1.Inhibition of Epithelial-mesenchymal Transition Mechanism in Chronic Atrophic Gastritis Rats by Banxia Xiexintang via Regulating IL-17/ERK/C/EBPβ Signaling Pathway
Wenyu WU ; Xinyu ZENG ; Hao LI ; Weiqi SUN ; Jiahui REN ; Yang YU ; Tingting ZHOU ; Aili XU ; Wei WEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):1-10
ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang (BXT) inhibits epithelial-mesenchymal transition (EMT) in chronic atrophic gastritis (CAG) rats by regulating the interleukin-17(IL-17)/extracellular regulated protein kinases(ERK)/CCAAT enhancer binding protein β(C/EBPβ)signaling pathway, thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling, the rats were randomly divided into the model group, low-, medium-, and high-dose groups (0.549, 1.098, 2.196 g·kg-1, respectively) of BXT, and the positive drug group (vitacoenzyme, 0.3 g·kg-1). A normal control group was also set up. After 8 weeks of intervention, the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of IL-17, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and C/EBPβ in serum, as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin, N-cadherin, and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17, p-ERK, and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ, ERK, and its phosphorylated form (p)-ERK in gastric mucosa. Real-time polymerase chain reaction (Real-time PCR) was applied to measure the mRNA expression levels of ERK, COX-2, and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group, the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly increased (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBPβ in serum were significantly increased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased, while the content of E-cadherin was significantly decreased (P<0.01). Compared with the model group, after intervention with different doses of BXT, the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly reduced (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBP β in serum were significantly decreased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased, while the content of E-cadherin was increased (P<0.05,P<0.01). ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum, regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.
2.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
3.Ancient and Modern Documentation of Classic Formula Sangjuyin
Xiaofang WANG ; Lyuyuan LIANG ; Jialei CAO ; Ziming XU ; Wangju ZHOU ; Yiping WANG ; Yujie CHANG ; Ruiting SU ; Yihan LI ; Jingwen LI ; Bingqi WEI ; Bingxiang MA ; Wenli SHI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):200-207
Sangjuyin, as a pungent and cooling agent with precise therapeutic effect, is a classic pungent formula for cooling relief of the epidermis, which is highly respected by medical practitioners. This formula is from the Wenbing Tiaobian written by WU Jutong in the Qing dynasty, on the basis of which subsequent medical practitioners have made additions and subtractions to apply it. The authors used the bibliometric method to systematically organize the medical books from the Qing dynasty and the Republic of China and modern literature to analyze the composition, concoction, decoction, efficacy, and previous and modern application of Sangjuyin. After examination, the drug base of this formula is basically clear. Armeniacae Semen Amarum is the dried mature seeds of Armeniaca vulgaris, family Rosaceae. Forsythiae Fructus is the dried fruit of Forsythia suspensa, family Mulleinaceae. Menthae Haplocalycis Herba is the dried above-ground part of Mentha haplocalyx, family Labiatae. Mori Folium is the dried leaves of Morus alba, family Moraceae. Chrysanthemi Flos is the dried head of Chrysanthemum morifolium, family Asteraceae. Platycodonis Radix is the dried root of Eryngium grandiflorum, family Eryngium. Glycyrrhizae Radix et Rhizoma is the dried root and rhizome of Glycyrrhiza uralensis of the Leguminosae family, and Phragmitis Rhizoma is the fresh or dried rhizome of Phragmites communis of the Gramineae family. It is recommended that the eight drugs be used in raw form as medicine. The dosage and method of decoction were converted into a modern single dosage of 7.46 g Armeniacae Semen Amarum, 5.60 g Forsythiae Fructus, 2.98 g Menthae Haplocalycis Herba, 9.33 g Mori Folium, 3.73 g Chrysanthemi Flos, 7.46 g Platycodonis Radix, 2.98 g Glycyrrhizae Radix et Rhizoma, and 11.19 g Phragmitis Rhizoma, with 400 mL water added, and the solution was boiled to obtain 200 mL, taken twice a day. Sangjuyin has the efficacy of dispersing wind and clearing heat, promoting lung and relieving cough, and it is used for treating the initial onset of wind-warmth and the evidence of evil spirits in the lungs and collaterals. Modern research has shown that Sangjuyin is often used in the treatment of cough, pneumonia, rhinitis, and other respiratory diseases, and the results of this study provide a reference for the later development of Sangjuyin.
