BackgroundRenal fibrosis is a hallmark and the final outcome of chronic kidney disease (CKD). Jingtian Granule (JT), a traditional formula used in the clinical treatment of CKD for many years. However, the mechanism of action of JT against renal interstitial fibrosis remain unknown.ObjectiveThis study aimed to explore the potential effects and mechanisms of JT on adenine - diet - induced CKD in mice.MethodsRenal interstitial fibrosis was induced in mice by adenine - diet and treated with JT. Renal function was assessed by measuring blood urea nitrogen and serum creatinine levels. Masson’s staining and type I collagen expression were used to evaluate renal collagen deposition. RNA sequencing was used to analyze the expression levels of mRNA in mouse kidney samples after JT treatment. The levels of glutathione (GSH) and malondialdehyde (MDA) were measured to assess lipid peroxidation in the kidneys. Iron metabolism levels were detected by Prussian blue staining and measurement of iron content. The protein levels of SIRT3, P53, glutathione peroxidase 4 (GPX4), and solute carrier family 7 member 11 (SLC7A11) were detected by Western blot. Subsequently, under the premise of SIRT3 knockout, renal function, fibrosis level, iron metabolism level, and lipid peroxidation level were detected, and mitochondrial damage was observed by transmission electron microscope (TEM). In addition, human proximal tubule epithelial cells (HK - 2) were treated with Erastin to induce ferroptosis, followed by exposure to JT. The levels of reactive oxygen species (ROS) were detected.ResultsJT significantly reduced collagen deposition in the kidneys. RNA sequencing identified 20 mRNAs that were differentially expressed in response to JT treatment. Bioinformatics analysis revealed that SIRT3 was a key mRNA regulated by JT. JT activated SIRT3 in fibrotic kidneys to inhibit the acetylation of P53. Under the premise of SIRT3 knockout, JT did not show significant therapeutic effects in inhibiting ferroptosis and fibrosis. In vitro experiments also showed that JT promoted the downregulation of ROS.ConclusionSIRT3 is the key ferroptosis - related mRNA regulated by JT. The ability of JT to modulate the SIRT3/P53 signaling pathway may be a viable approach for the treatment of renal interstitial fibrosis.

ObjectiveTo explore and compare the therapeutic effects and underlying mechanisms of Qingfei Dayuan Granules (QFDYGs) and Qingfei Dayuan Decoctions (QFDYDs) for the treatment of acute lung injury (ALI), focusing on the modulation of the TLR4 signaling pathway, intestinal microbiota, and related metabolic pathways.MethodsThe active metabolite contents were measured by ultrahigh-performance liquid chromatography. A mouse model of lipopolysaccharide-induced ALI (tracheal instillation) was used to assess efficacy. After drug administration, lung tissue damage was analyzed by hematoxylin-eosin staining and quantification of inflammatory cytokines and oxidative stress biomarkers with enzyme-linked immunosorbent assays. Components of the TLR4 signaling pathway were quantified by Western blot analysis. Intestinal flora regulation was assessed by 16S rRNA sequencing with metabolic pathway analysis via metabolomics. Multivariate statistical methods were applied to analyze differences in gut microbiota and metabolites between groups.ResultsLevels of eight metabolites were 2.44–3.74 times greater following treatment with QFDYGs vs. QFDYDs, although both demonstrated significant protective effects against pulmonary inflammation through TLR4 signaling pathway modulation, gut microbiota restoration, and metabolic regulation. QFDYDs more effectively suppressed production of the pro-inflammatory cytokines TNF-α and IL-1β, while QFDYGs exhibited superior capability to reduce malondialdehyde levels and restore glutathione, catalase, and superoxide dismutase activities. QFDYGs demonstrated greater inhibition of the TLR4-TRIF/MyD88-NF-κB-NLRP3 signaling pathway, whereas QFDYDs more effectively normalized lung injury-induced metabolic changes. Both formulations significantly modulated metabolic pathways, as evidenced by sustained changes to 11 key metabolites, and improved intestinal microbiota composition and functionality.ConclusionBoth QFDYGs and QFDYDs offer protection against ALI. QFDYGs could serve as effective alternatives to QFDYDs, with equivalent or potentially superior therapeutic effects. The choice between QFDYGs and QFDYDs should be guided by specific clinical presentations and therapeutic goals.

