Psoriasis is characterized by a lingering course and a tendency for recurrence.The"four-layer method for differentiating toxin depth"dynamically analyzes pathogenic evolution and treatment by categorizing toxin-induced diseases into four sequential stages:superficial,dynamic,deep,and latent,based on the progression from exterior to interior.Its core pathogenesis is identified as healthy qi deficiency with toxin invasion,with the conflict between healthy qi and pathogens demonstrating distinct layer-based transmission features as the disease evolves.This paper posits that psoriasis is rooted in healthy qi deficiency,with toxin invasion as the manifestation.Specifically,in the superficial layer,when pathogenic toxins invade the exterior of the skin and the condition is mild;the treatment should focus on releasing the exterior and dispersing toxins,which is assisted by boosting qi,using the modified Jiedu Fuwei Decoction.In the dynamic layer,heat-toxin is abundant in the blood,and an intense struggle exists between vital qi and pathogenic factors.Hence,the treatment should focus on cooling the blood and counteracting toxins,combined with nourishing yin,using the modified Liangxue Baidu Decoction.In the deep layer,stagnant toxins and blood stasis bind together,obstructing blood vessels;thus,the treatment should focus on resolving stasis and detoxifying,as well as nourishing blood and unblocking collaterals,using the modified Huayu Jiedu Decoction.In the latent layer,toxins are hidden and vital qi is deficient.In such conditions,the treatment should focus on boosting qi to expel toxins and harmonizing the nutritional and defensive levels using the modified Yiqi Fuzheng Decoction.The transmission of pathogenic toxins through the superficial,dynamic,deep,and latent layers in psoriasis embodies the dynamic process of moving from the exterior to the interior and from excess to deficiency.By tailoring treatment according to the toxin layer and the relationship between healthy qi and pathogens in clinical practice,allowing for dynamic adjustments,this approach provides a clear framework for the differentiation of the syndrome and treatment of psoriasis using a traditional Chinese medicine approach.
Sweating disease in children is not merely a disorder of the striae and interstitial spaces,but rather a local manifestation of systemic qi movement and orifice dysfunction.The spleen pertains to the central soil and serves as the pivot of the qi movement.In children,the spleen is often insufficient.The spleen governs transportation and transformation,preferring dryness to dampness while avoiding dampness.When the transportation and transformation functions of the spleen fail,the water-dampness accumulates,leading to stagnation of the pivot mechanism.Consequently,pathological turbidity,such as damp-heat,retention of food,and latent fire,is generated internally.These pathogenic factors congest the orifices,force the fluid outward and eventually result in a sweating disorder.Based on the theory of"treat it with lan and eliminate turbidity"from the Treatise on Strange Diseases of Plain Questions,our research team proposes that aromatic Chinese medicinals can"invigorate the spleen to eliminate dampness and activate the pivot mechanism."The basic therapeutic method was established as moving the pivot and eliminating the turbidity resolving dampness with aromatics,moving the pivot to stop sweating.In clinical practice,treatment is tailored based on pattern differentiation.For the pattern of spleen deficiency due to dampness stagnancy,treatment focuses on moving the pivot and eliminating the turbidity,resolving dampness with aromatics.For the pattern of dyspepsia,treatment focuses on moving the pivot and eliminating the turbidity,promoting digestion and removing food stagnation.For the pattern of phlegm-heat attacking internally,the treatment focuses on moving the pivot and eliminating the turbidity,clearing heat,and dissipating phlegm.For disharmony between the nutrient qi and the defensive qi,the treatment focuses on moving the pivot and eliminating the turbidity,harmonizing ying fen and wei fen.These approaches aim to restore movement of the pivot mechanism and ensure free flow of the orifices,leading to spontaneous cessation of sweating.This study systematically elaborates the key points of applying the theory of"moving the pivot and eliminating the turbidity"in the treatment of sweating disease in children,aiming to provide a new approach to clinical pattern differentiation and treatment.
The Maimendong Decoction from the Classic of the Golden Chamber and Jade Sheath is a lesser-known classical prescription.According to the existing fine edition(the CHEN Shijie edition),its composition includes six Chinese medicinal herbs:radix ophiopogonis,pinelliae rhizoma,radix ginseng,radix glycyrrhizae,oryzae semen,and fructus jujubae,which is completely identical to Maimendong Decoction in the Synopsis of Golden Chamber.However,the processing method and post-prescription notes for Maimendong Decoction in the extant Classic of the Golden Chamber and Jade Sheath do not conform to the editorial conventions established by the Song Dynasty editors,indicating that it is not the original form after their revision.Further research reveals possible reasons for this discrepancy:the prescription for Maimendong Decoction in the Classic of the Golden Chamber and Jade Sheath was already lost by the time CHEN Shijie obtained a handwritten copy in 1712 during the Kangxi reign of the Qing Dynasty.When CHEN Shijie published the Classic of the Golden Chamber and Jade Sheath,he supplemented it based on the Maimendong Decoction from the DENG Zhen edition of the Synopsis of Golden Chamber.Analysis of the administration method and formula characteristics of the Maimendong Decoction supplemented by CHEN Shijie shows that the supplemented formula does not seem to correspond appropriately to the disease it purportedly treats.Through textual,it is concluded that the composition of Maimendong Decoction in the Classic of the Golden Chamber and Jade Sheath should be consistent with the Maimendong Decoction"for treating relapse due to overexertion"recorded in medical texts such as Essential Prescriptions Worth a Thousand Gold for Emergencies,Book to Safeguard Life Arranged according to a Classified Pattern,and New Book of Pediatrics.Its composition includes radix ophiopogonis,fructus jujubae,herba lophatheri,radix glycyrrhizae,and oryzae semen.Further analysis combining the original text passage and the formula composition defines its clinical application.It is proposed that this formula is suitable for treating"relapse of cold damage"characterized by external pathogenic heat and internal deficiency of both fluids and qi.Its pattern is primarily marked by fever,accompanied by manifestations such as scant qi and a sense of exhaustion,emaciation,dry mouth,intense thirst,fatigue,reluctance to speak,scanty coating of the tongue,and thin weak pulse.
