最新刊期

    30 6 2024
    • YANG Chaomao,ZHANG Shunxiao,LI Yuanyuan,GAO Jiandong
      Vol. 30, Issue 6, Pages: 1-9(2024) DOI: 10.13422/j.cnki.syfjx.20232122
      摘要:ObjectiveTo explore the mechanism of modified Liuwei Dihuangtang in preventing and treating renal injury in diabetic kidney disease (DKD) via the angiotensin-converting enzyme 1 (ACE1)/angiotensin Ⅱ (AngⅡ)/angiotensin Ⅱ type 1 receptor (AT1R) axis.MethodFifty male SD rats were randomized into a normal group (n=8) and a modeling group (n=42). The rats in the modeling group were fed with a high-sugar and high-fat diet for 6 weeks and intraperitoneally injected with 35 mg·kg-1 streptozotocin (STZ) to establish the model of DKD. After successful modeling, the rats were randomized into model, traditional Chinese medicine (modified Liuwei Dihuangtang granules 21 g·kg-1), western medicine (losartan potassium, 33 mg·kg-1), and integrated Chinese and western medicine (losartan potassium 33 mg·kg-1 combined with modified Liuwei Dihuangtang granules 21 g·kg-1) groups. The levels of fasting blood glucose (FBG), urinary protein (Up), blood urea nitrogen (Bun), and serum creatinine (SCr) were measured in each group after 8 consecutive weeks of drug intervention. Enzyme-linked immunosorbent assay was employed to determine the serum levels of ACE1, AngⅡ, and AT1R. Western blot was employed to measure the protein levels of ACE1, AngⅡ, and AT1R in the renal tissue. The pathological and morphological changes of the renal tissue were observed after hematoxylin-eosin (HE) staining, Masson staining, and periodic acid Schiff 's (PAS) staining. The fecal samples of rats in each group were collected for 16S rDNA high-throughput sequencing.ResultCompared with the normal group, the model group showed elevated levels of Up, FBG, Bun, SCr, ACE1, AngⅡ, and AT1R (P<0.01), serious lesions in the renal tissue, up-regulated protein levels of ACE1, AngⅡ, and AT1R (P<0.01), increased Firmicutes/Bacteroidetes (F/B) ratio, decreased relative abundance of Lactobacillus, and increased relative abundance of Moralella and Bifidobacteria. Compared with the model group, drug intervention lowered the levels of Bun, SCr, ACE1, AngⅡ, and AT1R (P<0.01) and alleviated the pathological changes in the renal tissue. Chinese medicine and integrated Chinese and western medicine lowered the levels of Up and FBG (P<0.01), and western medicine and integrated Chinese and western medicine down-regulated the protein levels of ACE1, AngⅡ, and AT1R. In addition, Chinese medicine down-regulated the protein levels of AngⅡ (P<0.01) as well as ACE1 and AT1R (P<0.05). Chinese medicine and integrated Chinese and western medicine decreased the F/B ratio, and western medicine and Chinese medicine increased the relative abundance of Blautia. Chinese medicine and integrated Chinese and western medicine increased the relative abundance of Lactobacillus, Ruminococcus undetermined genera, and Bifidobacteria, decreased the relative abundance of Moralella, and increased the Chao 1 and Ace indexes (P<0.05). Compared with the western medicine group, the integrated Chinese and western medicine group showed lowered levels of Up (P<0.01), Bun (P<0.05), and ACE1 and AT1R (P<0.01), down-regulated protein levels of ACE1, AngⅡ, and AT1R (P<0.05), alleviated pathological changes in the renal tissue, increased relative abundance of Bifidobacteria, and increased Chao 1 and Ace indexes (P<0.05).ConclusionModified Liuwei Dihuangtang combined with losartan potassium can mitigate renal fibrosis by regulating the ACE1/AngⅡ/AT1R axis, increasing the relative abundance of Lactobacillus and Bifidobacterium, reducing the relative abundance of Moralella, improving the richness and evenness of intestinal flora, and alleviating pathological damage in the renal tissue.  
      关键词:angiotensin-converting enzyme 1 (ACE1);angiotensin Ⅱ (AngⅡ);angiotensin Ⅱ type 1 receptor (AT1R);intestinal flora;modified Liuwei Dihuangtang   
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      发布时间:2024-01-02
    • LI Ling,LI Yaxing,WANG Xue,QIU Xiao,GUO Wei,HUANG Hailiang,LIU Xijian,HAN Tao
      Vol. 30, Issue 6, Pages: 10-19(2024) DOI: 10.13422/j.cnki.syfjx.20231424
      摘要:ObjectiveTo observe the effect of Banxia Xiexintang (BXT) on the proliferation of human gastric cancer HGC-27, MKN-45, and AGS cells and its mechanism.MethodCell counting kit-8 (CCK-8) was used to detect the effects of different concentrations of BXT-containing serum (5%, 10%, and 20%) on the proliferation of HGC-27, MKN-45, and AGS cells. A mitochondrial membrane potential probe (TMRE) was used to detect the expression of mitochondrial membrane potential in cells. A kit was used to detect iron ion (Fe2+ content, lipid peroxide (LPO), and superoxide dismutase (SOD) activity. Western blot was used to detect the protein expression levels of glycogen synthase3β (GSK3β), phosphorylated GSK3β (p-GSK3β), nuclear factor E2 related factor 2 (Nrf2), and glutathione peroxidase 4 (GPX4). The real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of member 11 of the cystine/glutamic acid reverse transporter solute vector family 7 (SLC7A11), member 2 of the heavy chain solute vector family 3 (SLC3A2), transferrin receptor 3 (TFRC), and tumor protein (TP)53.ResultCCK-8 results showed that BXT and capecitabine could significantly reduce the survival rate of three kinds of gastric cancer cells after treatment with drug-containing serum for 24 h (P<0.01). After 48 h of intervention with drug-containing serum, the survival rate of three kinds of gastric cancer cells was significantly decreased in both the capecitabine group and the BXT group compared with the blank group. The BXT group was dose-dependent, with 20% BXT having the most significant effect (P<0.01). In terms of biochemical indicators of ferroptosis, compared with the blank group, BXT and capecitabine significantly decreased the expression of mitochondrial membrane potential (P<0.01) and SOD activity (P<0.01) and significantly increased the contents of LPO and Fe2+ (P<0.01), so as to improve the sensitivity of gastric cancer cells to ferroptosis. In terms of the Nrf2/GPX4 pathway, compared with the blank group, the BXT group could reduce the protein expressions of p-GSK3β, Nrf2, and GPX4 (P<0.01) in gastric cancer cells and increase mRNA expressions of SLC7A11 and SLC3A2 (P<0.05). It could also increase the protein expression of GSK3β (P<0.01) and mRNA expression of TP53 and TFRC (P<0.05, P<0.01) in gastric cancer cells. Inhibition of the Nrf2/GPX4 pathway induces ferroptosis in gastric cancer cells. Compared with the capecitabine group, the 20% BXT group showed a more obvious effect.ConclusionBanxia Xiexintang can induce ferroptosis in gastric cancer cells HGC-27, MKN-45, and AGS by inhibiting the Nrf2/GPX4 pathway.  
      关键词:Banxia Xiexintang;gastric cancer;ferroptosis;nuclear factor E2 related factor 2 (Nrf2);glutathione peroxidase 4 (GPX4)   
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      发布时间:2024-02-04
    • LI Yuanyuan,ZHONG Xuan,LIU Lei,SUN Shuya,LING Jiajun,LIN Rongfeng
      Vol. 30, Issue 6, Pages: 20-28(2024) DOI: 10.13422/j.cnki.syfjx.20231813
      摘要:ObjectiveMolecular docking and animal experiments were employed to explore the protective effect and mechanism of Da Chengqitang (DCQD) on intestinal barrier in septic mice.MethodText mining method was used to screen the active ingredients in DCQD. AutoDock Tools and Discovery Studio were used to study the interactions of active components with the core target proteins [claudin-1, tumor necrosis factor (TNF)-α, interleukin (IL)-6, endogenous antimicrobial peptide mCRAMP, Toll-like receptor 4 (TLR4), and myeloid differentiation primary response gene 88 (MyD88)] in sepsis. Fifty C57BL/6 mice were randomized into sham, model, low- and high-dose (4 g∙kg-1 and 8 g∙kg-1) DCQD, and ulinastatin groups (n=10). Before, during, and after the day of modeling surgery, each group was administrated with corresponding drugs. The mice in other groups except the model group were subjected to modeling by cecal ligation and puncture. Enzyme-linked immunosorbent assay (ELISA) was used measure the serum level of D-lactic acid to assess intestinal mucosa permeability. Hematoxylin-eosin staining was employed to observe the histopathological changes in the ileum and assess the intestinal mucosal damage and inflammatory infiltration. Western blotting was employed to determine the expression levels of tight junction proteins claudin-1 and occludin in the ileal tissue, which were indicative of the bowel barrier function. The TNF-α and IL-6 levels were measured by ELISA to assess the intestinal inflammation. The expression of mCRAMP in the ileal tissue was observed by immunohistochemistry. The mRNA levels of mCRAMP, TLR4, and MyD88 in mouse ileal tissue were determined by Real-time polymerase chain reaction, on the basis of which the mechanism of DCQD in protecting the intestinal barrier of septic mice was explored.ResultMolecular docking results showed that most of the 10 active ingredients of DCQD that were screened out by text mining could bind to sepsis targets by van der Waals force, hydrogen bonding, and other conjugated systems. The results of animal experiments showed that compared with the model group, low- or high-dose DCQD lowered the D-lactic acid level in the serum (P<0.01), alleviated damage to the ileal tissue and mucosal edema, protected the small intestine villus integrity, reduced inflammatory cell infiltration, promoted the expression of claudin-1 (P<0.01), lowered the IL-6 level (P<0.01), up-regulated the mRNA and protein levels of mCRAMP (P<0.01), and down-regulated the mRNA and protein levels of TLR4 and MyD88 (P<0.01) in the ileal tissue. In addition, high-dose DCQD lowered the TNF-α level and promoted the expression of occludin in the ileum tissue (P<0.01), and low-dose DCQD up-regulated the protein level of occludin in the ileum tissue (P<0.05).ConclusionDCQD has a protective effect on intestinal barrier in septic mice. It can reduce intestinal inflammation, repair intestinal mucosal damage, improve the tight junction protein level, and reduce intestinal mucosal permeability by up-regulating the mRNA and protein levels of mCRAMP and the down-regulating the expression of genes in the TLR4/MyD88 pathway.  
