Rheumatoid arthritis (RA) is an autoimmune disease whose exact cause remains unclear and is likely the result of multiple factors such as genetics and environmental influences. This disease primarily affects the joints and subsequently presents with extra-articular manifestations.The pathogenesis of RA is complex, and current research is yet to fully elucidate the underlying mechanisms. Consequently, investigations into the pathophysiological processes of RA remain in its early stages. Recent advancements in diagnostic methodologies and pharmacological interventions have significantly improved RA management. A growing number of novel therapeutic agents have been introduced, with methotrexate (MTX) remaining the cornerstone of first-line treatment. Furthermore, contemporary drug development efforts have increasingly focused on molecular medicine to enhance the therapeutic efficacy and safety profiles. Traditional Chinese medicine (TCM), with its unique theoretical system and therapeutic approaches, demonstrates promising potential in the treatment of RA and is increasingly attracting global attention. Clinical studies on Tripterygium wilfordii (thunder god vine) and preparations of Paeonia lactiflora (white peony) in rheumatoid arthritis and related conditions have also demonstrated certain efficacy and safety of Chinese herbal medicine. Currently, the integration of traditional Chinese and Western medical approaches for RA treatment is gaining wider acceptance. Therefore, this review will focus on exploring the potential of traditional Chinese medicine in improving RA outcomes, based on the diagnosis, epidemiology, and pathophysiological mechanisms of rheumatoid arthritis.

Depression comorbid with insomnia (DCI) is a highly prevalent mental disorder with complex pathogenesis, posing great clinical challenges for Western medical interventions due to adverse reactions, drug dependence and single targets. Accumulating preclinical evidence confirms the microbiota-gut-brain axis (MGBA) as a core regulatory hub in DCI pathogenesis, with gut microbiota dysbiosis being the initiating factor that disrupts host neuroendocrine, immune and circadian systems via multiple pathways, forming a vicious circle to aggravate DCI symptoms. Huanglian Wendan Decoction (HLWDD), a classic traditional Chinese medicine herbal formula, shows potential therapeutic effects on DCI by targeting the gut microbiota—the core node of MGBA. Notably, most relevant evidence is derived from animal preclinical models. This Mini Review succinctly summarizes the core pathological mechanisms of gut microbiota dysbiosis inducing DCI via MGBA, and elaborates HLWDD’s multi-target therapeutic effects on DCI centered on gut microbiota regulation: reshaping gut microbiota composition, promoting short-chain fatty acids (SCFAs) production, and protecting intestinal mucosal barrier integrity, as well as improving central nervous system dysfunction via MGBA bidirectional regulation. We also discuss the existing academic controversies, critical research gaps and potential future development directions in this field. This review highlights the gut microbiota as a key therapeutic target of HLWDD for DCI, and provides a scientific basis for its clinical application and translational research via MGBA modulation.

Stroke has emerged as the second leading cause of mortality. Insomnia after stroke is a highly prevalent complication of stroke with a complex mechanism, impacting daily activities and hindering neurological function rehabilitation while also increasing the risk of stroke recurrence. With the development of molecular biology, intestinal flora has garnered considerable interest in the past few years because of its significant implications for human physiology and pathology. Numerous studies have emphasized the crucial function of intestinal flora in the pathological changes associated with insomnia after stroke. It can influence sleep patterns following a stroke by modulating various pathways, including the hypothalamic-pituitary-adrenal (HPA) axis, immune responses, and neural mechanisms. Disruption of intestinal flora can adversely affect post-stroke sleep quality, while sleep after stroke can also lead to intestinal flora imbalance. Based on the intestinal flora, this paper explores the involvement of hypothalamic-pituitary-adrenal axis (HPA axis), immune pathway and neural pathway in insomnia after stroke, aiming to offer insights for the prevention, treatment, and research of post-stroke insomnia.

