1.History and Clinical Application of Classic Famous Formula Danggui Sinitang
Sihong LIU ; Siqi JIA ; Lin TONG ; Li REN ; Lei ZHANG ; Lei YANG ; Yanhui KUANG ; Deqin WANG ; Bing LI ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):53-60
Danggui Sinitang is first recorded in the Treatise on Cold Damage written by ZHANG Zhongjing in the Han dynasty. It is composed of Angelicae Sinensis Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Asari Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Tetrapanacis Medulla, and Jujubae Fructus and serves as a classic formula for treating the syndrome of blood deficiency and cold reversal. This study systematically reviews the records of Danggui Sinitang in ancient Chinese medicine books of various dynasties and the modern clinical applications to probe into the composition, plant species, processing, dosage, decocting method, and indications of Danggui Sinitang, aiming to provide a reference for the development and clinical application of this classic formula. The review of the records showed that there were a variety of records of Danggui Sinitang with different composition, and the composition of this formula listed in the Treatise on Cold Damage has a significant impact on later generations and has been used by medical practitioners throughout history. Although the dosage of some drugs decreased during the Ming and Qing dynasties, the medical practitioners continued to use the original formula. In terms of processing, although there were slight changes in the processing of Angelicae Sinensis Radix, Paeoniae Radix Alba, Glycyrrhizae Radix et Rhizoma, and Tetrapanacis Medulla, the original processing method was inherited. In terms of indications, Danggui Sinitang was designed to treat cold reversal due to blood deficiency and dysentery. Furthermore, it was used to treat headache, convulsive disease, infantile convulsion, and private part adduction in the Ming and Qing dynasties. Nowadays, this formula is mostly used to treat diabetes peripheral neuropathy, rheumatoid arthritis, dysmenorrhea, Raynaud's disease and other diseases. In terms of precautions, ancient physicians believed that Danggui Sinitang should not be taken by pregnant women and should only be used for limb chills caused by blood deficiency and cold coagulation. For limb chills caused by other reasons, this formula should not be used indiscriminately. Modern research has not reported any serious adverse reactions related to this formula. Danggui Sinitang has a definite therapeutic effect. In subsequent research and development, quality control standards of Danggui Sinitang should be established while its safety is ensured, and the related preparations should be developed and applied.
2.Relationship between tumor-infiltrating lymphocytes,PD-1 and PD-L1 expression with the prognosis of peritoneal mesothelioma
Yue CHEN ; Xuemei DU ; Zhonghe JI ; Ying GAO ; Zhiran YANG ; Huamin QIN
Chinese Journal of Clinical and Experimental Pathology 2024;40(8):828-833
Purpose To investigate the relationship be-tween the expressions of CD3,CD4,CD8,CD20,CD68,PD-1 and PD-L1 and the clinical prognosis of peritoneal mesothelioma(PM).Methods Clinical data of 69 PM patients were collect-ed.EnVision two-step immunohistochemical method was used to detect the expression of CD3,CD4,CD8,CD20,CD68,PD-1 and PD-L1 in PM.Associations between expression levels and survival were estimated by univariate and multivariate Cox pro-portional-hazards models.Results There were no significant differences in the expressions of CD3,CD4,CD8,CD20,CD68,and PD-1 in tumor infiltrating lymphocytes(TILs)of ep-ithelioid and non-epithelioid PM.The expression of PD-L1 in non-epithelioid PM TILs was higher than that in epithelioid PM TILs,but the difference was not statistically significant.The median overall survival(mOS)time of PM was 19.1 months.Multivariate models identified asbestos exposure(P=0.002),PCI score(P=0.034),histological type(P=0.036),and CD4 expression(P=0.043)was independent prognostic factors for PM.Conclusion Asbestos exposure,PCI score,histologi-cal type and CD4 expression in TILs may exert significant im-pacts on survival of PM patients.
