The concept of cause in TCM is different from the etiology concept in modern TCM. In modern TCM,the etiology is equal to pathogenic factors.At present,the significance of 'pathogenic factors'in TCM was affected by modern TCM,and this description can't show the essence of TCM theory and is not conducive to the development of cause theory of TCM.

This article unscrambled the concept of pathogenesis theory,through textual research of literatures,directly explained the concept connotation.From the relationship between pathogenesis and symptom differentiation and the innovation of pathogenesis theory of doctors in past dynasties,it demonstrated the possibility that pathogenesis theory was the innovation breakthrough point of traditional Chinese medicine theory.It proposed the conjecture that pathogenesis was the "saddle point" "sensitive point" of traditional Chinese medicine is theory,and proposed several assume about pathogenesis theory study.

Objective To investigate the clinical characteristics of a clustering infection caused by human adenovirus-B type 7 (HAdV-B7) which occurred in one military camp located at the southeastern coastal region in January 2014.Methods All clinical characteristics of the 70 patients were collected for analysis,including clinical symptoms and signs,chest computer tomography (CT) scans and laboratory results.Throat swabs were collected and real time polymerase chain reaction (RT-PCR) was performed to detect viral nucleotide.Results The prominent symptoms of these patients with HAdV-B7 infection included fever (100.0％,70/70),cough (82.9％,58/70),productive cough (72.9％,51/70) and sore throat (61.4％,43/70).All patients showed posterior pharyngeal wall linear congestion with ovoid follicle.Fifty-four (77.1 ％) patients had enlarged tonsils and 46 (65.7 ％) patients had tonsils covered by white secretions.Fifty-eight (82.9 ％) patients had pharyngeal follicular hyperplasia.Fifty-one (72.9 ％) patients had abnormalities on chest radiograph,including lung-marking fuzzy,pulmonary interstitial inflammation and parenchymal serous exudation.Of the 54 throat swabs from patients,34(63.0％) were identified as HAdV-B7.All patients were cured.Conclusions The clinical features of patients with HAdV-B7 infection are different from other viral infection.HAdV-B7 is easy to cause clustering infection in particular populations.Early detection and early intervention are needed to avoid exacerbation and transmission.

Objective:To study the effect of Huanglian-Jiedu Decoction on the white matter lesion of rats with focal cerebral ischemia and to explore the regulative role of the active fraction of Huanglian-Jiedu Decoction on NogoA/NgR. Methods:Male SD rats were randomly divided into sham operation group, model group, total alkaloid group, total flavonoid group, and total iridoid group. Except for the sham operation group, the rats in the other groups were used to establish the middle cerebral artery occlusion rat model by the suture method. 2 hours after modeling, rats in the total alkaloid group were given intragastric administration with 44 mg/kg total alkaloids; rats in the total flavonoid group were given intragastric administration 50 mg/kg total flavonoids; rats in the total iridoid group were given intragastric administration 80 mg/kg total iridoids, the sham operation group and the model group were intragastrically given equal volume of normal saline, once a day, for 7 consecutive days. The pathological changes of rat white matter were observed by HE staining, the pathological changes of rat myelin sheath were observed by Luxol fast blue (LFB) staining, and the expression of Amyloid precursor protein (APP), NogoA, and NgR in the internal and external capsule areas of the brain was detected by immunohistochemical staining. Real-time fluorescence quantitative PCR was used to detect the expression of NogoA and NgR in the tissues surrounding the ischemic infarct.Results:Compared with the model group, the total alkaloid group, total flavonoid group, and total iridoid group had lower pathological damage scores in the internal and external capsule areas of rats ( P<0.05 or P<0.01), increased integral optical density value of LFB staining ( P<0.01), decreased expression of APP and NogoA; the expression of NgR in the internal and external capsules of rats in the total alkaloid group and the total iridoid group decreased ( P<0.05 or P<0.01), and the expression of NgR in the inner capsule of rats in the total flavonoid group decreased ( P<0.01); the expression of NogoA (1.20 ± 0.17, 1.55 ± 0.30, 1.19 ± 0.38 vs. 2.22 ± 0.58) and NgR (1.98 ± 0.55, 1.48 ± 0.31, 1.58 ± 0.27 vs. 3.36 ± 0.41) genes in the tissues around the infarct focus of rats in the total alkaloid group, total flavonoid group and total iridoid group decreased ( P<0.01). Conclusion:The present study investigates the therapeutic effects of Huanglian-Jiedu Decoction, promoting white matter repair by decreasing the overexpression of NogoA and NgR in an experimental animal model of stroke.

