treatise on Pathogenic Diseases, also made great achievements in warm diseases.He cleared the source of cold pathogenic diseases and warm diseases, distinguish the difference between them. He put forward the importance of correcting and understanding the disease nomenclature.He explained the names of warm diseases, wind-warm disonder, pestilence, damp-warm disease, warm toxin and warm malaria.He divided warm diseases into newly acquired warm disease, warm disease caused by incubating pathogens, warm disease mixed with dampness and pestilence.He used pungent and cool natured drugs and the method of regulating lung to treat wind warm diseases.In the treatment of warm toxin, he used the method of venting pathogen with cool-scattered natured drugs. In the treatment of warm disease caused by incubating pathogens, he used the method of clearing away heat, nourishing yin and venting pathogen. In the treatment of dampness-warm disease, he used the method of eliminating dampness and heat separately.In the treatment of pestilence, he took the location of disease as the core.According to the different disease locations of the pestilence, different treatment methods and prescriptions were selected.He listed five methods of treating pestilence and established a theoretical framework for the treatment of pestilence, embodying the thought of guiding the trend along the development.He put forward the theory of Six Channels directing Cold and Warm early.He tried to use the syndrome differentiation of six channels system to direct all exogenous diseases such as cold pathogenic diseases and warm diseases.He was the pioneer advocator of the cold-warm combined theory. His views on warm diseases had a profound impact on later doctors. This paper summarizes his main points, analyzes his theory, and provides inspiration for the diagnosis and treatment of warm diseases.关键词：YOU Zaijing;warm disease;pestilence;Six Channels direct Cold and Warm;clinical experience
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发布时间：2024-05-20
Literature Studies
- 摘要：ObjectiveWe aimed to study the protective effect of total glucosides of paeony (TGP) on chemical liver injury with pattern of liver yin deficiency in rats and determine whether it exerts these effects through the phosphoinositide 3-kinase(PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway.MethodsForty male Sprague-Dawley rats were randomly divided into the following four groups: (i) the blank group, (ii) the model group, (iii) the Yiguan Jian group, and (iv) the TGP group (10 rats per group). For 6 weeks, rats in all groups except for the blank group were injected intraperitoneally with 20% carbon tetrachloride olive oil solution and were given thyroid tablets (30 mg/kg) by gavage in order to establish the model of chemical liver injury with pattern of liver yin deficiency. During the modeling period, rats in the blank and model groups were gavaged daily with distilled water, while rats in the Yiguan Jian group and the TGP group were gavaged with 635 mg/kg of Yiguan Jian decoction and 50 mg/kg of TGP suspension, respectively. During the administration period, the body weight and rectal temperature of rats were measured every 2 weeks. After the administration, 24-hour food intake, 24-hour water intake, and moisture capacity in tongue surface were recorded. Serum cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and interleukin-1 receptor antagonist (IL-1Ra) contents were measured by ELISA and the cAMP/cGMP ratio was calculated. Changes in the serum levels of alanine aminotransferase (ALT), alanine transaminase (AST), gamma-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), total bilirubin (TBIL), and total bile acids (TBA) were detected using colorimetric method. Masson staining was performed to observe the degree of liver fibrosis and to calculate the relative collagen area. Real-time PCR and Western blotting were conducted to determine the PI3K, AKT, and mTOR mRNA and protein expression levels in rat liver.ResultsCompared with the blank group, rats in the model group had a lower body weight at weeks 2, 4, and 6, a higher rectal temperature at weeks 2, 4, and 6, and a higher 24-hour food intake; the cAMP level was elevated, the cGMP level was decreased, and the cAMP/cGMP ratio was elevated; the contents of IL-1, IL-6, and