Ethnopharmacological relevance Shenling Baizhu San (SLBZS) is a Traditional Chinese Medicine (TCM) formula composed of 10 medicinal herbs, historically used to strengthen the spleen, replenish qi, and alleviate fatigue-related symptoms. SLBZS originates from the 'Taiping Huimin Heji Ju Fang' of the Song Dynasty. Central fatigue (CF), a subtype of fatigue, is considered in TCM to be closely associated with spleen deficiency. However, there is currently a lack of research on SLBZS's therapeutic effects on CF and the pharmacological mechanisms underlying its potential benefits. Aim of the study This study aims to assess the effects of SLBZS on CF in rats induced by the Modified Multiple Platform Method (MMPM) and to elucidate the underlying mechanisms, focusing on mitochondrial biogenesis and SIRT1/PGC-1α pathway regulation. Materials and methods CF was induced in male Wistar rats using MMPM, involving intermittent sleep deprivation over 21 days. SLBZS was administered at low(LSLBZS), medium(MSLBZS), and high doses(HSLBZS). Chemical components of SLBZS were identified and quantified using Liquid Chromatography-Tandem Mass Spectrometry(LC-MS/MS). Behavioral tests evaluated physical performance, emotional state, and cognitive function, while serum biochemical markers, mitochondrial morphology, and the protein and gene expression levels of the SIRT1/PGC-1α pathway were analyzed to explore underlying mechanisms. Results A total of 141 main compounds in SLBZS were identified, comprising various components such as flavonoids, phenylpropanoids, terpenoids, among others. SLBZS significantly improved physical performance, alleviated negative emotions, and enhanced cognitive function in CF rats. Biochemically, SLBZS increased serum ATP levels and reduced fatigue-related markers. Mitochondrial analysis demonstrated that SLBZS reversed mitochondrial degeneration, increased mitochondrial number, and increased mtDNA copy number in the hippocampus. Furthermore, SLBZS upregulated SIRT1 /PGC-1α pathway expression at both the protein and gene levels in the hippocampus. Notably, the HSLBZS group demonstrated particularly pronounced effects. Conclusion SLBZS significantly alleviates CF symptoms enhances mitochondrial function via upregulating the SIRT1/PGC-1α pathway, positioning it as a promising alternative for CF management by addressing both its physiological and symptomatic aspects.

BackgroundJiuwan decoction has been used to treat chronic eczema since the Qing Dynasty. According to clinical experience, Shizhenqing granules (SZQG), derived from the Jiuwan decoction, exert beneficial clinical effects on acute eczema and reduce recurrence. Therefore, we elucidated the underlying mechanisms of SZQG through network pharmacology, molecular docking, and experimental validation.MethodsThe main chemical components of SZQG were identified by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). And the targets of SZQG against eczema were screened out through online databases. Then, the regulatory network map of the “herbal compound–potential target” and the target protein-protein interaction (PPI) network was constructed. The Gene Ontology (GO) analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted using by R language. Additionally, the interaction between the active compounds and the targets was verified by molecular docking technology. Finally, an experiment in vivo was used to verify the effect and mechanism of SZQG on eczema.ResultsUsing UHPLC-MS/MS, 158 main chemical compounds of SZQG were identified, and 72 compounds were selected according to the criteria for further analysis. All 237 potential targets of SZQG in eczema were explored using multiple online databases. The network with 14 core targets was screened out, including STAT3, RELA, TNF, JUN, MAPK3, IL-6, PIK3CA, STAT1, MAPK14, MAPK1, IL-4, NFKBIA, IL1B, and MYC. KEGG analyses indicated that the therapeutic effects of SZQG on eczema were predominantly associated with cytokine-cytokine receptor interaction, TNF, MAPK, NF-κB, toll-like receptor, T cell receptor, and Th1 and Th2 cell differentiation signaling pathways. Furthermore, the good affinity between the core compounds and core targets was verified by molecular docking technology, particularly for RELA and MAPK. Animal experiments revealed that SZQG downregulated MAPK14, RELA, T-bet, and GATA3 mRNA expression, reduced immunoglobulin E (IgE) and interleukin-4 (IL-4) serum concentrations, and improved eczema-like lesions in model rats.ConclusionThis study identified potential targets and signaling pathways of SZQG in the treatment of eczema, whereby RELA and MAPK14 may constitute the main therapeutic targets of SZQG in cytokine regulation and reduction of inflammatory responses.