Qing-fei-da-yuan granules (QFDYGs) had been proved to be an effective TCM prescription for treating coronavirus disease 2019 (COVID-19), which are composed of a variety of TCMs, and characterized by multiple components, multiple targets and overall regulation. It is meaningful to further study the chemical composition and pharmacology of QFDYGs for quality evaluation. However, due to the complexity of the components of QFDYGs, there are no reliable and simple analytical methods for current quality evaluation. In this work, antipyretic activity assessment of QFDYGs in the LPS-induced New Zealand rabbit model was carried out to verify the efficacy firstly. It was proved that QFDYGs can be used to relieve fever to help preventing or controlling the prevalence of influenza and pneumonia. Subsequently, UHPLC-ESI-QTOF-MS/MS combined with network pharmacology, quality markers and fingerprint analysis were used to establish the quality control condition. The chemical compositions were analyzed by UHPLC-ESI-QTOF-MS/MS, and 79 of them were identified, such as arecoline, mangiferin, paeoniflorin, etc. Then, the network pharmacology strategy based on 45 candidate components (CCs) in conjunction with influenza and pneumonia diseases was employed to screen the potential active ingredients. According to the drug-CCs-genes-diseases (D-CCs-G-D) networks, baicalein, honokiol, baicalin, paeoniflorin, saikosaponin A, glycyrrhizic acid and hesperidin were selected as quality markers. And a method for content determination of the 7 quality markers was established by optimizing extraction methods, chromatographic conditions and methodological verification. Finally, the quality of 15 batches of QFDYGs was evaluated by using the 7 quality markers combined with fingerprints and principal component analysis (PCA). The analyzed results showed that baicalin, paeoniflorin, glycyrrhizic acid and hesperidin were the high content and stable quality markers. QFDYGs were characterized by overall consistency and individual ingredient differences among the 15 batches. Our quality evaluation study will provide reference for the further development and research of QFDYGs.

BACKGROUND:Clinical studies have confirmed that Qingfei Dayuan (QFDY) granules are effective in the treatment of influenza and upper respiratory tract infections (URTIs) caused by pulmonary heat-toxin syndrome (PHTS). Granules of Chinese medicine formulations have become a widely used dosage form in clinical practice. With the continuous optimization of extraction technology, the advantages of Chinese medicine granules have been gradually demonstrated, but the price of Chinese medicine granules is generally higher than that of traditional dosage forms of Chinese medicine, and we support the rational use of the appropriate dosage of QFDY for patients with these conditions. Therefore, we set up half of the conventional dose as the low dose group, and designed the three-arm study to rigorously compare the efficacy difference of low-dose QFDY, QFDY and the placebo group, with the expectation of providing scientific support for the rational selection of the dose and the safe and effective use of the medicine in clinical practice. METHODS:We recruited 108 patients with clinical diagnoses of influenza and URTIs caused by PHTS to receive treatment at six hospitals in Hubei, China. Using a centralized randomization system, patients were randomly assigned at a 1:1:1 ratio to the QFDY, low-dose QFDY, or placebo control groups to receive the corresponding drug, and the study physicians, subjects, outcome assessors, and statisticians were unaware of group assignments. The primary outcome was the time to complete fever relief. Secondary outcomes included the efficacy of Chinese medicine in alleviating signs and symptoms and the disappearance rate of individual symptoms. Adverse events were monitored throughout the trial. RESULTS:A total of 108 patients were recruited. A total of 106 patients were included in the full analysis set (FAS). In the FAS analysis, there was no statistically significant difference in baseline of the three groups before treatment (P > 0.05). 1. Regarding the median time to complete fever relief, the QFDY, low-dose QFDY and placebo groups had median times of 26 h, 40 h and 48 h, respectively. The QFDY group had a shorter time to complete fever relief than the placebo group, and the difference was statistically significant (P < 0.05), while the low-dose QFDY group had a shorter time than the placebo group, but the difference was not statistically significant (P > 0.05). 2. In terms of the total efficacy of Chinese medicine in alleviating symptoms at the end of three full days of treatment, as well as the cure rate of red and sore throat, stuffy and runny nose, and sneezing, QFDY and low-dose QFDY were superior to the placebo, and the differences were statistically significant (P < 0.01). There was no statistical significance in the comparison between the QFDY group and the low-dose QFDY group (P > 0.05). 3. In terms of the headache cure rate after three full days of treatment, QFDY was superior to the placebo, with a statistically significant difference (P < 0.05), and there was no significant efficacy of low-dose QFDY. 4. Safety comparisons showed no serious adverse events and 30 minor adverse events, which were not clinically considered to be related to the drug and were not statistically significant. CONCLUSIONS:In the treatment of patients with influenza and URTIs caused by PHTS, which are mainly characterized by clinical symptoms such as red and sore throat, stuffy and runny nose, and sneezing, when fever is not obvious or low-grade fever is present, the use of low-dose QFDY to simply alleviate the clinical symptoms is recommended and preferred. Moreover, with its good safety profile, QFDY can be used in the treatment of patients with influenza and URTIs caused by PHTS, which can effectively shorten the duration of fever, significantly increase the total efficacy of Chinese medicine in alleviating symptoms after 3 days of treatment, and accelerate the recovery of symptoms such as red and sore throat, stuffy and runny nose, sneezing, and headache, etc. Clinical Trial Registration: http://www.chictr.org.cn. TRIAL NUMBER:ChiCTR2100043449. Registered on 18 February 2021.