Objective To investigate the therapeutic effects and mechanisms of Qufeng Xuanfei Formula in guinea pigs with cough hypersensitivity induced by neurogenic inflammation. Methods According to the random number table method, 30 guinea pigs were randomly divided into the blank group, model group, Qufeng Xuanfei Formula group, pregabalin group, and voltage-gated sodium channel (Nav) 1.7 inhibitor group, with 6 animals per group. Except the blank group, the guinea pigs of the other groups were immunocompromised by intraperitoneal injection of cyclophosphamide (3u00D710-2 g/kg); 2 days later, they were sensitized by intraperitoneal injection of 1 mL normal saline containing 2 mg ovalbumin and 100 mg aluminum hydroxide; 3 weeks later, they received booster sensitization by intraperitoneal injection of 1 mL normal saline containing 0.01 mg ovalbumin and 100 mg aluminum hydroxide. The blank group was injected intraperitoneally with the same volume of normal saline. Three weeks after booster sensitization, 1% ovalbumin solution was administered by aerosol inhalation for challenge. Successful modeling was defined as cough frequency u226510 times within 3 minutes after challenge and was accompanied by typical coughing behaviors. After successful modeling, the Qufeng Xuanfei Formula group was given Qufeng Xuanfei Formula (5 g/kg) by gavage; the blank group and model group were given an equal volume of normal saline by gavage; the pregabalin group was given pregabalin solution (3u00D710-2 g/kg) by gavage; the Nav1.7 inhibitor group received aerosol inhalation of Nav1.7 inhibitor PF-05089771 solution (100 u03BCmol/L) for 20 minutes each time; all interventions were administered once daily for 7 days. The general condition of guinea pigs was observed. Cough frequency was measured by capsaicin aerosol stimulation. Serum levels of interleukin (IL)-4, IL-6, IL-1u03B2, and tumor necrosis factor-u03B1 (TNF-u03B1) were detected by enzyme-linked immunosorbent assay. The mRNA expressions of Nav1.7, substance P (SP), and nuclear factor-u03BAB (NF-u03BAB) p65 in the dorsal root ganglia were detected by real-time PCR. The protein expressions of Nav1.7, SP, NF-u03BAB p65, and phosphorylated NF-u03BAB p65 (p-NF-u03BAB p65) in the dorsal root ganglia were detected by western blotting. Results Compared with the blank group, guinea pigs in the model group exhibited typical behavioral characteristics including increased respiratory rate, frequent coughing, obvious abdominal muscle contraction, forelimb extension, neck extension, and open-mouth breathing. Their general condition was poor, manifested as reduced food and water intake, decreased activity, preference for curling up, listless mental state, and fluffy coat. After capsaicin stimulation, cough frequency increased, serum levels of IL-4, IL-6, IL-1u03B2, and TNF-u03B1 increased, and the mRNA expressions of Nav1.7, SP, and NF-u03BAB p65 in dorsal root ganglia, as well as the protein expressions of Nav1.7, SP, p-NF-u03BAB p65, and p-NF-u03BAB p65/NF-u03BAB p65 were all elevated (Pu0026lt;0.05). Compared with the model group, guinea pigs in each treatment group showed decreased spontaneous cough frequency over time, gradual recovery of food and water intake, increased activity, improved mental state, and gradually lustrous coat. Cough frequency induced by capsaicin decreased, serum levels of IL-4, IL-6, IL-1u03B2, and TNF-u03B1 decreased, and in the Qufeng Xuanfei Formula group and Nav1.7 inhibitor group, the mRNA expressions of Nav1.7, SP, and NF-u03BAB p65 in the dorsal root ganglia, as well as the protein expressions of Nav1.7, SP, p-NF-u03BAB p65, and p-NF-u03BAB p65/NF-u03BAB p65 were all decreased (Pu0026lt;0.05). Conclusion Qufeng Xuanfei Formula can effectively alleviate cough symptoms in guinea pigs with cough hypersensitivity. Its mechanism may involve inhibiting the activity of the NF-u03BAB signaling pathway in the dorsal root ganglia, thereby down-regulating Nav1.7 expression and alleviating neurogenic inflammation.
Based on the"yin fire"theory of LI Dongyuan,this article systematically discusses the pathogenesis and treatment method for anxiety disorder outlined by traditional Chinese medicine(TCM).The study posits that although anxiety disorder has traditionally been ascribed to the heart and liver in terms of pattern identification and treatment,its essential pathogenesis is intrinsically linked to dysfunction of the spleen and stomach.From the viewpoint of"yin fire"theory,the pathogenesis of anxiety disorder can be summarized as spleen and stomach deficiency as the root,and upward disturbance of"yin fire"as the manifestation.The spleen and stomach are the acquired foundation of the human body and the source of the production and transformation of qi and blood.The spleen and stomach ascend lucidity and descend turbidity and regulate and mediate the qi movement of the whole body.Impairment of the spleen and stomach caused by improper diet,physical overstrain,excessive mental contemplation,and other internal damage factors will lead to the failure of clear yang to ascend and turbid yin to descend,as well as the sinking of the middle qi into the lower energizer.Consequently,the"yin fire"is the lower energizer and loses its restraint,takes advantage of the deficiency to ascend and disturb the earth position,resulting in disharmony between qi and fire,upward disturbance of"yin fire",and eventually manifesting as a series of anxiety-related symptoms including restlessness,easy fatigability,palpitations,and insomnia.In terms of treatment,this paper emphasizes the basic therapeutic principle of tonifying qi and ascending yang,regulate qi movement,mildly purging floating fire.It advocates taking Buzhong Yiqi Decoction as the primary prescription,supplemented with a small amount of heat-clearing medicinal,and attaches great importance to nourishing and astringing yin,so as to restore the transportation and transformation function of the middle energizer and harmonize qi and fire.Based on the traditional therapeutic strategy for treating the heart and liver,this paper expands a new perspective for the diagnosis and treatment of anxiety by treating it from the spleen and stomach,which holds certain theoretical significance and practical reference value for the clinical diagnosis and treatment of anxiety disorder with spleen-stomach deficiency pattern.