4.Molecular Mechanisms of Salvia Miltiorrhiza and Its Active Ingredients against Colorectal Cancer: A Review
Jianing GUO ; Xiaochen NI ; Kaiyuan ZHANG ; Wei FAN ; Chuhang WANG ; Chao XU ; Jianbo HUANG ; Tao JIANG ; Guangji ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):307-314
Colorectal cancer (CRC) is one of the most common cancers, with its incidence ranking high among cancers. It stands as the second leading cause of cancer-related death worldwide. In the early stages, CRC lacks specific symptoms, and most patients are diagnosed at advanced stages, making it a major research focus in the field of gastrointestinal tumors. Currently, clinical CRC treatments face several common challenges, including high surgical risks, frequent metastasis and recurrence, drug resistance, and significant side effects from chemotherapy and radiation therapy. With the development and application of traditional Chinese medicine (TCM), it has been found that TCM and its active ingredients can effectively inhibit CRC cell proliferation, invasion, migration, and angiogenesis, and promote apoptosis and autophagy, thereby slowing the progression of CRC. This has become a key focus of CRC treatment research. Salvia Miltiorrhiza has multiple pharmacological effects, including activating blood circulation to dispel blood stasis, unlocking meridians to relieve pain, clearing heat to calm irritability, and cooling blood to reduce abscesses. It contains a variety of chemical components, including diterpenoids, phenolic acids, flavonoids, polysaccharides, nitrogen-containing compounds, steroids, and lactone compounds. This review summarized the molecular mechanisms of Salvia miltiorrhiza and its active ingredients in the treatment of CRC. It is found that these ingredients exert anti-CRC effects through various molecular mechanisms, including cell cycle arrest, promotion of apoptosis, inhibition of cell invasion and migration, induction of autophagy, suppression of tumor angiogenesis, and remodeling of the tumor microenvironment. The review aims to provide new insights for the drug development and clinical application of Salvia miltiorrhiza in CRC treatment.
5.Severe Intravascular Large B-cell Lymphoma Presenting as Pulmonary Arterial Hypertension: A Case Report
Jianhua LI ; Wei HUANG ; Qing ZHANG ; Weiyuan LUO ; Yanqiong WU ; Xiukai CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):115-119
Intravascular large B-cell lymphoma(IVLBCL) is a rare and aggressive type of lymphoma with diverse and nonspecific clinical manifestations, often leading to misdiagnosis. This article reports a case of IVLBCL in a middle-aged male patient who initially presented with pulmonary arterial hypertension(PAH). The patient exhibited progressive hypoxemia and PAH, showing poor response to standard PAH therapy. Laboratory tests indicated a hyperinflammatory state and significantly elevated lactate dehydrogenase levels, while imaging revealed diffuse bilateral lung lesions. Random skin biopsy identified atypical B lymphocytes within subcutaneous capillaries, confirming the diagnosis of IVLBCL. Following treatment with the ZR-CHOP regimen, the patient's symptoms and laboratory parameters improved markedly. By reviewing relevant literature, this article systematically outlines the diagnostic and therapeutic process of this case, aiming to provide insights for the clinical recognition of such rare presentations.
