RATIONALE:Acute ischemic stroke is an important cause of in worldwide mortality and morbidity. nevertheless, in certain instances of concomitant idiopathic tremor, stroke lesions may have a therapeutic effect in alleviating the symptoms of idiopathic tremor. Limited reports exist on the improvement of essential tremor (ET) following a stroke. This research presents a case of symptom improvement in ET following acute stroke thrombolysis in the right centrum semiovale of a patient. PATIENT CONCERNS:The patient is a retired 75-year-old male who is right-handed. He was hospitalized on January 1, 2021, due to limited movement in his left limbs and difficulties with speech. The patient has experienced a bilateral tremor in the upper limbs for 30 years, with exacerbation on the left side. The left finger-nose test lacked stability and precision. DIAGNOSES:The cranial computed tomography revealed scattered lacunar infarctions in the brain. The magnetic resonance imaging revealed many lacunar lesions in the bilateral basal ganglia and the centrum semiovale. A fresh lesion was seen in the right centrum semiovale. OUTCOMES:In the treatment of cerebral infarction, patients did not receive treatment and intervention for tremor symptoms. However, the patient also showed significant improvement in tremor in both upper extremities after the symptoms of acute cerebral infarction subsided, and the finger-nose test was consistent and precise on both sides. Fahn-Tolosa-Marin tremor rating scale 7 points. LESSONS:The three-dimensional T1-weighted imaging, diffusion weighted imaging and diffusion tensor imaging sequences of magnetic resonance imaging images were analyzed, and BrainVoyager was used to visualize the location relationship between the infarct focus, thalamus and related fiber conduction tracts. It was inferred that the descending corticospinal tract and the 2 ascending conduction tracts from thalamus to cerebral cortex formed a complete neural circuit. The location of the infarct intersects the above conduction tract and thus interferes with the oscillatory network within it. Therefore, it is possible to break the oscillation network of ET by interfering with a certain node, which can provide more ideas for the treatment of ET in the future.

OBJECTIVE:The neurovascular unit (NVU) is a core structural and functional entity involved in migraine pathogenesis. Acupuncture may exert therapeutic effects by protecting NVU integrity. This narrative review aims to summarize the current evidence on the mechanisms by which acupuncture protects the NVU in migraine. METHODS:We reviewed and synthesized relevant literature focusing on the effects of acupuncture on neuronal excitation, blood-brain barrier (BBB) components, neuroinflammation, and energy metabolism in the context of migraine. RESULTS:Acupuncture protects the NVU through four major pathways: (1) Acupuncture inhibits pathological excitation of neurons, including activating the endogenous pain regulation system, regulating the balance of neurotransmitters and receptors, and inhibiting peripheral sensitization and inflammation; (2) Acupuncture maintains the integrity of the BBB, specifically involving improving endothelial cell function and tight junctions (TJs), regulating astrocyte reactivity, enhancing pericyte function, and inhibiting extracellular matrix (ECM) degradation; (3) Acupuncture regulates neuroinflammation mediated by microglia; (4) Acupuncture improves energy metabolism and oxidative stress. CONCLUSIONS:Acupuncture exerts multi-target, comprehensive protective effects on NVU damage in migraine. These findings provide a mechanistic basis for its clinical application and may offer new therapeutic directions for migraine management.

BACKGROUND:Stroke persists as a paramount global health priority, maintaining persistently elevated incidence and mortality metrics across epidemiological registries. Post-stroke dysphagia, serving as a critical determinant of functional prognosis, imposes multidimensional burdens spanning aspiration pneumonia risk, nutritional compromise, and psychosocial well-being. This neurogenic deglutition disorder has consequently catalyzed clinical innovation in rehabilitation modalities, with scalp acupuncture emerging as a promising neuromodulatory intervention. METHODS:We conducted a systematic search of 8 databases for randomized controlled trials (RCTs) assessing scalp acupuncture treatment for post-stroke dysphagia. The primary outcomes included clinical efficacy, while the secondary outcomes comprised the Kubota Water Swallowing Test (WST), standardized swallowing assessment (SSA), videofluoroscopic dysphagia scale (VDS), and adverse events. Rigorous evaluation of potential biases within the selected studies was performed by the Cochrane Handbook (version 5.1.0) for systematic reviews of interventions. Heterogeneity among studies was addressed through sensitivity analysis. RESULTS:Based on data derived from 20 RCTs involving 1278 participants, the meta-analysis revealed significant clinical effective rate in the application of scalp acupuncture for post-stroke dysphagia [odds ratio = 4.45, 95% confidence interval (CI) (3.04, 6.51), P < .01], improvement in the Kubota WST [mean differences (MD) = -0.82, 95% CI (-1.04, -0.59), P < .00001], SSA [MD = -4.01, 95% CI (-4.59, -3.42), P < .00001], VDS [MD = -5.75, 95% CI (-8.33, -3.17), P < .0001], in comparison with the conventional rehabilitation protocols. Only one study reported adverse events. CONCLUSION:Current evidence suggests that scalp acupuncture therapy may be an effective measure for post-stroke dysphagia.