Application of network pharmacology in traditional Chinese medicine (TCM) will be benefit for clarifying active components and mechanism of action of TCM and increase the study level of new drug of Chinese medicine. ADME process can identify drug components from TCM and obtain the possible metabolites which can clarify active components in vivo. For the complexity of active constituents of TCM, it indicated that the ADME process will be the precondition for application of network pharmacology in TCM. This paper introduced the study ideas of the combination of ADME process in vivo and network pharmacology.
Drug Delivery Systems ; methods ; Drug Therapy ; methods ; Drugs, Chinese Herbal ; administration & dosage ; metabolism ; pharmacokinetics ; Humans ; Medicine, Chinese Traditional ; methods ; Pharmacology ; methods

OBJECTIVE:To provide reference for the sustainable development of pharmaceutical industry in Guizhou province.METHODS:By literature review,personal interview and questionnaire survey,the current situation about the development of pharmaceutical industry in Guizhou province were investigated and analyzed,and the corresponding countermeasures and suggestions were put forward.RESULTS:The literatures were obtained from network literature by Baidu search engine,published data by government portal website of administrative department,documents by CNKI and VIE Five personal interviews involved the relevant management personnel in Policies and Regulations Department,Medicine and Cosmetics Production Supervision Department,Medical Device Supervision Department of Guizhou Province Food and Drug Administration.A total of 70 questionnaires (drug production enterprises as object) were sent out,and 57 valid questionnaires were collected with the effective recovery rate of 81.4％.In the present,there were a total of 175 pharmaceutical production enterprises (56.5％ in Guiyang city) and 106 medical device manufacturers in Guizhou province.Of 57 pharmaceutical manufacturing enterprises investigated,87.8％ of them were certified by the 2010 edition of Good Manufacturing Practice (GMP).The number of varieties of Chinese herbal medicines in Guizhou province ranked second in the whole country;total area of Chinese herbal medicine planting,wild protection and tending ranked third in the whole country in 2015;the industrial output value of Chinese patent medicine accounted for 85.1％ of the total output value of the pharmaceutical industry;but no approved new medicines were class 1 and 2 new medicines;R&D personnel with high education levels took small proportion significantly.The output capacity of chemical medicine industry was far lower than the average national level;the chemical industry output value accounted for only about 10％ of the total output value of the pharmaceutical industry in the province;the rate of success approval was almost zero for new drugs declared by drug manufacturers in recent years.Biological products industry was an emerging industry,currently there were only 3 biological products production enterprises.Of 341 products in medical device industry,there were 146 class Ⅰ products,190 class Ⅱ products and 5 classⅢproducts,manifesting as narrow coverage,few production type,relatively backward level.Seven percent of pharmaceutical production enterprise involved in the derivatives industry,and the development of TCM health care industry attracted more and more attention.CONCLUSIONS:The Chinese and national medicine industry has been the dominant force,the development of chemical medicine,biological products and medical device indusmy has lagged behind,and medicine derivatives industry needs to promote the integration of TCM and health-and-fitness.Thewhole industry strategic consciousness is comparatively backward,high-end R&D personnel is lack,and independent innovation ability is weak.It is suggested to done the top design,guide enterprises mergers and restructuring;develop characteristic medicine,support small molecule chemical medicines and biological products enterprises deeply;deepen the understanding of industrial policy,and increase investment in independent innovation;develop new medicine derivatives,and expand the pharmaceutical e-commerce sales channel;broaden the industry chain depth,breadth and width,and excavate medical big data.