Insomnia, as one of the emotional diseases, has been increasing in recent years, which has a great impact on people's life and work. Therefore, researchers are eager to find a more perfect treatment. The microbiome-gut-brain axis is a new theory that has gradually become popular abroad in recent years and has a profound impact in the field of insomnia. In recent years, traditional Chinese medicine (TCM) has played an increasingly important role in the treatment of insomnia, especially acupuncture and Chinese herbal medicine. It is the main method of TCM in the treatment of insomnia. This paper mainly reviews the combination degree of "microorganism-gut-brain axis" theory with TCM and acupuncture under the system of TCM. To explore the mechanism of TCM and acupuncture in the treatment of insomnia under the guidance of "microorganism-gut-brain axis" theory, in order to provide a new idea for the diagnosis and treatment of insomnia.

Diabetic peripheral neuropathy (DPN) is one of the strongest risk factors for diabetic foot ulcers (neuropathic ulcerations) and the existing ulcers may further deteriorate due to the damage to sensory neurons. Moreover, the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short time. DPN is associated with gut microbiota dysbiosis. Traditional Chinese medicine (TCM) compounds such as Shenqi Dihuang Decoction, Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut microbiota. The current review discusses whether TCM compounds can reduce the risk of DPN by improving gut mic-robiota.

Herpes zoster virus infectious facial paralysis is caused by the reactivation and replication of varicella-zoster virus, which leads to herpetic inflammatory lesions, resulting in peripheral facial paralysis associated with herpes rash in the auricle and external ear, and vestibular cochlear dysfunction. It is also known as Ramsey-Hunter syndrome (Hunt syndrome). Facial paralysis caused by herpes zoster is difficult to cure due to its easy loss of treatment and mistreatment. Cause a greater burden on the patient's body and mind. However, the treatment of Western medicine has lagged behind and there are many adverse reactions, which cannot be completely cured, and new alternatives are urgently needed. This article briefly reviews the advantages and disadvantages of modern medical treatment of Hunt syndrome. This paper expounds the unique ideas of traditional Chinese medicine in the treatment of Hunt syndrome from the perspectives of antiviral, antibacterial, improving blood circulation, protecting cardiovascular, cerebrovascular, and nerve. This article discusses the superiority of traditional Chinese medicine in the treatment of Hunt syndrome from 2 aspects of Chinese medicine therapy and acupuncture therapy, and points out the feasibility of combined treatment of acupuncture and traditional Chinese medicine. So as to provide a new treatment for Hunt syndrome.

古代经典名方柴胡加龙骨牡蛎汤出自《伤寒论》,由小柴胡汤衍变而来,此方主治少阳枢机不利,气郁津凝,热邪扰神,为和解少阳之邪、通阳泄热、重镇安神之剂.文章通过查阅古今医籍和大量文献,对柴胡加龙骨牡蛎汤的来源追溯、历史发展、变化进程以及临床应用均进行了系统梳理,以期为柴胡加龙骨牡蛎汤的临床定位、新药研发转化研究提供有效性和安全性的参考依据.研究结果表明,柴胡加龙骨牡蛎汤经历代医家的不断探索与临床实践,临床应用不断丰富,凡属于"少阳枢机不利"出现的病证均可采用本方随证加减,主治疾病包括神经类病、心血管病、脑血管疾病、妇科病、男科病、儿科病、皮肤病、消化系疾病、肿瘤、综合征、肺病、肾病、骨病及传染病等.