Low blood pressure at acute ischemic stroke onset is associated with both short- and long-term adverse outcomes. Studies have shown that YQFM (YiQiFuMai lyophilized injection) can ameliorate neurological deficits in ischemic stroke.However, all of these studies are all small-sample clinical observations lacking rigorous study design for AIS with inappropriate blood pressure. To describe the design of the YQFM aimed at reducing the disability rate in AIS patients with inappropriate blood pressure. This trial is a prospective, multicenter, randomized, double-blind, placebo-controlled, superiority trial aimed at evaluating the efficacy and safety of YQFM in reducing the disability rate in patients with acute hypoperfusion stroke within 90 days. We will recruit 480 patients with AIS within 48 h of symptom onset from 24 hospitals, who have large atherosclerosis, systolic pressure ≤ 155 mmHg, and an NIHSS score of 4–18. Eligible patients will be randomly assigned to receive either YQFM or 0.9 https://www.chictr.org.cn/showproj.html?Proj=200686 .

RATIONALE:With the development of magnetic resonance imaging (MRI) technology, most of the research tends to find that there is a significant positive correlation between white matter hyperintensities (WMHs) and cognitive dysfunction in cerebral small vessel vascular disease. In this paper, we report 2 cases of cerebral small vessel disease with significant differences in cognitive function and analyze them by multidimensional assessment using imaging technology so as to provide a methodological reference for identifying and diagnosing the causes of differences in cognitive function in cerebral small vessel disease patients. PATIENT CONCERNS:Patient 1 was a 64-year-old middle-aged man who presented 10 years ago with slow reaction time, memory loss, and loss of self-care ability, and MRI suggested multiple ischemic infarct foci with cerebral white matter changes. Patient 2 was a 69-year-old middle-aged woman, who did not have any significant abnormalities in cognitive function, and imaging suggested multiple ischemic foci, infarct foci, and cerebral white matter degeneration. DIAGNOSIS:MRI showed a large fusion of high signal in the cerebral white matter in both patients, which belonged to the category of cerebral small vessel disease according to the Fazekas classification of grade 3. INTERVENTIONS:We used imaging techniques to compare the 2 MRI brain white matter high signals in a multidimensional manner and further compared the differences in cognitive functioning between the 2 in terms of brain age, brain functional networks, focal loading of white matter fiber tracts, and neuropsychological scales. OUTCOMES:Brain age difference was assessed by whole-brain level and brain function network, white matter fiber bundle lesion load, and Montreal Cognitive Assessment and Mini-Mental State Examination scale scores; the results suggested that patient 1 had relatively poor cognitive function. LESSONS:In this paper, we concluded that the volume of high white matter signal in WMH is not positively correlated with the severity of cognitive impairment. In addition to cerebral WMHs, we believe that alterations in cerebral network connectivity and white matter microstructure may be the neuroimaging basis of cognitive decline in patients with WMH, which may provide a new idea for the early diagnosis of cognitive function in patients with cerebral small vessel disease.

克-雅病是一种罕见的由朊病毒蛋白诱导的神经退行性脑病,此病平均生存期为 6 个月,病死率高,预后极差.本报告回顾性分析了北京中医药大学东直门医院收治的克-雅病患者 1 例,该患者表现为快速进展的痴呆、视觉障碍、明显的锥体外系受损,并迅速进展至昏迷,最终死于重症肺炎,总病程 1 年 4 个月.西医缺乏针对该病有效的治疗手段,基于个体的同源脑功能网络分析显示,中医辨治可对延缓疾病进展起到一定作用.本文分析1例克-雅病患者的中医诊治过程,并进行文献回顾,以期加强对本病的认识,探索中医药治疗优势.