Objective To evaluate the short-term efficacy and quality of life of primary hepatocellular carcinoma patients after radiotherapy and pregabalin treatment for neuropathic pain with bone metastasis. Methods 32 patients with primary hepatocellular carcinoma bone metastases were treated with radiotherapy combined with pregabalin treatment.Then, we prospectively studied the analgesic efficacy for neuropathic pain and quality of life, used the brief pain inventory and douleur neuropathique 4 questionnaire (DN4) to evaluate pain at baseline, one and two months after radiotherapy, assessed pain response using the international consensus endpoint definition of bone metastasis, and used European Organization for Research and Treatment of Cancer Research and Treatment Quality of Life Questionnaire (EORTC QLQ-C30) and bone metastasis module (QLQ-BM22) for quality of life assessment. Results One and two months after radiotherapy, the average DN4 score of neuropathic pain decreased, and the objective pain relief rates were 62.8% and 68.6%, respectively.The physical, emotional, social, and role functional scores of EORTC QLQ-C30 functional scale significantly increased in the first month after radiotherapy.Symptom scale of pain (P=0.015), insomnia (P=0.035), and loss of appetite (P=0.022) improved, and fatigue was aggravated (P < 0.05).Two months after radiotherapy, the mean overall health score and all functional scale scores significantly increased than those at baseline.The scores of all symptom scales decreased, except fatigue, constipation, and financial difficulties (P < 0.05).In addition, pain responders showed significant improvement in emotional function (P=0.025) and physical function (P=0.029) in the functional scale and in pain (P=0.014) and fatigue (P=0.035) in the symptom scale.The QLQ-BM22 score showed that the painful sites (P=0.021) and pain characteristics (P=0.04) of the responders significantly improved compared with those of nonresponders two months after radiotherapy. Conclusion Radiotherapy combined with pregabalin can relieve neuropathic pain caused by bone metastasis from primary hepatocellular carcinoma and greatly improve the quality of life, particularly in pain responders.

ObjectiveTo elucidate the underlying mechanism of the efficacy of Levo-tetrahydropalmatine （l-THP） in alleviating chronic pain and identify the key metabolites and metabolic pathways for l-THP regulation. MethodA classical chronic constrictive injury （CCI） model was built in rats’ bodies， and the pain intensity was evaluated by detecting the mechanical withdrawal threshold. On the sixth day after surgery， oral administration of l-THP （64 mg·kg^-1） and positive control drug pregabalin （Pre， 30 mg·kg^-1） was performed on rats. After the last administration following consecutive five times of administration， ipsilateral spinal cord tissues were collected for widely-targeted metabonomics， with eight rats in each group. Differential metabolites （DEMs） were identified according to the standard of VIP>1.0 and P<0.05， and functional enrichment and interaction analyses of the Kyoto Encyclopedia of Genes and Genomes （KEGG） were performed to obtain the key metabolites and metabolic pathways associated with the analgesic effects of l-THP. ResultIn behavioral science， administration of both l-THP and Pre significantly improved mechanical hyperalgesia in CCI rats （P<0.01）， thus mitigating pain. Metabonomic analysis results revealed that l-THP administration corrected the aberrant metabolic profile in the spinal cord of CCI rats. Meanwhile， 53 DEMs were called back， including several classical pain biomarkers such as sphingosine-1-phosphate （S1P）， cyclic adenosine monophosphate （cAMP）， acetylcholine， and glutamate. Functional enrichment analysis of the DEMs indicated the involvement of metabolic pathways such as ferroptosis， autophagy， neuroactive ligand-receptor interactions， phospholipase D and cAMP-related signaling pathways， glutathione metabolism， and cofactor biosynthesis in mediating the effects of l-THP on the metabolic profile of the spinal cord. Further analyses on the relative metabolite abundance and metabolic pathways indicated that by significantly decreasing the relative levels of glutamate （P<0.01） and glycine （P<0.01） in the spinal cord， l-THP can promote the synthesis of reduced glutathione （GSH） and increase the ratio of reduced/oxidized GSH （P<0.05）. Additionally， it can relieve oxidative stress in the spinal cord of CCI rats and significantly reduce the acetyl-CoA level （P<0.01） to finally inhibit ferroptosis occurrence. Conclusionl-THP may exert analgesic effects by regulating multiple metabolic pathways including GSH metabolism， ferroptosis， cofactor biosynthesis， and amino acid synthesis to correct the aberrant metabolic profile in the spinal cord of CCI rats. Ferroptosis and GSH metabolism may be the key pathways for l-THP regulation， with glutamate， glycine， glutathione， and acetyl-CoA as the key metabolites.

