1.Discussion of sequential diagnosis and treatment model of diabetes mellitus of spatiotemporal syndrome differentiation from the perspective of qi, blood, and fluid
Jinhao HU ; Guiyan SUN ; Yufeng YANG ; Yan SHI
Journal of Beijing University of Traditional Chinese Medicine 2025;48(1):8-13
The dysfunction of qi, blood, and fluid underlies the pathology of diabetes mellitus. The symptoms, signs, and physical and chemical indexes of diabetes mellitus patients reflect the duration, degree, primary and secondary pathological state of the abnormal metabolism of qi, blood, and fluid. It is necessary to construct a three-dimensional syndrome differentiation system of diabetes mellitus based on spatial and temporal dimensions. According to the four stages of depression, heat, deficiency, and damage, the location of the disease can be locked into qi, ying, and blood levels. The process reflects the pathological trend of the abnormal metabolism of qi, blood, and fluid: qi depression (prodromal stage: asymptomatic metabolic disorder/early stage of qi level) → qi heat (initial stage: index stage/late stage of qi level) → deficiency of both qi and yin (middle stage: symptom stage of three more and one less/stage of ying level) → damage of zang-fu viscera and meridians (late stage: complication stage/stage of blood level). According to the time process, the treatment principles are proposed as follows: during the early stage of qi level, treatment should focus on strengthening the spleen to regulate qi flow, to prevent the accumulation of glucose; during the late stage of qi level, treatment should focus on clearing heat and resolving turbidity, to remove the stagnated heat caused by glucose; during the stage of ying level, treatment should focus on benefiting qi and nourishing yin, to improve the symptoms about deficiency of both qi and yin; during the stage of blood level, treatment should focus on promoting blood circulation and removing blood stasis, to remove the complication. According to the etiology and pathogenesis of diabetes mellitus, the sequential treatment strategy is thus proposed, which is strengthening the spleen to regulate qi flow, clearing heat and resolving turbidity, benefiting qi and nourishing yin, and promoting blood circulation and removing blood stasis. The compound prescriptions such as Houpo Sanwu Decoction, Baihu Jia Renshen Decoction, Danggui Liuhuang Decoction, and Taohong Siwu Decoction are used with modification in the stage-based treatment.
2.Role of Macrophage Activation and Polarization in Diabetes Mellitus and Its Related Complications and Traditional Chinese Medicine Intervention
Zhichao CHEN ; Qiaoni LIN ; Liya SUN ; Jinxi WANG ; Zishan FU ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):311-320
The occurrence of diabetes mellitus (DM) is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver,fat,skeletal muscle,islets, and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response,improving insulin resistance,and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing,heat-clearing, and detoxicating medicinal,which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore,by summarizing the mechanisms between macrophage activation,polarization, and insulin resistance in various tissues,this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio,providing references for the future treatment of DM and its related complications with traditional Chinese medicine.
3.Experience in the Application of Jiao (角) Medicine in Treating Diabetes Mellitus from the Perspective of Qi, Blood and Fluids
Jinhao HU ; Guiyan SUN ; He GAO ; Yufeng YANG ; Nan HU ; Yan SHI
Journal of Traditional Chinese Medicine 2025;66(16):1727-1730
This paper summarizes the clinical experience in applying jiao (角) medicine to treat diabetes mellitus from the perspective of qi, blood, and fluids. It is believed that impaired spleen transportation and transformation is the key pathomechanism of diabetes, leading to metabolic disturbances in qi, blood, and fluids, and resulting in a sequential pathological progression of "qi → thick fluids → thin fluids → blood". At the qi level, the disease is mainly characterized by spleen qi deficiency and stagnation, and is commonly treated with Hongshen (Panax Ginseng), Huangqi (Astragalus Mongholicus), and Baizhu (Atractylodes Macrocephala) to tonify the spleen and regulate qi. At the thick fluids level, the condition manifests as abdominal distension, internal heat, and turbid pathogens, requiring Zexie (Alisma Orientale), Huanglian (Coptis Chinensis), and Dahuang (Rheum Palmatum) to clear the spleen and drain turbidity. At the thin fluids level, with qi and yin deficiency and predominant yin damage, Gegen (Pueraria Lobata), Wuweizi (Schisandra Chinensis), and Maidong (Ophiopogon Japonicus) are used to nourish yin and generate fluids. At the blood level, where vascular damage is predominant, Shuizhifen (Whitmania Pigra Powder), Danshen (Salvia Miltiorrhiza), and Sanqifen (Panax Notoginseng Powder) are applied to activate blood circulation, resolve stasis, and unblock the channels. Clinicians may flexibly select appropriate jiao medicine based on the specific pathological layer affected in each patient.