Objective: To explore the effect of Xinglou Chengqi decoction (XCD) on the brain-gut axis in mice with acute ischemic stroke. Methods: A cerebral ischemia-reperfusion model identified as phlegm-heat and fu-organ excess pattern was established by reforming the Longa method and based on the diagnostic criteria of traditional Chinese medicine. Sixty specific-pathogen free male C57BL/6 mice were randomly divided into five groups, and 36 antibiotic-treated (ABX) mice were randomly divided into three groups. Cecum norepinephrine (NE) and motilin (MTL) were detected by enzyme-linked immunosorbent assay, cecum tyrosine hydroxylase (TH) protein expression level was detected by immunohistochemistry, Iba-1 and glial fibrillary acidic protein (GFAP) expression levels were detected by immunofluorescence, and serum inflammatory factor contents were detected using the flow multifactor technique. Results: Compared to the sham group, a significant increase in TH expression level was observed in the cecum in the middle cerebral artery occlusion (MCAO) group (P = .015). MTL levels were significantly increased in the MCAO group compared with the sham group (P < .001) and significantly decreased in the XCD and nimodipine (Nim) groups compared with the MCAO group (P = .003 and P = .007, respectively). Astrocytes and microglia were markedly activated in the MCAO group, whereas activation was decreased in the XCD group compared to the MCAO group. Antibiotic-treated (ABX) mice astrocytes and microglia were obviously activated in the ABX-MCAO group, and activation tended to be lower in the ABX-XCD group. Interleukin-22 level significantly increased in the ABX-XCD group compared with the ABX-MCAO (P = .021). Conclusion: XCD has a significant regulatory effect on the immune pathway of the brain-gut axis in mice with acute ischemic stroke, while the removal of the gut microbiota attenuates the effect considerably.

Objective To explore the mechanism of Danggui Sini Decoction in the treatment of menstrual migraine（MM）by network pharmacology and molecular docking.Methods The active ingredients and targets of Angelicae Sinensis Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Asari Radix et Rhizoma, Tetrapanacis Medulla, Glycyrrhizae Radix et Rhizoma, and Jujubae Fructus were collected from the Traditional Chinese Medicine Systems Pharmacology Platform（TCMSP）.The targets of MM were retrieved from the Therapeutic Target Database, Drugbank, and DisGeNET,and the Venn diagram was established to screen the common targets shared by Danggui Sini Decoction and MM.The protein-protein interaction network of the common targets was built in String and Cytoscape 3.9.0,and the key targets were selected based on the parameters of network topology.Metascape was used to analyze the biological processes and signaling pathways involving the common targets, and the results were visualized as bar and bubble charts in Bioinformatics.The network of herb-core target-signaling pathway was built to visualize the main mechanism of Danggui Sini Decoction in the treatment of MM.Molecular docking was performed in AutoDock to verify the interaction between core components and key targets.Results A total of 77 active ingredients of Danggui Sini Decoction were screened out, corresponding to 256 therapeutic targets, 122 of which involved MM.The 10 core ingredients included quercetin, glypallichalcone, beta-sitosterol, kaempferol, cryptopin, stigmasterol, vestitol, licochalconea, isorhamnetin, and fumarine.Eight core targets were obtained, including PTGS2,PTGS1,ESR1,PPARG,NOS2,AR,F10,and ADRB2,among which ESR1,PTGS2,PTGS1,and AR were also those of the currently marketed drugs.The four newly discovered targets were PPARG,NOS2,ADRB2,and F10.The GO functional annotation predicted that the targets were mainly involved in inflammation, response to lipopolysaccharide, response to extracellular stimuli, organic matter cycle and complex cellular response.The KEGG enrichment predicted 89 pathways, which were mainly pathways in cancer, lipid and atherosclerosis, relaxin signaling pathway, HIF-1 signaling pathway, serotonergic synapse, prolactin signaling pathway, calcium signaling pathway, thyroid hormone signaling pathway, complement and coagulation cascades, and ovarian steroidogenesis.Conclusion Danggui Sini Decoction can treat MM in a multi-component, multi-target, and multi-pathway manner, demonstrating the principle of nourishing blood and dredging collaterals in the treatment of MM.Four targets, PPARG,NOS2,ADRB2,and F10,are revealed for the first time in this study and not involved in the available drugs for treating MM,which have the potential for research and application and remain to be validated by experimental studies.