TNF-α were elevated, and the contents of IL-10 and IL-1Ra were decreased; ALT, AST, γ-GT, ALP, TBIL, and TBA levels were elevated; the percentage of collagen area in the liver was increased; and the mRNA and protein phosphorylation levels of PI3K, AKT, and mTOR were elevated ( P<0.05). Compared with the model group, rats in the TGP group showed a decrease in rectal temperature at weeks 2, 4, and 6, a decrease in 24-hour food intake and water intake, and an increase in the moisture capacity in tongue surface; rats in the Yiguan Jian and TGP groups showed a decrease in cAMP, an increase in cGMP, and a decrease in the cAMP/cGMP, the contents of IL-1, IL-6, and TNF-α were decreased and the content of IL-10 was increased, the percentage of collagen area in the liver was decreased; ALT, AST, γ-GT, ALP, and TBIL levels were decreased in the TGP group, and PI3K, AKT, and mTOR were downregulated at the mRNA and protein levels(P<0.05).ConclusionTGP has a good protective effect on chemical liver injury with pattern of liver yin deficiency in rats. TGP may regulate the balance of yin and yang by inhibiting the PI3K/AKT/mTOR pathway, reducing the secretion of pro-inflammatory cytokines, and increasing the release of anti-inflammatory cytokines.关键词：total glucosides of paeony;chemical liver injury;pattern of liver yin deficiency;inflammatory factors;phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin pathway;rats
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发布时间：2024-05-20 - 摘要：ObjectiveThis study investigated the protective effects of Corni Fructus ethanol extract on β-amyloid protein 25-35 (Aβ25-35)-induced Alzheimer′s disease (AD) mice by regulating histone lysine-specific demethylase 1 (LSD1) / postsynaptic density protein 95 (PSD95) on synapses and neuroinflammation.MethodsSpecifically, according to the body weight, 40 C57BL/6N mice were randomized into four groups: the sham operation group, the model group, the low-dose (0.1 mg/g) and the high-dose (0.3 mg/g) Corni Fructus ethanol extract groups. Aβ25-35 was injected into the hippocampus of mice in three groups except for the sham operation group to established AD model. All mice were orally administered with either Corni Fructus ethanol extract or vehicle by gavage for 7 days before molding and continued 5 days after surgery for a total of 60 days. Morris water maze, Y maze and open field tests were performed to evaluate the recognition memory and space exploration ability of mice. The expression of LSD1, PSD95, synaptophysin (SYN), interleukin-1β (IL-1β), tumor necrosis factor-α(TNF-α) and H3K9me2 level were measured by Western blotting. Chromatin immunoprecipitation (CHIP) combined with qPCR was used to detect H3K9me2 modification of PSD95 promoter region and mRNA levels of PSD95. The correlation between the expression of H3K9me2 and PSD95 and the expression of IBA1 in the hippocampus were detected by immunofluorescence assay.ResultsThe result showed that Corni Fructus ethanol extract significantly reversed Aβ25-35-induced learning and memory impairment in AD mice. Compared with the model group, Corni Fructus ethanol extract demonstrated shorter escape latency, increased number and time of autonomous activities and the rate of autonomous alternation. Moreover, it increased the expression of LSD1 in hippocampus of AD mice(P<0.05), and reduced H3K9me2 modification level in the promoter region of PSD95 gene, and then promoted the mRNA transcription and protein expression of PSD95. Immunofluorescence staining indicated the reduction of H3K9me2 modification level in hippocampus was accompanied by the enhancement of PSD95 expression. Corni Fructus ethanol extract could also inhibit the activation of microglia and reduce the expression of proinflammatory factors IL-1β and TNF-α.ConclusionCorni Fructus ethanol extract may regulate PSD95 gene transcription by up-regulating the expression of LSD1 and reducing the H3K9me2 modification level in its promoter region, thereby increasing the expression of PSD95, a key protein in synaptic plasticity regulation, which alleviate neuroinflammatory response, improve learning and memory dysfunction in AD model mice, and thus play a protective role in Aβ25-35-induced nerve damage.关键词：Corni Fructus;lysine-specific demethylase 1;histone modification;Alzheimer′s disease;injury of nerve;mice