      关键词:Da Chengqitang;sepsis;intestinal barrier;antimicrobial peptide;Toll-like receptor 4 (TLR4)/myeloid differentiation primary response gene 88 (MyD88)   
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      发布时间:2024-02-04
    • GONG Zihan,WANG Ying,YANG Jingwen,LIANG Wenqing,MENG Danhua,SHE Kaijie,LIANG Yuan,YUE Guangxin
      Vol. 30, Issue 6, Pages: 29-38(2024) DOI: 10.13422/j.cnki.syfjx.20232244
      摘要:ObjectiveTo explore the syndromes and mechanisms of depression induced by maternal separation (MS) combined with chronic restraint stress (RS) in mice.MethodOn postnatal day 0 (PD0), the offspring mice were randomized into a blank group (NC) and a modeling group. The mouse model of depression was established by MS+RS for 21 days. After removal of female mice on PD21, the modeled mice were randomized into model, Wenyang, Jieyu, Wenyang Jieyu, and fluoxetine groups, with 15 mice in each group. The sucrose preference, tail suspension, and open field tests were carried out to evaluate the anxiety and depression-like behavior in mice. Enzyme-linked immunosorbent assay was used to measure the adrenocorticotrophic hormone (ACTH) and corticosterone (CORT) levels in mouse plasma. High performance liquid chromatography-electrochemical detector was used to determine the content of monoamine neurotransmitters in the hippocampus. Real-time fluorescence quantitative polymerase chain reaction was employed to determine the mRNA levels of genes in the 5-hydroxytryptamine (5-HT) system, hypothalamic-pituitary-adrenal (HPA) axis, and brain-derived neurotrophic factor (BDNF) signaling pathway in the hippocampus. Immunohistochemistry was employed to determine the expression levels of proteins in the 5-HT system and HPA axis in the hippocampus. The Simple Western system was used to determine the protein levels of BDNF and tyrosine kinase receptor B (TrkB) in the hippocampus.ResultCompared with the NC group, the model group exhibited depression-like behavior, which was significantly relieved by Wenyang Jieyu prescription and fluoxetine. Compared with the NC group, the model group showed elevated levels of CORT and ACTH in the plasma (P<0.01), which, however, were lowered by Wenyang Jieyu prescription and fluoxetine (P<0.05, P<0.01). Compared with the NC group, the model group showed inhibited expression of neurotransmitters in the hippocampus (P<0.05, P<0.01), while Wenyang Jieyu prescription and fluoxetine restored the expression of neurotransmitters (P<0.05, P<0.01). Compared with NC group, the model group showed inhibition of the 5-HTergic nerve and abnormal activation of the HPA axis, and Wenyang Jieyu prescription and fluoxetine regulated the abnormal state of the 5-HTergic nerve and HPA axis. Compared with NC group, the modeling down-regulated the mRNA and protein levels of BDNF and TrkB in the hippocampus (P<0.05, P<0.01), which, however, were recovered in Wenyang, Jieyu, Wenyang Jieyu, and fluoxetine groups (P<0.05, P<0.01).ConclusionThe mouse model of depression induced by MS+RS may present the syndrome of Yang deficiency and liver depression. Wenyang Jieyu prescription may increase the content of hippocampal neurotransmitters by regulating the 5-HT system and the BDNF signaling pathway mediated by the HPA axis, thereby alleviating depression-like behavior in mice.  
      关键词:second hit;depression-like behavior;5-hydroxytryptamine (5-HT) system;hypothalamic-pituitary-adrenal (HPA) axis;brain-derived neurotrophic factor (BDNF) signaling pathway;Yang deficiency and liver depression   
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      发布时间:2024-02-04
    • MENG Danhua,SHE Kaijie,MENG Xiaoying,GONG Zinhan,LIANG Wenqing,WANG Ying,LIANG Yuan,YUE Guangxin
      Vol. 30, Issue 6, Pages: 39-47(2024) DOI: 10.13422/j.cnki.syfjx.20230638
      摘要:ObjectiveTo explore the effects of Wenyang Jieyu prescription (WJP) on neuroinflammation and synaptic plasticity in the mouse model of depression induced by maternal separation combined with restraint stress.MethodThe mice on postnatal day 0 (PD0) were randomized into a control group and a modeling group. Maternal separation combined with restraint stress was employed to establish the mouse model of depression. After the removal of female mice, the modeled mice were randomized into model, Wenyang prescription (5.85 g·kg-1), Jieyu prescription (12.03 g·kg-1), WJP (16.71 g·kg-1), and fluoxetine (2.6 mg·kg-1) groups on the weaning day (PD21), with 15 mice in each group. The mice were administrated with corresponding drugs mixed with the diet from PD21 to PD111. The sucrose preference test, open field test, O-maze test, and novel object recognition test were then carried out to evaluate the depression state, memory, and learning ability of the mice. Immunohistochemistry (IHC) was employed to observe the ionized calcium-binding adapter molecule-1 (Iba-1) in hippocampal microglia. High performance liquid chromatography (HPLC) was employed to measure the content of noradrenaline (NE) and epinephrine (E) in the hippocampus. Enzyme-linked immunosorbent assay (ELISA) was employed to determine the content of interleukin (IL)-18 and IL-1β in the hippocampus. Western blot was employed to determine the protein levels of NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), cysteine aspartate-specific protease-1 (Caspase-1), IL-1β, synaptophysin (Syn), and postsynaptic density 95 (PSD95).ResultCompared with control group, the model group showed decreased sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.05, P<0.01). The microglia in the model group presented amoeba-like appearance, the Iba1 increased. Moreover, the model group showed decreased content of NE and E (P<0.01), elevated levels of IL-1β and IL-18 (P<0.01), down-regulated protein levels of PSD95 and Syn (P<0.05, P<0.01), and up-regulated protein levels of NLRP3, ASC, Caspase-1, and IL-1β (P<0.05, P<0.01). Compared with model group, WJP and fluoxetine increased the sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.05, P<0.01). They recovered the microglia and the Iba1 decreased. Moreover, the drugs increased the content of NE and E (P<0.05, P<0.01), lowered the levels of IL-1β and IL-18 (P<0.01), up-regulated the protein levels of PSD95 and Syn (P<0.01), down-regulated the protein levels of NLRP3, ASC, Caspase-1, and IL-1β (P<0.05, P<0.01).ConclusionWJP can treat the depressive behavior induced by maternal separation combined with restraint stress in mice, with the performance outperforming Wenyang prescription and Jieyu prescription. It may alleviate the neuroinflammation induced by microglia and improve the synaptic plasticity by regulating the NLRP3 pathway and increasing neurotransmitters in the hippocampus.  
      关键词:Wenyang Jieyu prescription;NOD-like receptor protein 3 (NLRP3);microglia;neuroinflammation;synaptic plasticity   
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      发布时间:2024-02-04
    • MENG Danhua,SHE Kaijie,MENG Xiaoying,GONG Zihan,LIANG Wenqing,WANG Ying,LIANG Yuan,YUE Guangxin
      Vol. 30, Issue 6, Pages: 48-57(2024) DOI: 10.13422/j.cnki.syfjx.20230838
      摘要:ObjectiveTo explore the mechanism of Wenyang Jieyu prescription in regulating hippocampal neuron apoptosis and improving synaptic plasticity in the mouse model of depression induced by maternal separation combined with restraint stress.MethodThe mice on postnatal day 0 (PD0) were randomly assigned into a control group (n=10) and a modeling group (n=50). Maternal separation combined with restraint stress was adopted to establish the mouse model of depression, and the modeled mice were randomized into model, Wenyang prescription, Jieyu prescription, Wenyang Jieyu prescription, and fluoxetine groups (n=10) on the weaning day (PD21). From PD21 to PD111, the mice were fed with the diets mixed with corresponding medicines. The sucrose preference test, open field test, O-maze test, and novel object recognition test were then conducted to evaluate the depression, memory, and learning abilities of mice. Immunohistochemistry (IHC) was employed to measure the atomic absorbance (AA) of postsynaptic density protein 95 (PSD95) in the hippocampus. Terminal-deoxynucleoitidyl transferase-mediated nick-end labeling (TUNEL) was employed to detect the apoptosis of hippocampal neurons. Western blot was employed to determine the protein levels of brain-derived neurotrophic factor (BDNF), phosphorylated tyrosine kinase receptor B/tyrosine kinase receptor B (p-TrkB/TrkB), phosphorylated protein kinase B/protein kinase B (p-Akt/Akt), phosphorylated mammalian target of rapamycin/mammalian target of rapamycin (p-mTOR/mTOR), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), cysteinyl aspartate-specific proteinase-3 (Caspase-3), synaptophysin (Syn), and PSD95.ResultCompared with the control group, the modeling decreased the sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.01). Furthermore, it decreased the expression of PSD95, increased the neuron apoptosis in the hippocampus (P<0.01), down-regulated the protein levels of BDNF, p-TrkB/TrkB, p-Akt/Akt, p-mTOR/mTOR, Bcl-2, PSD95, and Syn (P<0.01), and up-regulated the protein levels of Bax and Caspase-3 (P<0.05) in the hippocampus. Compared with the model group, Wenyang Jieyu prescription and fluoxetine increased the sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.05, P<0.01). Moreover, the drugs increased the expression of PSD95, reduced the neuron apoptosis (P<0.01), up-regulated the protein levels of BDNF, p-TrkB/TrkB, p-Akt/Akt, p-mTOR/mTOR, Bcl-2, PSD95, and Syn (P<0.01), and down-regulated the protein levels of Bax and Caspase-3 (P<0.01).ConclusionWenyang Jieyu prescription outperformed Wenyang prescription and Jieyu prescription in the treatment of the depressive behavior induced by maternal separation combined with restraint stress in mice. It exerted the therapeutic effect by reducing the hippocampal neuron apoptosis and improving the synaptic plasticity via the BDNF/Akt/mTOR pathway.  
