1.Effect of Qingxin Jieyu Granules Regulating Mitophagy on Ventricular Remodeling After Myocardial Infarction of C57B/L6 Mice
Yifan CHEN ; Jianfeng CHU ; Zhonghui JIANG ; Zhuye GAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):70-78
ObjectiveTo explore the effects of Qingxin Jieyu granules on ventricular remodeling of mice after myocardial infarction, and their regulatory role in mitophagy. MethodsSixty male C57BL/6 mice were randomly assigned to six groups: sham-operated group, model group, Qingxin Jieyu granules low-, medium-, and high-dose groups (1.3, 2.6, 5.2 g·kg-1), and sacubitril valsartan sodium group (0.03 g·kg-1), with 10 mice per group. Except for the sham-operated group, all other groups utilized left anterior descending coronary artery ligation to build a myocardial infarction model. Ultrasound was used to measure left ventricular parameters, including end-diastolic and end-systolic diameters (LVIDd, LVIDs), diastolic and systolic posterior wall thickness (LVPWd, LVPWs), end-diastolic and end-systolic volumes (LV Vold, LV Vols), left ventricular ejection fraction (LVEF), and fractional shortening (LVFS). Additionally, the heart mass index and heart weight/tibia length ratio of mice were calculated. Enzyme-linked immunosorbent assay (ELISA) was employed to quantify brain natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB), angiotensinⅡ (AngⅡ), and lactate dehydrogenase (LDH) levels in the serum of mice. Histological analysis using hematoxylin-eosin (HE) and Masson staining was conducted to examine morphological changes in myocardial tissue. Immunohistochemistry assessed the expression of vascular growth factors, including basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Transmission electron microscopy was used to scrutinize mitochondrial morphology in the myocardial tissue of mice. Western blot was performed to analyze the expression of phosphorylated adenosine monophosphate activated protein kinase (p-AMPK) and phosphorylated mammalian target of rapamycin (p-mTOR) proteins in myocardial tissue from each experimental group. ResultsCompared to the sham-operated group, the model group mice exhibited significantly elevated levels of LV Vold, LV Vols, LVIDd, LVIDs, cardiac mass index, heart weight/tibia length ratio, BNP, LDH, and p-mTOR protein expression (P<0.05), along with decreased levels of LVPWd, LVPWs, LVEF, LVFS, and p-AMPK protein expression (P<0.05). The model group also displayed substantial inflammatory cell infiltration, collagen deposition in myocardial cells, reduced expression of bFGF and VEGF, mitochondrial swelling, and cristae fragmentation. Compared to the model group, the sacubitril/valsartan group and mid-dose Qingxin Jieyu granules group showed significant reductions in LVIDs, LV Vold, LV Vols, BNP, CK-MB, LDH, and p-mTOR protein expression (P<0.05), coupled with increases in LVEF, LVFS, and p-AMPK expression (P<0.05). Improvements were observed across all treatment groups, including reduced inflammatory cell infiltration and collagen deposition, increased bFGF and VEGF expression, alleviated mitochondrial swelling, and the presence of autophagosomes and lysosomes
2.Guidelines of ethics review for clinical application of medical technology
Jiyin ZHOU ; Mingjie ZI ; Qi LU ; Hui JIANG
Chinese Medical Ethics 2025;38(1):15-22
Access to the clinical application of medical technology is one of the core institutional contents of medical quality management, involving medical quality assurance, the achievement of patient safety goals, and medical service satisfaction. Medical technology is only permitted for clinical use after its safety and effectiveness have been verified through clinical research, as well as evaluated and reviewed by the medical technology clinical application management committee and ethics committee of this medical and health institution. Based on the relevant laws, regulations, and ethical principles, combined with the experience of ethical review in the clinical application of medical technology from some medical and health institutions, a thematic discussion was held to formulate ethical review guidelines for the clinical application of medical technology for references. These guidelines elaborated on the management system for access to the clinical application of medical technology in medical and health institutions, the system of ethics committees and the requirements of review norms, technical plans and their review points, key points for the implementation of informed consent, technical teams and conditions, and other aspects.