Background: The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of anthropometric and biochemical indicators in overweight and obese patients is controversial. In this regard, the aim of this review was to summarize the evidence of TCE interventions to evaluate their effectiveness on the anthropometric and biochemical indicators of overweight and obese patients. Method: Five databases were systematically searched for relevant articles published from inception to October 2022. Randomized controlled trials examining TCE intervention in overweight and obese patients The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges’ g). The categorical and continuous variables were used to conduct moderator analyses. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42022377632). Result: Nine studies involving a total of 1297 participants were included in the final analysis. In the anthropometric indicators outcomes, the meta-analytic findings revealed large and significant improvements in body mass index (g = 1.44, 95% confidence interval [CI] = 1.27–1.61, P = .000, I2 = 99%), weight (g = 1.47, 95% CI = 1.25–1.68, P = .000, I2 = 95%), fat percentage (g = 1.22, 95% CI = 0.52–1.93, P = .000, I2 = 93%), and small and significant improvements in waist circumference (g = 0.38, 95% CI = 0.21–0.54, P = .000, I2 = 99%). In the biochemical indicators outcomes, the findings revealed large and significant improvements in low density lipoprotein (g = 2.08, 95% CI = 1.80–2.37, P = .000, I2 = 98%), moderate and significant improvements in triglyceride (g = 0.69, 95% CI = 0.56–0.81, P = .000, I2 = 96%), small and significant improvements in total cholesterol (g = 0.37, 95% CI = 0.19–0.54, P = .000, I2 = 77%), and high-density lipoprotein (g = −0.71, 95% CI = −0.86 to 0.57, P = .000, I2 = 99%). The moderator shows that the effects of TCE on anthropometric and biochemical indicators were moderated by frequency of exercise, exercise duration, and type of control group. Conclusion: TCE intervention is a beneficial non-pharmacological approach to improving anthropometric and biochemical indicators in overweight and obese subjects, especially in body mass index, weight, fat percentage, triglyceride, and low-density lipoprotein. The clinical relevance of our findings is pending more extensive trials and more rigorous study designs to strengthen the evidence.

血管性痴呆(VD)是一种由于流向大脑的血流减少或缺乏而导致的记忆和认知功能恶化的神经认知障碍.铜死亡是一种新的细胞调节性死亡方式,铜可以调节缺氧诱导因子-1(HIF-1),选择性激活HIF-1α以控制血管新生.血管新生指从已有血管中发芽形成新的血管,在神经组织再生中发挥重要作用.因此,通过抑制铜死亡促进血管新生,来恢复神经系统相关功能,可能是今后治疗VD等神经相关疾病的新思路.针刺可通过改善侧支循环、调节周细胞和星形胶质细胞的表达,进一步促进血管新生,目前较广泛地应用于治疗VD.本研究以针刺对微量元素铜的影响作为切入点,结合铜死亡和血管新生理论对VD后的相关损伤机制,探究针刺治疗VD的干预机制,以期为后续研究提供参考.

Diabetic peripheral neuropathy (DPN) is the most common neuropathy in the world, mainly manifested as bilateral symmetry numbness, pain or paresthesia, with a high rate of disability and mortality. Schwann cells (SCs), derived from neural ridge cells, are the largest number of glial cells in the peripheral nervous system, and play an important role in DPN. Studies have found that SCs are closely related to the pathogenesis of DPN, such as oxidative stress, endoplasmic reticulum stress, inflammation, impaired neurotrophic support and dyslipidemia. This article reviews the mechanism of SCs in DPN.

With the progress and rapid societal development, women are confronted with multifaceted pressures in their lives, encompassing familial and other domains. Furthermore, during the perimenopausal phase, endocrine equilibrium is disrupted, leading to the emergence of psychological and physiological health challenges. Insomnia is a prevalent symptom among perimenopausal individuals. The brain-gut-bacteria axis assumes a pivotal role in the prevention, diagnosis, and management of perimenopausal insomnia. Chaihu Jia Longgu Muli decoction is a commonly prescribed remedy for addressing perimenopopausal insomnia. Consequently, this paper aims to investigate the interplay between the brain-gut-bacteria axis, intestinal microbiota, and the pathogenesis of perimenopausal insomnia. The study focuses on examining the regulatory effects of Chaihu Jia Longgu Muli decoction on the nervous system, intestinal microbiota, and the hypothalamus-pituitary-adrenal axis. Additionally, it explores the mechanisms underlying Hujia Longgu Muli decoction in mitigating perimenopausal insomnia.

黄芪多糖(Astragalus polysaccharides,APS)是黄芪的重要活性成分之一,随着黄芪在临床上的使用越来越广泛,学者对APS的提取工艺、化学结构及药理作用的研究也愈来愈深入.不同的提取工艺对APS的含量和纯度均会产生不同程度的影响,进而对其药理作用的发挥也会有所影响.APS具有调节免疫、抗肿瘤、降血糖、抗衰老和抗炎等药理作用.在全面查阅并梳理文献资料的基础上,对APS的提取工艺、化学结构及药理作用进行综述,并对APS的研究前景进行展望,以期对APS的进一步开发利用和研究提供有效的理论支持.