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发布时间：2024-05-20 - 摘要：ObjectiveWe aimed to (i) observe the therapeutic effect of Yiqi Wenyang Prescription (YQWYP, which consists of milkvetch root, tangshen, dried ginger, cassig twig, ephedra, biond magnolia flower-bud, Chinese magnoliavine fruit, earthworm, and liquorice root) on an allergic rhinitis (AR) murine model and the protective effect on the tight junction (TJ) key proteins zonula occludens-1 (ZO-1) and occludin and (ii) elucidate whether YQWYP exerts these effects by inhibiting autophagy in nasal mucosal cells.MethodsThirty C57BL/6 mice were randomly divided into six groups with 5 mice per group: (i) the blank group, (ii) the model group, (iii-v) the YQWYP low-dose, mid-dose, and high-dose groups(7, 14, 28 g/kg), and (vi) the cetirizine group(1.667 mg/kg). The model was established by intraperitoneal injection and nasal stimulation of ovalbumin. 1 hour before the nasal stimulation, mice in the blank group or in the model group were given normal saline by gavage, mice in the YQWYP groups and those in the cetirizine group were given the corresponding medicines solution by gavage. After 7 days, mice behavior was scored. After that, the mice were sacrificed and the nasal mucosa tissues were harvested. The inflammatory reaction of the nasal mucosa was observed by HE staining, the proliferation of goblet cells in the nasal mucosa was observed by PAS staining, the IgE content in nasal lavage fluid was determined by ELISA, the expression levels of ZO-1 and occludin were analyzed by immunohistochemistry, and the expression levels of LC3B, P62, and Beclin1 in the nasal mucosa of the blank group, model group, and YQWYP high-dose group were analyzed by Western blotting.ResultsAfter the successful establishment of the AR model, compared with the blank group, the symptom scores of nose scratching, sneezing, and runny nose in the model group were higher, while the total scores was significantly higher(P<0.01). In the model group, the nasal mucosal epithelium was disrupted and destroyed, a large number of inflammatory cells were infiltrated, goblet cells showed hyperplasia, mucus production was increased, mucosal swelling was obvious, the amount of IgE in nasal lavage fluid was increased (P<0.01). The protein expression levels of ZO-1 and occludin were decreased(P<0.05), the protein expression levels of LC3BⅡ/Ⅰ and Beclin1 were increased (P<0.05), P62 protein expression was decreased (P<0.05). After medication intervention, compared with the model group, in the YQWYP high-dose group and the cetirizine group, the total score were reduced (P<0.01), the swelling of the nasal mucosa was reduced, the infiltration of inflammatory cells was inhibited, the number of goblet cells was decreased, the amount of IgE in nasal lavage fluid was reduced(P<0.01), the protein expression of ZO-1 and occludin were increased (P<0.05), the protein levels of LC3BII/I and Beclin1 were decreased (P<0.05), P62 protein expression was increased (P<0.05).ConclusionYQWYP has a good therapeutic effect on AR mice, and its mechanism may be related to the promotion of nasal mucosal repair by inhibiting autophagy of nasal mucosal cells.关键词：Yiqi Wenyang Prescription;allergic rhinitis;autophagy;tight junction;zonula occludens-1;occludin;mice
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发布时间：2024-05-20 - 摘要：ObjectiveTo explore the effect of Huoxue Xiaoyi Formula on ovarian function and pregnancy outcome in endometriosis rats.MethodsOne hundred female SD rats were fed adaptively for 7 days. According to body weight, 98 rats with a normal estrous cycle were randomly divided into the blank group (n=14), the sham operation group (n=14), the donor group (n=12), and the receptor group (n=58). A rat model of endometriosis was established using allogeneic endometrial transplantation. After the model was successfully established, according to the body weight, 56 rats in the receptor group were randomly divided into the model group, and the Huoxue Xiaoyi Formula low-, medium-, and high-dose groups, with 14 rats in each group. The Huoxue Xiaoyi Formula low-, medium-, and high-dose groups were given 5.86, 11.72, and 23.44 g/kg of Huoxue Xiaoyi Formula, and the blank group, the sham operation group, and the model group were given