介绍梅国强教授治疗小儿疳积的经验,分析疳积证的主要病因病机.梅国强教授认为小儿脏腑娇嫩,脾常不足是疳积的基本病因,脾胃运化受阻是其基本病机;另强调辨清虚实,重视小儿肝常有余的生理特性,气有余便是火,易致肝郁化火乘脾,愈加伤及脾胃;临证时,梅国强教授运用"轻可去实"法治疗小儿疳积,善用轻清之品,以祛浊气、运脾气,攻补兼施,见解独到;另重点将小儿"脾不足"与"肝有余"有机结合,疗效显著.

OBJECTIVE:To evaluate the effectiveness and safety of Xiangsha Liujun pills on the decreased digestive function in patients in the recovery phase of the Coronavirus disease 2019 (COVID-19).METHODS:A randomized, double blind, placebo controlled clinical trial was conducted. A total of 200 COVID-19 patients in the recovery phase were included in our study in Ezhou Hospital of Traditional Chinese Medicine. Totally 200 subjects were randomly divided into a treatment group (Xiangsha Liujun pills) and a control group (placebo), with 100 in each group. Subjects took Xiangsha Liujun pills or placebo orally three times a day for two weeks. Three visits were scheduled at week 0 (baseline), week 1 (the middle of the intervention) and week 2 (the end of the intervention) for each eligible patient. The total efficacy rates for improving the Traditional Chinese Medicine (TCM) symptoms (fatigue, poor appetite, abdominal distension and loose stools) and the disappearance rates of symptoms were observed and compared in the treatment and control groups. Adverse events were recorded during the study period. SAS 9.4 was used to analyze the data.RESULTS:A total of 200 patients were included in this study, among which 4 participants withdrew because the drugs did not work. Three patients were excluded for age. Before the treatment, there was no significant difference between the TCM symptoms scores of subjects. After 1 week of treatment, the full analysis set (FAS) showed that the efficacy rates for abdominal distension and loose stools in the treatment group were significantly higher than the control group ( 0.05). There were no significant differences in the efficacy rates for fatigue and poor appetite between the two groups (0.05). In addition, the disappearance rate of fatigue in the treatment group was significantly higher than the control group (0.05); there were no significant differences between the two groups after treatment in the rates of poor appetite, abdominal distension, and loose stools (>0.05). After 2 weeks of treatment, the efficacy rates for fatigue, poor appetite, abdominal distension, and loose stools in the treatment group were significantly higher than the control group (0.05). The disappearance rate of loose stools in the treatment group was significantly higher than the control group ( 0.05). However, there were no significant differences in the disappearance rates of fatigue, poor appetite, and abdominal distension between the two groups ( 0.05). No severe adverse events were reported by subjects during the study.CONCLUSIONS:This clinical study confirmed that Xiangsha Liujun pills can effectively improve the symptoms related to the decreased digestive function in COVID-19 convalescent patients.