Objective To explore the mechanism of Bushen Tiaojing Formula(BSTJF)underlying the promotion of proliferation and steroid hormone synthesis of ovarian granulosa cells in aged mice.Methods Twenty 7-8-week-old ICR female mice were assigned to the control group(intragastric administration of distilled water),and eighty 9-10-month-old ICR female mice were equally divided into the model group(intragastric administration of distilled water),the BSTJF low-dose group(intragastric administration of 25.6 g/kg BSTJF),the BSTJF high-dose group(intragastric administration of 51.2g/kg BSTJF),and the leukemia inhibitory factor(LIF)inhibitor group was treated with intragastric administration of BSTJF(51.2g/kg)and intraperitoneal injection of EC330(5.0×10-4 g/kg)according to random numbers.All groups underwent daily gavage or intraperitoneal administration for 30 days.The estrous cycle changes of mice were observed by a vaginal exfoliated cell smear.The levels of sex hormones were detected by ELISA.The mRNA and protein expressions of proliferating cell nuclear antigen(PCNA),the cell cycle protein D1(Cyclin D1),the acute steroidogenic regulatory protein(StAR),3β-hydroxysteroid dehydrogenase(3β-HSD),cytochrome P450 19A1(CYP19A1),LIF,and LIF receptor(LIFR)were detected by quantitative reverse transcription PCR and Western blotting.The expressions of LIF and LIFR were detected by immunohistochemistry.Results Compared with the control group,the estrous cycles of the mice in the model group were disordered and prolonged(P<0.05),the levels of estradiol(E2)and progesterone(P4)decreased(P<0.05),the levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),and the FSH/LH ratio increased(P<0.05).The mRNA and protein expressions of PCNA,Cyclin D1,StAR,3β-HSD,CYP19A1,LIF,and LIFR in granulosa cells decreased(P<0.05).Compared with the model group,the estrous cycles of the low-and high-dose groups of BSTJF were more regular and shorter(P<0.05),the levels of E2 and P4 increased(P<0.05),the levels of FSH,LH,and FSH/LH ratio decreased(P<0.05),and the mRNA and protein expressions of PCNA,Cyclin D1,StAR,3β-HSD,CYP19A1,LIF and LIFR in granulosa cells increased(P<0.05).Compared with the BSTJF high-dose group,the estrous cycle of mice in the LIF inhibitor group was disordered and prolonged(P<0.05),the levels of E2 and P4 decreased(P<0.05),FSH and LH levels increased as did the FSH/LH ratio(P<0.05).In addition,the mRNA and protein expressions of PCNA,Cyclin D1,StAR,3β-HSD,CYP19A1,and LIFR in granulosa cells decreased(P<0.05).Conclusion BSTJF may improve ovarian reserve function and promote follicular development by up-regulating LIF and LIFR,mediating the proliferation and steroid hormones synthesis of granulosa cells.
Objective To analyze the short-term and long-term clinical efficacy of modified Yiqi Fumai Formula(YQFMF)combined with conventional Western medicine in patients with paroxysmal atrial fibrillation(PAF)with qi deficiency and blood stasis,and phlegm-heat disturbing the heart syndrome who had not undergone radiofrequency catheter ablation.Methods A retrospective cohort study was conducted.A total of 132 patients with PAF of the qi deficiency and blood stasis,and phlegm-heat disturbing the heart syndrome,who had not undergone radiofrequency ablation,were enrolled from the outpatient and inpatient departments of cardiology at Dongfang Hospital and Dongzhimen Hospital of Beijing University of Chinese Medicine from January 1,2021,to December 31,2023.Based on the exposure factor"treatment with modified YQFMF,"patients meeting this criterion were assigned to the integrated Chinese and Western medicine cohort,while those not meeting it were assigned to the Western medicine cohort.All patients were followed up until December 2024.The short-term and long-term clinical efficacy were analyzed for both cohorts.Short-term efficacy included the primary symptom(palpitation)score,effective rate for palpitation symptom,changes in secondary symptoms,and safety indicators.Long-term efficacy assessed the incidence of persistent/long-standing persistent atrial fibrillation(AF).Factors influencing the progression of PAF were also analyzed.Results A total of 121 patients with PAF were ultimately included in the study,comprising 52 patients in the integrated Chinese and Western medicine cohort and 69 patients in the Western medicine cohort.With regard to short-term efficacy,compared with the Western medicine cohort,the integrated Chinese and Western medicine cohort demonstrated a reduction in the primary symptom score,a higher effective rate for treat of palpitations,and higher effective rates for the secondary symptoms of fatigue,shortness of breath,sweating,poor sleep,dry mouth,bitter taste in the mouth,and dry stool(P<0.05).There was no statistically significant difference between the two cohorts in the effective rates for the secondary symptoms of feelings of restlessness or yellow urine.No significant adverse reactions occurred during treatment in either cohort.Regarding long-term efficacy,the incidence of persistent/long-standing persistent AF was 5.77%(3/52)in the integrated Chinese and Western medicine cohort and 18.84%(13/69)in the Western medicine cohort,with the difference being statistically significant.Univariate logistic regression analysis indicated that age,disease duration,coexisting heart failure,and the administration of modified YQFMF might be influencing factors for the development of persistent/long-standing persistent AF in PAF patients(P<0.05).Multivariate logistic regression analysis result showed that administration of modified YQFMF was a protective factor against the progression from PAF to persistent/long-standing persistent AF(OR=0.211,95%CI(0.045～0.985),P<0.05).While age≥80 years was a risk factor(OR=6.589,95%CI(1.620～26.788),P<0.05).Conclusion Modified YQFMF combined with conventional Western medicine can effectively improve the clinical symptoms and enhance the short-term efficacy in patients with PAF and qi deficiency and blood stasis,and phlegm-heat disturbing the heart syndrome who had not undergone radiofrequency ablation.The administration of modified YQFMF may contribute to reducing the incidence of progression from PAF to persistent/long-standing persistent AF and improving long-term outcomes.