distilled water by gavage for 15 consecutive days. According to body weight, six rats were randomly selected to take abdominal aortic blood for determination of serum anti-Mullerian hormone (AMH) content by enzyme-linked immunosorbent assay. According to body weight, six rats were randomly selected in the remaining rats to undergo high-frequency small animal ultrasound examination to measure ovarian volume and ovarian artery blood supply (resistance index and pulsatility index), and follicle count were measured. The female mice were fed with male mice at a ratio of 2∶1 to observe the pregnancy rate, live fetus number, still fetus number, and absorbed fetus number. The weights of uterus and fetus were measured, while the placental weight, fetal weight, body length, and tail length were measured for live fetus. Bone and visceral malformations were also detected for live fetus.ResultsThere were no significant differences in serum AMH and ovarian volume among the groups. Compared with the model group, the numbers of follicles in the blank group, the sham operation group, and the Huoxue Xiaoyi Formula low-, medium-, and high-dose groups were increased; compared with the Huoxue Xiaoyi Formula low-dose group, the numbers of follicles in the blank group and the Huoxue Xiaoyi Formula medium-dose group were increased (P<0.05). Compared with the model group, the resistance index and pulsatility index of ovarian artery blood flow in the blank group, the sham operation group, and the Huoxue Xiaoyi Formula low-, medium-, and high-dose groups were decreased(P<0.05). There was no significant difference in pregnancy rate among the groups. Compared with the model group and the Huoxue Xiaoyi Formula low-dose group, the live fetus number and the weight of uterus and fetus in the blank group, the sham operation group, and the Huoxue Xiaoyi Formula medium- and high-dose groups were increased (P<0.05). There were no significant differences in the still fetus number, absorbed fetus number, placental weight, fetal weight, body length and tail length among the groups. No visceral or skeletal malformations were found in the live fetal rats among the groups.ConclusionIn endometriosis model rats, the ovarian artery blood flow perfusion is insufficient, and the follicle count is reduced, affecting ovary function, thereby reducing the live fetus number. After applying the Huoxue Xiaoyi Formula, it can improve ovarian blood supply, increase the follicle count, and increase the live fetus number. The effect of increasing the live fetus number with the medium- and high-doses of Huoxue Xiaoyi Formula is more significant, and there is no reproductive toxicity.关键词：Huoxue Xiaoyi Formula;endometriosis;ovarian function;pregnancy outcome;rats
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发布时间：2024-05-20 - 摘要：ObjectiveWe investigated the effects of Xueguan Ruanhua Pills(XGRHW) on ferroptosis in ApoE-/- atherosclerotic mice through the nuclear factor E2 related factor 2 (Nrf2)/xCT/glutathione peroxidase 4 (GPX4) signaling pathway.MethodsTen male C57BL/6J mice in the normal group were fed normal chow. Additionally, 50 ApoE-/- mice were fed high-fat chow for 12 weeks, and were divided into the following five groups (10 mice per group): the model group, the XGRHW low-dose (2.34 g/kg) group, the XGRHW high-dose (4.68 g/kg) group, the XGRHW high-dose combined with the Nrf2 inhibitor ML385 (0.03 g/kg) group, and the ferrostatin-1 (1 mg/kg) group. Drugs were administered for 6 weeks. The blood levels of four types of lipids were detected by an automatic lipid analyzer, lipid deposition in the aorta was observed by Oil Red O staining, histomorphological changes in the aortic sinus were observed by HE staining, the serum levels of Fe2+, MDA, GSH, and SOD were determined by colorimetric assays, and the expression levels of FTH1 and FTL in the aortic sinus were observed by immunofluorescence. The protein levels of Nrf2, xCT, and GPX4 in mouse aortic tissues were detected by Western blotting. The ultrastructural changes of aortic mitochondria were observed by transmission electron microscopy.ResultsCompared with the normal group, mice in the model group showed obvious lipid plaque deposition in the aorta, severely calcified lesions in the aortic sinus, elevated serum levels of TC, TG, LDL-C, Fe2+, and