6.Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock(2025)
Wei HUANG ; Xinchen WANG ; Wenzhao CHAI ; Keliang CUI ; Bo YAO ; Zhiqun XING ; Cui WANG ; Jingjing LIU ; Shiyi GONG ; Dongkai LI ; Wanhong YIN ; Xiaoting WANG ; Wei DU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):40-58
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the
7.Standards for the Application of Hemodynamic Monitoring Technology in Critical Care
Hua ZHAO ; Hongmin ZHANG ; Xin DING ; Huan CHEN ; Jun DUAN ; Wei DU ; Bo TANG ; Yuankai ZHOU ; Dongkai LI ; Xinchen WANG ; Cui WANG ; Gaosheng ZHOU ; Xiaoting WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(1):73-85
With the rapid advancement of hemodynamic indices and monitoring technologies, their classification methods and application processes have become increasingly complex. Currently, no unified standard hasbeen established, making it difficult to fully meet the clinical requirements for hemodynamic management. To assist in hemodynamic monitoring assessment and therapeutic decision-making in critically ill patients, the Critical Hemodynamic Therapy Collaborative Group, in conjunction with the Critical Ultrasound Study Group, has jointly developed the Standard for the Application of Hemodynamic Monitoring Techniques in Critical Care. The first part of this standard systematically categorizes hemodynamic indicators into flow indicators, pressure and its derivative indicators, and tissue perfusion indicators, while elaborating on the clinical application of each. The second part establishes a standardized clinical implementation pathway for hemodynamic monitoring. It proposes a tiered monitoring strategy-comprising basic, advanced, indication-specific, and special scenario monitoring-tailored to different clinical settings. It emphasizes the central role of critical care ultrasound across all levels of monitoring and establishes hemodynamic assessment standards for organs such as the brain, kidneys, and gastrointestinal tract. This standard aims to provide a unified framework for clinical practice, teaching, training, and research in critical care medicine, thereby promoting standardized development within the discipline.
8.Altered Lymphocyte Subsets in Perioperative Cancer Patients Before and After Septic Shock: Characteristics and Prognostic Implications
Miao WEI ; Lili YANG ; Xiaoyan LI ; Huifang LYU ; Yan DUAN
Medical Journal of Peking Union Medical College Hospital 2026;17(1):86-97
To investigate the changes in peripheral blood immune cells before and after the onset of septic shock in patients with malignant tumors, and to analyze the relationship between these immune cells and patient prognosis. A retrospective study was conducted, enrolling perioperative tumor patients who were transferred to the intensive care unit (ICU) due to septic shock at Shanxi Provincial Cancer Hospital between October 2018 and December 2019.Changes in lymphocyte counts and subsets were compared before and after septic shock (measured prior to septic shock onset and within 72 hours after onset).A multivariate Logistic regression model was used to analyze the relationship between these immune indicators and the 28-day mortality risk in tumor patients following septic shock. A total of 47 tumor patients transferred to the ICU due to septic shock were included.There were 32 males and 15 females, with a mean age of (63.9±11.2) years.Gastrointestinal tumors were the most common tumor type (76.60%, 36/47), and abdominal/pelvic infection (65.96%, 31/47) was the primary source of infection.Within 28 days after ICU transfer, 12 patients died and 35 survived. Compared to pre-septic shock levels, lymphocyte counts significantly decreased after septic shock[530(300, 830) cells/μL Perioperative tumor patients experience acute depletion of peripheral blood lymphocyte subsets following septic shock.Among various immune indicators, regulatory T cell count serves as an independent predictor of short-term mortality risk.Evaluating baseline immune function in such patients may help optimize treatment strategies and improve overall prognosis.
9.Mechanism of drug-containing serum of Dianxianqing granules in inhibiting microglial ferroptosis
Guangkun FAN ; Yue QI ; Jixian WANG ; Wei CHEN ; Chunpeng XIA ; Yihang WANG ; Yue ZHAO ; Yang AN
China Pharmacy 2026;37(3):317-323