糖尿病肾病是糖尿病患者的主要微血管并发症之一,也是导致糖尿病患者死亡的重要原因.国医大师吕仁和教授基于长期的临床经验创造性地提出了"微型癥瘕"理论.本文旨从"热伤气阴"的特点及"癥瘕致病,虚实相因"这一总病机切入,从糖尿病肾病病程的三期分析病机,进而分期论治及用药:初期益气补虚,养阴清热;中期补益脾肾,祛痰散瘀;后期阴阳并补,消散癥结.意将扶正和消癥相结合,从而维持肾中络脉血流通畅.通过总结和分析目前糖尿病肾病的研究现状,将糖尿病肾病初期、中期和晚期的治法和用药进行总结,以期为中医药临床实践提供用药理论依据,为临床从中医药角度防治糖尿病肾病提供参考.

Many studies have reported obvious seasonal differences in the intestinal flora of rats, and this stable distribution of the seasonal flora helps in maintaining the normal physiological function of the host. However, the mechanism underlying these seasonal differences in intestinal flora remains unclear. To explore the correlation among seasonal factors and intestinal water metabolism and intestinal flora, 20 Sprague Dawley (SD) rats were divided into spring, summer, autumn, and winter groups. The environment for the four seasons was simulated using the Balanced Temperature and Humidity Control system. The intestinal water metabolism was evaluated by determining the intestinal transmission function, fecal water content, water content of colonic tissue, and the colonic expression levels of AQP3, AQP4, and AQP8. The composition and relative abundance of intestinal microflora in rats in each season were assessed through 16S rDNA amplifier sequencing, and the relationship between the dominant flora and intestinal water metabolism in each season was analyzed using Spearman correlation analysis. The high temperature and humidity season could lead to an increase in intestinal water metabolism and intestinal water content in rats, whereas the low temperature and humidity season could lead to a decrease, which was closely related to the change in microflora. To explore the molecular mechanism of seasonal changes in intestinal water metabolism, the concentration of colonic 5-HT, VIP, cAMP, and PKA associated with intestinal water metabolism in rats were also examined. Seasonal changes could affect the concentration of colonic 5-HT and VIP in rats, and then regulate AQPs through cAMP/PKA pathway to affect the intestinal water metabolism. These results suggest that seasonal factors affect the level of intestinal water metabolism in rats and result in seasonal differences in intestinal flora.

本文分享了1例难治性SAPHO综合征中医诊疗过程,患者具有病情迁延日久,反复发作且西药治疗效果不明显的特点.本病属中医"痹证"范畴,为五脏同病,湿、热、毒三邪合犯.本文结合病案具体分析了辨证施治的过程,方证对应,以甘露消毒丹为主方,又灵活加减麻黄连翘赤小豆汤、麻黄细辛附子汤及过敏煎等.以"急则治其标,缓则治其本"为治则,清热解毒利湿为治法贯穿始终.初诊治疗注重清虚热,泻湿热;二诊治疗强调滋阴液,散硬结;再诊治疗围绕解热毒,温肾阳.整体上达到标本同治、五脏同调,使机体气血阴阳调和,脏腑经络功能正常.本次治疗取得确切疗效,为中医治疗SAPHO综合征提供临床思路.

在游览京城名胜之时,人民都免不了会品尝一下北京小吃——酸甜可口的冰糖葫芦.其用料山楂不仅可以满足味蕾的享受,还有健胃消食的作用.其实,山楂的功效不仅如此,还有许多食疗价值.