      关键词:Wenyang Jieyu prescription;brain-derived neurotrophic factor/protein kinase B/mammalian target of rapamycin(BDNF/Akt/mTOR) pathway;hippocampus;neuron apoptosis;synaptic plasticity   
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      发布时间:2024-02-04
    • PAN Mingmin,YUE Guangxin
      Vol. 30, Issue 6, Pages: 58-65(2024) DOI: 10.13422/j.cnki.syfjx.20231939
      摘要:Depression is a complex emotional and mental disorder. The traditional Chinese medicine (TCM) methods for treating depression mainly include soothing the liver and relieving depression. Our research team proposes that depression is caused by Yang Qi deficiency and obstructed Qi movement, which are closely related to neurological and psychological changes induced by early traumatic experiences. Therefore, we suggest that the treatment should focus on warming Yang, replenishing Qi, and promoting Qi movement and have formulated Wenyang Jieyu prescription based on Erxiantang for warming yang and Xiaoyaosan for relieving depression. The experiment with the mouse model of early trauma induced by maternal separation showed that Wenyang Jieyu prescription significantly improved the mouse activity and environmental exploration, reduced the immobility time in forced swimming and tail suspension tests, alleviated the behaviors such as aversion to darkness and fear of open space, enhanced social interaction and social cognitive abilities, altered decision-making biases, reduced depression-like behaviors, and improved the decision-making patterns. Additionally, the prescription lowered the serum level of cortisol, inhibited the cortisol surge in the dexamethasone/corticotropin-releasing hormone (Dex/CRH) test, up-regulated the expression of mineralocorticoid receptor (MR) and 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2) in the hippocampus, down-regulated the expression of glucocorticoid receptor (GR) and corticotropin-releasing hormone receptor 1 (CRHR1), inhibited the methylation of GR exon 1 and the expression of DNA methyltransferase 1 (DNMT1), and restored the negative feedback of the hypothalamic-pituitary-adrenal (HPA) axis. Furthermore, Wenyang Jieyu prescription up-regulated the protein level of brain-derived neurotrophic factor (BDNF), elevated the levels of postsynaptic density protein 95 (PSD95) and synaptophysin (Syn), decreased the cell apoptosis index and B-cell lymphoma (Bcl-2)-associated X (Bax)/Bcl-2 ratio, suppressed the expression of Caspase-3, and enhanced the neuroplasticity and anti-apoptotic capacity in the hippocampus. Considering the research results, related articles, and clinical experience, we conclude that depression should be treated with liver-soothing and depression-relieving herbs, which can be supplemented with spleen-invigorating and Qi-regulating herbs to alleviate depressive symptoms. The Yang-warming and kidney-tonifying herbs can be used to eliminate the root cause and prevent relapse. Additionally, the wind-dispersing herbs can be supplemented to regulate the Qi movement throughout the body, thereby enhancing the efficacy of depression-relieving treatment.  
      关键词:Wenyang Jieyu prescription;depression;maternal separation;correspondence between prescription and syndrome;medication rule   
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      发布时间:2024-02-04
    • YIN Kang,CHEN Keli,LIU Yanwen,LIU Songlin,HE Zilong,YANG Lichao,CHEN Xin,ZHAN Zhilai
      Vol. 30, Issue 6, Pages: 66-74(2024) DOI: 10.13422/j.cnki.syfjx.20240265
      摘要:ObjectiveTo investigate the mechanism of Atractylodis Macrocephalae Rhizoma(AMR) in the treatment of slow-transmission constipation(STC) by observing the effects of AMR on short-chain fatty acids and intestinal barries in STC mice.MethodForty-eight male KM mice were randomly divided into blank group, model group, AMR low-, medium-, high-dose groups(2.5, 5, 10 g·kg-1) and mosapride group(2.5 mg·kg-1). Except for the blank group, all groups were gavaged with loperamide suspension(5 mg·kg-1) twice daily for 14 d to construct the STC mouse model. At the same time, each drug administration group was given the corresponding drug by gavage for consecutive 14 d, the blank and model groups were gavaged with equal volume of distilled water. The effects of the treatment of AMR on body mass, defecation frequency, fecal water content and intestinal propulsion rate of mice were observed, the pathological changes of mouse colon were observed by hematoxylin-eosin(HE) staining and periodic acid-Schiff(PAS) staining, the levels of gastrin(GAS) and motilin(MTL) in serum were detected by enzyme-linked immunosorbent assay(ELISA), gas chromatography-mass spectrometry(GC-MS) was used to detect the contents of short-chain fatty acids(SCFAs) in mouse feces, real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) and Western blot were used to determine the mRNA and protein expression levels of zonula occludens-1(ZO-1), Occludin, and Claudin-1 in the colon of mice.ResultCompared with the blank group, the body mass, defecation frequency, fecal water content and intestinal propulsion rate of mice in the model group were significantly decreased(P<0.05, P<0.01), the arrangement of colonic tissues was disordered, and the number of goblet cells was reduced, the levels of GAS and MTL in serum were significantly decreased(P<0.01), and the levels of SCFAs in the feces were on a decreasing trend, with the contents of acetic acid, propionic acid, butyric acid, isobutyric acid and valeric acid were significantly decreased(P<0.05, P<0.01), the mRNA and protein expression levels of ZO-1, Occludin and Claudin-1 in the colonic tissues were significantly decreased(P<0.01). The above results suggested that STC mouse model was successfully constructed. Compared with the model group, the body mass, defecation frequency, fecal water content and intestinal propulsion rate of mice in AMP administration groups all increased significantly(P<0.05, P<0.01), the mucosal layer of the colonic tissues was structurally intact without obvious damage, and the number of goblet cells increased, serum levels of GAS and MTL were significantly increased(P<0.01), the contents of SCFAs in the feces were all on a rising trend, with the contents of acetic, propionic, butyric and isobutyric acids rising significantly(P<0.05, P<0.01), the mRNA and protein expression levels of ZO-1, Occludin and Claudin-1 in the colonic tissues were significantly increased(P<0.05, P<0.01).ConclusionAMR is able to improve the constipation symptoms in STC mice, and its mechanism may be related to increasing the contents of SCFAs in the intestine as well as promoting the mRNA and protein expression levels of ZO-1, Occludin and Claudin-1 in the colon.  
      关键词:Atractylodis Macrocephalae Rhizoma;slow-transmission constipation;short-chain fatty acids;intestinal barrier;loperamide;tight junctions;gas chromatography-mass spectrometry(GC-MS)   
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      发布时间:2024-02-04
    • LIU Gang,ZHANG Yaqi,QIN Lingling,ZHANG Chengfei,ZHANG Qiue,BAI Huizhong,ZHAO Yi,LIU Tonghua,MU Xiaohong
      Vol. 30, Issue 6, Pages: 75-82(2024) DOI: 10.13422/j.cnki.syfjx.20231327
      摘要:ObjectiveTo investigate the effect of Tangbikang granules on oxidative stress of sciatic nerve in diabetic rats by regulating adenylate activated protein kinase/peroxisome proliferator-activated receptor γ coactivator-1α/mitochondrial Sirtuins 3 (AMPK/PGC-1α/SIRT3) signaling pathway.MethodThe spontaneous obesity type 2 diabetes model was established using ZDF rats. After modeling, they were randomly divided into high, medium, and low dose Tangbikang granule groups (2.5, 1.25, 0.625 g·kg-1·d-1) and lipoic acid group (0.026 8 g·kg-1·d-1), and the normal group was set up. The rats were administered continuously for 12 weeks after modeling. The blood glucose of rats was detected before intervention and at 4, 8, 12 weeks after intervention. At the 12th week, motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), nerve blood flow velocity, mechanical pain threshold, and thermal pain threshold were detected. The sciatic nerve was taken for hematoxylin-eosin (HE) staining to observe the tissue morphology. The ultrastructure of the sciatic nerve was observed by transmission electron microscope. The expression levels of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in sciatic nerve were determined by enzyme-related immunosorbent assay (ELISA). The mRNA expressions of AMPKα, AMPKβ, PGC-1α, and SIRT3 in sciatic nerve were determined by real-time polymerase chain reaction (Real-time PCR).ResultCompared with the normal group, fasting blood glucose in the model group was increased at each time point (P<0.01). The mechanical pain threshold was decreased (P<0.05), and the incubation time of the hot plate was extended (P<0.01). MNCV, SNCV, and nerve blood flow velocity decreased (P<0.05). The expression level of SOD was decreased (P<0.01). The expression levels of MDA, IL-1β, and TNF-α were increased (P<0.01). The mRNA expression levels of AMPKα, AMPKβ, PGC-1α, and SIRT3 were decreased (P<0.01). The structure of sciatic nerve fibers in the model group was loose, and the arrangement was disordered. The demyelination change was obvious. Compared with the model group, the fasting blood glucose of rats in the high dose Tangbikang granule group was decreased after the intervention of eight weeks and 12 weeks (P<0.01). The mechanical pain threshold increased (P<0.05). The incubation time of the hot plate was shortened (P<0.01). MNCV, SNCV, and Flux increased (P<0.05). The expression level of SOD was increased (P<0.01). The expression levels of MDA, IL-1β, and TNF-α were decreased (P<0.01). The mRNA expression levels of AMPKα, AMPKβ, PGC-1α, and SIRT3 were increased (P<0.01). The sciatic nerve fibers in the high-dose Tangbikang granule group were tighter and more neatly arranged, with only a few demyelinating changes. The high, medium, and low dose Tangbikang granule groups showed a significant dose-effect trend.ConclusionTangbikang granules may improve sciatic nerve function in diabetic rats by regulating AMPK/PGC-1α/SIRT3 signaling pathway partly to inhibit oxidative stress.  
      关键词:Tangbikang granules;diabetic peripheral neuropathy;oxidative stress, adenylate activated protein kinase (AMPK);peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α);mitochondrial sirtuins 3 (SIRT3)   
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    • ZHENG Jiayi,SU Jie,YAN Meiqiu,YU Jingjing,CHEN Yigong,FU Meng,HU Xueling,CHANG Mengxi,LYU Guiyuan,JIANG Liqin
      Vol. 30, Issue 6, Pages: 83-90(2024) DOI: 10.13422/j.cnki.syfjx.20240112
      摘要:ObjectiveTo investigate the effect of Yunkang oral liquid on postpartum kidney deficiency in mice.MethodPostpartum mice were randomized into model and low-dose (6 mL·kg-1), medium-dose (9 mL·kg-1), and high-dose (12 mL·kg-1) Yunkang oral liquid groups. The mouse model of postpartum kidney deficiency was established by sleep deprivation combined with forced swimming. Another 9 female ICR mice were selected as the normal control group. The mice were administrated with Yunkang oral liquid during the period of modeling. The levels of estradiol (E2), progesterone (P), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in the serum were measured by the enzyme-linked immunosorbent assay. The morphological changes of ovaries and uterus were observed by hematoxylin-eosin (HE) staining, and the expression of transforming growth factor (TGF)-β and Smad2/3 was determined by immunohistochemistry and Western blotting.ResultThe mice in the model group showed prolonged estrous cycle, reduced voluntary activity, dorsal temperature, grip strength, and bone strength, and whitening tongue coating. Compared with the model group, Yunkang oral liquid shortened the estrous cycle, increased the voluntary activity, dorsal temperature, grip strength, and bone strength, and alleviated the whitening of tongue coating. Moreover, it elevated the E2 and P levels and lowered the FSH and LH levels in the serum, decreased ovarian follicular atresia rate, promoted uterine repair, and down-regulated the expression of TGF-β and Smad2/3 in the ovarian and uterine tissues.ConclusionYunkang oral liquid can ameliorate postpartum kidney deficiency in mice by regulating the TGF-β/Smads signaling pathway.  