3.Characteristics of Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Nannan SHI ; Dongfeng WEI ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Zhaoshuai YAN ; Weixuan BAI ; Xinghua XIANG ; Yaxin TIAN ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):137-148
This study used the Appraisal of Guidelines Research & Evaluation-Health Systems (AGREE-HS) to demonstratively compare 34 global coronavirus disease-2019 (COVID-19) health systems guidance documents (HSGs) and 6 World Health Organization (WHO) standard HSGs. The comparison involved topic, participants, methods, recommendations, and implementability, with the aim of exploring the characteristics of emergency HSGs. The results showed that the emergency HSGs had an overall average score of 49%, with topic having the highest score, recommendations having the second highest score, and participants having the lowest score. The standard HSGs had an overall average score of 79%, with high scores in all items. The emergency HSGs had lower scores in participants, methods, recommendations, and implementability than the standard HSGs (P<0.001), while the COVID-19 emergency HSGs developed by the WHO had higher score in topic than the standard HSGs (P<0.05). Compared with those released by countries, the COVID-19 emergency HSG developed by the WHO showed superiority in all items and overall scores (P=0.000 2). This indicates that emergency HSGs, represented by the COVID-19 emergency HSG, place equal emphasis on topic and recommendations as standard HSGs but have low requirements in terms of expert participation, evidence support, and comprehensive consideration in the time- and resource-limited context. They have the characteristics of prominent topics, clear purposes, orientation to demand, keeping up with the latest evidence, flexible adjustment, and timeliness, emphasizing immediate implementation effects, weakening long-term effects, and focusing on comprehensive benefits. Additionally, developers, types, and report completeness are important influencing factors.
4.Characteristics of Developing Methods for Emergency Health Systems Guidance Based on AGREE-HS
Danping ZHENG ; Wei YANG ; Dongfeng WEI ; Nannan SHI ; Lin TONG ; An LI ; Gezhi ZHANG ; Xue CHEN ; Fangqi LIU ; Weixuan BAI ; Xinghua XIANG ; Mengyu LIU ; Huamin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):149-156
The scientific rigor and efficacy of methodologies employed in drafting emergency health systems guidance documents (HSGs) are paramount in guaranteeing the quality, reliability, and applicability of HSGs. According to the Appraisal of Guidelines for Research and Evaluation- Health Systems (AGREE-HS), we demonstratively assessed both global coronavirus disease-2019 (COVID-19) emergency HSGs and World Health Organization (WHO) standard HSGs to uncover the core attributes of methods employed in the development of emergency HSGs. Our evaluation findings revealed that across the five assessment items of AGREE-HS, methods in the 34 emergency HSGs evaluated ranked third, trailing behind topic and recommendations. Notably, criterion 2 (the best available and most contextually relevant evidence is considered) received the highest score, whereas criterion 5 (evidence of cost and cost-effectiveness of the potential options is described) scored the lowest. Compared with the WHO standard HSGs, the COVID-19 emergency HSGs exhibited low scores in methods (P<0.05), which was reflected in nine criteria (P<0.05), especially in criteria 1 (systematic and transparent methods are used to identify and review the evidence) and 9 (systematic and transparent methods are used to agree upon the final recommendations). Among the COVID-19 emergency HSGs, that developed by the WHO achieved higher scores in eight out of all nine criteria, excluding criterion 8 (P<0.05). The clinically relevant emergency HSGs had higher scores in the criteria 3 (the evidence base is current) and 8 (the rationale behind the recommendations is clear) than other types of emergency HSGs. Collectively, the methodology for developing emergency HSGs, represented by the COVID-19 emergency HSG, underscores evidence orientation and integrates expert consensus. It is characterized by adaptable evidence synthesis strategies, streamlined evidence review protocols, and contextual relevance, all of which are influenced by external, internal, and implementation-specific factors.