Objective To explore the mechanism of action of the Liuwei Dihuang Pill in the intervention of Alzheimer disease(AD).Methods Twenty SD rats were randomly divided into a blank serum group and a drug-containing serum group,with 10 rats in each group.The rats in the drug-containing serum group were administered Liuwei Dihuang Pill(1.18 g/kg)by gavage,whereas the rats in the blank serum group were administered an equal volume of normal saline by gavage,twice daily for 5 consecutive days,to prepare the Liuwei Dihuang Pill drug-containing serum and blank serum as the control condition.BV2 cells(mouse microglia cell line)and N2a/APP695swe cells(mouse glioma cell line,transfected with APP695swe gene)were co-cultured and divided into:vector control,glycoprotein non-metastatic melanoma protein B(GPNMB)overexpression,negative control,and the GPNMB knockdown group to investigate the effect of GPNMB on the co-culture system,whereas the blank serum,drug-containing serum,negative control-drug-containing serum,and GPNMB knockdown-drug-containing serum group were used to explore the effects and mechanisms of Liuwei Dihuang Pill drug-containing serum on the co-culture system.The lentivirus transfection method was used to infect BV2 cells with the corresponding lentivirus for 48 h.Subsequently,BV2 cells were treated with the corresponding serum for 24 h and then co-inoculated with N2a/APP695swe cells in a co-culture system.The main components of the serum containing Liuwei Dihuang Pill were analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry.The optimal volume fraction of the serum containing Liuwei Dihuang Pill was screened using the CCK-8 method.The transfection effect of GPNMB knockdown lentivirus was detected by real-time PCR and western blotting.The content of amyloid β-protein(Aβ)in the supernatant of N2a/APP695swe cells was measured by an enzyme-linked immunosorbent assay.The proliferation rate of N2a/APP695swe cells was determined by the CCK-8 method.The expression of GPNMB,a disintegrin and metalloprotease 10(ADAM10),Beclin1,the ubiquitin-binding protein p62,and the microtubule-associated protein 1 light chain 3-Ⅱ/Ⅰ(LC3-Ⅱ/Ⅰ)in BV2 cells was detected by western blotting.Results The main components of the serum containing Liuwei Dihuang Pill were trijuganone C,cornuside,rhein,D(-)-tartaric acid,fabacein,7-dehydroxypyrogallin-4-carboxylic acid,goshonoside F1,cyclo(phe-leu),6-methyladenosine,and Danshensu.The optimal volume fraction of the serum containing Liuwei Dihuang Pill was 10%.Compared with the negative control lentivirus,the GPNMB mRNA and protein expressions were decreased in the GPNMB knockdown lentivirus(P<0.05).Compared with the vector control group,the Aβ content in the supernatant of N2a/APP695swe cells was decreased,the proliferation rate of N2a/APP695swe cells was increased,the protein expression of ADAM10,Beclin1,and LC3-Ⅱ/Ⅰ in BV2 cells was increased,whereas the protein expression of p62 was decreased in the GPNMB overexpression group(P<0.05).Compared with the negative control group,the Aβ content in the supernatant of N2a/APP695swe cells was increased,the proliferation rate of N2a/APP695swe cells was decreased,the protein expression of ADAM10,Beclin1,and LC3-Ⅱ/Ⅰ in BV2 cells was decreased,and the protein expression of p62 was increased in the GPNMB knockdown group(P<0.05).Compared with the blank serum group,the Aβ content in the supernatant of N2a/APP695swe cells was decreased,the proliferation rate of N2a/APP695swe cells was increased,the protein expression of GPNMB,ADAM10,Beclin1,and LC3-Ⅱ/Ⅰ in BV2 cells was increased,and the protein expression of p62 was decreased in the drug-containing serum group and in the negative control-drug-containing serum group(P<0.05).Compared with the drug-containing serum group and the negative control-drug-containing serum group,the Aβ content in the supernatant of N2a/APP695swe cells was increased,the proliferation rate of N2a/APP695swe cells was decreased,the protein expression of GPNMB,ADAM10,Beclin1,and LC3-Ⅱ/Ⅰ in BV2 cells was decreased,and the protein expression of p62 was increased in the GPNMB knockdown-drug-containing serum group(P<0.05).Conclusion Liuwei Dihuang Pill improves autophagy function of microglia by regulating GPNMB expression,thereby clearing Aβ deposition and exerting its effect on improving AD.