OBJECTIVE To explore the potential mechanism by which drug-containing serum of Dianxianqing granules (DXQ) inhibits microglial ferroptosis. METHODS Male SD rats were given normal saline and Dianxianqing granules solution via intragastric administration to prepare normal serum and DXQ, respectively. Mice microglia BV2 cells were collected and successfully transfected with a negative control small interfering RNA (si-NC), and then they were included in the si-NC group and cultured under normal conditions. Cells successfully transfected with small interfering RNA targeting glutathione peroxidase 4 (GPX4) (si-GPX4) were divided into the si-GPX4 group, the CsA group (treated with 1 μmol/L cyclosporine A), and the DXQ- L, DXQ-M and DXQ-H groups (treated with 5%, 7% and 10% DXQ, respectively). These groups were subsequently treated with their corresponding drug solutions and ferroptosis inducer Erastin (10 μmol/L). The intracellular levels of total iron ions, glutathione (GSH), reactive oxygen species (ROS), and the expression of mitochondrial superoxide were determined in each group after 48 h of treatment. Additionally, mitochondrial membrane potential, the opening degree of mitochondrial permeability transition pore (MPTP), and mRNA expressions of GPX4 and cyclophilin D (CypD) were detected. Furthermore, the expressions of ferroptosis-related proteins[GPX4, transferrin receptor 1 (TfR1) and ferritin heavy chain 1 (FTH1)], as well as MPTP-related proteins [adenine nucleotide translocator (ANT), cytochrome C (CytC), mitochondrial calcium uniporter (MCU) and CypD] were assessed. RESULTS Compared with si-NC group, the levels of total iron ions and ROS, the expression level of mitochondrial superoxide, the opening degree of MPTP, protein and its mRNA expressions of CypD as well as protein expressions of TfR1 and MCU were increased or up-regulated significantly (P<0.01); however, GSH content, mitochondrial membrane potential, protein and mRNA expressions of GPX4, and protein expressions of FTH1, ANT and CytC were decreased or down-regulated significantly (P<0.01). Compared with the si-GPX4 group, the cells in the DXQ-M, DXQ-H groups showed a general improvement in the above quantitative indicators (P<0.01 or P<0.05). CONCLUSIONS DXQ can enhance antioxidant capacity by activating the GSH/GPX4 pathway, regulate the expressions of TfR1 and FTH1 protein to correct iron ion homeostasis, inhibit excessive opening of MPTP to improve mitochondrial function, and ultimately suppress microglial ferroptosis.
10.Mechanism of Xibining Ⅱ in alleviating cold stimulus pain sensitivity in rats with cold-damp obstruction-type KOA by regulating SETDB2/H3K9me3 signaling axis
Enrui HU ; Yibao WEI ; Deren LIU ; Maimaitituxun AOBULIAISAN ; Peimin WANG ; Taiyang LIAO
China Pharmacy 2026;37(3):324-330
OBJECTIVE To investigate the mechanism by which the traditional Chinese medicine formula Xibining Ⅱ modulates cold-stimulus pain sensitivity in rats with cold-damp obstruction-type knee osteoarthritis (KOA) based on the SET domain bifurcated histone lysine methyltransferase 2 (SETDB2)/histone H3 lysine 9 trimethylation (H3K9me3) signaling axis. METHODS Fifty SD rats were randomly divided into control group (intragastric administration and intrathecal injection of equal volumes of normal saline), model group (intragastric administration and intrathecal injection of equal volumes of normal saline), Xibining Ⅱ low- and high-dose groups (4, 8 g/kg Xibining Ⅱ, intragastric administration), and high-dose of Xibining Ⅱ+small interfering RNA (siRNA) group (8 g/kg of Xibining Ⅱ via intragastric administration and intrathecal injection of SETDB2 siRNA at 0.2 mmol/L, 20 μL per rat), with 10 rats in each group. Except for the control group, cold-damp obstruction-type KOA model was induced in other groups. Drug administration commenced 14 days post-modeling and continued for 28 days. Following the final administration, the following were assessed: behavioral changes in cold-stimulation pain sensitivity, histopathological changes in the articular cartilage of the knee joint, the contents of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β)] and pain mediators [calcitonin gene-related peptide (CGRP), nerve growth factor (NGF)], as well as the expressions of SETDB2/H3K9me3 signaling axis,inflammatory factors and pain mediators related proteins and mRNAs in dorsal root ganglion (DRG) tissue. RESULTS After 28 days of drug administration, compared with the model group, Xibining Ⅱ low- and high-dose groups exhibited significantly prolonged cold-stimulus paw withdrawal latency (P<0.05); the number of positive responses in the acetone low-temperature test was significantly reduced (P<0.05); Mankin score and the Osteoarthritis Research Society International score for knee joint tissue, as well as the levels of inflammatory factors and pain mediators in the serum and their expression in DRG tissue were all significantly decreased (P<0.05); the protein expressions of SETDB2 and H3K9me3 in DRG tissue were significantly increased (P<0.05). Intrathecal injection of SETDB2 siRNA reversed the above effects of high-dose of Xibining Ⅱ (P<0.05). CONCLUSIONS Xibining Ⅱ may alleviate inflammatory and pain responses by activating the SETDB2/H3K9me3 signaling axis, ultimately improving cold-stimulus pain sensitivity in rats with cold-damp obstruction-type KOA.

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