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- Abstract：Microgravity-induced cardiac remodeling presents a substantial challenge that constrains the advancements in the international space industry, which mainly manifests as alterations in the morphology, structure, and function of the heart. This paper analyzed the core pathogenesis and treatment of microgravity-induced cardiac remodeling based on the theory of " yang transforming qi and yin forming shape" in Huangdi Neijing. " Yang transforming qi" reflects the changes in cardiac function, whereas " yin forming shape" reflects the changes in cardiac morphology and structure. Based on the basic and clinical research of space cardiac dysfunctions, the core pathogenesis of microgravity-induced cardiac remodeling is the insufficiency of " yang transforming qi", accompanied by yin excess and yang deficiency due to excessive " yin forming shape" in the early stage, which evolves into deficiency of both yin and yang in the late stage. Thus, this paper specifically refined the treatment methods and corresponding formulas, including warming viscera yang to transform qi, draining yin blood to restore yang qi, and consolidating yin and yang to nourish primal energy. These insights provide systematic theoretical support and conceptual inspiration for the traditional Chinese medicine treatment of microgravity-induced cardiac remodeling.Keywords：yang transforming qi;yin forming shape;microgravity;cardiac remodeling;etiology;pathogenesis;treatment method108|130|0<HTML><L-PDF>Updated：2025-12-04
- Abstract：Coronary heart disease with angina pectoris, characterized by myocardial ischemic injury as its fundamental pathological mechanism, represents a prevalent cardiovascular condition. The " State-Target Differential Diagnosis and Treatment" presents a holistic regulatory framework, integrating macroscopic state regulation with microscopic targeting. Guided by this approach, the pathological evolution of coronary heart disease is examined through four dimensions: " state-target-cause-effect." The " cause" encompasses both the pathogenesis and etiological factors of traditional Chinese and Western medicine. The " effect" manifests as adverse cardiovascular events, including myocardial infarction and heart failure. The " state" delineates the progressive development pattern of qi to blood to deficiency, beginning with qi stagnation and cold congealment in the initial stage, followed by blood stasis and phlegm obstruction in the intermediate stage, and culminating in qi-blood deficiency in the advanced stage. The " target" encompasses multi-level therapeutic interventions addressing both symptomatic manifestations and clinical indicators. Building on this theoretical foundation, this research focuses on the pattern of qi sinking and blood stasis commonly observed in late-stage angina, systematically elucidating its state regulation and targeting therapeutic strategies. Using the clinical empirical formula Shengxian Quyu Decoction as the baseline state prescription, an in-depth investigation was conducted to determine optimal combination patterns of symptom- and biomarker- targeted medications. This study aims to establish a modernized differential treatment system for angina pectoris with the pattern of qi sinking and blood stasis, providing novel research perspectives and theoretical foundations for enhancing clinical efficacy and reducing the risk of cardiovascular events.Keywords：State-Target Differential Diagnosis and Treatment;pattern of qi sinking and blood stasis;coronary heart disease;Angina Pectoris;Shengxian Quyu Decoction98|128|1<HTML><L-PDF>Updated：2025-12-04
Clinical study on the immediate and short-term therapeutic effects of Shexiang Tongxin Dripping Pill on improving coronary slow flow AI Introduction
Abstract：ObjectiveTo explore the immediate and short-term effects of Shexiang Tongxin Dripping Pill in the intervention of coronary slow flow (CSF).MethodsThrough Interactive Web Response System, Sixty-four patients with CSF from Dongzhimen Hospital, Beijing University of Chinese Medicine were divided into a Shexiang Tongxin Dripping Pill group (32 patients) and a placebo group (32 patients) in a 1: 1 ratio in a randomized, double-blind, placebo-controlled trial. After sublingual administration of four capsules of Shexiang Tongxin Dripping Pill or the placebo, coronary angiography was repeated, and the corrected TIMI frame count (CTFC) and microcirculatory resistance index (caIMR) were measured to evaluate immediate blood flow velocity. After taking Shexiang Tongxin Dripping Pill or the placebo for 12 weeks, the short-term efficacy was evaluated using traditional Chinese medicine (TCM) syndrome, blood stasis syndrome, and Seattle Angina Questionnaire (SAQ) scores.ResultsThe CTFC and caIMR were lower after administration in the Shexiang Tongxin Dripping Pill group (P < 0.05) than in the placebo group, and the differences in pre- and post- administration values between the two groups were significant(P<0.01). Intragroup comparisons showed that the CTFC and caIMR in the Shexiang Tongxin Dripping Pill group were lower after administration than before administration (P < 0.01). After 12 weeks of treatment, the blood stasis and TCM syndrome scores in the Shexiang Tongxin Dripping Pill group were lower than those in the placebo group, whereas the SAQ score was higher than that in the placebo group (P < 0.01). Intragroup comparisons indicated that the blood stasis syndrome score in the Shexiang Tongxin Dripping Pill group was lower after treatment than before treatment, whereas the TCM syndrome score in both groups was lower and the SAQ score was higher after treatment than before treatment (P < 0.01).ConclusionShexiang Tongxin Dripping Pill improve the immediate blood flow velocity of CSF, enhance the quality of life of patients, reduce the TCM syndrome and blood stasis syndrome scores, and have good safety.Keywords：Shexiang Tongxin Dripping Pill;coronary slow flow;coronary microcirculation;randomized controlled trial130|112|0<HTML><L-PDF>Updated：2025-12-04
Special Theme: TCM Prevention and Treatment of Cardiovascular Diseases