PM2.5-induced lung injury has emerged as a major public health concern.Western medicine currently lacks targeted curative approaches,whereas existing research in traditional Chinese medicine(TCM)has focused primarily on localized pathological mechanisms of the lung,with insufficient attention paid to the holistic perspective of meridian-qi-blood circulation.The classical theory of"lung failure in dispersion and descent"is limited to describing abnormalities in the rhythmic flow of qi,thus failing to encompass the complex pathological state of this disease.Consequently,drawing on the qi pathway theory and considering the composite pathogenic characteristics of PM2.5,which encompasses wind,cold,dampness,turbidity,and toxicity,this paper systematically elucidates the core pathogenesis of PM2.5-induced lung injury as"obstruction of the thoracic qi pathway by turbid toxins."This disruption leads to impaired pivoting movement of qi dynamics,subsequently inducing metabolic disorders of qi,blood,and body fluids,as well as lung-collateral damage.The disease progression evolves through three distinct stages:"qi pathway obstruction-pivoting dysfunction-systemic involvement."Jingfang Baidu Powder,through its precisely balanced composition of sovereign,minister,assistant,and envoy herbs,establishes a comprehensive therapeutic system aimed at"unblocking the pathway and restoring pivoting movement of qi."This offers a novel theoretical framework for the TCM-based diagnosis and treatment of PM2.5-related lung diseases,while also expanding the modern application of classical formulations.
Explore the transformation path of traditional Chinese medicine(TCM)constitution scholarship to TCM constitution science from the three dimensions of science,health,and civilization.Clarify the elements of the modern scientific paradigm:the ontological foundation,epistemological presuppositions,and methodological norms.By introducing qi ontology,the article establishes the scientific paradigm of modern Chinese medicine,demonstrating its rationality and feasibility.The article systematically elaborates,at the levels of Chinese philosophy,TCM theory,and TCM constitution science,that TCM constitution science,rooted in qi ontology,possesses the duality of"composition-generation"and embodies the holistic worldview of the unity of heaven and mankind.The article further identifies qi as the dynamic cause of constitution formation and evolution and delineates the core research object of TCM constitution science.Then the article clarifies the essential elements and necessary requirements of a scientific hypothesis,and proposes a phenomenological hypothesis of TCM constitutional science.The hypothesis centers on the effect of internal qi,as influenced by TCM therapeutic interventions,on human constitution,establishing a bridge from TCM constitution scholarship to TCM constitution science,representing a Chinese-style originality.After briefly describing conceptual repetition and cumulative evidence,the hypothesis has been preliminarily successfully tested by the cumulative experimental evidence of external qi that modifies in vitro genetic and non-genetic life substances.
Objective To study the effects of Qixiong Zuogui Compound(QXZG)on the neural function of the aged middle cerebral artery occlusion/reperfusion(MCAO/R)rat model by regulating exosomes derived from the bone marrow mesenchymal stem cell(MSC).Methods Male SPF grade SD rats were randomly divided into five groups using a random number table.Rats were divided into five groups(n=15):young sham-operated,aged sham-operated,aged MCAO/R,blank serum-treated exosome,and medicated serum-treated exosome groups.The aged rat model was established by intraperitoneal injection of D-galactose(500 mg/kg,once daily for 8 consecutive weeks)in all groups,except for the young sham-operated group,which received the same volume of normal saline as a control condition.After the final injection,the aged MCAO/R group,blank serum-treated exosome,and medicated serum-treated exosome groups underwent MCAO/R model induction using the modified suture method,whereas the sham-operated groups underwent vascular and nervous isolation without occlusion.The exosomes were isolated by differential centrifugation and were characterized using transmission electron microscopy,nanoparticle tracking analysis,and Western blotting.At 24 h and 72 h after surgery,rats in the blank serum-treated exosome and medicated serum-treated exosome groups were injected through the tail vein with an equal volume of blank serum-treated or serum-treated exosomes containing 10%QXZG,respectively.All rats were euthanized at Day 7 after surgery.Cerebral infarct area,neurological deficit severity,and learning and memory ability were assessed by 2,3,5-triphenyltetrazolium chloride staining,Zea-Longa scoring,and the Morris water maze test,respectively.Brain histopathological morphology,Nissl body number,and neuronal dendritic spine density were observed by HE staining,Nissl staining,and Golgi-Cox staining.The expression of neuronal nuclei(NeuN)and microtubule-associated protein 2(MAP-2)were detected by immunofluorescence and Western blotting.Results Compared with the young sham-operated group,the aged sham-operated group exhibited multiple deficits,including impaired learning and memory(prolonged escape latency,reduced time spent in the target quadrant and the number of platform crossings),decreased Nissl body,and dendritic spine density,with downregulated NeuN and MAP-2 protein expressions(P<0.05).Compared with the aged sham-operated group,the aged MCAO/R group exhibited exacerbated neurological deficits,as evidenced by higher neurological deficit scores and further impaired cognitive performance(prolonged escape latency,reduced time spent in the target quadrant,and fewer platform crossings).These functional impairments were accompanied by more severe neuropathological changes,including neuronal necrosis in the infarcted tissue,decreased Nissl body,reduced dendritic spine density,and downregulated NeuN and MAP-2 protein expressions(P<0.05).In comparison with the aged MCAO/R group,both the exosomes treated with blank serum group and the exosomes treated with medicated serum group demonstrated significant therapeutic effects characterized by reduced neurological deficit scores,improved brain histopathology,increased Nissl body,shortened escape latency,prolonged time spent in the target quadrant,increased platform crossings,elevated dendritic spine density,and upregulated NeuN and MAP-2 protein expressions(P<0.05).Notably,the improvements in the medicated serum-treated exosome group were significantly superior to those observed in the blank serum-treated exosome group(P<0.05).Conclusion QXZG may ameliorate cerebral histopathological damage and neuronal injury and improve learning and memory abilities as well as neurological function in aged MCAO/R rats,by regulating bone marrow MSC-derived exosomes.