目的 观察穴位贴敷与推拿治疗脑梗死后便秘的 效果。方法 筛选脑梗死后便秘的患者78例,分为对照组、穴位贴敷组(贴敷组)和推拿组(推拿组),三组患者人数分别为22例、31例和25例。对照组采用常规中西医治疗及护理；在此基础上,贴敷组患者采中药神阙穴贴敷；推拿组患者采用穴位推拿手法。干预2周,每日观察三组患者的排便情况,于治疗第7和14天对比三组患者的排便频率。采用Barthel指数(BI)评价患者日常生活活动能力。结果 治疗第1周,贴敷组患者排便频率高于推拿组和对照组,差异有统计学意义(P＜0.05)；治疗第2周,贴敷组患者排便频率高于同期的对照组(P＜0.05)；三组治疗第2周排便频率均较第1周均升高。三组患者出院时BI均较入院时均升高。结论 穴位贴敷治疗和推拿手法治疗能改善脑梗死后便秘患者排便频率,其中穴位贴敷治疗效果更明显。

Growing evidence has indicated that the characteristics of gut microbiota are associated with acute ischemic stroke (AIS). Phlegm-heat syndrome (PHS), a specific pathological state of the AIS, is one of the common traditional Chinese syndromes of stroke. The long duration of PHS in patients with AIS could lead to poor clinical outcomes. Gut microbiota characteristics in patients with both AIS and PHS, and their relationship remains unknown. This study was designed to investigate the alterations in gut microbiota in patients with AIS and PHS through a cross-sectional study. Fecal samples were collected from 10 patients with AIS and non-PHS (ntAIS), 7 patients with AIS and PHS (tAIS), and 10 healthy controls (HC). Samples were profiled via Illumina sequencing of the 16S rRNA V3-V4. Stroke severity was assessed at admission by the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS); their correlation with gut microbiota was investigated. The alpha-diversity of the bacterial communities was significantly higher in the fecal samples of patients with tAIS than in patients with ntAIS (Shannon index, P = 0.037). In addition, the combined tAIS and ntAIS group (tntAIS) exhibited higher microbiotic diversity when compared with HC (chao1, P = 0.019). The structure of intestinal microbiota was effectively distinguished between the tAIS and ntAIS group (ANOSIM, r = 0.337, P = 0.007). Additionally, the gut microbiota structure was significantly different between the tntAIS and HC groups (ANOSIM, r = 0.217, P = 0.005). The genera, Ruminococcaceae_ UCG_002 and Christensenellaceae_R-7_group, were implicated in the discrimination of PHS from non-PHS. The order Lactobacillales and family Lachnospiraceae were significantly negatively correlated with NIHSS and mRS at admission (P < 0.05). By contrast, the order Desulfovibrionales, families Christensenellaceae and Desulfovibrionaceae, and genera Ruminococcaceae UCG-014 and Ruminococcaceae UCG-002 were significantly positively correlated with NIHSS and mRS at admission (P < 0.05). This study is the first to profile the characteristics of gut microbiota in patients with AIS and PHS, compared with those with non-PHS. The genera, Ruminococcaceae_ UCG_002 and Christensenellaceae_R-7_group, may be objective indicators of this traditional Chinese medicine (TCM) syndrome in AIS. Furthermore, it provides a microbe-inspired biological basis for TCM syndrome differentiation.

Multiple system atrophy (MSA) is a common atypical parkinsonism, characterized by a varying combination of autonomic, cerebellar, and pyramidal systems. It has been noticed that the patients with MSA can be accompanied by some neuropsychiatric disorders, in particular depression. However, there is limited understanding of MSA-related depression. To bridge existing gaps, we summarized research progress on this topic and provided a new perspective regarding pathological, clinical, and imaging aspects. Firstly, we synthesized corresponding studies in order to investigate the relationship between depression and MSA from a pathological perspective. And then, from a clinical perspective, we focused on the prevalence of depression in MS patients and the comparison with other populations. Furthermore, the associations between depression and some clinical characteristics, such as life quality and gender, have been reported. The available neuroimaging studies were too sparse to draw conclusions about the radiological aspect of depression in MSA patients but we still described them in the presence of paper. Finally, we discussed some limitations and shortcomings existing in the included studies, which call for more high-quality basic research and clinical research in this field.