5.Efficacy-driving Mechanism of Danhong Injection for Stable Angina Pectoris Based on Composition-activity Relationship of Target Modules
Siwei TIAN ; Wenjing ZONG ; Jun LIU ; Wei YANG ; Qikai NIU ; Siqi ZHANG ; Jing'ai WANG ; Huamin ZHANG ; Zhong WANG ; Bing LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):121-128
ObjectiveTo explore the efficacy-driving mechanism of Danhong injection (DHI) in the treatment of stable angina pectoris (SAP) based on the composition-activity relationship of target modules and clarify the pharmacological effects of DHI. MethodAccording to the angina frequency (AF) in the Seattle Angina Questionnaire (SAQ) that was obtained in the previous clinical trial, the patients before and after DHI treatment were grouped based on efficacy. The transcriptomic data of the patients before treatment and in the best efficacy group 30 days post-treatment were selected as the data source, and then weighted gene co-expression network analysis (WGCNA) was employed to construct the co-expression network. Relevant modules in the network were identified and associated with clinical features. In addition, the On-modules (Z value below 0) were identified by Zsummary. The topological indicators such as density, centrality, and clustering coefficient were adopted to explore the dynamics of DHI efficacy at the network level and module level, respectively. In addition, the driver genes were screened by the personalized network control (PNC) algorithm. Finally, rat H9C2 cells were used to establish the model of hypoxia/reoxygenation (H/R), which was used to confirm the potential therapeutic target of DHI for SAP and provide a scientific basis for revealing the therapeutic mechanism of DHI. ResultWe identified 19 modules in the best efficacy group of DHI for SAP, and the comparison between day 0 and day 30 revealed 12 On-modules. The changes of network topological indicators at the network and module levels confirmed the correlation between the best efficacy of DHI treatment and topological dynamics. Finally, the driver genes, Klotho and fibroblast growth factor 22 (FGF22), in DHI treatment of SAP were verified by the H9C2 cell model of H/R. ConclusionBased on clinical transcriptome data, this study determined the composition-activity relationship of target modules of DHI for SAP, which provided a scientific basis for deciphering the efficacy-driven mechanism of DHI for SAP.
6.Cinnamomi Ramulus-Alismatis Rhizoma in Treatment of External-contraction Diseases from Traditional Chinese Medicine and Modern Pharmacy: A Review
Yuqing CAO ; Yang GUO ; Xiyu SHANG ; Zihan JIA ; Yibai XIONG ; Renbo CHEN ; Lei ZHANG ; Lin TONG ; Huamin ZHANG ; Yan MA
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):279-288
Cinnamomi Ramulus and Alismatis Rhizoma are commonly used in the treatment of external-contraction diseases. Cinnamomi Ramulus is pungent, sweet, and warm, with the effects of ventilating lung and dispersing cold, warming Yang and transforming Qi, and promoting water and liquid flow from Taiyang meridian to remove dampness. Alismatis Rhizoma is sweet and cold, with the effects of draining dampness and promoting urination, regulating the waterway, removing water retention in lung, and promoting urination to remove dampness and heat. Herbal pairs are extracted from the accumulated experience of medical practitioners over the ages in the use of medicines and have been proved by clinical application to be composed of simple and effective combinations for specific diseases. The herb pair Cinnamomi Ramulus-Alismatis Rhizoma is an important part in ancient classic formulas such as Wulingsan. Both herbs play a role in draining dampness and promoting urination, warming Yang and transforming Qi, being a representative herb pair used for treating external-contraction exterior syndrome and water retention inside. The review of ancient medical publications revealed that there were a large number of compound formulas containing Cinnamomi Ramulus-Alismatis Rhizoma for dispersing cold and removing dampness, which were widely used for thousands of years in clinical practice. Modern pharmacological studies have shown that the active pharmacological components of Cinnamomi Ramulus (cinnamaldehyde and cinnamic acid) and Alismatis Rhizoma (alisol A and 23-acetate alisol B) have anti-inflammatory, antiviral, and immunoregulatory effects and high safety. Qingfei Paidu decoction containing this herbal pair played an important role in fighting against COVID-19. Despite the extensive pharmacological studies on Cinnamomi Ramulus and Alismatis Rhizoma, few studies have been carried out regarding this herb pair. This paper summarizes the traditional Chinese medicine knowledge about Cinnamomi Ramulus and Alismatis Rhizoma in the treatment of external-contraction diseases and summarizes the chemical composition, pharmacological effects, toxicology and other aspects of the two herbs before and after compatibility, aiming to provide a reference for further research and clinical application.