Persistent postural-perceptual dizziness(PPPD)is typically characterized by high prevalence,a complex etiology and pathogenesis,and a prolonged disease course.It is also frequently associated with anxiety and depression.PPPD originates in the brain,with its pathogenesis primarily characterized by a deficiency-excess complex.Its onset often involves the spleen,liver,and kidney.Western medical treatment lacks specific therapeutic approaches owing to its unclear pathogenesis.The"turbid pathogen disturbing clearness"theory,which summarizes the pathogenic pattern of dampness-heat turbid pathogen clouding the clear orifices,is derived from the Wenre Lun.From this perspective,the paper hypothesizes that the causative factors of PPPD involve dysfunction of the spleen,liver,and kidney owing to irregular diet,emotional disturbances,aging,and chronic illness,which leads to the internal generation of turbid pathogens such as dampness-turbidity,phlegm-turbidity,and blood stasis turbidity.The core pathogenesis is that turbid pathogens obscure the clear orifices and disturb the clear yang,leading to dysfunction of the clear orifices and to the failure of the original spirit to govern.Based on the pathological progression of the turbid pathogen,the disease is treated in three stages:incipient,exuberant,and latent.The principle of phased treatment centers on regulating the zang-fu,expelling turbid pathogens,unblocking orifices,and strengthening the body's foundations.During the incipient stage,therapy focuses on strengthening the spleen,soothing the liver,and warming the kidney to prevent the generation of turbid pathogen;during the exuberant stage,therapy emphasizes resolving phlegm,dispelling dampness,and eliminating blood stasis to restore the function of the clear orifices;during the latent stage,therapy focuses on tonifying qi and clearing the mind to support vital qi and expel the latent turbid pathogen.During clinical management,adjustments can be made based on the progression of the turbid pathogen and the characteristics of the syndrome.Using the"turbid pathogen disturbing clearness"theory to guide the treatment of PPPD can provide new perspectives and practical guidance for its clinical diagnosis and treatment in traditional Chinese medicine.
Coronary heart diseases complicated by anxiety and depression are clinically prevalent dual-disease condition.As independent risk factors for coronary heart diseases,anxiety and depression exert severe negative impacts on patients' quality of life and long-term prognosis.Recurrent coronary heart diseases episodes further exacerbate patients' anxiety and depressive symptoms.Therefore,actively identifying and scientifically intervening in anxiety and depression holds significant value for reducing adverse events in coronary heart diseases.In traditional Chinese medicine theory,coronary heart disease and anxiety-depression fall under the categories of"chest obstruction"and"depression-related disorders"respectively.Their coexistence can lead to concurrent disorders of the"physical heart"and the"spiritual heart".Clinical treatment for such conditions often follows the principle of treating both mind and body.Guided by theory of"collapsed vital energy",this paper systematically explores the pathogenesis and diagnostic-therapeutic approach for coronary heart diseases complicated by anxiety and depression,integrating TCM theory with clinical practice.Our research team proposes that the initial stage centers on deficiency of vital energy in the chest,where weakened vital energy fails to support the heart meridian,leading to inadequate nourishment—characterized by insufficient vital energy and impaired heart meridian support.As the disease progresses,it involves the heart and lungs,impairing their regulatory functions and disrupting the ascending and descending movements of qi.This leads to the internal generation of phlegm and stasis,which obstruct the heart vessels and cause mental restlessness.The pathogenesis at this stage is stagnation of qi and blood,with phlegm and stasis obstruction.Prolonged disease ultimately results in depletion of qi and instability of the soul.Clinical treatment must closely follow the progression of pathogenesis,adhering to the overarching principle of fortifying healthy qi and expelling pathogenic factors.Medication should be administered in stages:In the initial stage,the therapeutic principle is to lift and tonify the vital qi to support the heart meridian using Shengxian Decoction with appropriate modifications.During progression,the approach involves nourishing qi to enrich the vessels,clearing phlegm,and unblocking obstructions using modified Yiqi Huayu Decoction combined with Erchen Decoction.In the terminal stage,when the condition is critical,increasing yang,lifting sinking qi,and stabilizing the spirit are prioritized using modified Guizhi Gancao Longgu Muli Decoction combined with Suanzao Ren Decoction.
Objective To investigate the mechanism of action of icariin in regulating ferroptosis in colon cancer cells via the mouse double minute 2(MDM2)/tumor protein 53(P53)/solute carrier family 7,member 11(SLC7A11)signaling pathway.Methods The core target of iicariin to promote ferroptosis in colon cancer cells was predicted and verified using network pharmacology and molecular docking.The experiment included the vehicle control group,icariin low-concentration group(5 μmol/L),icariin medium-concentration group(15 μmol/L),and icariin high-concentration group(25 μmol/L),ferroptosis promoter group,empty vector control group,MDM2 overexpression group,and MDM2 overexpression+icariin medium-concentration group.The MDM2 overexpression and control plasmids were transfected into human colon cancer HCT116 cells.Cell proliferation was assessed using the CCK-8 assay.The concentration of Fe2+,glutathione(GSH),and malonaldehyde(MDA)was detected using cobrimetric method,microplate method and TBA method.The expression level of reactive oxygen species(ROS)was detected using immunofluorescence.The expression level of MDM2,P53,SLC7A11,PTGS2,and GPX4 protein and mRNA was detected using western blotting and RT-qPCR,respectively.Results The 12 targets of icariin affecting ferroptosis in colon cancer were identified by network pharmacology,among which 4 core targets were MDM2,EGFR,PARP1,and SRC.Icariin has a good binding activity with MDM2 was revealed by molecular docking.Icariin regulates ferroptosis in colon cancer cells through MDM2.Compared with the vehicle control group,the proliferative activity,GSH concentration,MDM2,SLC7A11,and GPX4 protein and mRNA expression of cells decreased in the icariin medium-concentration and high-concentration groups(P<0.01);MDA and Fe2+concentrations,ROS levels,and P53 and PTGS2 protein and mRNA expression increased in the icariin medium-concentration and high-concentration groups(P<0.05,P<0.01).Compared with the MDM2 overexpression group,cell proliferative activity,GSH concentration,MDM2,SLC7A11,and GPX4 protein and mRNA expression decreased in the MDM2 overexpression+icariin medium-concentration group(P<0.01);MDA and Fe2+concentrations,ROS levels,and P53 and PTGS2 protein and mRNA expression increased in the MDM2 overexpression+icariin medium-concentration group(P<0.05,P<0.01).Conclusion Icariin can promote ferroptosis in human colon cancer HCT116 cells,and its mechanism may involve inhibiting MDM2 expression and regulating the MDM2/P53/SLC7A11 signaling pathway.