MDA, decreased levels of HDL-C, SOD, and GSH (P<0.01), and decreased protein expressions of aortic Nrf2, xCT, and GPX4 as well as the iron storage proteins FTH1 and FTL (P<0.01), and serve damage to mitochondrial structure and morphology. Compared with the model group, the relative aortic plaque area was decreased, calcified lesions in the aortic sinus were decreased, serum levels of TC, TG, LDL-C, Fe2+, and MDA were decreased, and HDL-C, SOD, and GSH levels were increased in the XGRHW low-dose and high-dose and ferrostatin-1 groups (P<0.05 or P<0.01), and Nrf2, xCT, GPX4, and the iron storage proteins FTH1 and FTL were upregulated in aortic tissues (P<0.05 or P<0.01), and mitochondrial structure approaching normal. In the XGRHW high-dose+ ML385 group, compared with the XGRHW high-dose group, the levels of blood lipids and lipid peroxidation were increased and the protein levels of Nrf2, xCT, and GPX4 in aortic tissue and the iron storage proteins FTH1 and FTL were decreased (P<0.01), and mitochondrial structure was damaged indicating that ML385 could inhibit the therapeutic effect of the XGRHW in atherosclerotic mice.ConclusionThe XGRHW can improve blood lipid levels and reduce the degree of arterial plaque lesions in atherosclerotic mice, and its mechanism of action may be related to activation of the Nrf2/xCT/GPX4 pathway to inhibit ferroptosis.关键词：atherosclerosis;Xueguan Ruanhua Pills;nuclear factor E2 related factor 2/xCT/glutathione peroxidase 4 pathway;ferroptosis;lipid peroxidation;mice
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发布时间：2024-05-20 - 摘要：ObjectiveWe aimed to investigate the effects of Biejiajian Pills on MHCC-97H hepatoma cells and whether Biejiajian Pills regulate the epidermal growth factor receptor (EGFR)/mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) signaling pathway through miR-885-5p.MethodsSPF SD rats (n = 10) were randomly divided into the blank group and the Biejiajian Pills (1.1 g/kg) group to prepare blank and Biejiajian Pills-containing serum. MHCC-97H cells in the logarithmic growth phase were divided into the model group, blank serum groups with different concentrations (5%, 10%, 15%, and 20%), the serum containing Biejiajian Pills group, and the blank group without cells. Cell proliferation was detected by the CCK-8 assay, and the optimal intervention time and concentration of drug-containing serum were screened. MHCC-97H cells were divided into the blank control group (no intervention), the Biejiajian Pills-containing serum group (20% Biejiajian Pills-containing serum), the miR-885-5p mimics group (transfected with miR-885-5p mimics), the miR-NC group (transfected with miR-885-5p NC), and the Biejiajian Pills-containing serum + miR-885-5p mimics group (treated with 20% Biejiajian Pills-containing serum and transfected with miR-885-5p mimics). Cells in each group were cultured for 72 hours. A dual luciferase reporter assay was conducted to verify the targeting relationship between miR-885-5p and EGFR. Cell proliferation was detected by the CCK-8 assay, cell migration and invasion abilities were detected by the cell scratch assay and the Transwell invasion assay. Annexin V-APC/PI double staining was performed to detect the apoptosis level, and real-time fluorescence quantitative PCR (RT-qPCR) analysis was conducted to determine the mRNA expression levels of miR-885-5p, EGFR, MEK, and ERK1/2. The expression levels of EGFR, p-EGFR, MEK, p-MEK, ERK1/2, p-ERK1/2, matrix metalloproteinase 1 (MMP1), and CyclinD1 were determined by Western blotting analysis. The subcutaneous tumor model of MHCC-97H hepatoma cells in nude mice was established by subcutaneous injection to observe the inhibitory effect of Biejiajian Pills of different doses(0.55, 1.1, 2.2 g/kg).ResultsThe optimal concentration and intervention time of Biejiajian Pills-containing serum were 20% and 72 hours, respectively. Meanwhile, the dual luciferase reporter assay showed that miR-885-5p could directly target EGFR. No statistical significances between the blank control group and the miR-NC group were observed (P>0.05). Compared with the blank control group, the proliferation rates of MHCC-97H hepatoma cells in the Biejiajian Pills-containing serum group, the miR-885-5p mimics group, and the Biejiajian Pills-containing serum + miR-885-5p mimics group were