3.Mechanism of Neochlorogenic Acid in Ameliorating Psoriatic Keratinocyte Proliferation and Inflammation by Targeting HSP90 to Modulate NF-κB/NLRP3 Signaling Pathway
Mengyao JIANG ; Xinwei ZHANG ; Bin YANG ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):89-98
ObjectiveTo investigate the target proteins directly bound by neochlorogenic acid (NA) and the molecular mechanisms that ameliorate the proliferation and inflammatory response of psoriatic keratinocytes. MethodsM5-induced HaCaT cells were used as a psoriatic keratinocyte proliferation and inflammatory cell model. The synthesized NA probe (NA-P) and NA prodrug were first evaluated for cell viability using a cell proliferation/cell counting kit-8(CCK-8). The potency of NA and NA-P was evaluated in the safe concentration range, and the effects of 0-100 μmol·L-1 NA and probe on M5-induced proliferation of HaCaT cells were detected using CCK-8. The effects of 20, 40, 80 μmol·L-1 NA and 80 μmol·L-1 NA-P on the expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-23 (IL-23), and interleukin-17A (IL-17A) inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA), and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to measure the effects of NA on the mRNA expression of keratin 16 (K16) in HaCaT cells, S100 calcium-binding protein A9 (S100A9), S100 calcium-binding protein A7 (S100A7), IL-6, IL-17A, and chemokine 1 (CXCL1). In vitro fluorescence labeling and competition experiments using NA-P were performed, and target protein angling and analysis using pull-down experiments combined with liquid chromatography-mass spectrometry (Pull-down/LC-MS/MS) were conducted. Target validation was performed using pull-down experiments combined with protein immunoblotting (Pull down-WB), cellular heat transfer analysis combined with protein immunoblot (CETSA-WB) experiments, and molecular docking. Finally, Real-time PCR was utilized to detect the effects of 20, 40, 80 μmol·L-1 NA and 80 μmol·L-1 NA-P on the mRNA expression of IL-1β, nucleotide-binding oligomeric structural domain-like receptor protein 3 (NLRP3), apoptosis-associated speckled-like protein (ASC), and cysteine protease-1 (Caspase-1) in HaCaT cells. Protein immunoblot (Western blot) was used to detect the effects of phosphorylated p65 (p-p65), p65, phosphorylated human nuclear factor-κB inhibitory protein α (p-IκBα), human nuclear factor κB inhibitory protein α (IκBα), and heat shock protein 90 (HSP90) expression. ResultsIn the 200 μmol·L-1 safe concentration range, HaCaT cell proliferation, increased expression of TNF-α, IL-1β, IL-23, and IL-17A inflammatory factors, and increased mRNA expression of K16, S100A9, S100A7, IL-6, IL-17A, and CXCL1 were observed in the M5 group compared with the blank group. Cell proliferation in 5-100 μmol·L-1 NA and NA-P groups was inhibited, and the expression of TNF-α, IL-1β, IL-23, and IL-17A inflammatory factors was decreased in the NA-L, NA-M, NA-H, and NA-P-H groups. The mRNA expression of K16, S100A9, S100A7, IL-6, IL-17A, and CXCL1 was decreased (P<0.05). High-confidence targets were screened for HSP90 protein by Pull-down/LC-MS/MS using 200 μmol·L-1 NA competing with 100 μmol·L-1 NA-P. Compared with that in the blank group, the mRNA expression of NLRP3, IL-1β, ASC, and Caspase-1, as well as the expression of p-p65/p65, p-IκBα/IκBα, and HSP90 protein, were increased in HaCaT cells in the M5 group (P<0.05). Compared with that in the M5 group, the mRNA expression of NLRP3, IL-1β, ASC, and Caspase-1 of cells in the NA-L group, the NA-M group, the NA-H group, and the NA-P-H group was decreased (P<0.05). p-p65/p65 and p-IκBα/IκBα were decreased in the NA-M and NA-H groups (P<0.05), and there was no change in HSP90 protein. Pull down-WB showed that NA could directly target HSP90 protein, and NA binding to HSP90 protein enhanced its thermal stability. Molecular docking of NA with HSP90 family proteins HSP90AA1, HSP90B1, and HSP90AB1 all resulted in highly stable binding. ConclusionNA can inhibit the proliferation and inflammatory response of psoriatic keratinocytes by a mechanism that may be achieved by targeting HSP90 to modulate the NF-κB/NLRP3 signaling pathway.