- Abstract：ObjectiveTo construct an animal model of dilated cardiomyopathy (DCM) with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine (TCM) syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.MethodsFifteen male SD rats were divided into a blank control, doxorubicin, or DCM with heart failure toxin syndrome group using a random number table method, with five rats per group. The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg, administered on the first and fourth days of each week, along with a standard diet. The DCM with heart failure toxin syndrome group, in addition to the doxorubicin treatment, was given 42% white liquor (10 mL/kg) via gavage every other day, along with a 45% high-fat feed and 10% fructose water. The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group, along with a standard diet. The model was established for 10 weeks. At the fourth and tenth weeks of modeling, echocardiography was performed to measure left ventricular ejection fraction (LVEF), fractional shortening (FS), systolic left ventricular posterior wall thickness (LVPWs), diastolic left ventricular posterior wall thickness, systolic left ventricular internal diameter (LVIDs), and diastolic left ventricular internal diameter (LVIDd); macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method. After modeling, the open field test was conducted to evaluate the exercise tolerance of the rats, and the grip strength test was performed to assess changes in forelimb grip strength. Hematoxylin-eosin, Masson, and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue. Bulk RNA sequencing analysis was performed to identify differentially expressed genes (DEGs) in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups. Using DCM, the Blue value of rat fur color, and forelimb grip strength as phenotypic traits, weighted gene co-expression network analysis (WGCNA) was performed to screen for characteristic module gene sets (MEs) associated with DCM with heart failure toxin syndrome. Overlapping analysis was performed on DEGs, immune-related gene sets, and MEs, and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome. The sensitivity and specificity of these targets were evaluated using receiver operating characteristic (ROC) curve analysis.ResultsCompared with the blank control group, at the tenth week of modeling, the LVEF, FS, and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased, whereas LVIDs and LVIDd increased, and the movement distance of the open field test and forelimb grip strength were reduced (P < 0.05). At the 10th week of modeling, the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups (P < 0.05). Compared with the blank control group, rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue, accompanied by collagen deposition and cardiomyocyte hypertrophy. Bulk RNA sequencing identified 2, 003 DEGs, including 1, 082 downregulated genes and 921 upregulated genes. WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength. The overlapping analysis identified four intersecting genes: bone morphogenetic protein 6 (Bmp6), serine-threonine-protein kinase 1 (Pak1), proto-oncogene JunD (JunD), and S100 calcium-binding protein A3 (S100A3). ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.ConclusionThe rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed, fructose water, and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome. Bmp6, JunD, Pak1, and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.Keywords：dilated cardiomyopathy;heart failure;toxin syndrome;biomarker;rats198|222|1<HTML><L-PDF>Updated：2025-12-04
Experimental Study
Effects of Gandou Fumu Decoction on hepatic fibrosis, iron metabolism, and ferroptosis in patients with hepatolenticular degeneration AI Introduction
Abstract：ObjectiveTo investigate the effects of Gandou Fumu Decoction on liver fibrosis, iron metabolism, and ferroptosis in patients with hepatolenticular degeneration(Wilson disease, WD).MethodsSeventy-eight hospitalized patients with WD characterized by kidney and liver deficiency, with phlegm and blood stasis, from the Department of Neurology, the First Affiliated Hospital of Anhui University of Chinese Medicine, were randomly assigned to two groups using a random number table method. The control group (n=39) received sodium dimercaptosulfonate in combination with a low-copper and high-protein diet. The observation group (n=39) received the same treatment as the control group, with the addition of Gandou Fumu Decoction (one dose per day, taken twice daily, in the morning and evening). Both groups underwent six treatment cycles, each lasting eight days. Ultrasonographic parameters, including portal vein main trunk diameter (PVMD), portal vein velocity (PVV), shear wave velocity (SWV), liver stiffness measurement (LSM), serum liver fibrosis markers (hyaluronic acid [HA], laminin [LN], procollagen typeⅢN-terminal peptide [PⅢNP], collagen type Ⅳ [CⅣ], aspartate aminotransferase to platelet ratio index [APRI], fibrosis-4 index [FIB-4]), and iron metabolism indicators (serum iron [SI], ferritin [FT]) were compared before and after treatment. The relationship between baseline iron metabolism markers and ultrasonographic parameters, as well as serum liver fibrosis markers, was analyzed. Clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, and adverse reactions were also compared between the groups. Additionally, bioinformatics analysis was performed to identify potential targets of Gandou Fumu Decoction for WD treatment. Peripheral blood mononuclear cells were collected from a normal group of 20 healthy individuals, as well as from both the control and observation groups before and after treatment. Real time fluorogenic quantitative PCR was performed to validate the expression changes of these targets across the groups.ResultsCompared with pre-treatment values, no significant changes were observed in PVMD levels in either group after treatment. No significant change in PVV was observed in the control group, whereas a significant decrease was noted in the observation group (P < 0.01). SWV, LSM, HA, LN, PⅢNP, CⅣ, APRI, FIB-4, and FT levels were significantly reduced