significantly decreased (P<0.01), and their migration and invasion abilities were significantly decreased (P<0.05, P<0.01). At the same time, the protein expression levels of CyclinD1 and MMP1, which are closely related to cell proliferation and invasion, were significantly downregulated (P<0.05, P<0.01). The proportions of late apoptotic cells and the proportion of total apoptotic cells were significantly increased (P<0.01). In the Biejiajian Pills-containing serum group, the miR-885-5p mimics group, and the Biejiajian Pills-containing serum + miR-885-5p mimics group, miR-885-5p mRNA was significantly upregulated (P<0.01) and EGFR, MEK, and ERK1/2 were significantly downregulated at the mRNA level (P<0.05, P<0.01). EGFR, MEK, and ERK1/2 phosphorylation was inhibited (P<0.01), and the Biejiajian Pills-containing serum + miR-885-5p mimics group showed the best effect (P<0.05, P<0.01). The subcutaneous liver tumor model in nude mice verified that Biejiajian Pills can inhibit tumor growth in a dose-dependent manner.ConclusionBiejiajian Pills can promote apoptosis of MHCC-97H hepatoma cells and inhibit their proliferation, invasion, and migration. The mechanism may be related to the targeted regulation of the EGFR/MAPK/ERK signaling pathway by miR-885-5p.关键词：Biejiajian Pills;miR-885-5p;epidermal growth factor receptor;mitogen-activated protein kinase;MHCC-97H hepatoma cells;nude mice;subcutaneous tumor
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发布时间：2024-05-20
Experimental Studies
- 摘要：Cronkhite-Canada syndrome is a disease characterized by multiple polyps and changes in the ectoderm of the digestive tract, but its etiology and pathogenesis have not been completely elucidated. Endogenous toxins are a special class of intrinsic pathogenic factors, which are released upon visceral dysfunction and abnormal movement of qi and blood. Endogenous toxins can hide deeply in the body, they can enter the meridians and collaterals, and they can be mixed with phlegm and blood stasis. Endogenous toxins can damage the skin externally, corrode the internal organs, attack hands and feet, and damage the vital qi. The pathogenesis of Cronkhite-Canada syndrome can be understood from the perspective of " endogenous toxins cause the disease". Dampness-heat due to spleen deficiency and dampness toxin accumulation are the fundamental causes of Cronkhite-Canada syndrome. The mutual fusion of phlegm toxin and blood stasis toxin is the pathological essence of the diffuse growth of gastrointestinal polyps in Cronkhite-Canada syndrome. The internal toxin transformation process of " dampness toxin-phlegm stasis toxin-cancer toxin" may be a potential mechanism for the occurrence of cancer. The treatment of Cronkhite-Canada syndrome should be based on the principle of strengthening the spleen, removing dampness, and detoxification. Among them, strengthening the spleen is the foundation, removing dampness is the key, and detoxification is the core. The treatment of Cronkhite-Canada syndrome can be achieved through methods such as strengthening the spleen and infiltrating dampness, promoting diuresis and detoxification, resolving phlegm, and removing blood stasis. At the same time, correcting the patient's biased constitution should be used as an auxiliary treatment method, and treatment based on a combination of traditional Chinese and western medicine should be emphasized.关键词：Cronkhite-Canada syndrome;endogenous toxins cause the disease;polyp;pathogenesis;treatment
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发布时间：2024-05-20 - 摘要：Postmenopausal osteoporosis (PMO) is a clinically refractory bone metabolic disease that often occurs in women after menopause. According to its clinical manifestations, it is classified as " bone flaccidity" and " bone withering" in traditional Chinese medicine (TCM). Based on the theory of " kidney qi heat", this paper explains the etiology and pathogenesis of PMO. It is proposed that yin deficiency, depletion of liquid, and yin not containing yang form the basis of its pathogenesis. Furthermore, the internal heat of yang hyperactivity and crippled backbones are the central links that lead to the mutual loss of yin and yang and the withering of bones. Based on the above pathogenesis, the early treatment of the disease is based on nourishing yin