Based on the theory of dissipative structure, this paper discussed the methods, basis and significance of ’opening Xuanfu and assisting gasification’ in clinical treatment of traditional Chinese medicine. The author put forward that human body is a typical dissipative structure, and life feeds on negative entropy, and Xuanfu is the key to maintain the dissipative structure of human body. There are three bases: First, Xuanfu determines the openness of human body system; Second, the opening and closing of Xuanfu maintains the ’negative entropy flow’ of the body; Third, Xuanfu is closed and entropy accumulation is a disease. Therefore, the basic principle of treating entropy disease is to penetrate the mystery and eliminate entropy. When the thermal entropy is stagnant, it is appropriate to open the mystery and eliminate entropy with pungent taste, and the generalized entropy disease is suitable to pass the mystery and adjust the order. This treatment idea has important guiding significance for clinical determination of treatment principles.

"五脏应时"是中医藏象理论的核心内容,其深刻内涵及机制尚未完全阐明.本文基于系统科学的自组织原理,通过论述脏腑自组织系统是"五脏应时"的内在基础,从而阐明其系统科学内涵及机制,提出"五脏应时"是通过脏腑自组织形成的"功能—时间—空间"结构,其"应时"过程是机体从自然获取有序性的机制,因此"应时关系"紊乱会导致季节性疾病的发生,并提出"应时令之序,愈自组织能力,调人天关系"的养生防病基本法则.正确理解"五脏应时"的内涵及机制有助于解释季节性疾病的发作,指导临床养生防病和辨证论治.

脏腑自组织系统是机体应时演化的内部动力,也是演化平稳过渡的重要保障.交节时刻是系统演化的关键时期,此时一旦脏腑自组织机制失常,系统自稳无力,内外合因将使机体表现出天人关系紊乱的病理现象,这是交节病的关键病机.因此,应从时间结构的动态演化中把握交节病的主要病机,交节病的防治不应单纯着眼于特异病邪的祛除,而是将调理机体自组织机制作为治疗之本,顺"应时演化"之势,恢复五脏的自稳和防御机制,增强机体自组织能力,调和天人关系,达到"以平为期".

Objective: To explore the impact of seasonal changes on the T-helper 1（Th1）/T-helper 2（Th2） immune balance of the body in order to elucidate the internal immunological mechanisms underlying seasonal eczema.Methods: Eighty 4-week-old male Sprague-Dawley rats were divided into 5 season groups kept in corresponding season simulation environments, and subdivided into the model group and the control group. The Eczema Area and Severity Index（EASI） and scratching frequency were evaluated. The serum levels of immunoglobulin E（IgE）, interleukin-2（IL-2）, interleukin-12（IL-12）, and interferon-gamma（IFN-γ）, interleukin-4（IL-4）, interleukin-25（IL-25）, and interleukin-31（IL-31）, and melatonin（MT）, as well as the MT receptor（MTR） levels in the spleen, were detected by enzyme-linked immunosorbent assay analysis. The mRNA expression levels of T-bet and GATA3 were detected by quantitative real-time polymerase chain reaction.Results: EASI scores and the scratching frequency of the model group were higher in the long summer than in the other 4 seasons. Meanwhile, the serum levels of IgE and the Th2 cytokines IL-4, IL-25, and IL-31, as well as GATA3 mRNA expression levels, were high during the long summer in both groups. However, the serum levels of the Th1 cytokines IL-2, IL-12, and IFN-γ, as well as MT, MTR, and T-bet mRNA levels, were lower during the long summer. In all 5 seasonal groups（spring, summer, long summer, autumn, and winter）, the levels of all immune factors, especially IL-4 and IL-31, were higher in the model group than those in the control group,while the concentrations of MT and MTR were lower.Conclusion: Under long light, hot, and humid conditions in the long summer, the body is more likely to suffer from Th2-dominated immune imbalance. This is the internal mechanism behind the high incidence and severity of eczema during the long summer. MT and MTR play a key role in the seasonal onset of eczema.