7.Knowledge Graph Construction and Visualization Analysis of Shen Nong Ben Cao Jing Based on Named Entity Recognition
Lin TONG ; Huamin ZHANG ; Xu TONG ; Lei LEI ; Cheng WANG ; Ziling ZENG ; Hongjun YANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(8):37-43
Objective To construct the knowledge map of Shen Nong Ben Cao Jing;To analyze basic knowledge of materia medica,explore implicit knowledge,and conduct visualization display;To provide methodological references for the study of ancient books.Methods The types of knowledge entities and relationships between entities involved in the Shen Nong Ben Cao Jing were organized and expressed.A training corpus dataset was produced using the BIO sequence labeling method;a self-developed CNLP text labeling system was used for text labeling;the BERT model was used to recognize named entities;the relationships between entities were set based on rules and semantic associations;the data were imported into the Neo4j-community 4.4.9 graph database using Cypher language for storage and visualization display after knowledge fusion;finally a knowledge graph was constructed.Results The knowledge map of Shen Nong Ben Cao Jing included 5 273 nodes and 11 064 relationships.The pattern layer contained 14 entity classes and 16 relationship types.Through Cypher language query,knowledge was visualized from the aspects of TCM classification,medicinal property theory,compatibility of seven emotions and application of TCM.Conclusion The knowledge graph constructed in this study intuitively reflects the knowledge recorded in Shen Nong Ben Cao Jing and the recessive relationship,which is suitable for knowledge mining and intuitive multi-dimensional display of ancient TCM books.
8.Analysis of mineral and bone disorder in elderly hemodialysis patients
Xiao LIANG ; Jing YANG ; Ruifang ZHOU ; Huamin WANG
Chinese Journal of Geriatrics 2023;42(12):1411-1417
Objective:To analyze clinical data related to mineral and bone disorder(MBD)in elderly maintenance hemodialysis patients and provide a basis for the development of precise clinical treatment strategies.Methods:A total of 267 patients receiving regular hemodialysis at Beijing Huairou Hospital and Huairou District Hospital of Traditional Chinese Medicine between April 2022 and June 2022 were selected and divided into an elderly group(age≥60 years)with 129 patients and a younger group(age<60 years)with 138 patients.Patients' general information, medication use, and laboratory data including routine blood work, blood calcium, blood phosphorus, and intact parathyroid hormone were collected, and a survey questionnaire was conducted to collect data on hyperphosphatemia patients' knowledge about diet and medication use.Differences in the rate of meeting calcium and phosphorus target ranges, medication use, and questionnaire scores were compared between patients in the two groups.Results:(1)The rates of controlled Ca(2.3±0.2)mmol/L, P(1.9±0.6)mmol/L and iPTH[213.5(93.5, 359.9)ng/L]levels in the elderly group were 65.1%(84/129), 43.4%(56/129)and 51.2%(66/129), respectively.There were no statistically significant differences compared with the younger group(all P>0.05). The prevalence of hyperphosphatemia in the elderly group(66/129, 51.2%)was lower than that in the younger group(90/138, 65.2%)( χ2=5.422, P=0.020). (2)Compared with the younger group, the elderly group had lower levels of serum creatinine[(796.6±225.2)μmol/L vs.(1025.6±281.4)μmol/L], uric acid[(416.9±97.0)μmol/L vs.(445.0±106.6)μmol/L], albumin[(37.9±2.9)g/L vs.(39.0±3.0)g/L]and serum phosphorus[(1.9±0.6)mmol/L vs.