通过分析仝小林院士提出的"以病为先,以态为基,以靶为参"这一全新的中医特色辨治模式的内涵,探索将态靶辨证理论应用于肾病的辨证与治疗,以期提高临床治疗肾病疗效的精确性、靶向性.参照现代医学对肾病发病机制的认识,把握本病整个发展阶段中的核心病因病机,提出肾病中医态的发展演变规律即邪结态→肾虚态→络瘀态.邪结态可分为风热郁结证、水湿蕴结证;肾虚态可分为肾气虚证、肾阴虚证、肾阳虚证、肾阴阳两虚证;络瘀态可分为瘀热阻络证、瘀毒阻络证、痰瘀阻络证.并据此确立治法处方,同时结合中药药理学研究成果,筛选出针对症靶、标靶的多种靶药,辨态识靶,态靶同调,标本兼治,以提高临床疗效.

目的:探究加味大黄附子汤保护慢性肾脏病小鼠的认知功能及其机制.方法:采用0.2％腺嘌呤饲料喂养5周建立慢性肾脏病模型,成功建模后将小鼠随机分为模型组,加味大黄附子汤低、中、高剂量组(低、中、高剂量组),加味大黄附子汤高剂量+Wnt/β-环形蛋白(β-catenin)信号通路抑制剂(IWR-I)组(高剂量+IWR-I组),每组各10只,另取10只正常C57BL/6小鼠作对照组.低、中、高剂量组分别灌胃8、16、24 g/kg加味大黄附子汤,高剂量+IWR-I组灌胃24 g/kg加味大黄附子汤+腹腔注射5 mg/kg IWR-I.采用Morris水迷宫实验评价小鼠认知功能,眼眶取血检测血清肌酐、尿素氮、乙酰胆碱酯酶(AChE)和胆碱乙酰转移酶(ChAT)水平,HE染色观察肾脏及脑组织病理学变化,Western blot法检测脑组织Wnt3a、β-cate-nin蛋白表达.结果:与模型组比较,中、高剂量组第3～5天逃避潜伏期、血清肌酐、尿素氮、AChE水平均降低,穿越平台次数、ChAT、脑组织中Wnt3a、β-catenin蛋白表达水平均升高(P<0.05);与高剂量组比较,高剂量+IWR-I组第2～5天逃避潜伏期、肌酐、尿素氮、AChE水平均升高,穿越平台次数、ChAT、脑组织中Wnt3a、β-catenin蛋白表达水平均降低(P<0.05).结论:加味大黄附子汤可改善慢性肾脏病小鼠认知功能,其作用可能与激活Wnt/β-catenin信号通路有关.

OBJECTIVE To study the efficacy of Xiaoyao capsule in improving the clinical symptoms of sleep and mood disorders during recovery from coronavirus disease 2019 (COVID-19). METHODS The study cohort comprised 200 patients with sleep and mood disorders during recovery from COVID-19. Patients were randomized into the control group and the experimental group in a 1:1 ratio by blocked randomization. The patients received either Xiaoyao capsule (experimental group) or a placebo Xiaoyao capsule (control group) for 2 weeks. The improvements in the Traditional Chinese Medicine (TCM) syndrome scales, total effective rates, and disappearance rates of irritability, anxiety, and poor sleep were compared between the two groups. RESULTS The TCM syndrome pattern scales, total effective rates, and disappearance rates of irritability, anxiety, and poor sleep did not significantly differ between the experimental group versus the control group in the full analysis set and the per protocol set after 1 and 2 weeks of treatment ( > 0.05). CONCLUSIONS Xiaoyao capsule do not significantly improve the clinical symptoms of sleep and mood disorders in patients in recovery from COVID-19.