compared to pre-treatment levels (P < 0.05, P < 0.01), whereas SI remained unchanged. Compared with the control group, the observation group had no significant difference in PVMD but had significantly lower PVV, SWV, LSM, HA, LN, PⅢNP, CⅣ, APRI, FIB-4, and FT levels (P < 0.05, P < 0.01), whereas SI remained unchanged. The total effective rate of treatment in the observation group was significantly higher than that in the control group (P < 0.05). Both groups showed a significant reduction in TCM syndrome scores after treatment (P < 0.01), with a significantly greater reduction observed in the observation group (P < 0.01). No significant adverse reactions were reported during treatment. Before treatment, there was no significant correlation between the SI of both groups and PVMD, PVV, SWV, LSM, HA, LN, PⅢNP, CⅣ, APRI, and FIB-4. In the observation group, FT showed a positive correlation with SWV, LSM, LN, PⅢNP, CⅣ, APRI, and FIB-4 (P < 0.05, P < 0.01), while in the control group, FT showed a positive correlation with HA, LN, PⅢNP, CⅣ, APRI, and FIB-4 (P < 0.01). After treatment, in the control group, SI showed a positive correlation with APRI and FIB-4 (P < 0.05, P < 0.01), but there was no significant correlation between SI in the observation group and FT in both groups with the above-mentioned indicators. Bioinformatics analysis identified four potential targets of Gandou Fumu Decoction for treating WD, namely heme oxygenase 1 (HMOX1), peroxisome proliferator-activated receptor alpha (PPARα), small heat shock protein B1 (HSPB1), and mitogen-activated protein kinase 3 (MAPK3). Compared to the normal group, both the control and observation groups had significantly lower PPARα and HSPB1 expression and significantly higher HMOX1 and MAPK3 expression before treatment (P < 0.01). Compared to before treatment within the same group, both groups showed significantly increased PPARα and HSPB1 expression and significantly decreased HMOX1 and MAPK3 expression after treatment (P < 0.05, P < 0.01). After treatment, the observation group had significantly higher PPARα and HSPB1 expression and lower HMOX1 and MAPK3 expression than the control group (P < 0.05, P < 0.01).ConclusionGandou Fumu Decoction demonstrates remarkable advantages in improving clinical efficacy, Chinese medicine syndrome scores, iron metabolism, liver fibrosis progression, ultrasound imaging parameters, and ferroptosis-related biomarkers expression in patients with WD, with a favorable safety profile.Keywords：Gandou Fumu Decoction;hepatolenticular degeneration;liver fibrosis;iron metabolism;ferroptosis74|84|2<HTML><L-PDF>Updated：2025-12-04Multimorbidity pattern and traditional Chinese medicine syndrome characteristics of patients with adenomyosis: A cross-sectional study AI Introduction
Abstract：ObjectiveTo explore the multimorbidity pattern and traditional Chinese medicine (TCM) syndrome characteristics of patients with adenomyosis (AM) and to provide insights and data support for medical treatment and comprehensive AM management.MethodsBy retrospectively analyzing multi-center, large-sample, nationwide cross-sectional survey data, patients were divided into a single AM group or a multimorbidity group based on whether they had other diseases. The prevalence rates of specific multimorbidity or a combination of multimorbidities were calculated respectively. Single-factor analysis was used to explore the influence of age, course of disease, education level, labor nature, monthly income, production history, abortion history, operation history, region, and TCM syndromes on multimorbidity in patients with AM. The multimorbidity patterns of patients with AM were explored using Apriori association rules, and the distribution characteristics of TCM syndromes in different multimorbidity patterns were explored.ResultsAmong 1, 814 patients with AM, 1, 429 were in the multimorbidity group (prevalence of 78.78%). Compared with the single AM group, the patients in the multimorbidity group had a long disease course, high academic qualifications, jobs that mostly involved sitting, a history of surgery, and were primarily concentrated in the north (P<0.05). The proportion of patients with qi stagnation and blood stasis syndrome decreased, whereas the proportion of patients with kidney deficiency and blood stasis syndrome increased. Ten multimorbidity association rules were sorted according to the confidence level, and the first place of binary association rules was breast nodule to breast hyperplasia, and the first place of ternary association rules was hysteromyoma, breast nodule to breast hyperplasia. Comprehensive support and confidence level, in the binary association rules, the strong association rule was breast nodule to thyroid nodule, and sub-strong association rule was thyroid nodule to breast hyperplasia; In the ternary association rules, the strong association rule was hysteromyoma, breast nodules to breast hyperplasia, and sub-strong association rule was endometriosis, thyroid nodules to breast hyperplasia.There was no significant difference in the distribution of TCM syndromes in AM patients with different binary and ternary multimorbidity patterns.ConclusionPatients with AM have different multimorbidity patterns, and the TCM syndromes of patients with AM under different multimorbidity patterns have different characteristics. The management system of AM multimorbidity should be further developed to ensure more comprehensive and standardized health management for patients with AM.Keywords：adenomyosis;multimorbidity;Association Rule;traditional Chinese medicine syndrome102|164|0<HTML><L-PDF>Updated：2025-12-04
Clinical Study