      关键词:Yunkang oral liquid;postpartum mice;kidney deficiency;mechanism   
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    • YANG Jialin,CAI Bingjie,DAI Yuhao,LI Shuting,ZHANG Keke,GAO Yanhua,ZHANG Qiman,ZHANG Ying,SHEN Jianying,LI Shaojing
      Vol. 30, Issue 6, Pages: 91-100(2024) DOI: 10.13422/j.cnki.syfjx.20231817
      摘要:ObjectiveTo explore the possible mechanism of the Yiqi Jiedu formula (YQ) in treating ischemic stroke (IS) from the perspective of the microbial-gut-brain axis (MGBA).MethodRats were randomly divided into five groups, with six in each group, including sham surgery group, model group, and low, medium, and high dose YQ groups (1, 5, and 25 mg·kg-1). Except for the sham surgery group, all other groups were established with a middle cerebral artery occlusion (MCAO) model using the thread occlusion method. The success of modeling was determined through neurobehavioral scoring, and the protective effect of YQ on IS was evaluated. Then, the changes in gut microbiota before and after MCAO modeling and YQ administration were compared using 16S rDNA sequencing technology, and the possible biological pathways related to the effect of this formula were analyzed. The expression of inflammatory factors such as interleukin-6 (IL-6), interleukin-17A (IL-17A), and interleukin-10 (IL-10) in serum was detected by enzyme-linked immunosorbent assay (ELISA). Western blot was used to detect the expression of tight junction proteins ZO-1 and Occludin in brain and intestinal tissue, and hematoxylin-eosin staining (HE) was used to observe pathological changes in the cerebral cortex and colon, so as to validate the possible mechanism of action.ResultYQ significantly improved the neurobehavioral score of MCAO rats (P<0.01) and played a good regulatory role in intestinal microbial disorders caused by enriched pathogens and opportunistic pathogens during the acute phase. Among them, significantly changed microorganisms include Morgentia, Escherichia Shigella, Adlercreutzia, and Androbacter. Bioinformatics analysis found that these bacteria may be related to the regulation of inflammation in the brain. Compared with the blank group, the detection of inflammatory factors in the serum of IS model rats showed an increase in inflammatory factors IL-6 and IL-17A (P<0.01) and a decrease in the content of anti-inflammatory factor IL-10 (P<0.01). Compared with the model group, the content of inflammatory factors IL-6 and IL-17A in the serum of the treatment group decreased (P<0.05), and that of anti-inflammatory factor IL-10 increased (P<0.01). The expression results of barrier proteins ZO-1 and Occludin in brain and intestinal tissue showed that the expression levels of both decreased in IS model rats (P<0.05), while the expression levels of both increased in the treatment group (P<0.05).ConclusionAcute cerebral ischemia can lead to an imbalance of intestinal microbiota and damage to the intestinal barrier, and it can increase intestinal permeability. YQ can regulate intestinal microbiota imbalance caused by ischemia, inhibit systemic inflammatory response, and improve the disruption of the gut-blood brain barrier, preventing secondary cascade damage to brain tissue caused by inflammation. The MGBA may be an important mechanism against the IS.  
      关键词:Yiqi Jiedu formula;intestinal microbiota;microbiota-gut-brain axis;ischemic stroke;16S rDNA   
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    • CUI Mengdi,GAO Jiawei,ZHU Lvqun,CHEN Guisheng,CHEN Yiliang
      Vol. 30, Issue 6, Pages: 101-108(2024) DOI: 10.13422/j.cnki.syfjx.20240116
      摘要:ObjectiveTo investigate the promotional effect of astragaloside on the repair and healing of chronic non-healing wounds and its mechanism.MethodA total of 60 male SD rats were constructed with full-layer skin defect wounds on the back, and except for the control (Con) group, the rest were constructed with non-healing wounds, which were then randomly divided into the sham-operation (sham) group, the low-dose astragaloside group, the high-dose astragaloside group, the astragaloside + LY294002 [phosphatidylinositol 3-kinase (PI3K) inhibitor] group, and the astragaloside + EX527 [silencing regulatory protein 1 (SIRT1) inhibitor] group. The percentage of wound area in each group was observed on the 2nd, 4th, 6th, and 8th days after wound molding. Collagen type Ⅰ alpha 1 (COL1A1) and alpha smooth muscle actin (α-SMA) expressions in the wound tissue were detected by immunofluorescence. Hematoxylin and eosin (HE) staining was performed to determine the pathological structure of the wound. The mRNA expression of inflammatory factors in the wound was measured by real-time polymerase chain reaction (Real-time PCR), and the expression of proteins related to the SIRT1/ nuclear factor (NF)-κB and PI3K/protein kinase B (Akt) signaling pathways in the wound was tested by Western blot.ResultCompared with the sham group, the percentage of postoperative wound area of rats in both low-dose and high-dose astragaloside groups gradually decreased with time, and the efficacy of the high-dose astragaloside group was better. Compared with the Con group, the fluorescence intensity of COL1A1 in wound tissue of the sham group decreased, while the expression of α-SMA increased. The epithelial tissue was severely damaged, with an increase in the thickness, and a large number of inflammatory cells were seen in the infiltration. The mRNA expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and inducible nitric oxide synthase (iNOS) was elevated. The protein expression of NF-κB p65, p-PI3K/PI3K, and p-Akt/Akt was elevated, while SIRT1 expression was decreased (P<0.05). Compared with the sham group, the fluorescence intensity of COL1A1 and α-SMA increased after astragaloside treatment. The number of epithelial cells increased, and the thickness decreased. The inflammatory cells decreased, and the amount of collagen increased. The mRNA expression of TNF-α, IL-1β, IL-6, and iNOS was decreased, and the protein expression of NF-κB p65, p-PI3K/PI3K, and p-Akt/Akt was decreased. SIRT1 was elevated, and the effect was better in the high-dose astragaloside group (P<0.05). Compared with the high-dose astragaloside group, inhibition of the PI3K/Akt and SIRT1 pathways by LY294002 and EX527 prevented the therapeutic efficacy of astragaloside on chronic non-healing wounds.ConclusionThe topical application of astragaloside significantly promotes the healing of chronic non-healing wounds in rats, and the mechanism may be related to the activation of the PI3K/Akt pathway and the SIRT1/NF-κB pathway.  
      关键词:astragaloside;phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt);silencing regulatory protein 1 (SIRT1);chronic non-healing wounds   
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    • XIE Ying,XIAO Min,JIANG Xiaocui,ZHANG Jinrong,SHI Ruoyi,ZHANG Jiawei,ZHAO Min
      Vol. 30, Issue 6, Pages: 109-118(2024) DOI: 10.13422/j.cnki.syfjx.20231201
      摘要:ObjectiveThe active ingredients, action targets, and signaling pathways of Cuscutae Semen to control premature ovarian failure were initially predicted by network pharmacology and molecular docking techniques, and an animal model of premature ovarian failure was constructed to explore the mechanism of Cuscutae Semen based on lipid and atherosclerosis signaling pathways.MethodThe effective components and corresponding targets of drugs were obtained from Traditional Chinese Medicines Systems Pharmacology Platform (TCMSP), Swiss Target Prediction, Pharmmapper, and other databases. GeneCards database was used to collect disease-related targets. Venny2.1.0 online tool was used to screen out the intersection targets of drugs and diseases, and STRING database and Cytoscape v3.7.2 software were used to construct the network diagram of "drug-component-target" and protein-protein interaction (PPI). The gene ontology (GO) and the Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses of the intersection targets were performed by running the R language script. The molecular docking technology was utilized to dock drug components with targets and visualize some of the docking results. The mice were randomly divided into a blank group, a model group, a Cuscutae Semen group, and an estradiol valerate group, and the ovarian premature failure model was prepared by chronic stress. The blank group and the model group were gavaged with the same amount of normal saline, and the Cuscutae Semen group was given a Cuscutae Semen decoction of 2.6 g·kg-1·d-1. The estradiol valerate group was given an estradiol valerate solution of 0.13 mg·kg-1·d-1. After four weeks, samples were collected, and hematoxylin-eosin (HE) staining was performed to observe the histopathological changes in the ovary. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), Muller's tube inhibitor/anti-Muller's tube hormone (AMH), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were determined by enzyme-linked immunosorbent assay (ELISA). The expression levels of extracellular regulatory protein kinase (ERK), nuclear transcription factor-κB p65 (NF-κB p65), nuclear transcription factor-κB suppressor α (IκBα), interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were measured by Western blot.ResultA total of 171 targets of Cuscutae Semen for the prevention and treatment of premature ovarian failure were screened, mainly including tumor protein p53 (TP53), protein kinase B1 (Akt1), sarcoma (SRC), tumor necrosis factor (TNF), epidermal growth factor receptor (EGFR), etc. KEGG pathway enrichment analysis predicts that Cuscutae Semen is mainly involved in lipid and atherosclerosis, TNF signaling pathway, and TP53 signaling pathway to control premature ovarian failure. The animal experiments show that compared with the premature ovarian failure model group, the Cuscutae Semen group can significantly upregulate AMH, E2, and HDL-C (P<0.05, P<0.01), significantly downregulate LH, TC, and LDL-C (P<0.01), greatly reduce IL-1β, IL-6, and TNF-α protein levels, as well as ERK, NF-κB p65, and their phosphorylation levels (P<0.01).ConclusionCuscutae Semen can regulate hormone levels and improve ovarian function through a multi-component, multi-target, and multi-pathway approach, and the mechanism may be related to the regulation of lipid and atherosclerosis signaling pathways.  