and promoting liquid, supplementing qi and nourishing blood production using Yiyin Zengye Decoction with modification. In the medium term, the treatment is based on nourishing yin, clearing heat, invigorating the kidney, and supplementing essence using Ziyin Qingre Decoction with modification. In the final terminal stage, the treatment is based on nourishing yin, tonifying yang, and strengthening the foundation using Yinyang Shuangbu Decoction with modification. At the same time, the correlation between " kidney qi heat" and inflammatory and immune reaction is explored to provide new concepts for clinical research and improve the clinical application value of TCM in the prevention and treatment of PMO.关键词：postmenopausal osteoporosis;kidney qi heat;inflammatory reaction;immune reaction;nourishing yin and clearing heat
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发布时间：2024-05-20 - 摘要：ObjectiveTo analyze the characteristics of pattern elements and the distribution of patterns of femoral head necrosis, hip osteoarthritis, and hip rheumatoid arthritis, in order to provide a theoretical basis for the " different diseases with the same pattern" of chronic bone diseases.MethodsA cross-sectional survey was conducted to select patients with femoral head necrosis Association Research Circulation Osseous Ⅰ-Ⅱ stages, hip osteoarthritis Kellgren & Lawrence Ⅰ-Ⅱ stages, and acute or subacute hip rheumatoid arthritis who visited the Minimally Invasive Arthrology Department, Traumatology Department, and Rheumatology and Immunology Department of Beijing University of Chinese Medicine Third Affiliated Hospital from June 2020 to June 2022. The " case report form - traditional Chinese medicine pattern manifestation scale" previously developed by our team was used to collect the pattern manifestations, which were included into an Excel 2020 spreadsheet to establish a database. SPSS 20.0 software was used for factor analysis and cluster analysis to extract pattern element information, such as disease nature and location, in order to summarize the characteristics of pattern elements, the distribution of patterns, and the similarities and differences of the three kinds of early hip joint diseases.ResultsA total of 410 patients were included, including 150 patients with femoral head necrosis, 160 patients with hip osteoarthritis, and 100 patients with hip rheumatoid arthritis. The pattern elements of the disease nature of femoral head necrosis include phlegm (dampness), blood stasis, yang deficiency, essence deficiency, and qi deficiency. The pattern types were initially divided into four categories: syndrome of meridian obstruction (43.33%), syndrome of phlegm and blood stasis blocking collaterals (38.00%), syndrome of liver and kidney deficiency (12.00%), and syndrome of kidney essence deficiency (6.67%). The pattern elements of the disease nature of hip osteoarthritis include phlegm (dampness), blood stasis, qi deficiency, essence deficiency, yang deficiency, and cold (dampness). The pattern types were preliminarily divided into five categories: syndrome of spleen and kidney deficiency (37.50%), syndrome of meridian obstruction (26.87%), syndrome of cold and dampness obstruction (18.75%), syndrome of phlegm and blood stasis obstruction (9.38%), and syndrome of liver and kidney deficiency (7.50%). The pattern elements of the disease nature of hip rheumatoid arthritis include phlegm (dampness), blood stasis, qi deficiency, yin and yang deficiency, cold (dampness), and essence deficiency. The pattern types were preliminarily divided into four categories: syndrome of phlegm and blood stasis obstruction (34.00%), syndrome of cold and dampness obstruction (28.00%), syndrome of blood stasis blocking collaterals (23.00%), and syndrome of liver and kidney deficiency (15.00%). Overall, the top five pattern manifestations of the three kinds of hip joint diseases were hip joint pain (96.59%), tenderness (93.90%), fixed pain (87.56%), heavy joints (85.37%), and sourness of lower limbs (75.37%). The pattern elements of the disease nature include phlegm (dampness), blood stasis, qi deficiency, etc. The pattern types were preliminarily divided into five categories: syndrome of phlegm stasis blocking collaterals (33.17%), syndrome of meridian obstruction (31.95%), syndrome of cold dampness