- Abstract：Systemic sclerosis is an autoimmune rheumatic disease that often leads to multisystem diseases, frequently resulting in pulmonary interstitial fibrosis. According to the theory of sanjiao (triple energizers) membranous channels, sanjiao connects the five zang-organs and six fu-viscera internally and the skin, muscles, and bones externally. It serves as a four-way membranous channel that connects internal organs and external structures, linking with the micromembranes of organs and blood vessels. The pathogenesis of pulmonary interstitial fibrosis secondary to systemic sclerosis involves external cold obstructing the skin and interstitial layers, impairing the defense qi and defense yang, which originate in the essence of the kidney. This leads to weak defensive qi and kidney deficiency, causing stagnation in sanjiao′s energy flow and disruption of water and gasification and loss of fluid, resulting in accumulation of dampness, phlegm, and blood stasis. These obstructive factors spread along sanjiao′s membranous channels, leading to multiorgan micromembrane involvement and systemic damage. The lungs, which are in direct contact with the external environment, are particularly susceptible to invasion by external pathogens. When combined with stagnation of dampness, phlegm, and blood in the lungs, this leads to secondary pulmonary fibrosis, resulting in lung dysfunction. Continuous stagnation of sanjiao exacerbates the overall condition of the patient, leading to a mixed cold-heat imbalance. Treatment focuses on " unblocking, transforming, and regulating" to restore sanjiao function, promote qi and fluid circulation, invigorate blood, and adjust the cold-heat imbalance, ultimately restoring the overall condition of the patient.Keywords：systemic sclerosis;pulmonary interstitial fibrosis;theory of sanjiao (triple energizers) membranous channels;viscera and bowels micro-membrane;dredging and regulating triple energizers71|86|0<HTML><L-PDF>Updated：2025-12-04
Exploring differentiation and treatment strategies for perimenopausal insomnia through thief and child fire AI Introduction
Abstract：Perimenopausal women are more susceptible to fire pathogen disturbances, often resulting in the restlessness of the mind owing to the deficiency and decline of the thoroughfare and conception vessels, as well as the insufficiency of the essence and blood of the viscera. CHENG Zhongling′s theory of thief and child fire in Medical Insights proposes that thief fire primarily arises from exogenous pathogen invasion and improper diet, leading to syndromes such as food retention in the stomach or phlegm-fire stagnation. In contrast, child fire is generated endogenously, often owing to liver and kidney deficiency, resulting in an imbalance of water and fire and liver dysfunction, leading to excessive fire transformation. This theory provides a novel perspective for understanding the pathogenesis of perimenopausal insomnia. An in-depth exploration of the role of thief fire and child fire in perimenopausal insomnia is presented, along with a detailed discussion of corresponding treatment strategies. For the invasion of thief fire, therapeutic approaches include ascending and dispersing stagnant fire, clearing and moistening to remove interior heat, purging the heat accumulation to unblock the bowels, and subduing the fire and nourishing yin to eliminate depression. When child fire disturbs the spirit, treatment methods involve smoothing and relieving the liver qi to clear the stagnant heat, nourishing the true yin to restrain the yang, warming and nurturing the primordial qi and harmonizing the nutrient and defensive qi, and guiding and reducing the deficient heat to remove the floating fire. Clinical practice necessitates precise identification of thief and child fire, thorough investigation of exogenous pathogens and internal damage, and careful differentiation between deficiency and excess, as well as the superficial and internal aspects. Strict adherence to the treatment principle of " nourishing the child fire can drive out the thief fire, but driving out the thief fire should not harm the child fire" ensures a balanced approach. By harmonizing the yin and yang of the viscera and allowing the mind to be at ease, this strategy effectively alleviates perimenopausal insomnia. The application of these principles provides a practical and feasible theoretical foundation and practical guidance for the treatment of perimenopausal insomnia using traditional Chinese medicine.Keywords：perimenopausal period;insomnia;Medical Insights;fire pathogen82|530|0<HTML><L-PDF>Updated：2025-12-04Treatment of female stress incontinence based on the " brain-kidney-bladder" axis, conception vessel, and governor vessel AI Introduction
Abstract：Guided by the theory of " kidney generating marrow" and " kidney associating with bladder", the concept of " brain-kidney-bladder" axis was proposed. From the perspective of meridian circulation and physiological function, the conception vessel and governor vessel are the links of the " brain-kidney-bladder" axis. Kidney essence deficiency, brain spirit losing, and dysfunction of bladder are the core pathogenesis of female stress incontinence. From the dysfunction of the " brain-kidney-bladder" axis and the deficiency of conception vessel and governor vessel, an integrated model of " one acupunture, two medication, and three daoyin therapy" was proposed for the treatment of female stress incontinence. " One acupunture" is based on the theoretical guidance of " treating on the bone, and even under the navel ying" in Gukong Lun in Suwen, and the regulating conception vessel and dredging governor vessel acupuncture method is used to harmonize yin and yang, replenish qi, and consolidate bladder, using governor vessel points such as Baihui (DU20), Shenting (DU24), Mingmen (DU4), and conception vessel points such as Qihai (RN6), Guanyuan (RN64), Zhongji (RN3), and cooperating with Baliao points (BL31, BL32, BL33, and BL34) of the bladder meridian. " Two medication" is guided by the theory that " dispersing conditions should be astringed, and deficient conditions should be warmed" in Zhizhenyao Dalun in Suwen; the treatment method focuses on consolidating conception vessel, dredging governor vessel, and harmonizing and nourishing qi and blood, and the Guren Tongdu Formula is selected. " Three daoyin therapy", that is, using the abdominal contraction and anal lifting exercise, the Mawangdui daoyin therapy, and pelvic floor muscle training to cultivate qi, preserve spirit, and maintain the unity of body and mind.Keywords：stress incontinence;"brain-kidney-bladder" axis;conception vessel;governor vessel159|540|0<HTML><L-PDF>Updated：2025-12-04Application of Tongjing Jiedu Formula in the treatment of asthenospermia based on the " kidney deficiency toxic-stasis" theory AI Introduction