OBJECTIVE:To explore the active components and mechanism of Jiaotai Pill (JTP) in the treatment of primary insomnia (PI) based on gene expression omnibus. METHODS:The main active components of Jiaotai Pills were obtained by TCMSP and literature mining, and the targets of the active components of Jiaotai Pills were predicted. The targets were verified and standardized by Uniprot database. PI-related targets were obtained from GeneCards, OMIM, DrugBank, PharmGKB, and TTD databases. Obtaining an intersection action target point of the Jiaotai pill and the PI by using a Venny diagram; Gene chip data (GSE208668) was downloaded from gene expression omnibus database, and then gene probe enrichment analysis (GSEA) was used to screen the differentially expressed genes between PI patients and normal controls, and molecular docking was used to virtually verify the screened differentially expressed genes with potential active compounds. RESULTS:21 active components and 263 potential targets of Jiaotai Pill were screened by database analysis and literature mining, 112 of which were intersected with PI. Molecular docking results showed that quercetin, EGCG, kaempferol, R-kanatin, stigmasterol, berberine and other core active components had good docking activity with related differential genes. CONCLUSION:Jiaotai Pill can regulate the release of inflammatory factors through multiple active ingredients, multiple disease targets, multiple biological pathways and multiple pathways to achieve the purpose of treating PI, which provides a theoretical basis for the clinical treatment of PI and broadens the clinical use of Jiaotai Pill.

OBJECTIVE:To explore the curative effect of "Jiaotai Pill" combined with head rhythmic massage consistent with 5-tone rhythm on insomnia of heart-kidney disharmony type.METHODS:Sixty patients with insomnia in massage clinic and ward were randomly divided into treatment group A (30 cases) and treatment group B (30 cases). Patients in group A were treated with traditional head massage combined with oral estazolam tablets. Group B was treated with "Jiaotai Pill" combined with head rhythmic massage therapy consistent with 5-tone rhythm. After 2 weeks of treatment, the scores of Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index and Traditional Chinese Medicine Symptom Scale, as well as the expression changes of interleukin (IL)-6 and IL-8 in serum were compared between the 2 groups before and after treatment.RESULTS:After 2 weeks of treatment, the total effective rate of group B was 93. 33%, which was significantly higher than that of group A (66. 67%) (P < .05). After treatment, the scores of Hamilton Anxiety Scale, PQSI, insomnia severity index and traditional Chinese medicine symptom scores were significantly decreased in both groups, and the decrease in group B was more significant than that in group A (P < .05). After treatment, the serum levels of IL-6 and IL-8 were significantly decreased in both groups, and the decrease in group B was greater than that in group A, the difference was statistically significant (P < .05).CONCLUSION:The overall efficacy of Jiaotai Pill combined with head massage therapy consistent with 5-tone rhythm is significantly better than that of traditional massage combined with 5-element music therapy for insomnia patients with heart-kidney disharmony.

目的:新型无痛针灸进针器结合电针治疗就医者面部皱纹的临床效果分析.方法:30例面部皱纹就医者通过无痛针灸进针器进行针灸美容治疗,每周治疗2次,10次为1疗程,共治疗1个疗程.观察其治疗前后的面部皱纹量表(FWS)评分,视觉模拟评分(VAS),治疗3个月后的临床疗效及就医者满意度评分.结果:治疗后皱纹评分均较治疗期明显降低,差异有统计学意义(P<0.01);第1次进针时的VAS评分显示针灸器进针接近无痛;治疗3个月后总有效率为90％,就医者满意度为97％.结论:新型无痛针灸进针器结合电针治疗面部皱纹效果佳,疼痛程度低,且可一定程度改善肤质,值得临床推广应用.