obstruction (21.46%), syndrome of liver and kidney deficiency (7.32%), and syndrome of spleen and kidney deficiency (6.10%). There were 21 similar pattern manifestations in the three kinds of early hip joint diseases, with blood stasis and spleen deficiency being the main pattern.ConclusionThe common pattern characteristics of three kinds of early hip joint diseases are spleen deficiency and blood stasis. In addition, femoral head necrosis is accompanied with phlegm-dampness pattern, hip osteoarthritis is accompanied with kidney deficiency and phlegm-dampness pattern, hip rheumatoid arthritis is accompanied with kidney deficiency and cold-dampness pattern.关键词：femoral head necrosis;hip osteoarthritis;hip rheumatoid arthritis;pattern element;pattern
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发布时间：2024-05-20
Clinical Studies
- 摘要：ObjectiveWe aimed to investigate the TCM syndrome characteristics and risk factors of early death in higher-risk patients with myelodysplastic syndromes with excess blasts (HR-MDS-EB).MethodsThe data of 57 HR-MDS-EB patients in the hematology ward of Xiyuan Hospital, China Academy of Chinese Medical Sciences admitted between January 2013 and August 2020 were analyzed. Patients were divided into an early death group and a non-early death group according to the survival time. The basic information, clinical characteristics, specialized examination, complete blood cell counts and laboratory examination result for first diagnosis, TCM syndrome characteristics, and other data of patients were collected and analyzed to screen the risk factors of death.ResultsThere were statistically significant differences in Charlson comorbidity index (CCI) score, Barthel index score, platelet count at first diagnosis, blast ratio in peripheral blood, lactate dehydrogenase levels, blazing pathogenic heat pattern, and constipation between the early death group and the non-early death group (P<0.05). According to the result of the above univariate analysis, logistic multivariate regression analysis was performed for significant factors P<0.05. CCI score had statistically significant effects on the risk of death (P<0.05).ConclusionHigher CCI score is an independent risk factor for early death in HR-MDS-EB patients.关键词：myelodysplastic syndromes;risk factors for death;blasts;Charlson comorbidity index score;TCM syndrome characteristics;retrospective analysis
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发布时间：2024-05-20 - 摘要：In view of the difficulties and blind spots of western medicine, how to make scientific decisions to standardize the treatment of breast cancer in traditional Chinese medicine and improve the participation of traditional Chinese medicine in the treatment of breast cancer is an important focus of innovative breakthroughs in breast cancer treatment. Based on the clinical experience of Professor LIN Yi, a master of traditional Chinese medicine, and on the basis of " disease identification and syndrome differentiation", this paper summarizes and refines the status of qi and blood imbalance, accumulation of phlegm and blood stasis, viscera deficiency, and cold heat cementation in breast cancer, and further proposes the " six views" of breast cancer balanced treatment: the pathogenesis view focuses on " evil invasion due to vital qi deficiency, and the proliferation of tumors", and the pathogenesis view focuses on " cancer toxin and imbalance of yin and yang", the diagnostic view focuses on " examining the underlying factors and understanding the causes and effects", the differentiation view focuses on " balancing qi, blood, yin, and yang to achieve harmony", the therapeutic view focuses on " supporting vital qi and eliminating evil, and considering the root cause and syndromes", and the rehabilitation view focuses on " adjusting balance to maintain a stable state". We are committed to holistic syndrome differentiation and treatment, balancing yin, yang, qi, and blood, thereby harmonizing the internal environment of the human body, and mobilizing the immune and rehabilitation functions of the body.关键词：breast cancer;traditional Chinese medicine;pathogenesis and state identification;balance
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发布时间：2024-05-20
Hematology and Oncology
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