Background Shenzhi Jiannao (SZJN) prescription is a type of herbal formula adopted in the management of cognitive impairment and related disorders. However, its effects and related regulatory mechanisms on vascular dementia (VD) are elusive. Herein, network pharmacology prediction was employed to explore the pharmacological effects and molecular mechanisms of SZJN prescription on VD using network pharmacology prediction, and validated the results through in vitro experiments. Methods Through a search in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database, chemical composition and targets for SZJN prescription were retrieved. The potential targets for VD were then obtained from the GeneCards and DisGeNET databases. The network was constructed that depicted the interactions between putative SZJN prescription and known therapeutic targets for VD using Cytoscape 3.7.1. Analysis of protein-protein interaction was achieved via STRING 11.0 software, followed by Gene Ontology (GO) functional enrichment and Kyoto Gene and Genome Encyclopedia (KEGG) pathway analyses. To validate the computer-predicted results, in vitro experiments based on an excitotoxic injury model were designed using glutamate-exposed PC12 cells, and treated with varying concentrations (low, 0.05; medium, 0.1 and high, 0.2 mg/mL) of SZJN prescription. Cell viability and cell death were detected using the IncuCyte imaging system. Moreover, the expression profiles of Caspase-3 were analyzed through qRT-PCR. Results Twenty-eight potentially active ingredients for SZJN prescription, including stigmasterol, beta-sitosterol, and kaempferol, plus 21 therapeutic targets for VD, including PTGS2, PTGS1, and PGR were revealed. The protein-protein interaction network was employed for the analysis of 20 target proteins, including CASP3, JUN, and AChE. The enrichment analysis demonstrated candidate targets of SZJN prescription were more frequently involved in neuroactive ligand-receptor interaction, calcium, apoptosis, and cholinergic synaptic signaling pathways. In vitro experiments revealed that SZJN prescription could significantly reverse glutamate-induced cell viability loss and cell death, and lower the levels of Caspase-3 mRNA in glutamate-induced PC12 cells. Conclusions Collectively, this study demonstrated that SZJN prescription exerted the effect of treating VD by regulating multi-targets and multi-channels with multi-components through the method of network pharmacology. Furthermore, in vitro results confirmed that SZJN prescription attenuated glutamate-induced neurotoxicity.

Objective. To explore the brain protection mechanism of Xingnaojing injection (XNJ) against ischemic stroke (IS) by the network pharmacology approach and gut microbiota analysis. Methods. We used network pharmacology analysis to identify the active components of XNJ and its potential targets against IS and inflammatory bowel disease (IBD) and carried out network analysis, functional annotation, and pathway enrichment analysis. Then, transient middle cerebral artery occlusion (tMCAO) mice model was used to verify the molecular mechanism of XNJ. Results. 36 active compounds were identified from XNJ, and the effect of XNJ against IS was related to the VEGF signaling pathway, NF-kappa B signaling pathway, and gap junction. The effect of XNJ against IBD was related to the T cell receptor signaling pathway, NF-kappa B signaling pathway, and gap junction. In vitro experiments showed that XNJ significantly improved the neurological function of tMCAO mice, reduced the size of cerebral infarction, decreased the permeability of blood-brain barrier (BBB), downregulated the expressions of TLR4, MyD88, and NF-kappa B in the ischemic site, and upregulated the expressions of occludin and ZO-1 in the colon. High-throughput 16S rDNA gene sequencing showed that XNJ upregulated the levels of Akkermansia and downregulated the levels of Flavobacteriaceae, Deferribacteraceae, and Deferribacteres. XNJ increased the concentrations of the short-chain fatty acids (SCFAs) PA (propionate), VA (valerate), IBA (isobutyrate), and IVA (isovalerate) in the feces of the sham germ-free experiment group (SGFEG) mice. Conclusion. IS causes dysbiosis of some specific bacteria in the gut microbiota. XNJ is an effective treatment for IS, and its mechanism was related to improving intestinal barrier function and regulating intestinal flora and SCFAs. Network pharmacology revealed that XNJ acts through multiple targets and multiple pathways.