脾气升动,布散精微以濡养全身,是脾的生理特性.中医天人相应理论认为,脾气升清功能存在季节性节律,具体体现为:脾气升清应时而变,以顺自然气机升降之势;长夏脾受湿困,调节不及,升清乏力是脾脏功能的季节特性.因此,夏季常表现为脾升无力的脾虚证.现代研究认为,线粒体中的能量代谢可能是"脾气升清"的物质基础,其功能状态可以反应"脾气升清"的能力.褪黑素不仅是机体"授时因子",还可以在线粒体中发挥强大的抗氧化作用,调控线粒体氧化磷酸化功能.本文据此提出:"脾气升清"功能的季节特性与褪黑素调节线粒体能量代谢的季节性变化相关,即长夏季节气候因素使褪黑素分泌减少,影响线粒体活性氧的清除,导致氧化损伤加重,实现对线粒体能量代谢的季节性调控.

药引子曾经广泛应用于中医临床,至今在民间仍很受关注.药引子多是日常生活中相对容易得到而药房相对少有储备的,具有引导药力、增强疗效、保护脾胃、矫正口味、减轻毒性等多方面作用的食材或药食两用之品,其理论内涵与中药归经理论等密切相关.药引子具有容易获取,不易保存、具有导向作用、药效大多单一的特征,可发挥促进方药有效成分溶解、引药入口、引药入胃、引药入血、引药入靶等作用.药引子有时是方剂的亮点、要点所在,甚至是方药中不可或缺的组分.临床根据药引子的性味、归经以及所针对的疾病病因病机,在辨病辨证、处方遣药过程中,灵活选用合适的药引子,可发挥多种不同效用.深入理解药引子的理论内涵和作用特点,掌握药引子的应用方法和技巧,有助于提高中医临床疗效.

在专业课程中融入思想政治教育,实现课程思政教学具有时代必然性,同时也面临一些问题.将共情理念运用到课程思想政治教育的"改革""创新"工作中,有利于贯彻落实新时代"以人为本"教育理念.结合重大事件、社会热点、情景模拟、经典案例、科学创新、身边故事,以及真实数据的共情方案,探讨了"中医学基础"课程思政的思想政治教育元素的挖掘、课程设计与方法,以及教学评价和改进建议,以期有效推动和优化"中医学基础"课程思政的本科教学.

本文介绍了韩一斋升降补泻学术思想及其传承.韩一斋是清太医院御医,从气机失调角度分析了虚实夹杂证临床治疗难点,提出以恢复脏腑气机升降出入为目标,运用药物性味理论对脏腑进行补泻的用药遣方思路,形成"补泻寓于升降,首重气机畅通"的学术思想以应对治疗中"攻邪恐伤正,补虚易碍邪"的困难.其学术思想被其弟子继承发展,弟子赵绍琴善以宣畅气机治疗温病,升降气机治内伤杂病;郗霈龄运用补泻升降理论治疗伪膜性肠炎危重证,再传弟子王宝恩以气机升降理论为指导,采用中西医结合方法治疗多脏器衰竭,这些均是对韩一斋升降补泻学术思想的继承与发展,对后世临床有深远影响,值得深入挖掘.

刘红梅教授以历代中医文献为基础,认为幻肢痛(phantom limb pain,PLP)的病位在心,心神不宁而致疼痛,临证治疗时,运用脐针,注重宁心调神止痛,兼顾调畅气血.现主要阐述刘红梅教授从心论治幻肢痛的理论依据,为临床治疗幻肢痛带来新思路.