Objective To evaluate the prognostic value of radiation-induced lymphocytopenia in the survival of patients with primary hepatocellular carcinoma receiving radiation therapy. Methods The clinical data of 98 patients with unresectable primary hepatocellular carcinoma who received radiotherapy were retrospectively analyzed. The minimum absolute lymphocyte count (min ALC) was graded in accordance with CTCAE V4.0. The optimal threshold of min ALC for prognosis was calculated by using the receiver operating characteristic curve, and the correlation of min ALC with clinical characteristics and dosimetry parameters was analyzed. The Kaplan-Meier method was employed to analyze the survival of patients with different levels of min ALC. Univariate and multivariate Cox proportional regression models were applied to analyze prognostic factors. Results The baseline and min ALC of 98 patients during radiotherapy were 1.52×10⁹/L and 0.45×10⁹/L, respectively(P<0.001). The optimal cut-off value of min ALC for the prediction of the one-year survival rate was 0.38×10⁹/L. GTV, the mean dose of the liver and spleen, the V5 and V10 of the liver and spleen, and the V15 of the spleen were correlated with min ALC, and the V5 of the liver was an independent predictor of min ALC. The overall survival of patients with high min ALC was higher than that of patients with low min ALC. Independent prognostic factors were min ALC≤0.38×10⁹/L (HR=0.515, P=0.024), min ALC≥grade 3 (HR=0.576, P=0.032), tumor thrombus in the portal/vena cava, Child-Pugh grade A, increase of ≥2 points in the Child-Pugh score after radiotherapy, and received more than two other therapies. Conclusion Min ALC≤0.38×10⁹/L and min ALC≥grade 3 have independent prognostic value in patients with unresectable hepatocellular carcinoma receiving radiotherapy.

ObjectiveTo improve the quality standard of Yuanhu Zhitong oral liquid in order to strengthen the quality control of this oral liquid. MethodThin layer chromatography（TLC） was used for the qualitative identification of Corydalis Rhizoma and Angelicae Dahuricae Radix in Yuanhu Zhitong oral liquid by taking tetrahydropalmatine， corydaline reference substances and Corydalis Rhizoma reference medicinal materials as reference， and cyclohexane-trichloromethane-methanol（5∶3∶0.5） as developing solvent， Corydalis Rhizoma was identified using GF254 glass thin layer plate under ultraviolet light（365 nm）. And taking petroleum ether（60-90 ℃） -ether-formic acid（10∶10∶1） as developing solvent， Angelicae Dahuricae Radix was identified using a silica gel G TLC plate under ultraviolet light（305 nm）. High performance liquid chromatography（HPLC） was performed on a Waters XSelect HSS T3 column（4.6 mm×250 mm， 5 μm） with acetonitrile（A）-0.1% glacial acetic acid solution（adjusted pH to 6.1 by triethylamine）（B） as the mobile phase for gradient elution（0-10 min， 20%-30%A； 10-25 min， 30%-40%A； 25-40 min， 40%-50%A； 40-60 min， 50%-60%A）， the detection wavelength was set at 280 nm， then the fingerprint of Yuanhu Zhitong oral liquid was established， and the contents of tetrahydropalmatine and corydaline were determined. ResultIn the thin layer chromatograms， the corresponding spots of Yuanhu Zhitong oral liquid， the reference substances and reference medicinal materials were clear， with good separation and strong specificity. A total of 12 common peaks were identified in 10 batches of Yuanhu Zhitong oral liquid samples， and the peaks of berberine hydrochloride， dehydrocorydaline， glaucine， tetrahydropalmatine and corydaline. The similarities between the 10 batches of samples and the control fingerprint were all >0.90. The results of determination showed that the concentrations of corydaline and tetrahydropalmatine had good linearity with paek area in the range of 0.038 6-0.193 0， 0.034 0-0.170 0 g·L^-1， respectively. The methodological investigation was qualified， and the contents of corydaline and tetrahydropalmatine in 10 batches of Yuanhu Zhitong oral liquid samples were 0.077 5-0.142 9、0.126 1-0.178 2 g·L^-1， respectively. ConclusionThe established TLC， fingerprint and determination are simple， specific and reproducible， which can be used to improve the quality control standard of Yuanhu Zhitong oral liquid.