目的 探讨参麦注射液对急性脑梗死的治疗效果.方法 回顾性分析2017年6月至2019年6月于北京中医药大学东直门医院脑病科一区治疗的急性脑梗死患者122例的临床资料,根据治疗方法将其分为治疗组(66例)和对照组(56例).两组均随症给予抗血小板、降脂、降压、控制血糖等常规治疗,治疗组在常规治疗基础上给予参麦注射液静脉滴注;对照组给予丹红注射液静脉滴注,两组均治疗14 d.比较两组治疗前与治疗14 d后的美国国立卫生研究院脑卒中量表(NIHSS)评分及不良事件发生情况.结果 治疗14 d后,两组NIHSS评分均较治疗前降低,且治疗组低于对照组,差异有统计学意义(P<0.05).两组病因不明(UE)亚型NIHSS评分治疗前后比较,差异无统计学意义(P>0.05).治疗14 d后,两组心源性栓塞(CS)、大动脉粥样硬化型(LAA)、穿支动脉疾病(PAD)、其他病因(OE)亚型NIHSS评分均较治疗前降低,差异有统计学意义(P<0.05),治疗组LAA亚型NIHSS评分低于对照组,差异有统计学意义(P<0.05),两组CS、PAD、OE、UE亚型NIHSS评分比较,差异无统计学意义(P>0.05).两组在治疗过程中均未发现明显不良反应.结论 参麦注射液能够有效改善急性脑梗死患者神经功能缺损程度,其对LAA亚型脑梗疗效明显优于丹红注射液,在其他亚型中与丹红注射液作用相似.

BACKGROUND:Shenzhi Jiannao formula (SZJNF) is a herbal prescription which is used for detoxification, dredging collaterals, and activating blood circulation and Qi flow in traditional Chinese medicine. SZJNF is a clinical effective prescription for the treatment of vascular dementia (VD) first formulated based on the classical theory of traditional Chinese medicine, but its anti-VD mechanism remains ambiguous.PURPOSE:The aim of this study was to elucidate the multi-target mechanisms of SZJNF against VD using a network pharmacology approach and verify its effects through biological experiments.STUDY DESIGN AND METHODS:We utilized network pharmacology-based prediction and molecular docking techniques to uncover the potential micro-mechanism of SZJNF against VD. We identified active components and potential targets, and performed network analysis, functional annotation, and pathway enrichment analysis. Subsequently, glutamate-induced PC12 cells and VD rats were used to verify the molecular mechanisms of SZJNF.RESULTS:Seventeen active compounds were identified in SZJNF rat plasma; moreover, 773 predicted targets and 1544 VD-related targets were found. Various networks, including the PPI, herb-compound-target, and compound-target-pathway network were constructed. A total of 188 shared targets were identified by network topological analysis, which were closely associated to the anti-VD effects of SZJNF. They were also enriched in various biological processes through hypoxia reaction, promotion of cell proliferation, inhibition of apoptosis, neuroactive ligand-receptor interaction, and calcium signaling pathway, as evaluated by the analysis of advanced functions and pathways. SZJNF components docked well with the key targets. Treatment with SZJNF promoted cell proliferation, ameliorated apoptosis and oxidative stress injury, and improved neurological and cognitive abilities.CONCLUSION:This study comprehensively demonstrated the multi-target mechanisms of SZJNF in VD using network pharmacology and molecular biology experiments. This provides evidence for further mechanistic studies and for the development of SZJNF as a potential treatment for patients with VD.