      关键词:Cuscutae Semen;network pharmacology;premature ovarian failure;molecular docking;experimental verification   
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    • ZHOU Yuxin,ZHANG Rongqing,LU Su,XU Meijuan,CHEN Yun
      Vol. 30, Issue 6, Pages: 119-125(2024) DOI: 10.13422/j.cnki.syfjx.20241091
      摘要:ObjectiveTo explore the comprehensive effects of Qingxin Zishen decoction on the symptom score and neuroendocrine indexes and the mechanism of the decoction in regulating KNDy neurons in the patients with menopausal syndrome.MethodA total of 60 patients with menopausal syndrome due to yin deficiency with effulgent fire who attended the menopausal outpatient of Jiangsu Province Hospital of Chinese Medicine were randomized into an experimental (Qingxin Zishen decoction) group (30 cases) and a control (femoston) group (30 cases). The treatment lasted for 12 weeks in both groups. The two groups were compared in terms of the comprehensive efficacy, frequency and degree of hot flashes and sweating, modified Kupperman score, and the serum levels of hypothalamic peptide kisspeptin, neurokinin B (NKB), dynorphin (Dyn), follicle-stimulating hormone (FSH), and estradiol (E2).Result① Comprehensive efficacy: The comprehensive efficacy of the two groups was comparable. ② Frequency and degrees of hot flashes and sweating: After treatment, the frequency and degrees of hot flashes and sweating in the two groups were reduced (P<0.05) and the control group outperformed the experimental group (P<0.05). ③ Modified Kupperman score and menopausal symptoms: After treatment, the modified Kupperman score decreased in both groups (P<0.05). After 4 weeks of treatment, the experimental group was superior to the control group in terms of the scores of dizziness and headache (P<0.05). ④ Serum levels of sex hormones: After treatment, the serum E2 level elevated and the FSH level lowered in both groups (P<0.05), and the changes were more obvious in the control group (P<0.05). ⑤ Neuroendocrine indexes: After treatment, the serum levels of kisspeptin and NKB in the two groups decreased (P<0.05), and the serum Dyn level in the experimental group increased (P<0.05). Moreover, the experimental group had higher Dyn level than the control group after treatment (P<0.05).ConclusionQingxin Zishen decoction can alleviate hot flashes, sweating, and other symptoms in the women with menopausal syndrome by acting on the KNDy neurons to lower the kisspeptin and NKB levels and elevate the Dyn level. The findings provide new ideas for the clinical treatment of hot flashes in menopause.  
      关键词:menopausal syndrome;Qingxin Zishen decoction;KNDy neurons;mechanism   
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    • WANG Yaxing,SU Xinxin,HUANG Yanli,CUI Xin,LI Yuanyuan,XIE Yanming
      Vol. 30, Issue 6, Pages: 126-133(2024) DOI: 10.13422/j.cnki.syfjx.20241094
      摘要:ObjectiveTo systematically review the studies about Yiqing Capsules in the treatment of pharyngitis, tonsillitis, gingivitis, and oral ulcers with heat-toxin syndrome and clarify the advantages and therapeutic characteristics of Yiqing capsules, thus providing reference for the decision-making by relevant departments and clues for the clinical and basic research.MethodThe multi-criteria decision analysis (MCDA) model and CSC v2.0 were employed to comprehensively evaluate Yiqing capsules from multiple aspects.ResultThe serious adverse reactions in the spontaneous reporting system (SRS) monitoring data of Yiqing capsules included pruritus, rash, an ddiarrhea, all of which were relieved or cured, without aggravation or interhospital transfer for treatment. Literature data showed that the main clinical adverse reactions were abdominal pain, diarrhea, etc. Both acute toxicity and long-term toxicity tests showed good safety, and thus the safety of Yiqing capsules was rated as grade B. The results of Meta-analysis showed that Yiqing capsules used alone or in combination with other medicines outperformed Niuhuang Jiedu capsules or Western medicine in the treatment of pharyngitis, tonsillitis, gingivitis, and oral ulcers with heat toxin in terms of symptom alleviation, disappearance rate of main symptoms, and recurrence rate of aphtha. Pharmacological and pharmacodynamic studies showed that Yiqing capsules had antimicrobial, antiviral, and anti-inflammatory effects, with the effectiveness rated as grade B. The decision tree model was adopted to analyze the incremental cost-effectiveness ratio. With the threshold of 1 fold per capita GDP and the disappearing rate of pain in gingivitis as the indicator, Yiqing capsules had an economic advantage in the treatment of gingivitis due to heat-toxin compared with Niuhuang Jiedu capsules, and the incremental cost-effectiveness ratio was 0.39 yuan/%, which indicated acceptable cost, with the economy rated as grade B. Yiqing capsules can not only clear heat from Qi aspect but also purge blood fire, serving as the representative prescription of clearing and purging for heat-toxin syndrome. Considering the industrial service system and enterprise innovation, the comprehensive innovation of Yiqing capsules was rated as grade B. Generally, this product does not require personalized treatment plans and features convenient supply, storage, transportation, policy publicity, drug information standards, and easy operation for medical care and patients. The Chinese patent medicine information was complete and in line with national standards, and thus the suitability of Yiqing capsules was rated as grade A. With a low price and good availability and affordability, the accessibility of Yiqing capsules was rated as grade A. The Yiqing capsules prescription, Sanhuang Xiexin decoction, originated from ancient medical books, with rich real-world studies, and thus the traditional Chinese medicine characteristics of Yiqing capsules was rated as grade C.ConclusionThe clinical value of Yiqing capsules was rated as grade B from the "6+1" dimensions, suggesting that it could be conditionally converted into the relevant policy results of basic clinical drug management according to the procedure.  
      关键词:Yiqing capsules;heat-toxin syndrome;syndrome alleviation;clinical comprehensive evaluation;multi-criteria decision analysis   
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    • DAI Zeqi,JING Chengyang,WU Xue,ZHANG Le,LIAO Xing
      Vol. 30, Issue 6, Pages: 134-143(2024) DOI: 10.13422/j.cnki.syfjx.20231149
      摘要:ObjectiveTo establish the clinical comprehensive evaluation index system for Chinese patent medicine(CPM) based on Evidence and Value:Impact on DEcisionMaking(EVIDEM) framework, so as to promote the scientific, systematic and standardized implementation of clinical comprehensive evaluation of CPM.MethodThe clinical comprehensive evaluation index system was determined through literature review, semi-structured interview and Delphi method, and the weights of each index were clarified by analytic hierarchy process(AHP).ResultThe recovery rates of both rounds of expert consultation were 100%, and the authority coefficient of experts was 0.90 and 0.905, respectively. Kendall's coordination coefficients(W) of the second- and third-level indicators in the first-round consultation were 0.320 and 0.283(P<0.001), and in the second round were 0.411 and 0.351, respectively(P<0.001). The finally constructed clinical comprehensive evaluation index system for CPM included 6 first-level indicators, 13 second-level indicators and 28 third-level indicators. Among the first-level indicators, the weights of effectiveness, safety, economy, innovation, suitability and accessibility were 37.34%, 32.68%, 11.85%, 5.87%, 5.79% and 6.47%, respectively.ConclusionThis study has constructed a universal clinical comprehensive evaluation index system for CPM, and the domain and criteria are introduced and interpreted in detail, which can provide reference and information for carrying out the clinical comprehensive evaluation of CPM, but it needs to be refined and improved in combination with the clinical practice of CPM for specialized diseases.  
      关键词:Evidence and Value:Impact on DEcisionMaking(EVIDEM);clinical comprehensive evaluation;health technology assessment(HTA) reporting;index system;Chinese patent medicine;multi-criteria decision analysis(MCDA) model;analytic hierarchy process(AHP)   
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    • CHAI Jiaqi,TAN Yumeng,XIANG Xinghua,LI Miaomiao,WEN Tiancai,ZHAO Hui
      Vol. 30, Issue 6, Pages: 144-150(2024) DOI: 10.13422/j.cnki.syfjx.20231448
      摘要:ObjectiveTo systematically sort out the knowledge framework and conceptual logic relationship of "disease-syndrome-treatment-prescription-medicine" in the existing literature on traditional Chinese medicine(TCM) treatment of diabetic peripheral neuropathy(DPN), to construct of the knowledge map of TCM treatment of DPN, and to promote the explicitation of the implicit knowledge in the literature on the treatment of DPN with TCM.MethodTaking the literature of China National Knowledge Infrastructure about TCM treatment of DPN as the main data source, TCM-related concepts and entities were constructed by manual citation, and the corresponding relationships between the entities were established. Structured data were formed by processing with Python 3.7, and the knowledge graph was constructed based on Neo4j 3.5.34 graph database.ResultThe resulting knowledge graph with TCM diagnosis and treatment logic, defined 12 node labels such as prescriptions, Chinese medicines and syndrome types at the schema layer, as well as 4 types of relationships, such as inclusion, correspondence, selection and composition. It could support the query and discovery of nodes(syndrome elements, syndrome types and treatment methods), as well as the relationship between each node.ConclusionBased on the literature data, this study constructed a knowledge map for TCM treatment of DPN, which brought together various methods of TCM treatment of DPN, including internal and external treatment. The whole chain knowledge structure of syndrome differentiation and classification for DPN treatment is formed from syndrome element analysis, syndrome type composition to treatment method selection, which can provide new ideas and methods for literature data to serve clinical and scientific research work, as well as reference for visualization of TCM literature knowledge, intellectualization of TCM knowledge services and the standardization of TCM diagnosis and treatment.  
      关键词:traditional Chinese medicine;diabetic peripheral neuropathy(DPN);knowledge graph;Neo4j;syndrome elements;syndrome types;treatment method and principle   
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    • SONG Yanan,WANG Yun,YANG Hongjun,JIA Zhe,ZHANG Cun
      Vol. 30, Issue 6, Pages: 151-159(2024) DOI: 10.13422/j.cnki.syfjx.20231162
      摘要:ObjectiveBased on response surface methodology combined with principal component analysis(PCA), the optimal decocting process of Moringa oleifera leaf standard decoction was optimized, and its multi-index quality evaluation system was established, in order to provide scientific basis for the quality control of this standard decoction.MethodResponse surface methodology and PCA were used to optimize the decoction process by taking the relative peak areas of 8 characteristic peaks and dry extract yield as indexes. Based on this, the quality of 15 batches of the standard decoction was evaluated by high performance liquid chromatography(HPLC) characteristic chromatogram, determination of major components(neochlorogenic acid, L-tryptophan, cryptochlorogenic acid, vicenin-2, isoquercetin, astragalin), determination of active parts(total flavonoids, total organic acids, total polysaccharides, total α-amino acids, total sinapine), dry extract yield, specific gravity and pH.ResultThe optimal decocting process was to soak M. oleifera leaves(100.00 g) for 30 min and decoct twice with the first decoction of 12 times the amount of water for 30 min and the second decoction of 10 times the amount of water for 20 min. Standard decoction containing 0.2 g·mL-1 of crude drug was defined by x¯±30%, the specific gravity was 0.722-1.340, pH was 3.86-7.16, dry extract yield was 23.1%-42.9%, and the alcohol-soluble extract content was 8.26%-15.34%. Calculated according to the dried products of the standard decoction, the contents of neochlorogenic acid, L-tryptophan, cryptochlorogenic acid, vicenin-2, isoquercetin and astragalin were 1.99-3.69, 1.20-2.22, 1.44-2.67, 0.53-0.99, 2.45-4.55, 1.22-2.26 mg·g-1, the relative transfer rates relative to the herbs were 34.37%-63.83%, 62.43%-115.94%, 64.65%-120.06%, 56.98%-105.82%, 37.46%-69.57%, 41.81%-77.64%, respectively. The contents of total flavonoids, total organic acids, total polysaccharides, total α-amino acids, total sinapine were 10.19-18.92, 11.82-21.96, 94.07-174.71, 42.69-79.27, 9.55-17.73 mg·g-1, the relative transfer rates for herbs were 25.72%-47.77%, 41.78%-77.59%, 64.90%-120.54%, 42.30%-78.57%, 34.99%-64.99%, respectively.ConclusionThe optimized decocting technology of M. oleifera leaf standard decoction is stable and feasible, and the established multi-indicator quality evaluation system can lay the foundation for the quality control of this standard decoction.  