Objective To explore the clinical characteristics of patients with large-artery atherosclerosis type(LAA)and non-LAA with phlegm-heat syndrome in acute ischemic stroke and to provide a reference for the treatment of this disease.Methods Based on the China Stroke Registry for Patients with Traditional Chinese Medicine registration platform,a cross-sectional study was conducted to enroll patients with acute ischemic stroke and phlegm-heat syndrome with clear etiological classification from September 2022 to February 2025.The patients were divided into the LAA and non-LAA groups,and the demographic data,four traditional Chinese medicine(TCM)diagnosis information,neurological deficits,and laboratory indicators of the two groups were compared.Results A total of 196 patients were enrolled,with 110 and 86 patients in the LAA and non-LAA groups,respectively.No significant differences in age,sex,and modified Rankin Scale score at admission were observed between the two groups(P>0.05).In terms of TCM clinical manifestation,the frequency of weakness(81/110,73.64%),deep-colored urine(48/110,43.64%),choking cough after drinking(35/110,31.82%)in the LAA group were significantly higher than those in the non-LAA group(P<0.05):weakness(49/86,56.98%),deep-colored urine(24/86,27.91%),and choking cough after drinking(15/86,17.44%).Among tongue and pulse manifestations,cyanotic sublingual vessels(51/110,46.36%)were significantly more common in the LAA group than in the non-LAA group(26/86,30.23%).In contrast,petechia or ecchymosis on the tongue was significantly lower in the LAA group(13/110,11.82%)than in the non-LAA group(21/86,24.42%)(P<0.05).No significant differences in stroke severity or scores were observed between the two groups(P>0.05),nor were any significant differences in laboratory parameters(P>0.05).Conclusion Significant differences were observed in some TCM clinical manifestation and tongue and pulse manifestations between the LAA and non-LAA groups in patients with acute ischemic stroke with phlegm-heat syndrome.The incidence of weakness,deep-colored urine,choking cough after drinking,and cyanotic sublingual vessels is higher in the LAA group,whereas the incidence of petechia or ecchymosis on the tongue is relatively higher in the non-LAA group.These results provide a reference for the clinical diagnosis and treatment of the disease.
"Pan-nodules" refer to the comorbidity phenomenon in which multiple organ nodules
This study examines 419 related terms from the Huangdi Neijing using a corpus-driven approach combined with cognitive semantics to analyze their precise meanings and connections
Objective To investigate the effects of ionizing radiation on Sertoli cell glycolytic energy supply function and the protective mechanism of Yiqi Jiedu Formula(YQJDF).Methods Sixty Sprague-Dawley rats were randomly assigned to the blank(n=24),Anduolin(n=12),YQJDF high-dose(n=12),and YQJDF low-dose(n=12)groups using the random number table method.The groups received intragastric administration of deionized water,Anduolin suspension(0.35 g/kg),YQJDF high-dose(10.44 g/kg),and YQJDF low-dose(5.22 g/kg)at 10 mL/kg once daily for 5 days,respectively.Prepared corresponding serum,and used high-performance liquid chromatography-mass spectrometry(HPLC-MS)to detect the drug components in the drug-containing serum.Subsequently,cellular experiments were performed.(1)Used the GC-2 spermatocytes to establish normal control group,model control group,and lactic acid intervention series(2,4,5,6,8,10,16,and 20 mmol/L).All groups were cultured in medium containing 10%blank serum.After pretreatment with the corresponding serum,all groups except the normal control group were irradiated with 12 Gy 60 Co γ-rays to establish a GC-2 radiation injury model.Cell viability was assessed using the CCK-8 assay at 24 h post-irradiation.(2)Used mouse testicular Sertoli cell line TM4 to establish normal control(10%blank serum),model control(10%blank serum),Anduolin-containing serum(10%Anduolin-containing serum),YQJDF high-dose-containing serum(10%YQJDF high-dose-containing serum),and YQJDF low-dose-containing serum groups(10%YQJDF low-dose-containing serum).After pretreatment with the corresponding serum,all groups except the normal control group were irradiated with 12 Gy 60 Co γ-rays,with analyses at 24 h post-irradiation.Used colorimetry to detect lactic acid content,lactate dehydrogenase(LDH)activity,pyruvate,phosphofructokinase(PFK)activity,and adenosine triphosphate(ATP)content.The glycolysis rate and maximum glycolysis capacity were measured using an Aligent Seahorse XF Pro XFe 96 Extracellular Flux Analyzer.Monocarboxylate transporter 4(MCT4)and glucose transporter 1(GLUT1)expression was determined using immunofluorescence.