4.Mechanism of Neochlorogenic Acid in Ameliorating Psoriatic Keratinocyte Proliferation and Inflammation by Targeting HSP90 to Modulate NF-κB/NLRP3 Signaling Pathway
Mengyao JIANG ; Xinwei ZHANG ; Bin YANG ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):89-98
ObjectiveTo investigate the target proteins directly bound by neochlorogenic acid (NA) and the molecular mechanisms that ameliorate the proliferation and inflammatory response of psoriatic keratinocytes. MethodsM5-induced HaCaT cells were used as a psoriatic keratinocyte proliferation and inflammatory cell model. The synthesized NA probe (NA-P) and NA prodrug were first evaluated for cell viability using a cell proliferation/cell counting kit-8(CCK-8). The potency of NA and NA-P was evaluated in the safe concentration range, and the effects of 0-100 μmol·L-1 NA and probe on M5-induced proliferation of HaCaT cells were detected using CCK-8. The effects of 20, 40, 80 μmol·L-1 NA and 80 μmol·L-1 NA-P on the expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-23 (IL-23), and interleukin-17A (IL-17A) inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA), and real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to measure the effects of NA on the mRNA expression of keratin 16 (K16) in HaCaT cells, S100 calcium-binding protein A9 (S100A9), S100 calcium-binding protein A7 (S100A7), IL-6, IL-17A, and chemokine 1 (CXCL1). In vitro fluorescence labeling and competition experiments using NA-P were performed, and target protein angling and analysis using pull-down experiments combined with liquid chromatography-mass spectrometry (Pull-down/LC-MS/MS) were conducted. Target validation was performed using pull-down experiments combined with protein immunoblotting (Pull down-WB), cellular heat transfer analysis combined with protein immunoblot (CETSA-WB) experiments, and molecular docking. Finally, Real-time PCR was utilized to detect the effects of 20, 40, 80 μmol·L-1 NA and 80 μmol·L-1 NA-P on the mRNA expression of IL-1β, nucleotide-binding oligomeric structural domain-like receptor protein 3 (NLRP3), apoptosis-associated speckled-like protein (ASC), and cysteine protease-1 (Caspase-1) in HaCaT cells. Protein immunoblot (Western blot) was used to detect the effects of phosphorylated p65 (p-p65), p65, phosphorylated human nuclear factor-κB inhibitory protein α (p-IκBα), human nuclear factor κB inhibitory protein α (IκBα), and heat shock protein 90 (HSP90) expression. ResultsIn the 200 μmol·L-1 safe concentration range, HaCaT cell proliferation, increased expression of TNF-α, IL-1β, IL-23, and IL-17A inflammatory factors, and increased mRNA expression of K16, S100A9, S100A7, IL-6, IL-17A, and CXCL1 were observed in the M5 group compared with the blank group. Cell proliferation in 5-100 μmol·L-1 NA and NA-P groups was inhibited, and the expression of TNF-α, IL-1β, IL-23, and IL-17A inflammatory factors was decreased in the NA-L, NA-M, NA-H, and NA-P-H groups. The mRNA expression of K16, S100A9, S100A7, IL-6, IL-17A, and CXCL1 was decreased (P<0.05). High-confidence targets were screened for HSP90 protein by Pull-down/LC-MS/MS using 200 μmol·L-1 NA competing with 100 μmol·L-1 NA-P. Compared with that in the blank group, the mRNA expression of NLRP3, IL-1β, ASC, and Caspase-1, as well as the expression of p-p65/p65, p-IκBα/IκBα, and HSP90 protein, were increased in HaCaT cells in the M5 group (P<0.05). Compared with that in the M5 group, the mRNA expression of NLRP3, IL-1β, ASC, and Caspase-1 of cells in the NA-L group, the NA-M group, the NA-H group, and the NA-P-H group was decreased (P<0.05). p-p65/p65 and p-IκBα/IκBα were decreased in the NA-M and NA-H groups (P<0.05), and there was no change in HSP90 protein. Pull down-WB showed that NA could directly target HSP90 protein, and NA binding to HSP90 protein enhanced its thermal stability. Molecular docking of NA with HSP90 family proteins HSP90AA1, HSP90B1, and HSP90AB1 all resulted in highly stable binding. ConclusionNA can inhibit the proliferation and inflammatory response of psoriatic keratinocytes by a mechanism that may be achieved by targeting HSP90 to modulate the NF-κB/NLRP3 signaling pathway.
5.Novel paradigms in KRAS targeting: Unveiling strategies to combat drug resistance.