Abstract：Asthenospermia is one of the important causes of male infertility, and its etiology and pathogenesis are complex. Traditional Chinese medicine(TCM) offers unique advantages in treating this disease. The " kidney deficiency and toxic-stasis" theory reveals the dynamic relationship between kidney essence deficiency and the interaction of toxic-stasis in disease pathogenesis, which can be applied clinically to guide the differentiation and treatment of asthenospermia. The formation of asthenospermia is closely related to the deficiency of kidney essence and the blockage of toxic stasis. The kidney essence is the source of reproductive essence. If the kidney essence is depleted for a long time and the kidney essence is deficient, the essence chamber cannot be enriched, resulting in spermatozoa dysfunction and poor spermatozoa mobility. The poison stasis interferes with the spermatozoa and turns into spermatotoxin, which directly harms spermatozoa fertility and leads to the decrease of spermatozoa mobility. Tongjing Jiedu Formula takes tonifying kidney to supply essence, diuresis and detoxification, activating blood circulation and removing blood stasis as the treatment principle, focusing on tonifying kidney to fill essence and nourishing healthy qi to restore the nourishing effect of kidney essence, and also emphasizes clearing heat and detoxification, activating blood circulation and removing blood stasis, promoting diuresis and dredging collaterals to remove poisonous damp-heat and static blood and harmonize blood and vessel, improving spermatogenic environment and improving sperm vitality to help men have children. This article analyzes the application of Tongjing Jiedu Formula in treating asthenospermia from the perspective of " kidney deficiency and toxic stasis", aiming to provid new ideas and methods for the explanation of the pathogenesis of the disease and TCM treatment.Keywords：kidney deficiency and toxic stasis;Tongjing Jiedu Formula;asthenospermia;toxic pathogen88|135|2<HTML><L-PDF>Updated：2025-12-04- Abstract：Deficiencies remain in the early identification and screening method for type 2 diabetes mellitus (T2DM). Relying solely on blood glucose indicators as diagnostic criteria fails to capture the systematic evolution of glucose metabolism destabilization and does not allow for the identification of the critical transition period preceding the onset of T2DM. In the complex system of the human body, structural and state variables correspond to the traditional Chinese medicine concepts of " zang" and " xiang." These variables determine the landscape of the systemic state changes over time. The pathogenesis of T2DM is characterized by a shift from compensatory insulin secretion to β-cell dysfunction, driven by negative-positive feedback dynamics, ultimately resulting in a marked increase in blood glucose levels. A critical transition exists between glycemic homeostasis and the establishment of T2DM disease homeostasis. Using theoretical approaches such as critical slowing and dynamic network markers in dynamical systems theory, various clinical case data—including four-diagnosis information, multiple biological samples, and histological analysis method—can be leveraged to identify the critical transition key stage from pre-disease to disease of T2DM, facilitating early intervention. This paper aims to develop a dynamic model describing the transition from " glucose homeostasis-glycemic state of instability-steady state of T2DM" by analyzing the mechanism of the complex human system and the dynamic characteristics underlying T2DM onset. This framework aims to enhance early identification method. Establishing this holistic approach offers a novel perspective for the prevention and treatment of T2DM.Keywords：type 2 diabetes mellitus;pre-disease;critical state;identification of critical transition;dynamical system78|281|0<HTML><L-PDF>Updated：2025-12-04
Discussing the " disharmony of rhythm and state" of myopia based on the " opening-closing-pivot" theory AI Introduction
Abstract：Traditional Chinese medicine upholds the unity of nature and humanity as its fundamental principle, asserting that man is in harmony with heaven and earth and corresponds to the sun and moon. Human life processes align with the circadian rhythms of nature, exhibiting periodic temporal changes—concepts that Western medicine defines as biological rhythms. The " opening-closing-pivot" of the three yin and three yang meridians represents the primary mode of interaction between nature and humanity. This mechanism regulates the transformation of yin and yang to qi within the body, ensuring synchronization with the circadian rhythm. Building upon this foundation, the concept of " the harmony of rhythms and states" was proposed to explain human growth and aging. " Rhythms" encompass not only circadian cycles but also the movement of qi and blood, as well as the contraction rhythm of muscle fascia, among other physiological processes. " States" refer to the dynamic evolution and transformation of qi during the " opening-closing-pivot" stages in both time and space. " Harmony" pertains not only to the individual physiological balance of " rhythms" or " states" but also to their coherent interaction. The fundamental cause of myopia is " the disharmony of rhythms and states", considering that rhythm disorders, qi and blood disorders, and fascia imbalances contribute to this disease. Based on this understanding, myopia prevention and treatment should center on " regulating rhythms and states", with adjusting the pivot to brighten the eyes as the core therapeutic principle throughout the entire cycle of myopia. Treatment should be tailored to different disease stages and supplemented with methods such as time-based regulation, qi and blood harmonization, tendon relaxation and collateral dredging, and essence and blood nourishment to prevent and manage myopia effectively.Keywords：the same rhythm of nature and humans;opening-closing-pivot;disharmony of rhythm and state;adjusting the pivot to brighten eyes method;myopia60|236|0<HTML><L-PDF>Updated：2025-12-04