      关键词:Moringa oleifera leaves;standard decoction;high performance liquid chromatography(HPLC);quality standard;response surface methodology;principal component analysis(PCA);decocting technology   
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    • LIU Wangsuo,QIU Kaiyang,BA Darifu,GAO Xuehua,YANG Zhiming,GAO Min,ZHANG Fang,ZHANG Bo
      Vol. 30, Issue 6, Pages: 160-168(2024) DOI: 10.13422/j.cnki.syfjx.20231415
      摘要:ObjectiveTo explore the interaction among root fungi of Stellaria dichotoma var. lanceolata, soil factors, and main components of medicinal materials in lithosol habitats.MethodHigh-throughput sequencing technology was employed to determine the fungal community of the root system of S. dichotoma var. lanceolata at different levels (bulk soil, rhizosphere soil, rhizoplane soil, and root interior) and the soil properties of the root system (bulk and rhizosphere), and the relationship among the fungal community, soil properties, and the main components of medicinal materials was analyzed.ResultThe total phosphorus, available phosphorus, alkaline nitrogen, dissolved organic carbon, and soil water content in the rhizosphere soil of S. dichotoma var. lanceolata were slightly higher than those in the rhizosphere, but the difference was not significant. Ascomycota is the dominant phylum of root fungi in S. dichotoma var. lanceolata. In the progressive level of bulk-rhizosphere-rhizoplane-root interior system, although the fungal diversity gradually decreased, the abundance of Hypocreales, a new phylum (unclassified_ k_ Fungi), Helotiales, and Natipusilales gradually increased, among which Hypocreales is the most important fungal group in the root system of S. dichotoma var. lanceolata. The structural equation model (SEM) shows that the physicochemical factors of the root-soil play an important regulatory role in the fungal community and the main components of medicinal herbs, with soil total nitrogen, alkaline nitrogen, soil water content, and pH being the main regulatory factors. Soil nitrogen content is the key to promoting the main components of the medicinal herbs, and Penicillium fungi are the key fungal group to regulate the main components of the medicinal herbs.ConclusionIt highlights that the physicochemical properties of the soil of S. dichotoma var. lanceolata play a crucial role in the fungal community and the components of medicinal materials. Hypocreales fungi in the root of S. dichotoma var. lanceolata were an important group, and Penicillium fungi had a certain role in mediating the components of medicinal materials.  
      关键词:Stellaria dichotoma var. lanceolata;Fungi;lithosol;soil properties;medicinal ingredients   
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    • JIANG Qiyao,LIU Chenchen,CHEN Huiling,HUANG Zhifeng,ZHAO Wei,LIANG Ying,PAN Huafeng,ZHUO Yue
      Vol. 30, Issue 6, Pages: 169-178(2024) DOI: 10.13422/j.cnki.syfjx.20240162
      摘要:ObjectiveTo establish a qualitative and quantitative analysis method for chemical constituents in Liu Junzitang(LJZT), and to clarify its material basis.MethodThe chemical constituents in LJZT were analyzed by ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS), and the resulting compounds were identified by using databases, such as MassBank, PubChem, ChemSpider, Traditional Chinese Medicine Systems Pharmacology Database and Analytical Platform(TCMSP), and by combining with relevant literature. UPLC was used to establish a quantitative method for analysis of 9 compounds in LJZT, including liquiritin, hesperidin, lobetyolin, liquiritigenin, glycyrrhizic acid, nobiletin, tangeretin, atractylenolide Ⅱ and Ⅰ.ResultBy combining the relevant literature, database and MS information, a total of 79 compounds were identified from LJZT, including 31 flavonoids, 15 terpenoids, 14 nitrogen-containing compounds, 6 phenylpropanoids, 6 organic acids and 7 other compounds. The established quantitative analytical method for the nine representative components showed good linearity within their respective linear ranges, and the precision, stability, reproducibility and recovery were in accordance with the requirements. The quantitative results showed that the contents of liquiritin, hesperidin, lobetyolin, liquiritigenin, glycyrrhizic acid, nobiletin, tangeretin, atractylenolide Ⅱ and Ⅰ in LJZT were 0.376 5, 2.602 1, 0.082 6, 0.128 1, 1.778 6, 0.015 7, 0.006 7, 0.030 4, 0.003 2 mg·g-1, respectively.ConclusionThe established method can quickly, sensitively and accurately analyze the chemical constituents in LJZT, clarify that the material basis of LJZT is mainly flavonoids, terpenoids and nitrogen-containing compounds, and simultaneously determine the contents of the 9 components, which can lay a foundation for the research on quality control, mechanism and clinical application of LJZT.  
      关键词:Liu Junzitang;lyophilized powder;ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS);chemical component;quantitative analysis;qualitative analysis;flavonoids   
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    • YANG Liping,GUO Xudong,XI Shaoyang,MA Xiaohui,ZHAN Zhilai,JIN Ling
      Vol. 30, Issue 6, Pages: 179-189(2024) DOI: 10.13422/j.cnki.syfjx.20230862
      摘要:By consulting the ancient and modern literature, the textual research of Pharbitidis Semen has been conducted to clarify the name, origin, distribution of production areas, quality specification, harvesting, processing and so on, so as to provide reference for the development and utilization of the relevant famous classical formulas. Through textual research, it can be seen that Pharbitidis Semen was first published in Mingyi Bielu(《名医别录》), and all dynasties have taken Qianniuzi as the correct name. Based on the original research, the main source of Pharbitidis Semen used in previous dynasties is the dried mature seeds of Pharbitis nil, which is consistent in ancient and modern times. The white Pharbitidis Semen appearing in Compendium of Materia Medica(《本草纲目》) from Ming dynasty is similar to the present P. purpurea. It is produced all over the country, and the quality is better if the particles are full and free of impurities. In ancient times, the harvesting time was mostly in the September. Now it is autumn. The fruits are ripe and harvested, dried to remove impurities for standby. In ancient times, the processing methods of Pharbitidis Semen were mainly wine steaming, steaming and frying until half cooked and grinding the head and end. In modern times, they have been simplified to stir-frying method. The nature, taste, meridian tropism and their effects also change supplements with the deepening of practice. Before the Ming dynasty, they were all bitter, cold and toxic. In the Ming dynasty, there appeared the characteristics of pungent, hot and small poisonous. The efficacy has evolved from controlling low Qi, curing foot edema, removing wind toxin, and facilitating urination to facilitating water and defecation, eliminating phlegm and drinking, and eliminating accumulated insects. The main clinical contraindications are those with weak spleen and kidney, those with weak spleen and stomach, pregnant women, and should not be used with croton and croton cream. Based on the textual research, it is suggested that when developing the classic famous formula with Pharbitidis Semen as the main raw material in the future, it is clear that the source should be the dried mature seeds of Pharbitis nil(black product is its black-brown seeds, white product is its beige seeds). The processing requirements indicated in the original formula are all processed according to the requirements, and the raw product is recommended to be used as medicine if not specified.  
      关键词:famous classical formulas;Pharbitidis Semen;origin;herbal textual research;quality evaluation;processing;clinical contraindication   
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    • ZHANG Kaige,SHANG Hongcai,ZHU Yong,HUANG Weijun,ZHANG Xiaoxiao
      Vol. 30, Issue 6, Pages: 190-195(2024) DOI: 10.13422/j.cnki.syfjx.20240563
      摘要:China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value, ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction, in order to further consolidate the foundation and ensure the quality and authority of case reports, we need to fully understand the origin and development of Chinese medical cases. Therefore, we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports, comparing the differences between Chinese and western medical case reports in terms of content and writing requirements, finally formed the main points of systematic case report norms and quality evaluation system, aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development, scientific research innovation, clinical practice and guidance, talent evaluation and training, so as to promote its innovative development in a broader direction.  
      关键词:China Association of Chinese Medicine;China Clinical Cases Library of Traditional Chinese Medicine;Chinese medical cases;development status;innovation and development;talent evaluation system   
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    • WANG Ting,SUN Ke,LI Jingyi,ZHOU Yali,LI Hongmei
      Vol. 30, Issue 6, Pages: 196-204(2024) DOI: 10.13422/j.cnki.syfjx.20231126
      摘要:As a commonly used traditional Chinese medicine in clinical practice, Tripterygium wilfordii has the functions of dispelling wind and removing dampness, detoxicating and destroying parasites, detumescence, pain relief, promoting blood circulation, and dredging collateral. Modern pharmacological studies show that it also has other functions such as anticancer, anti-inflammation, and immunosuppression. It has been widely used to treat autoimmune diseases, renal diseases, and tumors. T. wilfordii contains a variety of chemical components, among which triptolide (TP) can cause varying degrees of damage to human digestive, circulatory, reproductive, and other systems, with liver injury being the most common one, which greatly limits the development of TP in new drug research and industrial application. Therefore, the authors focused on the research hotspot of TP-induced liver injury and summarized relevant Chinese and international literature regarding the clinical manifestations, injury mechanisms, and detoxification strategies of TP-induced liver injury. This helps to provide a scientific basis for the clinical drug safety and scientific drug supervision of TP. The clinical manifestations of TP-induced liver injury are mostly abnormal transaminases, loss of appetite, nausea and vomiting, anorexia, yellow staining of skin and sclera, and yellow urine. The mechanisms of the above clinical manifestations involve apoptosis, oxidative stress, influence on cytochrome P450 superfamily, macrophage polarization, regulation of biological clock gene Clock, etc. Among them, cell apoptosis is related to neurogenic locus notch homolog protein 1 (Notch1), dynamin-related protein 1 (Drp1)-cytochrome C (Cyt C), phosphatidylinositide 3-kinases (PI3K)/protein kinase B (Akt), mitogen-activated protein kinase (MAPK), tumor suppressor protein 53 (p53), Fas cell surface death receptor (Fas)/Caspase-8, and other signaling pathways. Oxidative stress is related to inhibition of nuclear factor-erythroid 2-related factor 2 (NRF2) signaling pathway, promotion of cytochrome P450 2E1 (CYP2E1) expression, and excessive accumulation of reactive oxygen (ROS). The influence of the cytochrome P450 superfamily is manifested as reducing the substrate affinity, activity, and expression of cytochrome P450 3A (CYP3A), cytochrome P450 2C9 (CYP2C9), cytochrome P450 2C19 (CYP2C19), and cytochrome P450 1A2 (CYP1A2). Promoting the transformation of macrophages into the M1 type is related to the secretion of inflammatory factors and the accumulation of endotoxin, and the internal rhythmic regulation of the biological clock gene Clock, is related to the expression of cytochrome P450 3A11 (CYP3A11) metabolic enzyme. The detoxification strategies in the clinical application include herbs-processing detoxification strategy and drug-pairing detoxification. The traditional Chinese medicines and monomers that are helpful for detoxification include Glycyrrhiza uralensis, Paeonia lactiflora, Lysimachia christinae, Rehmannia glutinosa, saffron, and paeoniflorin. The reviews and discussion about these topics can help to provide more references for related research and clinical application of TP.  