Xiyuan LUO ; Feihan ZHOU ; Yuemeng TANG ; Xiaohong LIU ; Ruilin XIAO ; Minzhi GU ; Jialu BAI ; Decheng JIANG ; Gang YANG ; Lei YOU ; Yupei ZHAO
Chinese Medical Journal 2025;138(18):2243-2267
The Kirsten rat sarcoma viral oncogene homolog ( KRAS ) mutation is one of the most prevalent activating alterations in cancer. It indicates a poor overall prognosis due to its highly invasive nature. Although several KRAS inhibitors have been developed in recent years, a significant clinical challenge has emerged as a substantial proportion of patients eventually develop resistance to these therapies. Therefore, identifying determinants of drug resistance is critical for guiding treatment strategies. This review provides a comprehensive overview of the mutation landscape and molecular mechanisms of KRAS activity in various cancers. Meanwhile, it summaries the progress and prospects of small molecule KRAS inhibitors undergoing clinical trials. Furthemore, this review explores potential strategies to overcome drug resistance, with the ultimate goal of steering toward patient-centric precision oncology in the foreseeable future.
Humans
;
Drug Resistance, Neoplasm/drug effects*
;
Proto-Oncogene Proteins p21(ras)/metabolism*
;
Mutation/genetics*
;
Neoplasms/genetics*
;
Antineoplastic Agents/therapeutic use*
6.Zedoarondiol Inhibits Neovascularization in Atherosclerotic Plaques of ApoE-/- Mice by Reducing Platelet Exosomes-Derived MiR-let-7a.
Bei-Li XIE ; Bo-Ce SONG ; Ming-Wang LIU ; Wei WEN ; Yu-Xin YAN ; Meng-Jie GAO ; Lu-Lian JIANG ; Zhi-Die JIN ; Lin YANG ; Jian-Gang LIU ; Da-Zhuo SHI ; Fu-Hai ZHAO
Chinese journal of integrative medicine 2025;31(3):228-239
OBJECTIVE:
To investigate the effect of zedoarondiol on neovascularization of atherosclerotic (AS) plaque by exosomes experiment.
METHODS:
ApoE-/- mice were fed with high-fat diet to establish AS model and treated with high- and low-dose (10, 5 mg/kg daily) of zedoarondiol, respectively. After 14 weeks, the expressions of anti-angiogenic protein thrombospondin 1 (THBS-1) and its receptor CD36 in plaques, as well as platelet activation rate and exosome-derived miR-let-7a were detected. Then, zedoarondiol was used to intervene in platelets in vitro, and miR-let-7a was detected in platelet-derived exosomes (Pexo). Finally, human umbilical vein endothelial cells (HUVECs) were transfected with miR-let-7a mimics and treated with Pexo to observe the effect of miR-let-7a in Pexo on tube formation.
RESULTS:
Animal experiments showed that after treating with zedoarondiol, the neovascularization density in plaques of AS mice was significantly reduced, THBS-1 and CD36 increased, the platelet activation rate was markedly reduced, and the miR-let-7a level in Pexo was reduced (P<0.01). In vitro experiments, the platelet activation rate and miR-let-7a levels in Pexo were significantly reduced after zedoarondiol's intervention. Cell experiments showed that after Pexo's intervention, the tube length increased, and the transfection of miR-let-7a minics further increased the tube length of cells, while reducing the expressions of THBS-1 and CD36.
CONCLUSION
Zedoarondiol has the effect of inhibiting neovascularization within plaque in AS mice, and its mechanism may be potentially related to inhibiting platelet activation and reducing the Pexo-derived miRNA-let-7a level.
Animals
;
MicroRNAs/genetics*
;
Exosomes/drug effects*
;
Plaque, Atherosclerotic/genetics*
;
Neovascularization, Pathologic/genetics*
;
Human Umbilical Vein Endothelial Cells/metabolism*
;
Humans
;
Blood Platelets/drug effects*
;
Apolipoproteins E/deficiency*
;
Thrombospondin 1/metabolism*
;
CD36 Antigens/metabolism*
;
Platelet Activation/drug effects*
;
Male
;
Mice
;
Mice, Inbred C57BL
8.Pseudolaric Acid B Alleviates Non-alcoholic Fatty Liver Disease by Targeting PPARα to Regulate Lipid Metabolism and Promote Mitochondrial Biogenesis.