Thought and Method
- Abstract：The phlegm-dampness constitution is a physical state characterized by the accumulation of stagnant water and fluid in the body, leading to the formation of phlegm-dampness, a common underlying factor in various metabolic diseases. The occurrence of this metabolic disorder is closely related to the small intestine. The concept of small intestine separating purity from turbidity describes the essential functions of the small intestine in digestion, absorption, and excretion. Dysfunction of the small intestine leads to metabolic disorders of phlegm-dampness constitution through three aspects of the action of phlegm-dampness obstructing qi movement, internal accumulation of phlegm-dampness leading to damage to yang qi, and phlegm and turbidity stagnating in the small intestine without clearance. However, the microscopic mechanisms remain unclear. One key factor in metabolic regulation is incretin, an intestinal hormone secreted by endocrine cells in the small intestine, which plays an essential role in maintaining metabolic balance. Inspired by the prescription thought of national medical master WANG Qi, the Yiqi Jianyun Decoction was developed to regulate the phlegm-dampness constitution. This prescription integrates key therapeutic principles such as Banxia Xiexin Decoction, benefiting qi and warming yang, as Sijunzi Decoction with modification, which supports qi nourishment and yang warming, and rhubarb root and rhizome, which facilitates small intestine clearance. These components effectively regulate incretin levels and improve overall metabolism. This article aims to provide a new scientific interpretation of the small intestine separating purity from turbidity theory from the perspective of incretins, enriching the modern scientific connotation of the pharmacological mechanism of Yiqi Jianyun Decoction, and providing a novel theoretical basis and prescription thought for the clinical intervention of the phlegm-dampness constitution, diagnosis and treatment of metabolic diseases.Keywords：small intestine separating purity from turbidity;incretin;metabolic disorder;phlegm-dampness constitution75|425|0<HTML><L-PDF>Updated：2025-12-04
TCM Constitution
- Abstract：The incidence of apoplexy remains persistently high among the older population. Based on the traditional Chinese medicine principle of " treating the elderly by focusing on the fu", this paper explores the holistic connotation of " fu". It proposes that the onset of apoplexy in the elderly is characterized by obstruction, stagnation, depression, and sluggishness, which should be treated from six fu viscera, xuanfu, and collaterals. The interconnected hierarchical network of these three systems, serving as macro- and micro-channels for qi and fluid metabolism, plays a central role in both disease development and treatment. The failure of the six fu viscera to descend and the upward invasion of turbid yin are identified as prerequisites for apoplexy onset, whereas yang qi stagnation and xuanfu blockage act as key pathogenic drivers, and the core mechanisms involve phlegm-stasis-toxin accumulation, and dysfunction of the collaterals and fu. In the treatment, acute phase requires unblocking fu viscera and restoring xuanfu patency; chronic phase focuses on dredging collaterals and opening xuanfu; and recovery phase emphasizes tonifying combined with regulating xuanfu. The understanding of " treating the elderly by focusing on the fu" emphasizes that the pathogenesis of the disease should be changed to individual conditions; " six fu viscera-xuanfu-collaterals" exhibits a pathological mechanism characterized by the transmission and reception of pathogenic factors, as well as progressive mutual involvement; in clinical practice, treatment should meticulously assess the severity and nuances of the condition, prioritizing method that emphasizes unobstructed flow; additionally, therapy should be essential to protect stomach qi and integrate therapeutic attacks within a framework of supplementation. These principles offer valuable reference for the differentiation and treatment of apoplexy.Keywords：treating the elderly by focusing on the fu;Apoplexy;six fu viscera;Xuanfu;Collaterals82|404|0<HTML><L-PDF>Updated：2025-12-04
Extracerebral control mechanism of ischemic stroke based on the " brain as the sea of medulla" theory AI Introduction
Abstract：Ischemic stroke is a leading cause of death and disability worldwide, with an increasing incidence among younger populations. Therefore, effective prevention and treatment remain urgent scientific challenges. In traditional Chinese medicine (TCM) theory, the brain, spinal cord, bone marrow, and teeth are classified as components of the medulla, and the " brain as the sea of medulla" theory highlights the close connection between the brain and other medullary structures. This paper examines the origins of this theory and its relationship with the medulla, emphasizing that deficiency of the sea of medulla constitutes a key pathophysiological mechanism of ischemic stroke, contributing to its rapid progression and challenging recovery. The study further explores the intricate relationship between the medulla and the brain, considering the roles of the spinal cord, bone marrow, and teeth. Medullary disorders, such as osteoporosis and periodontitis, can be the early warning symptoms of ischemic stroke, offering opportunities for early detection and prevention. Additionally, the mechanism of action of corticospinal tract remodeling, bone marrow mesenchymal stem cell transplantation, and dental pulp stem cell regeneration in stroke treatment are analyzed, along with the significant therapeutic contributions of TCM. Investigating extracerebral mechanisms aims to provide novel perspectives for ischemic stroke prevention and treatment, broaden strategies for managing brain diseases, and establish a more comprehensive systematic approach to brain disease prevention and therapy.Keywords：ischemic stroke;deficiency of the sea of medulla;osteoporosis;periodontitis;corticospinal tract;bone marrow mesenchymal stem cells;dental pulp stem cells69|281|0<HTML><L-PDF>Updated：2025-12-04