      关键词:triptolide;liver injury;clinical features;mechanism;detoxification strategies   
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    • ZHAO Yongkang,LIU Yuyang,SHI Wei,GAO Han,LI Zheng,BAI Zhaofang,SONG Haibo,GAO Yuan,WANG Jiabo,XIAO Xiaohe
      Vol. 30, Issue 6, Pages: 205-210(2024) DOI: 10.13422/j.cnki.syfjx.20230712
      摘要:ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation (EP) and explore the possible risk factors of liver injury, so as to provide a reference for the safe clinical application of Epimedii Folium (EF).MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016.ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend, indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men, with an onset age range of 15-91 years old and a median onset age of 60 years old (median onset ages for men and women are 59 and 60 years old, respectively). The time span from taking EP alone to the occurrence of liver injury is 1-386 days, with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days, with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney, indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors, it is found that patients have unreasonable medication methods such as excessive dosage, repeated use, and multi-drug combination, which may also be one of the important risk factors for EF-related liver injury.ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP, and in clinical use, it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.  
      关键词:Epimedii Folium preparation;adverse drug reaction;clinical characteristics;unreasonable drug use;risk factor   
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    • YIN Yujie,CHANG Liping,WEI Cong
      Vol. 30, Issue 6, Pages: 211-217(2024) DOI: 10.13422/j.cnki.syfjx.20232446
      摘要:Patients with cancer-related fatigue are prone to symptoms and signs such as anorexia, weight loss, and abdominal distension, which seriously reduces the quality of life and becomes an independent risk factor affecting the survival rate of patients with malignant tumors. Therefore, it is urgent to find effective treatment strategies and drugs. In the past, the academic viewpoint of improving syndromes—a new strategy for tumor treatment was proposed based on the guidance of the Luobing theory. Based on this, this article proposes the pathogenesis of cancer-related fatigue is characterized by spleen and kidney deficiency, stasis and toxin internal obstruction, as well as the treatment method of strengthening the spleen and tonifying the kidney, resolving blood stasis and detoxification guided by the core theory of the Qiluo doctrine of Chengzhi Tiaoping. The representative drug Yangzheng Xiaoji capsules has been developed, not only has good therapeutic effect on solid tumors, but also shows good advantages in treating cancer-related fatigue, which can help to restore the homeostasis of tumor bearing survival in patients with malignant tumors and provide new drug choices for the clinical treatment of cancer-related fatigue.  
      关键词:Luobing theory;malignant tumors;cancer-related fatigue(CRF);Chengzhi Tiaoping;Yangzheng Xiaoji capsules;traditional Chinese medicine(TCM);human experience   
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    • JIANG Fengru,HE Youcheng,WU Yue,PAN Keyi,ZHOU Chunyu,CAI Shuyu,YUAN Jianye
      Vol. 30, Issue 6, Pages: 218-227(2024) DOI: 10.13422/j.cnki.syfjx.20241097
      摘要:Diarrhea-irritable bowel syndrome (IBS-D) is one of the common functional bowel diseases in clinical practice. Since it pathogenesis is complex and has not been fully elucidated, effective treatment methods remains to be developed for this disease. Establishing the animal models of IBS-D in accordance with the clinical characteristics of traditional Chinese medicine (TCM) and Western medicine helps to reveal the pathogenesis of this disease and improve the treatment plan. The fitting degree of an animal model with clinical characteristics is an indicator to evaluate the effectiveness of the animal model in simulating the disease characteristics of Western medicine and the syndromes of TCM based on the latest diagnostic standards. By reviewing the relevant articles about the animal models of IBS-D, we discovered that rats were the preferred animals for modeling, and the models were mainly induced by single factors, double factors, or the combination of multiple factors. The established animal models mainly present symptoms or signs associated with visceral hypersensitivity or/and gastrointestinal motility abnormalities. The single factor-induced rat models of IBS-D had high fitting degrees with the clinical characteristics of Western medicine but low fitting degrees with the TCM syndromes. The animal models induced by two or more factors had high but varied fitting degrees with the clinical characteristics of Western medicine. In addition, the animal models of IBS-D considering TCM syndromes mainly focuses on the syndrome of liver depression and spleen deficiency, and few models were established for the syndromes of spleen-kidney Yang deficiency, spleen-stomach dampness-heat, spleen deficiency and dampness excess, and cold and heat in complexity. Therefore, it is essential to improve the existing or develop new animal models of IBS-D in the future, so as to provide more tools for deciphering the mechanisms of TCM and Western medicine and developing treatment methods for this disease.  
      关键词:diarrhea-irritable bowel syndrome;animal model;disease characteristics of Western medicine and syndromes of traditional Chinese medicine;fitting degree with clinical characteristics   
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    • WU Yijuan,SUN Xinghong,GUO Haixia,ZAHNG Xiang'an
      Vol. 30, Issue 6, Pages: 228-237(2024) DOI: 10.13422/j.cnki.syfjx.20231130
      摘要:Colorectal cancer (CRC) is a malignant tumor of the intestinal tract with changes in bowel habits, blood in the stool, and pain as the main clinical manifestations. With the change in lifestyle and diet structure in recent years, the incidence of CRC has been increasing year by year. The pathogenesis of CRC is closely related to abnormal immune response and chronic inflammation, intestinal microbial dysbiosis, and the production of oncogenic metabolites. There is a two-way communication between the intestinal microbiota and the body's immunity, which not only plays a key role in maintaining the body's health but also has a close relationship with the development of diseases. An increasing number of studies have shown that abnormal immune responses accelerate the disease process by producing inflammatory factors, causing chronic inflammation in the body, disrupting the intestinal mucosal barrier, and increasing mucosal permeability, thus resulting in dysbiosis of the intestinal microbial ecology and a large number of pathogenic microorganisms and their metabolites. In addition, dysbiosis of intestinal microbes, by suppressing the normal immune response, leads to the disruption of multiple metabolic pathways in the body, affecting the internal and external stress response of the intestine, inducing inflammation, and thus producing disease. Therefore, the complex crosstalk mechanism between the immune response and intestinal microbial axis is closely related to the development of CRC. Based on traditional Chinese medicine theory and clinical research, it was found that dietary factors are an important causative factor in the development of CRC. The deficiency of positive energy is the root cause of the disease, and damp-heat accumulation is the key pathogenesis. Through modern medical and biological research, it is believed that abnormal immune response is the microscopic manifestation of damp-heat entrapment, while intestinal microbial dysbiosis is the biological basis of toxic injection into the large intestine, and in the pathogenesis of CRC, the imbalance of immune response-intestinal microbial axis is compatible with damp-heat accumulation in traditional Chinese medicine. This study aims to explore the biological connotation of CRC due to damp-heat accumulation from the immune response-intestinal microbial axis, so as to interpret the pathogenesis of CRC due to damp-heat accumulation with objective data and provide new ideas and theoretical basis for the pathogenesis and treatment strategies of CRC due to damp-heat accumulation.  
      关键词:immune response-intestinal microbial axis;colorectal cancer;immune response;intestinal microbes;crosstalk mechanism;damp-heat accumulation;biological connotation   
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    • YU Mingwei,ZHANG Huairui,ZHANG Xinghan,LI Xiao,WANG Rengui,LONG Zhiqiang,WANG Zhen,PANG Bo,HUO Jianwei,CHEN Wei,ZHU Yong,LIU Baoli,LOU Yanni,ZHANG Ganlin,NIAN Jiayun,MO Mei,ZHANG Xiaoxiao,YANG Guowang
      Vol. 30, Issue 6, Pages: 238-245(2024) DOI: 10.13422/j.cnki.syfjx.20241096
      摘要:In recent years, the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine (TCM) in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine, the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances, TCM theories of etiology and pathogenesis, the role and advantages of TCM in the whole course management of pulmonary nodules, contents and methods of research on pulmonary nodules, and science popularization work, aiming to provide a reference for clinical practice and scientific research. After discussion, the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness, blood stasis, and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules, improving physical constitution, ameliorating multi-system nodular diseases, reducing anxiety and avoiding excessive diagnosis and treatment, and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present, the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed, which needs to be further studied from multiple perspectives such as clinical epidemiology, biology, and evidence-based medicine. The primary task of current research is to find out the advantages, effective prescriptions, and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time, basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized, scientific, and accurate effective diagnosis and treatment.  
      关键词:pulmonary nodules;disease responding specifically;integrated traditional Chinese and western medicine;innovation of traditional Chinese medicine;expert consensus   
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    • WANG Xuejiao,SHAO Zhen,MENG Chao,JIANG Chunyun,CHEN Hengwen,LI Jun
      Vol. 30, Issue 6, Pages: 246-252(2024) DOI: 10.13422/j.cnki.syfjx.20231323
      摘要:Cold and heat belong to the eight-principal syndrome differentiation of traditional Chinese medicine, which can reflect the rise and fall of Yin and Yang in the body and the Yin and Yang nature of the disease. At present, traditional Chinese medicine has an inconsistent understanding of cold and heat in acute coronary syndrome. The emphasis on pathogenic factors of cold and heat is biased, and the elements of cold and heat syndrome are not fully reflected in the scale. Therefore, the literature has been reviewed from the perspectives of etiology, pathogenesis, symptom elements, and test signs with drugs. From the perspective of etiology, both cold evil and heat evil can increase the risk of acute coronary syndrome. It was previously believed that acute coronary syndrome occurs frequently in cold climates such as winter and spring. Based on this understanding, hot weather can also induce acute coronary syndrome, and different temperatures have different effects on patients of different ages and with different underlying diseases. In addition, artificial pathogenic factors such as excessive consumption of cold food and refrigeration air conditioners were added. From the perspective of pathogenesis, on the basis of the traditional ''asthenia in origin and asthenia in superficiality'' and ''phlegm stagnation'', it is found that Yin-cold and fire-heat can both cause paralysis of the heart chakra and pain induced by the blockage. The pathogenesis of acute coronary syndrome characterized by heat stagnation and coldness featuring heartburn should be distinguished from gastroesophageal reflux disease. Moreover, the pathogenesis of Yin cold coagulation and pulse stagnation and wind obstruction are different. The acute coronary syndrome is in line with the wind characteristics of frequent changes and can be treated with wind medicine. From the perspective of syndrome elements, the syndrome elements such as cold condensation, heat accumulation, and toxicity are analyzed, and the use of basic syndrome elements and their combination forms facilitates clinical and scientific research. In addition, according to the test sign with the drug, it can be seen that the attributes of cold and heat of traditional Chinese medicine prescriptions for acute coronary syndrome can be explained according to the temperature-sensitive transient receptor potential (TRP) ion channel, thus proving the pathogenesis of cold and heat of acute coronary syndrome.  