Shu-Yan LIU ; Xiao-Wei ZHANG ; Gai GAO ; Chang-Xin LIU ; Hui CHEN ; Zhong-Xue FU ; Jiang-Yan XU ; Zhen-Zhen WANG ; Zhen-Qiang ZHANG ; Zhi-Shen XIE
Chinese journal of integrative medicine 2025;31(10):877-888
OBJECTIVE:
To investigate the therapeutic potential of pseudolaric acid B (PAB) on non-alcoholic fatty liver disease (NAFLD) and its underlying molecular mechanism in vitro and in vivo.
METHODS:
Eight-week-old male C57BL/6J mice (n=32) were fed either a normal chow diet (NCD) or a high-fat diet (HFD) for 8 weeks. The HFD mice were divided into 3 groups according to a simple random method, including HFD, PAB low-dose [10 mg/(kg·d), PAB-L], and PAB high-dose [20 mg/(kg·d), PAB-H] groups. After 8 weeks of treatment, glucose metabolism and insulin resistance were assessed by oral glucose tolerance test (OGTT) and insulin tolerance test (ITT). Biochemical assays were used to measure the serum and cellular levels of total cholesterol (TC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). White adipose tissue (WAT), brown adipose tissue (BAT) and liver tissue were subjected to hematoxylin and eosin (H&E) staining or Oil Red O staining to observe the alterations in adipose tissue and liver injury. PharmMapper and DisGeNet were used to predict the NAFLD-related PAB targets. Peroxisome proliferator-activated receptor alpha (PPARα) pathway involvement was suggested by Kyoto Encyclopedia of Genes and Genomes (KEGG) and search tool Retrieval of Interacting Genes (STRING) analyses. Luciferase reporter assay, cellular thermal shift assay (CETSA), and drug affinity responsive target stability assay (DARTS) were conducted to confirm direct binding of PAB with PPARα. Molecular dynamics simulations were applied to further validate target engagement. RT-qPCR and Western blot were performed to assess the downstream genes and proteins expression, and validated by PPARα inhibitor MK886.
RESULTS:
PAB significantly reduced serum TC, TG, LDL-C, AST, and ALT levels, and increased HDL-C level in HFD mice (P<0.01). Target prediction analysis indicated a significant correlation between PAB and PPARα pathway. PAB direct target binding with PPARα was confirmed through luciferase reporter assay, CETSA, and DARTS (P<0.05 or P<0.01). The target engagement between PAB and PPARα protein was further confirmed by molecular dynamics simulations and the top 3 amino acid residues, LEU321, MET355, and PHE273 showed the most significant changes in mutational energy. Subsequently, PAB upregulated the genes expressions involved in lipid metabolism and mitochondrial biogenesis downstream of PPARα (P<0.05 or P<0.01). Significantly, the PPARα inhibitor MK886 effectively reversed the lipid-lowering and PPARα activation properties of PAB (P<0.05 or P<0.01).
CONCLUSION
PAB mitigates lipid accumulation, ameliorates liver damage, and improves mitochondrial biogenesis by binding with PPARα, thus presenting a potential candidate for pharmaceutical development in the treatment of NAFLD.
Animals
;
PPAR alpha/metabolism*
;
Non-alcoholic Fatty Liver Disease/pathology*
;
Male
;
Mice, Inbred C57BL
;
Lipid Metabolism/drug effects*
;
Diterpenes/therapeutic use*
;
Organelle Biogenesis
;
Diet, High-Fat
;
Humans
;
Mice
;
Liver/metabolism*
;
Insulin Resistance
;
Mitochondria/metabolism*
;
Molecular Docking Simulation
9.Analysis of the Nature,Flavor and Combination Characteristics of the Two-herb Compound Formulas inTreatise on Cold Damage and Miscellaneous Diseases (《伤寒杂病论》)
Ying ZHANG ; Yihan ZHAO ; Qinghua SHANG ; Ruina BAI ; Wenhui DUAN ; Jianpeng DU ; Zhuye GAO ; Zhonghui JIANG ; Dazhuo SHI
Journal of Traditional Chinese Medicine 2024;65(22):2378-2382
Based on the natures and flavors of herbal medicinals recorded in Shen Nong's Classic of the Materia Medica (《神农本草经》); Miscellaneous Records of Famous Physicians (《名医别录》), this study analyzed the characte-ristics of the natures, flavors and combination of medicinals of the two-herb compound formulas in Treatise on Cold Damage and Miscellaneous Diseases (《伤寒杂病论》).Finally, 31 compound formulas were included, and it was found that the nature and flavor of the herbs in these two-herb compound formulas are closely related to the functions of the compound formulas, such as the common pairing of the acrid and the sweet herbs to warm yang and transform qi, the acrid and the bitter herbs in pairs to regulate and harmonize cold and heat, the sweet and the bitter in pairs to remove dampness and clear heat, the acrid and the acrid in pairs to arrest vomiting and direct qi downward, and the sour and the sweet in pairs to slow the urgent and relieve pain. Regardless of the deficiency or excess nature of the disease, the corresponding two-herb compound formulas often aim to reinforce healthy qi while eliminating pathogenic factors, with some formulas showcasing a unique correspondence between the disease pattern and the symptoms addressed.