OBJECTIVE: To evaluate the effectiveness and safety of Jinshuibao capsules (kzI M theta Sc ), a Traditional Chinese Medicine (TCM), in the treatment of residual cardiopulmonary symptoms in convalescent corona virus disease 2019 (COVID-19) patients.METHODS: A total of 200 participants with COVID-19 in convalescence phase were randomly assigned into two groups at a 1:1 ratio in this multicenter randomized, double-blind, placebo-controlled trial. One group received Jinshuibao capsules, and the other received placebo. The patients were followed up at one and two weeks of treatment. Five symptoms (dry cough, shortness of breath, sweating, chest tightness and palpitation) improvement rates and full recovery rates were compared.RESULTS: All baseline characteristics were comparable between the two groups. After two weeks of treatment, symptom improvement rates for dry cough (74.00% vs 50.00%, P = 0.015), shortness of breath (78.95% vs 46.15%, P < 0.001), sweating (80.00% vs 57.75%, P = 0.004), chest tightness (87.06% vs 60.47%, P < 0.001) and palpitation (82.50% vs 64.56%, P = 0.010) were significantly higher in the Jinshuibao group compared with the control group. Meanwhile, Jinshuibao capsules treatment also displayed more satisfactory full recovery rates of all five symptoms (dry cough 58.00% vs 19.57%, shortness of breath 18.95% vs 7.69%, sweating 36.00% vs 19.72%, chest tightness 32.94% vs 13.95%, and palpitation 48.75% vs 29.11%) in participants with COVID-19 in convalescence phase compared with the control group (P < 0.05). No severe adverse events were reported in either group.CONCLUSIONS: Jinshuibao capsules have the potential to improve residual cardiopulmonary symptoms in convalescent COVID-19 patients, with few adverse events.(c) 2023 JTCM. All rights reserved.

Background: Patients diagnosed with influenza and upper respiratory tract infections (URTIs) have similar clinical manifestations and biochemical indices and a low detection rate of viral pathogens, mixed infection with diverse respiratory viruses, and targeted antiviral treatment difficulty in the early stage. According to the treatment strategy of “homotherapy for heteropathy” in traditional Chinese medicine (TCM), different diseases with the same clinical symptoms can be treated with the same medicines. Qingfei Dayuan granules (QFDY), a type of Chinese herbal preparation included in the TCM Diagnosis and Treatment Protocol for COVID-19 of Hubei Province issued by the Health Commission of Hubei Province in 2021, are recommended for patients suffering from COVID-19 with symptoms of fever, cough, and fatigue, among others. Additionally, recent studies have shown that QFDY effectively alleviates fever, cough, and other clinical symptoms in patients with influenza and URTIs.Materials and methods: The study was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial for treatment for influenza and URTIs manifested by pulmonary heat-toxin syndrome (PHTS) with QFDY. A total of 220 eligible patients were enrolled from eight first-class hospitals in five cities of Hubei Province in China and randomly assigned to receive either 15 g of QFDY or a placebo three times a day for 5 days. The primary outcome was the complete fever relief time. Secondary outcomes included efficacy evaluation of TCM syndromes, scores of TCM syndromes, cure rate of each single symptom, incidence of comorbidities and progression to severe conditions, combined medications, and laboratory tests. Safety evaluations mainly involved adverse events (AEs) and changes in vital signs during the study.Results: Compared with the placebo group, the complete fever relief time was shorter in the QFDY group, 24 h (12.0, 48.0) in the full analysis set (FAS) and 24 h (12.0, 49.5) in the per-protocol set (PPS) (p ≤ 0.001). After a 3-day treatment, the clinical recovery rate (22.3% in the FAS and 21.6% in the PPS) and cure rate of cough (38.6% in the FAS and 37.9% in the PPS), a stuffy and running nose, and sneezing (60.0% in the FAS and 59.5% in the PPS) in the QFDY group were higher than those in the placebo group (p < 0.05). The number of patients taking antibiotics for more than 24 h in the placebo group (nine cases) was significantly higher than that in the QFDY group (one case) (p < 0.05). There were no significant differences between the two groups in terms of scores of TCM syndromes, incidence of comorbidities or progression to severe conditions, combined use of acetaminophen tablets or phlegm-resolving medicines, and laboratory tests (p > 0.05). Meanwhile, no significant difference was found in the incidence of AEs and vital signs between the two groups (p > 0.05).Conclusion: The trial showed that QFDY was an effective and safe treatment modality for influenza and URTIs manifested by PHTS because it shortened the complete fever relief time, accelerated clinical recovery, and alleviated symptoms such as cough, a stuffy and running nose, and sneezing during the course of treatment.Clinical trial registration:https://www.chictr.org.cn/showproj.aspx?proj=131702, identifier ChiCTR2100049695.