(3)Based on the experiment(2)group,set up an additional wortmannin group(10%blank serum).Used colorimetry to detect lactic acid content of TM4 cells.Phosphatidylinositol 3-kinase 85 kDa regulatory subunit alpha(PI3K p85α),protein kinase B(Akt),and phosphorylated Akt(p-Akt)expressions were detected using western blotting,with that of p-Akt further confirmed using immunofluorescence.Results Chlorogenic acid,albiflorin,and ginsenosides(Re,Rg1,Rg6)were detected as the main active components in the YQJDF-containing seurm.In the experiment(1),compared with the normal control group,cell viability was reduced in the model control group(P<0.01).Compared with the model control group,cell viability was increased in the 4,5,6,8,and 10 mmol/L lactic acid intervention groups(P<0.05,P<0.01);however,cell viability decreased in the 20 mmol/L lactic acid group(P<0.01).In the experiment(2),compared with the normal control group,the lactic acid content,LDH activity,MCT4 expression,glycolysis rate,GLUT1 expression,PFK activity,pyruvate content,and ATP content were all decreased in the model control group(P<0.05,P<0.01).Compared with the model control group,the lactic acid content,LDH activity,MCT4 expression,glycolysis rate,GLUT1 expression,PFK activity,pyruvate content,and ATP content were all increased in YQJDF high-dose-containing serum group(P<0.05,P<0.01).In the experiment(3),compared with the normal control group,model control group and wortmannin group showed reductions in lactic acid content and p-Akt expression,model control group showed reductions in PI3K p85α expression and p-Akt/Akt ratio(P<0.05,P<0.01).Compared with the model control group,YQJDF low-dose-containing serum group showed increased lactic acid content and p-Akt expression(P<0.01).Conclusion Ionizing radiation impairs the glycolytic capacity and lactate secretion of Sertoli cells by inhibiting the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway and downregulating the expression and activity of key glycolytic enzymes/proteins,including GLUT1,PFK,LDH,and MCT4,resulting in an insufficient energy supply to spermatogenic cells.In contrast,YQJDF restores glucose uptake,glycolytic capacity,and energy supply in Sertoli cells by activating the PI3K/Akt pathway.
Objective To evaluate the effect of integrated traditional Chinese medicine(TCM)and western medicine therapy(WM)(TCM-WM)on the survival of patients with peritoneal metastasis of colorectal cancer(CRC-PM).Methods A retrospective cohort study was conducted using medical records of patients diagnosed with CRC-PM from four tertiary Grade A hospitals between August 2013 and December 2022.The patients were assigned to either the TCM-WM or WM cohorts based on whether they received continuous TCM therapy for≥3 months.The primary endpoint was overall survival.Secondary endpoints included the 3-year cumulative survival rate(3-Y CSR)and progression-free survival after first-line therapy.Subgroup analysis was performed using age,sex,the anatomical site of the primary tumor,and RAS/BRAF mutation status(mutant or wild-type)as grouping variables.Finally,treatment method,age,and local therapy status were included as covariates in a multivariate Cox regression model to assess their effect on patient survival.Results A total of 129 patients with CRC-PM were included,with 46 and 83 patients in the TCM-WM and WM cohorts,respectively.The median overall survival time was 30.4 and 23.3 months in the TCM-WM and WM cohorts,respectively,with a significant difference[HR=0.53,95%CI(0.36,0.79),P<0.01].3-Y CSR were 32.61%and 14.46%in the TCM-WM and WM cohorts,respectively,with a significant difference(P<0.05).Subgroup analyses demonstrated a significant survival benefit associated with TCM-WM in the following subgroups:male[HR=0.41,95%CI(0.24,0.70)],age<65 years[HR=0.50,95%CI(0.29,0.83)],right-sided colon cancer[HR=0.42,95%CI(0.20,0.82)],left-sided colon cancer[HR=0.56,95%CI(0.34,0.93)],and those with RAS/BRAF mutations[HR=0.56,95%CI(0.33,0.92)](all P<0.05).Multivariate Cox regression analysis demonstrated that after adjusting for age and receipt of local therapy,TCM-WM significantly prolonged survival time compared with WM alone[adjusted HR=0.51,95%CI(0.34,0.76),P<0.01].Conclusion TCM-WM significantly prolongs survival and reduces the risk of death in patients with CRC-PM.
"Avoiding pathogenic influences and damaging winds in due season"is a concise yet inclusive scripture in Huangdi Neijing that not only focuses on avoiding pathogenic qi in the four seasons but is also explained from the two perspectives of"three deficiencies"and"eight cardinal directions."First,in terms of"three deficiencies,"in the year of overrestraint,we should avoid the conquest of abnormal changes of climate from the first to third qi,and avoid the retaliation of abnormal changes of climate from the fourth qi to last;second,on the first day of each lunar month and one to two days before and after,the human body is in a weak state under the influence of the moon;therefore,deficient nature pathogens should be avoided.Third,when the solar terms are exchanged,climate changes should be observed to anticipate them.In terms of"eight cardinal directions,"we should prevent abnormal wind and rain,which come early or late around the eight solar terms(Beginning of Spring,the Spring Equinox,the Beginning of Summer,the Summer Solstice,the Beginning of Autumn,the Autumn Equinox,the Beginning of Winter,and the Winter Solstice).In contrast,especially on the day of the eight solar terms,the wind coming from the opposite direction of the corresponding solar terms should be paid attention to,as this wind is violent and easily opens the pores to cause disease.Therefore,it is necessary to stay indoors on such days.Additionally,the wind,coming from the rest of the six directions in addition to the direction and the opposite direction of the corresponding solar terms,on the first day of the first month of the lunar calendar,is regarded as the basis for predicting the prevalence of diseases of the coming year,which also needs special attention.Therefore,"avoiding pathogenic influences and damaging winds in due season"must be deeply interpreted to fully use the Huangdi Neijing to prevent and treat diseases.