本文总结了王国才教授以血瘀为主要病机论治不寐的理论和临床经验.认为本病缠绵难愈与血瘀关系密切,血瘀病机贯穿疾病全过程,在治疗上以活血化瘀为主,佐以补益心脾、化痰理气、疏肝解郁、重镇安神等方法,并附相应验案,以供同道探讨.

张济民从医50余年,他对妇科疾病的辨证尤为精准,用药独特,临床效果显著.他认为妇女月经病多由瘀而来,妇女多以血为本,即使月经病病因复杂,但辨别清楚病因病机,不论是气滞、寒凝,还是气虚、情志不畅等,均可产生气血运行不畅,导致"不通则痛",其中"瘀"是本病病机之关键.文章总结了张济民治疗妇科月经病的学术思想及临床经验,希望对广大医者有所启发.

Restless leg syndrome (Restless legs syndrome, RLS) is a common neurological disorder. The pathogenesis of RLS remains unknown, and recent pathophysiological developments have shown the contribution of various genetic markers, neurotransmitter dysfunction, and iron deficiency to the disease, as well as other unidentified contributing mechanisms, particularly chronic renal dysfunction. RLS enhancement syndrome is frequently observed in patients with RLS who have received long-term dopamine agonist therapy, manifesting as a worsening of RLS symptoms, usually associated with an increase in the dose of dopamine agonist. Some patients with RLS can adequately control their symptoms with non-pharmacological measures such as massage and warm baths. First-line treatment options include iron supplementation for those with evidence of reduced iron stores, or gabapentin or pregabalin, as well as dopamine agonists, such as pramipexole. Second-line therapies include opioids such as tramadol. RLS seriously affects the quality of life of patients, and because its pathogenesis is unclear, more biological evidence and treatment methods need to be explored.

Objective The purpose of this study was to investigate the impact of cell necrosis-related genes on prognosis of patients with hepatocellular carcinoma（HCC）. Methods The mRNA data of patients with HCC and the clinical data of corresponding patients were downloaded from the Cancer Genome Atlas TCGA database. The polynecrosis-related gene prognostic models were constructed in TCGA files by using LASSO Cox regression. Results by univariate Cox regression analysis, 23 cell necrosis-related differentially expressed genes were associated with prognostic survival（P ＜ 0.05）; in this protocol, a significantly correlated prognostic model of 6 cell necrosis-related genes was constructed; the patients were divided into two groups according to the threshold of risk, and the overall survival in patients with high risk was significantly reduced as compared to in those with low risk（P＜0.01）; meanwhile, by multivariate Cox regression analysis, the risk score met the criteria for independent prognostic factors（P＜0.01）; the enrichment analysis（GO/KEGG） and one-sample gene set enrichment analysis（ssGSEA） were performed based on differentially gene levels, and the differential genes were found to be correlated to immune pathways（P＜0.05）. Conclusion The prognostic model we constructed by 6 cell necrosis-related genes could be applied to predict independently the prognosis of patients with HCC and provide a reference for the clinical management appropriately.

Narcolepsy is a relatively rare brain disorder caused by the selective loss of orexin neurons. Narcolepsy is divided into Narcolepsy Type 1 (NT1) and Narcolepsis Type 2 (NT2). The pathogenesis of NT1 has been well established due to the severe loss of orexin neurons, while NT2 is still poorly understood, and little is known about its underlying neurobiological mechanisms. human leukocyte antigen alleles have been found to strongly influence the development of narcolepsy, with more than 90% of NT1 patients carrying the human leukocyte antigen II allele DQB1*06:02. In addition to the genetic evidence for the DQBI*06:02 allele, some other evidence suggests that a T cell-mediated immune mechanism destroys the orexin neurons of NT1, with CD4 + T cells being key. For this disease, traditional Chinese medicine (TCM) therapy has its own characteristics and advantages, especially the combination of acupuncture and medicine in the treatment of this disease in TCM, which has made considerable and gratifying progress. The purpose of this review is to introduce the frontier progress of neurobiology of narcolepsy, and to explore the syndrome differentiation and treatment of narcolepsy with the combined use of TCM and Western medicine combined with TCM.