Renal fibrosis is a major pathological feature of chronic kidney disease (CKD). While emodin is reported to elicit anti-fibrotic effects on renal injury, little is known about its effects on microRNA (miRNA)-modulated mechanisms in renal fibrosis. In this study, we established a unilateral ureteral obstruction (UUO) model and a transforming growth factor (TGF)-β1-induced normal rat renal tubular epithelial cell line (NRK-52E) model to investigate the protective effects of emodin on renal fibrosis and its miRNA/target gene mechanisms. Dual-luciferase assay was performed to confirm the direct binding of miRNA and target genes in HEK293 cells. Results showed that oral administration of emodin significantly ameliorated the loss of body weight and the increase in physicochemical parameters, including serum uric acid, creatinine, and urea nitrogen in UUO mice. Inflammatory cytokines, including tumor necrosis factor-α, monocyte chemoattractant protein-1, and interleukin (IL)-1β, but not IL-6, were down-regulated by emodin administration. Emodin decreased the expression levels of TGF-β1 and fibrotic-related proteins, including alpha-smooth muscle actin, Collagen IV, and Fibronectin, and increased the expression of E-cadherin. Furthermore, miR-490-3p was decreased in UUO mice and negatively correlated with increased expression of high migration protein A2 (HMGA2). We further confirmed HMGA2 was the target of miR-490-3p. Transfection of miR-490-3p mimics decreased, while transfection of miR-490-3p inhibitors increased fibrotic-related proteins and HMGA2 expression levels in TGF-β1-induced NRK-52E cells. Furthermore, transfection of miR-490-3p mimics enhanced the anti-fibrotic effects of emodin, while transfection of miR-490-3p inhibitors abolished the protective effects of emodin. Thus, as a novel target of emodin that prevents renal fibrosis in the HMGA2-dependent signaling pathway, miR-490-3p has potential implications in CKD pathology.

总结巴元明教授基于"水石互结"理论运用五苓二金汤治疗肾积水的临证经验.认为肾积水为"蓄水"的微观之证,病机为水饮内停,下焦湿热,治疗当以化气行水,清热利湿为主,方用五苓散化裁即自拟五苓二金汤,并随证灵活加减,疗效显著.

慢性肾炎是临床较为常见的一种泌尿系统疾病,其发病隐匿、病程较长、病情缠绵,常伴有不同程度的肾功能损害.现代医学对于导致慢性肾炎的原因、发病机制尚不明确,且对于治疗本病无特效手段.中医药在治疗慢性肾炎、改善患者临床症状及延缓肾功能进展方面具有一定的疗效.中医学认为慢性肾炎属于"风水""水肿""肾风""血尿"等范畴,以水肿、血尿、蛋白尿、高血压等为主要临床表现,邪伏肾络是其中较为常见的一种证型.仝小林院士根据其多年丰富的临床经验,结合现代医学理论,创造性的提出"态靶辨证"辨证组方理论,对于治疗邪伏肾络型慢性肾炎具有较好的治疗效果,仝教授以"邪伏肾络"为态,高血压、水肿、蛋白尿、血尿等为靶,升降散疏风透邪、升清降浊、活血通络为靶方,金银花、连翘、冬凌草为靶药清热解毒,共同打靶,态靶辨证,疗效显著.

目的:IgA肾病(IgAN)是引起终末期肾病(ESRD)最常见的原发性肾小球肾炎,其潜在发病机制和关键基因有待深入地探索,本研究旨在确定IgAN发病的关键基因.方法:从高通量功能基因组(GEO)数据库中获取IgAN相关表达谱芯片GSE93798和GSE37460,筛选出两个数据集中共同的差异基因.通过基因本体论(GO)和京都基因与基因组百科全书(KEGG)通路分析上述差异基因的生物学作用.利用STRING数据库构建蛋白互作网络(PPI),同时筛选出关键基因.通过Nephroseq数据库对关键基因进行验证并分析其对IgAN患者临床特征的影响.结果:GSE93798和GSE37460数据集中共筛选出70个共同差异基因,其中包括24个上调基因和46个下调基因.GO富集分析表明:差异基因主要富集于含胶原的细胞外基质、细胞外基质、有机阴离子转运、毒性物质反应、抗氧化活性、细胞外基质结构成分等.KEGG结果显示:差异基因与PI3K-Akt信号通路、ECM受体相互作用、蛋白质消化吸收有关.在PPI网络中筛选出10个关键基因:CSF1R、TYROBP、C1QB、C1QA、CD14、VSIG4、ALB、APOH、FN1和HRG.其中TYROBP、C1 QB、C1 QA、CD14、VSIG4、APOH、FN1和HRG的表达对IgAN患者肾小球滤过率、血肌酐和蛋白尿有一定的影响.结论:IgAN肾病的生物信息学分析结果可能为探索IgAN潜在发病机制和关键基因提供支持证据.