TCM Encephalopathy
Mechanism of mitochondrial dysfunction on immune thrombocytopenia-related fatigue based on the " excessive fire consuming healthy qi" theory AI Introduction
Abstract：Immune thrombocytopenia (ITP) is an autoimmune disease characterized primarily by bleeding and fatigue. ITP-related fatigue can substantially affect health-related quality of life and has been recognized as a treatment indication in the latest guidelines. However, its pathogenesis remains unclear, and targeted therapies are lacking. This paper explores the theoretical foundation of the " excessive fire consuming healthy qi" theory, linking two key conceptual pairs: " excessive fire" with inflammation and " healthy qi consumption" with mitochondrial dysfunction. Chronic inflammation leads to continuous " qi consumption" and damage to mitochondrial structure and function, ultimately resulting in symptoms of qi deficiency such as tiredness and fatigue. The imbalance between qi and fire, leading to imbalance of yin and yang, is the primary pathogenesis of ITP-related fatigue, with the disease mainly affecting the spleen. Considering the etiology and pathogenesis of ITP, and relative equilibrium of yin-yang, the therapeutic approach of invigorating spleen and benefiting qi to promote the production of blood serves as a core treatment strategy. Previous research has demonstrated the clinical efficacy of Jianpi Yiqi Shexue Formula, consisting of milkvetch root, tangshen, Indian bread, largehead atractylodes rhizome, India madder root, and ass hide glue in treating patients with ITP-related fatigue. Designed to invigorate the spleen and regulate qi and blood, this formula aligns with the pathogenesis of ITP-related fatigue characterized by deficiency of spleen qi and stomach qi. The formula also modulates the expression levels of key proteins and genes involved in mitochondrial energy metabolism and alleviates the immune dysfunction. These findings highlight the potential for further research into the mechanism of ITP-related fatigue, particularly by using inflammation-mediated mitochondrial energy metabolism as a promising entry point.Keywords：immune thrombocytopenia;fatigue;excessive fire consuming healthy qi;mitochondrial dysfunction;invigorating spleen and benefiting qi to promote the production of blood89|238|1<HTML><L-PDF>Updated：2025-12-04Pathogenesis and treatment of breast cancer from the perspective of " blood cold accumulation at the uterine ostium" AI Introduction
Abstract：Breast cancer remains a substantial threat to women′s health and is one of the most prevalent malignant tumors in women. Because breast cancer onset is closely associated with female physiological characteristics, this article proposes that breast cancer be classified as a " women′s miscellaneous diseases" and that its treatment be explored from this perspective. Drawing from Chapter 8 on Golden Chamber of Prescriptions for Miscellaneous Diseases in Women of Synopsis of Golden Chamber, the initial pathogenesis of breast cancer is associated with " emotional stress, improper lifestyle, deficiency, cold, and stagnation." The fundamental mechanism behind its formation is " blood cold accumulation and hardened masses." Specifically, emotional imbalance and improper lifestyle habits contribute to the combined invasion of the uterus by " deficiency, " " accumulated cold, " and " stagnant qi." Over time, " cold-blood stasis accumulates at the uterine ostium, " and the cold and the stasis ascends from the uterus along the thoroughfare and conception vessels, obstructing the breast collaterals. This combination of yang qi stagnation and yin cold congealment, ultimately leads to the development of breast cancer.The treatment principle should focus on " activating yang and dispersing cold." A therapeutic approach centered on Wenjing Decoction combined with Xiaoyao Powder can be adapted based on the stage and type of breast cancer while also considering the dynamic interplay between pathogenic factors and healthy qi, along with shifts in deficiency and excess patterns of disease. By adhering to the principles of consistency and flexibility and integrating disease and syndrome differentiation, the goal is to develop precise and personalized treatment strategies to improve clinical outcomes.Keywords：breast cancer;Synopsis of Golden Chamber;uterus;Wenjing Decoction;Xiaoyao Powder70|101|1<HTML><L-PDF>Updated：2025-12-04Pathogenesis and treatment strategies of cancer-related cognitive impairment from the perspective of " toxin damaging brain collaterals" AI Introduction
Abstract：Cancer-related cognitive impairment (CRCI) refers to cognitive dysfunction that occurs during or after chemotherapy in patients with cancer. However, the pathogenesis of CRCI remains unclear, and effective treatments are lacking in clinical practice. Based on the " toxin damaging brain collaterals" theory, this study systematically explores the traditional Chinese medicine (TCM) etiology, pathogenesis, and treatment strategies of CRCI. In TCM, CRCI is attributed to a " deficiency of brain collaterals" in patients with cancer. Chemotherapy drugs, as exogenous pathogens, invade the brain when the body is weakened and interact with endogenous phlegm, blood stasis, and turbid toxins. This creates a vicious cycle of " toxin, blood stasis, phlegm, deficiency" ultimately leading to the malnourishment of the sea of marrow and the dysfunction of the spiritual mechanism. Modern biological research aligns with this TCM perspective, as neurotoxicity, oxidative stress, and inflammatory responses associated with CRCI correspond to the TCM concepts of " toxin damaging brain collaterals." Pathological changes such as increased microvascular permeability and neuronal network disruption are similar to the TCM pathogenesis characteristics of " toxin and blood stasis blocking the collaterals" and " emptiness of the sea of marrow." Given the progressive nature of CRCI pathogenesis, TCM therapeutic principles focus on strengthening healthy qi, enhancing cognitive function, eliminating toxins, and unblocking collaterals. Acupuncture, moxibustion, and Daoyin serve as supplementary external treatments, forming a comprehensive treatment approach of " treating the viscera through the collaterals and regulating the body to nourish the spirit." This framework provides novel insights for TCM diagnosis and CRCI treatment.Keywords：cancer-related cognitive impairment;toxin damaging brain collaterals;etiology and pathogenesis;concurrent damage of body and spirit;regulating the body to nourish the spirit94|88|0<HTML><L-PDF>Updated：2025-12-04