      关键词:acute coronary syndrome;cold and heat;etiology and pathogenesis;syndrome elements;transient receptor potential (TRP) ion channel   
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    • GAO Jing,LIU Feixiang,ZHANG Yunke
      Vol. 30, Issue 6, Pages: 253-261(2024) DOI: 10.13422/j.cnki.syfjx.20231123
      摘要:Cerebral ischemia/reperfusion injury (CIRI) is a complex cascade reaction process in which the blood flow and oxygen supply of brain tissue in the infarcted area recover after cerebral ischemia, resulting in secondary injury of ischemic brain tissue. At present, thrombolysis as soon as possible and restoration of cerebral blood supply are still the only strategies for the treatment of stroke, but a considerable number of patients' symptoms will be more serious after reperfusion, making patients face adverse outcomes such as neurological function injury and even death and seriously affecting the quality of life and safety of patients. Therefore, an in-depth exploration of the mechanism and treatment strategy of CIRI has important clinical significance. The phosphatidylinositol 3- kinase (PI3K)/protein kinase B (Akt) signaling pathway is one of the classic anti-apoptosis/reproductive-promoting signal transduction pathways, which is responsible for cell proliferation, growth, and differentiation. It is the key cascade signaling pathway of CIRI, located at the core site in many mechanisms such as mitochondrial disorder, apoptosis, autophagy, oxidative stress, and inflammation. It is closely related to the occurrence and development of CIRI. Traditional Chinese medicine has been used in the clinical treatment of stroke and its complications for thousands of years, and the clinical effect of traditional Chinese medicine in the prevention and treatment of CIRI has been affirmed by a large number of research results in recent years. It is further clarified that the monomers, active components, and their compound prescriptions of traditional Chinese medicine can directly or indirectly regulate the PI3K/Akt signaling pathway by virtue of the biological advantages of multi-targets, multi-components, and multi-pathways and play an overall protective role in CIRI. By analyzing the related research progress of traditional Chinese medicine in China and abroad in recent years, the authors summarized the role and mechanism of regulating the PI3K/Akt signaling pathway in the prevention and treatment of CIRI, so as to provide further theoretical basis for the study of the mechanism of clinical prevention and treatment of CIRI.  
      关键词:traditional Chinese medicine;compound of traditional Chinese medicine;cerebral ischemia reperfusion injury;phosphatidylinositol 3- kinase (PI3K)/protein kinase B (Akt) signaling pathway;research progress   
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    • ZHANG Honglin,JIANG Haixu,WEI Qiuzhu,SUN Yuhe,ZHAO Zihan,LU Qingyi
      Vol. 30, Issue 6, Pages: 262-268(2024) DOI: 10.13422/j.cnki.syfjx.20232139
      摘要:Rheumatoid arthritis (RA) is a systemic autoimmune disease with local joint pain as the main clinical manifestation. It is one of the diseases specifically responding to traditional Chinese medicine (TCM). The occurrence of RA is not only related to innate factors like genetic disorder but also associated with environmental factors, such as diets and microbial infection. The intestine, a vital human organ with digestive and immune functions, is a place where microorganisms colonize and exert intestinal metabolism-improving, barrier-protecting, and immunomodulatory effects. As the research on the onset and treatment of RA is deepening, the potential relationship of intestinal structural and functional abnormalities with the pathogenesis and progression of RA has been revealed. As clinical and experimental studies indicated, joint inflammation coexists with the impaired barrier function, imbalanced immune cells, and disordered gut microbiota. The theory of the gut-joint axis in the pathogenesis, progression, and treatment of RA is highly consistent with the holistic view in TCM. The recent pharmacological studies have shown that Chinese medicine prescriptions and active components can inhibit inflammation, protect joints, and maintain the intestinal function. This article summarizes the basic connotation of the gut-joint axis in RA and the mechanism by which TCM protect the intestinal barrier and modulate the immunity by regulating the gut microbiota structure and improving microbial metabolism in the treatment of RA. This review gives insights into the future research on the gut-joint axis in RA.  
      关键词:rheumatoid arthritis;Chinese medicine;gut-joint axis;gut microbiota   
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    • LIU Yongfang,ZHOU Li,LIU Huiyang,HUANG Rui,FENG Zhiying,YIN Tiantian
      Vol. 30, Issue 6, Pages: 269-279(2024) DOI: 10.13422/j.cnki.syfjx.20240994
      摘要:IgA nephropathy is recognized as the most common primary glomerular disease, with up to 20%-40% of patients developing end-stage kidney disease within 20 years of onset. The deposition of IgA1-containing immune complexes targeting glycosylation defects in the mesangial region and the subsequent inflammation caused by T lymphocyte activation are considered as the main causes of IgA nephropathy, and innate immunity is also involved in the pathogenesis. Nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) is a newly discovered pattern recognition receptor expressed in renal intrinsic cells such as renal tubular epithelial cells, mesangial cells, and podocytes. Activated by external stimuli, NLRP3 can form NLRP3 inflammasomes with apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC). The NLRP3 inflammasome can activate cysteine aspartate-specific protease-1 (Caspase-1), causing the maturation and release of interleukin-18 (IL-18) and interleukin-1β (IL-1β) involved in inflammation. Increasing evidence has suggested that NLRP3 inflammasomes are involved in the pathogenesis and progression of IgA nephropathy and associated with the damage of renal intrinsic cells such as podocytes, mesangial cells, endothelial cells, and renal tubular epithelial cells. Chinese medicine can regulate inflammatory cytokines and their signaling pathways by acting on NLRP3 inflammasomes and related molecules, exerting therapeutic effects on IgA nephropathy. This article introduces the role of NLRP3 inflammasomes in IgA nephropathy and reviews the clinical and experimental research progress of Chinese medicine intervention in IgA nephropathy via NLRP3 inflammasomes, aiming to provide a reference for further research and application of Chinese medicine intervention in the NLRP3 inflammasome as a new therapeutic target.  
      关键词:IgA nephropathy;NOD-like receptor protein 3 (NLRP3) inflammasome;traditional Chinese medicine;inflammation   
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      发布时间:2024-02-04
    • ZHANG Qinyuan,JIN Zhisheng,JIANG Xiaoxue,CHEN Yanxu,ZHANG Boling,FU Yaoqin
      Vol. 30, Issue 6, Pages: 280-288(2024) DOI: 10.13422/j.cnki.syfjx.20231109
      摘要:Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by absolute or relative insufficiency of insulin secretion. As the disease progresses, patients begin to suffer from diabetic nephropathy, diabetic cardiomyopathy, non-alcoholic fatty liver disease or other complications, which increase the burden on the patients. Moreover, the number of patients is increasing, which brings a heavy burden to the society. Ferroptosis is a new type of programmed cell death which has attracted wide attention in recent years. It refers to the cell death caused by the excessive accumulation of lipid peroxide under the overload of iron ions. Studies have discovered that ferroptosis exists in diabetes mellitus and its complications. Inhibiting ferroptosis can greatly slow down the occurrence and progression of diabetes mellitus and its complications. Chinese medicine, the unique medical treasure in China, acts in a multi-pathway, multi-target manner and is praised for the cheap price, low toxicity, and mild side effects. It has been widely used in the treatment of diabetes mellitus and its complications and has demonstrated definite therapeutic effects, bringing the good news for the majority of patients. The regulation of ferroptosis by Chinese medicine may be a new direction for the treatment of diabetes mellitus and its complications in the future. This paper briefly describes the mechanism of ferroptosis, explores the relationship of ferroptosis with diabetes mellitus and its complications, summarizes the research status of Chinese medicine interventions, and puts forward suggestions, aiming to provide a reference for further research on the treatment of diabetes mellitus and its complications with Chinese medicine.  
      关键词:ferroptosis;diabetes mellitus;diabetic complications;Chinese medicine;mechanism   
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      发布时间:2024-02-04
    • CHAI Jutang,NING Hongxia,LI Yongzhang,LIU Xiaoyu,Wei Xiaotao,LIU Tao,WEN Zhigang
      Vol. 30, Issue 6, Pages: 289-298(2024) DOI: 10.13422/j.cnki.syfjx.20232021
      摘要:Osteoarthritis (OA), rheumatoid arthritis (RA), gouty arthritis (GA), and intervertebral disc degeneration (IVDD) are the most common bone and joint-related diseases in clinical practice. They can all affect related joints, leading to joint pain, swelling, dysfunction, and other symptoms. The difference is that OA is mainly caused by joint wear and age-related degradation and is manifested as joint pain, stiffness, and limited movement. RA is an autoimmune disease, manifested as joint pain, swelling, morning stiffness, and systemic symptoms. GA is caused by abnormal uric acid metabolism, manifested as acute arthritis, and IVDD is caused by intervertebral disc degeneration. Studies have shown that the mechanism of the occurrence and development of these bone and joint diseases is extremely complex. Pyroptosis is closely related to these bone and joint-related diseases by participating in bone and joint inflammation, cartilage metabolism imbalance, extracellular matrix degradation, and pathological damage of bone and joint. Inhibition of bone and joint-related pyroptosis will effectively prevent and treat bone and joint-related diseases. At the same time, many studies have confirmed that traditional Chinese medicine (TCM) has a prominent curative effect and obvious advantages in the prevention and treatment of bone and joint-related diseases. TCM can reduce the inflammatory reaction of bone and joints, improve the pathological damage of bone and joint diseases, and relieve bone and joint pain by inhibiting pyroptosis. Therefore, this article aims to briefly explain the relationship between pyroptosis and the occurrence and development of bone and joint-related diseases and summarize the latest research reports on the intervention of pyroptosis in the treatment of bone and joint-related diseases by TCM monomers, TCM extracts, and TCM compounds. It offers new ideas for the in-depth study of the pathogenesis and drug treatment of bone and joint diseases and provides a basis for the clinical use of TCM to prevent and treat bone and joint diseases.  
      关键词:pyroptosis;osteoarthritis;rheumatoid arthritis;gouty arthritis;intervertebral disc degeneration;traditional Chinese medicine   
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