Background and Objective. With the exact clinical efficacy, Buyang Huanwu decoction (BHD) is a classical prescription for the treatment of ischemic stroke (IS). Here, we aimed to investigate the pharmacological mechanisms of BHD in treating IS using systems biology approaches. Methods. The bioactive components and potential targets of BHD were screened by TCMSP, BATMAN-TCM, ETCM, and SymMap databases. Besides, compounds that failed to find the targets from the above databases were predicted through STITCH, SwissTargetPrediction, and SEA. Moreover, six databases were searched to mine targets of IS. The intersection targets were obtained and analyzed by GO and KEGG enrichment. Furthermore, BHD-IS PPI network, compound-target network, and herb-target-pathway network were constructed by Cytoscape 3.6.0. Finally, AutoDock was used for molecular docking verification. Results. A total of 235 putative targets were obtained from 59 active compounds in BHD. Among them, 62 targets were related to IS. PPI network showed that the top ten key targets were IL6, TNF, VEGFA, AKT1, etc. The enrichment analysis demonstrated candidate BHD targets were more frequently involved in TNF, PI3K-Akt, and NF-kappa B signaling pathway. Network topology analysis showed that Radix Astragali was the main herb in BHD, and the key components were quercetin, beta-sitosterol, kaempferol, stigmasterol, etc. The results of molecular docking showed the active components in BHD had a good binding ability with the key targets. Conclusions. Our study demonstrated that BHD exerted the effect of treating IS by regulating multitargets and multichannels with multicomponents through the method of network pharmacology and molecular docking.

近年来,神经系统疾病的发病率逐年上升,为充分发挥中医药在神经系统疾病领域的疗效优势,明确中西医结合切入点,进一步规范中医临床诊疗,制订出中医西医公认的、融合的诊疗方案,提高神经系统疾病的疗效,中华中医药学会组织中西医神经内科专家围绕具有代表性的脑卒中、头痛、眩晕、多发性硬化、癫痫的中医、中西医结合治疗优势环节等进行深入探讨,提出优势病种的中西医治疗建议,为临床实际诊疗和科学研究提供参考依据和有益借鉴.

The current study was designed to explore the brain protection mechanism of Xinglou Chengqi Decoction（XCD）based on gut microbiota analysis and network pharmacology. A transient middle cerebral artery occlusion（MCAO） model of mice was established, followed by behavioral evaluation, TTC and TUNEL staining. Additionally, to investigate the effects of gut microbiota on neurological function after stroke, C57BL/6 mice were treated with anti-biotic cocktails 14 days prior to ischemic stroke（IS） to deplete the gut microbiota. High-throughput 16S rDNA gene sequencing, metabonomics technique, and flow multifactor technology were used to analyze bacterial communities, SCFAs and inflammatory cytokines respectively. Finally, as a supplement, network pharmacology and molecular docking were applied to fully explore the multicomponent-multitarget-multichannel mechanism of XCD in treating IS, implicated in ADME screening, target identification, network analysis, functional annotation, and pathway enrichment analysis.We found that XCD effectively improved neurological function, relieved cerebral infarction and decreased the neuronal apoptosis.Moreover, XCD promoted the release of anti-inflammatory factor like IL-10, while down-regulating pro-inflammatory factors such as TNF-α, IL-17A, and IL-22. Furthermore, XCD significantly increased the levels of short chain fatty acids（SCFAs）, especially butyric acid. The mechanism might be related to the regulation of SCFAs-producing bacteria like Verrucomicrobia and Akkermansia, and bacteria that regulate inflammation like Paraprevotella, Roseburia, Streptophyta and Enterococcu. Finally, in the network pharmacological analysis, 51 active compounds in XCD and 44 intersection targets of IS and XCD were selected. As a validation, components in XCD docked well with key targets. It was obviously that biological processes were mainly involved in the regulation of apoptotic process, inflammatory response, response to fatty acid, and regulation of establishment of endothelial barrier in GO enrichment. XCD can improve neurological function in experimental stroke mice, partly due to the regulation of gut microbiota. Besises, XCD has the characteristic of "multi-component, multi-target and multi-channel" in the treatment of IS revealed by network pharmacology and molecular docking.

2020年1月27日北京中医药大学组建国家中医医疗队赴武汉参与一线抗疫工作.为协助医疗队更好地救治重型患者,提高疗效,北京中医药大学组织了远程专家视频会诊,邀请北京中医药大学医学专家组的部分专家与医疗队员通过网络会议形式讨论病情,指导辨证用药.以2020年2月14日远程专家会诊的2则新型冠状病毒肺炎重型患者为例,介绍会诊专家对具体病例难点和用药思路的分析,体现远程会诊模式在新型冠状病毒肺炎诊疗中的作用,推动中医药在救治新型冠状病毒肺炎患者中的广泛应用.