(2.1±0.6)mmol/l]( t=7.289, 2.238, 2.941, 2.820, P<0.05), and a higher blood glucose level[6.9(5.2, 9.8)mmol/L vs.6.1(4.9, 8.2)mmol/l, Z=2.314, P=0.015]. (3)Compared with the younger group, the elderly group had significantly lower utilization rates of calcium-free phosphate binders[12.4%(16/129) vs.23.9%(33/138)]and calcimimetics[2.3%(3/129) vs.10.9%(15/138)]( χ2=5.895, 7.742, P<0.05, respectively). (4)Compared with the younger group, the elderly group had a lower total questionnaire score(36.8±6.6 vs.39.5±6.0), a lower hyperphosphatemia knowledge score(4.7±3.1 vs.6.0±2.8), a lower diet knowledge score(2.8±2.2 vs.4.0±1.9)and a lower medication knowledge score(2.1±1.9 vs.3.1±1.8, t=3.442, 3.694, 4.677, 4.398, respectively, P<0.05 for all), but had a higher compliance score(17.3±1.9 vs.16.4±2.4, t=3.390, P=0.001). (5)Multivariate Logistic regression analysis indicated that pre-dialysis blood urea nitrogen( OR=1.082, 95% CI: 1.011-1.159, P=0.024)and serum creatinine( OR=1.002, 95% CI: 1.001-1.005, P=0.036)were independent predictors of hyperphosphatemia in elderly hemodialysis patients. Conclusions:Compared with the younger group, the serum albumin and phosphorus levels were lower, the utilization rates of calcium-free phosphate binders and calcimimetics were lower, and the total score of the hyperphosphatemia questionnaire was also lower in the elderly group.However, the compliance score was significantly higher in the elderly group.We should focus on the relevant weak links to bolster diet education and medication management for elderly hemodialysis patients.
9.Comparison of acoustic radiation force impulse and supersonic shear imaging in diagnosis of liver fibrosis in patients with chronic hepatitis B
Kun WANG ; Wenxiao ZHANG ; Minghui WANG ; Huamin ZHU ; Zhi YANG
Chinese Journal of Postgraduates of Medicine 2018;41(2):133-136
Objective To compare acoustic radiation force impulse(ARFI)and supersonic shear imaging (SWE) in diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods Eighty patients with chronic hepatitis B having underwent ARFI and SWE examination were enrolled in this study.The elastic modulus E value(EI)was measured by SWE.The liver shear wave velocity(VTQ)was measured by ARFI.All patients underwent liver biopsy.The diagnostic values of SWE and ARFI for liver fibrosis were analyzed with Sperman correlation and the ROC curve.Results The values of EI and VTQ were increased with the pathological stage determined by liver biopsy and there were significantly differences(P<0.01).The correlation coefficient of SWE and ARFI was 0.651,P<0.01.The correlation coefficient of SWE, ARFI and pathological stage determined by liver biopsy were 0.784 and 0.683 and there were significant differences(P<0.01).The areas under ROC for diagnosing liver fibrosis≥S2,≥S3 and =S4 by using SWE were 0.912, 0.934 and 0.955 respectively and those by using ARFI were 0.870, 0.892 and 0.884. The sensitivity of ARFI in diagnosing liver fibrosis was similar with SWE, but SWE showed higher specificity (Z=8.756,P < 0.01; Z=10.802,P < 0.01; Z=15.871,P < 0.01). Conclusions Both SWE and ARFI can be effectively used in the evaluation of liver fibrosis in patients with chronic hepatitis B.The SWE technology has more advantages.
10.Discussion about the application of topic maps technology on knowledge organization of traditional Chinese medicine with the example ofShanghanlun
Qin LI ; Daming SU ; Huamin ZHANG ; Shuo YANG ; Renfang YIN
International Journal of Traditional Chinese Medicine 2017;39(2):101-105
Literature of TCM contains abundant information of Chinese medicine. Traditional Chinese medicine information is characterized by its high degree of knowledge-intensive and complex inter-knowledge, so it is difficult to integrate and share knowledge. TheShanghanlun is one of the Chinese medical classics, and it includes the rules and methods of syndrome differentiation and treatment and it showed good effects in the clinical application. However, it is difficult to master for beginners. As a kind of knowledge organization tool, topic maps can flexibly define the relationship between knowledge, which realizes the visualization of knowledge network, and integrates and shares the distributed knowledge. This paper focused on the current situation of topic maps researches. The topic maps was used to organize the original content ofShanghanlun, construct the concept model of it and explore the specific application of topic maps technology in the field of traditional Chinese medicine.

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