10.Research on Objective Characteristics of Tongue Manifestation in 315 Patients with Coronary Heart Disease
Mengyao DUAN ; Chuhao WANG ; Yuquan TAN ; Kun LIAN ; Xintian SHOU ; Yang JIANG ; Boyan MAO ; Zhixi HU
Journal of Traditional Chinese Medicine 2024;65(9):921-927
ObjectiveTo investigate the objective characteristics of tongue manifestations in patients with coronary heart disease (CHD). MethodsA total of 315 participants with CHD were recruited in the CHD group, and 211 healthy participants who underwent physical examination were recruited as the healthy control group. In addition, according to the common comorbidities (primary hypertension, carotid atherosclerosis, type 2 diabetes mellitus, fatty liver, hyperlipidaemia, heart failure, and cerebral infarction) in 315 participants with CHD, each comorbidity was classified into a group of comorbidities with that disease and a group of non-comorbidities. Tongue images were captured using a TFDA-1 tongue diagnostic instrument to characterise the tongue body (TB) and tongue coating (TC), comparing the RGB, HIS, and Lab colour spaces in the chromaticity index (R, red; G, green; B, blue; H, hue; I, intensity; S, saturation; L, lightness; a, red-green axis; b, yellow-blue axis), the tongue coating thickness index (per-All), contrast (CON), angular second moment (ASM), entropy (ENT), and mean (MEAN) in texture metrics. ResultsCompared with the healthy control group, the characteristic indexes of tongue body in CHD group showed lower TB-R, TB-G, TB-B, TB-I, TB-L and higher TB-H, TB-b; and the characteristic indexes of tongue coating in CHD group showed lower TC-R, TC-B and higher TC-CON, TC-MEAN, TC-H, TC-b (P<0.05 or P<0.01). Compared with non-combined primary hypertension group, CHD combined primary hypertension group showed higher per-All, TB-G, TB-L, and lower TB-a, TC-a (P<0.05); compared with the non-combined carotid atherosclerosis group, CHD combined carotid atherosclerosis group showed higher TB-CON, TB-ENT, TB-MEAN, and lower TB-ASM (P<0.05 or P<0.01); compared with the non-combined type 2 diabetes mellitus group, CHD combined type 2 diabetes mellitus group showed lower per-All and higher TB-H (P<0.05 or P<0.01); compared with the non-combined fatty liver group, CHD combined fatty liver group showed higher TB-CON, TB-MEAN, TB-ENT, and lower TB-ASM and TC-S (P<0.05 or P<0.01); compared with the non-combined hyperlipidaemia group, CHD combined hyperlipidaemia group showed lower TB-S and TB-a (P<0.05); compared with non-combined heart failure group, CHD combined heart failure group showed lower TB-R, TB-G, TB-I, TB-L, and higher TB-a (P<0.05 or P<0.01); compared with non-combined cerebral infarction group, CHD combined cerebral infarction group showed higher TC-CON, TC-ENT, TC-MEAN, and lower TC-ASM (P<0.05 or P<0.01). ConclusionCompared to healthy individuals, patients with CHD tend to have darker tongue colours and rougher TC textures. Compared with non-comorbidity participants, those with primary hypertension tended to be lighter tongue colour and thicker tongue coating, those with carotid atherosclerosis had paler tongue body, those with type 2 diabetes mellitus had thinner tongue coating, those with fatty liver disease had paler tongue body and whiter tongue colour, those with hyperlipidaemia and heart failure had paler tongue colour, and those with cerebral infarction had rougher tongue texture.

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