Hematology and Oncology
Exploring the rationality of non-acupoint shallow needling control setting based on chronic spontaneous urticaria AI Introduction
Abstract：ObjectiveTo explore the similarities and differences in clinical efficacy and mRNA transcriptomics characteristics between acupuncture and shallow needling at non-acupoints and to provide a basis for determining whether shallow needling at non-acupoints is suitable as a sham acupuncture control in acupuncture clinical trials.MethodsEighty patients with chronic spontaneous urticaria (CSU) who visited the Dermatology Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between July 8, 2018 and to July 29, 2019, were included. The patients were randomly divided into the acupuncture group (n=41) and the sham acupuncture group (n=39) using a computerized complete random design. Additionally, 12 healthy individuals were included as the healthy control group. For patients in the acupuncture group, " Baihui(GV20), " " Shenting (GV24), " " Zhongwan (CV12), " and bilateral " Quchi (LI11), " " Tianshu (ST25), " " Xuehai (SP10), " " Zusanli (ST36), " and " Sanyinjiao (SP6)" were selected for regular acupuncture. The sham acupuncture group received non-acupoint shallow needling at eight non-acupoints on the head, upper limbs, lower limbs, and abdomen. Both groups underwent daily treatment, with five consecutive days constituting one treatment course followed by a two-day interval. A total of two courses were administered. The urticaria activity score (UAS) was used to evaluate wheals and pruritus, whereas the visual analog scale (VAS) score was used to evaluate the degree of pruritus. Blinding effectiveness was also evaluated. Based on clinical evaluation and sample quality, serum samples from six patients in each treatment group before and after the intervention, along with those from six healthy individuals, were selected for RNA sequencing using the BGISEQ-500 sequencer. Differentially expressed mRNAs were identified using the " DEGseq" software package, and the similarities and differences in mRNA expression between the two groups were analyzed.ResultsUAS and VAS scores decreased in both groups at 1, 2, 3, and 4 weeks of treatment compared with before treatment (P < 0.01). The decrease in UAS and VAS scores in both groups was time-dependent (P < 0.01) but not related to the grouping or the interaction between grouping and time (P > 0.05). By the end of the second week of treatment, the number of patients in both groups who believed they had received true acupuncture was similar between the two groups, with no significant difference. mRNA transcriptomic sequencing revealed that, before and after treatment, the enrichment types and degrees of differentially expressed mRNA were similar between the acupuncture and sham acupuncture groups at the biological process, cellular component, and molecular function levels. In terms of biological processes, both groups were commonly enriched in coagulation, hematoma, oxygen transport, and gas transport. In terms of cellular components, both groups exhibited enrichment in hemoglobin complexes, platelet alpha granules, extracellular exosomes, extracellular organelles, and extracellular vesicles. At the molecular function level, both groups were commonly enriched in actin filament-binding substances, haptoglobin, peroxidase activity, and oxygen blood binding. In the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, both groups showed common enrichment in multiple entries such as cytokine-cytokine receptor interaction, ECM-receptor interaction, microRNAs in cancer, proteoglycans in cancer, bladder cancer, and malaria.ConclusionAcupuncture and sham acupuncture exhibited similar clinical treatment effects and mRNA transcriptomics profiles. In the design of acupuncture clinical trials, disease specificity should be carefully considered. Sham acupuncture control using non-acupoint shallow needling may not be suitable for skin diseases such as urticaria.Keywords：chronic spontaneous urticaria;acupuncture;sham acupuncture;control setting;rationality78|162|0<HTML><L-PDF>Updated：2025-12-04
Acupuncture Moxibustion and Tuina
Thoughts on the historical inheritance and new era development of Chinese medicine Zha Gui AI Introduction
Abstract：The Chinese medicine Zha Gui, the senior manager of traditional Chinese medicine dispensing, plays an important role and key function in the " front store and back factory" Chinese medicine pharmacy. Inheriting the valuable experience and excellent culture of Chinese medicine Zha Gui is of great academic value and practical significance in clarifying the development of the discipline of traditional Chinese medicine, standardizing the technical operation of traditional Chinese medicine preparation, and promoting the " living inheritance" of the old pharmacist′s skills. At the start of the new era and opening up to new thinking, this paper examined the rise of old Chinese medicine stores and Chinese medicine Zha Gui, analyzed the post responsibility, inheritance path and future development of Chinese medicine Zha Gui, and put forward the strategy of cultivating high-quality Chinese medicine Zha Gui talents, aiming at cultivating compound innovative talents in the traditional Chinese medicine industry in line with the needs of the contemporary society.Keywords：Chinese medicine Zha Gui;Chinese medicine dispensing;talent training;new era development74|105|0<HTML><L-PDF>Updated：2025-12-04
Selected Highlights of Chinese Materia Medica