中医"天人相应"理论包括天人相副、人天依存、天人相合等不同认识.西医学整体观包含着"人的可分解性",即合整体观;中医学整体观的核心是人与环境、人体自身的"不可分割性",即元整体观.从元整体观探讨天人相应的理论内涵可知,天人相应包含天人本一、以人应天、天人合一在内的逻辑递进的多层次概念.其具体表现在:从宇宙本体论来看,天人相应首先是天人本一;从宇宙发生的过程看,人的健康疾病与自然环境息息相关;从宇宙生态平衡角度看,养生防病上需要天人合一.阐明"天人相应"理论深层次内涵,有助于从根本上理解健康与疾病及其防治,有益于中医"天人相应"理论的继承和发展.

结合多学科交叉的知识,从增强民族自豪感的角度探讨了"中医基础理论"课程思政的设计,主要分为三个方面:一是从心理学的认知角度,剖析人们认为中医不科学的原因及相应的思维模式,改变学生对中医落伍和不科学的印象;二是通过比较学的方法,将中医学置于整个人类历史发展进程中介绍,发现中国古代技术思想为世界开学技术发展提供了思路,且早期西医学也有类似气的理论存在,从侧面印证了中医学的科学性;三是结合物理学、信息学和分子生物学的知识构架,进一步阐释中医学的生命科学内涵.

Background: Based on the effect of seasonal changes on human visceral function, this study investigated the impact of seasonal photoperiod of the pineal body on hypothalamic-pituitary-adrenal axis-hippocampal-receptor in rats, aiming to reveal the mechanism by which pineal gland melatonin regulates the seasonal secretion of hippocampal neurotransmitters.Methods: Vernal equinox, summer solstice, autumn equinox, and winter solstice were selected as four experimental time points, and rats were randomly divided into normal control group, sham operation group, and pinealectomized group. The seasonal changes in corticotropin-releasing hormone（CRH）,adrenocorticotropic hormone（ACTH）, corticosterone, hypothalamic melatonin receptor（MTR）, and hippocampal corticosterone receptor（CORTR） were examined by enzyme-linked immunosorbent assay.Results: Comparing the same group between different seasons, we showed that in the normal control group, CRH, ACTH, corticosterone, and MTR were higher, while CORTR was lower in autumn and winter than in spring（all P ＜.05）. Compared with the normal control group, the pinealectomized group showed higher levels of corticosterone（P =.01）, MTR（P =.01）, and CORTR（P =.03） during spring; reduced levels of MTR and CORTR（both P ＜.001） during summer; higher levels of ACTH（P =.001） and MTR（P ＜.001）,and lower levels of CRH（P =.001）, corticosterone（P ＜.001）, and CORTR（P =.003） during autumn; and lower levels of CRH（P ＜.001） and MTR（P =.004）, and higher level of ACTH（P ＜.001） in winter.Conclusions: Seasonal photoperiod acts on the pineal gland to secrete different levels of melatonin,resulting in seasonal changes in the hypothalamic-pituitary-adrenal axis-hippocampal-receptor, which may be the pathophysiological basis for the onset of seasonal affective disorder.

心脑血管疾病是目前危害中国人民生命健康的首要风险因素,其中,冠心病发病率与病死率呈现逐年增长趋势.冠心病属于中医"胸痹""真心痛"疾病范畴.历代医家认为其基本病机为阳微阴弦,而刘燕池教授对冠心病的发病和诊治有独到见解,强调"邪之所凑,其气必虚",以丹溪"阳有余而阴不足论"为指导,临证以滋阴法为根本大法治疗冠心病,效果显著.具体思路为分补不同脏腑之阴,通过养阴血、清相火,兼通痰瘀之阻,进而使阴阳调和,胸痹得解.因此,该文就刘燕池教授运用滋阴法治疗冠心病进行了多角度探讨:首先阐述了阴虚易成的机理;其次,从阴虚角度深入分析了胸痹的病程,指出阴虚所致的胸痹分为3个阶段:阴虚火热内生,火热内生炼津为痰,阴虚痰凝血瘀;同时,以脏腑划分层次,阐述了治疗胸痹滋阴药物的选用;最后通过验案举隅对刘燕池教授临证诊治冠心病的思路进行探讨,以期从滋阴法角度为冠心病的治疗提供参考经验.