Objective To explore the effect of Ludangshen oral liquid for treatment of convalescent patients with coronavirus disease 2019 (COVID-19) with randomized, double-blind, placebo-controlled multicenter method. Methods 200 convalescent COVID-19 patients who had symptoms related to decreased digestive and respiratory function were randomly divided to either receive Ludangshen oral liquid or placebo for 2 weeks. The severity of clinical symptoms including fatigue, anorexia, abdominal distension, loose stools, and shortness of breath were assessed by visual analogue scale and observed at before and after treatment. The improvement and resolution rates of clinical symptoms were evaluated. Full analysis set (FAS) and per-protocol set (PPS) were used for statistical analyses. Adverse events were recorded during the study. Results 8 patients did not complete the study. After 2 weeks of treatment, both FAS and PPS results showed that patients in Ludangshen group had significantly lower score of fatigue, anorexia, loose stools, and shortness of breath than placebo group (P < 0.05), while there was no significant difference in distention (P > 0.05). The improvement rate of fatigue, anorexia, distension, loose stools and shortness of breath were significantly higher in Ludangshen group (P < 0.05), as well as the resolution rates (P < 0.05) except for shortness of breath (P > 0.05). There were two cases of adverse events, with one nose bleeding in Ludangshen group and one headache in placebo group. Conclusion The study suggested that two weeks of Ludangshen oral liquid treatment may have certain effects for convalescent COVID-19 patients on improving digestive and respiratory symptoms including fatigue, anorexia, loose stools and shortness of breath, which may be one of the choices for management of convalescent COVID-19 patients with digestive and respiratory symptoms.

脾肾阳虚、浊毒内蕴是慢性肾衰竭的重要病机之一.针对阳虚浊毒型慢性肾衰竭患者,仝小林院士基于其特色的"态靶辨证"组方策略,提出以"脾肾阳虚、浊毒内蕴"为态,以"少尿或无尿、乏力、恶心呕吐、水肿"为靶,以大黄附子汤为靶方温补脾肾、泄浊排毒.靶药黄芪、丹参益气养血;茯苓、泽泻利水渗湿;骨碎补补肾强骨,宏观调态,微观定靶,标本兼顾,共同打靶,取得了显著的疗效.

文章通过梳理分析《伤寒杂病论》有关腰痛辨治的条文,总结得出仲景从风寒袭表、寒湿痹阻、血虚寒凝、肝阴不足、肾阳亏虚、肝郁气滞6大证出发,分别以麻黄汤发汗解表、甘姜苓术汤散寒除湿、当归四逆汤养血通脉、芍药甘草汤柔肝滋阴、肾气丸温肾化气助阳、四逆散疏肝理气对腰痛进行辨治.

This study aimed to investigate the protective effect of Stewed Rhubarb (SR) decoction on chronic renal failure (CRF) through the regulation of gut microbiota. Using a CRF mouse model induced by a 0.2% adenine diet, we proved that SR decoction (2.0 g crude SR/kg) significantly reduced the levels of urea and creatinine in plasma of CRF mice, accompanied by the improvement of renal fibrosis and tubular atrophy, amelioration of inflammation, and inhibition of aquaporins damage. Also, SR decoction alleviated gut barrier damage, indicative of the elevated mRNA expression of intestinal mucins and tight junctions. By 16S rDNA sequencing, SR decoction reshaped the imbalanced gut microbiota in CRF mice by statistically reversing the abundance changes of a wide range of intestinal bacteria at family and genus levels, which further led to balance in the production of intestinal metabolites, including short-chain fatty acids (acetic acid, propionic acid, and valeric acid), indole, and bile acids (TUDCA and CDCA). Inversely, SR decoction failed to repress the occurrence of CRF in mice with gut microbiota depletion, confirming the essential role of gut microbiota in SR decoction-initiated protection against CRF. In summary, SR decoction can improve adenine-induced CRF in mice by remolding the structure of destructed gut microbiota community. Our findings shed light on the clinical application of SR decoction in nephropathy treatment.