4.Mechanism Investigation of Qi-invigorating and Blood-activating Drug Combination in Yitangkang Compound Against Diabetic Cardiomyopathy Using Multimodal Research Approach
Chenghao YU ; Tingting LI ; Mingbo ZHANG ; Honghe XIAO ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):94-106
ObjectiveThrough multimodal research methods including medication rule mining, network pharmacology, molecular docking and dynamics simulation, and in vivo animal experiments, this study aims to speculate and verify the core composition (Ginseng Radix et Rhizoma Rubra-Salviae Miltiorrhizae Radix et Rhizoma-Notoginseng Radix et Rhizoma) and efficacy (Qi-invigorating and blood-activating) of the drug combination in Yitangkang Compound for improving diabetic cardiomyopathy (DCM), investigate the interaction relationship and binding strength between core active ingredients of the drug combination and key signaling pathway targets, and further explore the mechanism by which the Qi-invigorating and blood-activating drug combination regulates the calcium signaling pathway to improve cardiac function in DCM rats. MethodsThe Ancient and Modern Medical Cases Cloud Platform was used to construct a DCM prescription database, and the "Analysis Method" module of the platform was applied to mine and summarize medication rules, thereby determining the core composition of the Qi-invigorating and blood-activating drug combination in Yitangkang. Drug-active ingredient-signaling pathway-core target-disease analysis and visualization were conducted by combining network pharmacology with the Traditional Chinese Medicine System Pharmacology Platform (TCMSP) database, SwissTargetPrediction platform, GeneCards database, MetaScape database, CytoScape software, etc. Then, molecular docking was performed via the CB-Dock2 platform, and molecular dynamics simulation of the high-binding-strength docking complexes was carried out by Gromacs software. Finally, in vivo animal experiments were carried out. Twenty-eight Sprague Dawley (SD) rats meeting the research criteria were divided into a normal group, a model group, a drug combination group (3.3 g·kg-1), and a Yitangkang group (20 g·kg-1). A type 2 diabetes mellitus (T2DM) rat model was established by high-fat diet feeding combined with intraperitoneal injection of streptozotocin (STZ), followed by continuous feeding for eight weeks until the DCM model was successfully established. During this period, the traditional Chinese medicine (TCM) compound and drug combination were administered for prevention and treatment intervention. Meanwhile, changes in blood glucose, body weight, and heart index of each group were monitored. Cardiac function was assessed by echocardiography, and electrophysiological signals were detected by an electrocardiogram. The heart tissue was observed for pathological changes by hematoxylin-eosin (HE) and Masson staining, and the expression of L-type calcium channel (CACNA1C), calmodulin (CALM1), calcium/calmodulin-dependent protein kinase Ⅱδ (CAMK2D), and neuronal nitric oxide synthase (NOS1) proteins in the calcium signaling pathway of myocardial tissue was detected by Western blot. ResultsIn 62 DCM prescriptions, Ginseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma, and Notoginseng Radix et Rhizoma were used most frequently. Their meridian tropism mainly involved the spleen, heart, and lung, and their sweet and warm properties were prominent. The drugs for tonifying or blood-activating and stasis-resolving ranked top. In association rule analysis, (Ginseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma)-Notoginseng Radix et Rhizoma had the highest lift. Network pharmacology obtained 75 active ingredients of the drug combination, 714 drug combination action targets, 2 702 disease targets, and 286 intersection targets. Protein-protein interaction (PPI) network predicted nine interaction component-targets (nine active ingredients and four calcium signaling pathway target genes). Molecular docking showed the four complexes with the lowest binding energy were 2f3z-ginsenoside Re, 1cll-quercetin, 9blh-(6S)-6-(hydroxymethyl)-1,6-dimethyl-8,9-dihydro-7H-naphtho[8,7-g]benzofuran-10,11-dione, and 5vv0-miltionone Ⅱ. Dynamics simulation showed the CALM1-quercetin complex had the strongest binding affinity. The animal experiment results revealed that compared with the normal group, the model group showed significant changes in blood glucose, body weight, myocardial tissue morphology, heart index, cardiac function, electrophysiological indexes, and the expression levels of CACNA1C, CALM1, CAMK2D, and NOS1 proteins (P<0.05, P<0.01). Compared with the model group, the Yitangkang group had a certain improvement effect on the above indexes (P<0.05, P<0.01). Compared with the Yitangkang group, the drug combination group showed no significant difference in improving myocardial tissue morphology, heart index, cardiac function, electrophysiological indexes, and the expression of CACNA1C, CALM1, CAMK2D, and NOS1 proteins, except for blood glucose and body weight. ConclusionGinseng Radix et Rhizoma Rubra, Salviae Miltiorrhizae Radix et Rhizoma, and Notoginseng Radix et Rhizoma are the core Qi-invigorating and blood-activating drug combination in Yitangkang Compound. They have a good preventive and therapeutic effect on STZ-induced DCM in rats, and their mechanism of action may be related to the regulation of the calcium signaling pathway.
5.Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery.
Shiwen ZHANG ; Rui SHENG ; Zhen FAN ; Fang WANG ; Ping DI ; Junyu SHI ; Duohong ZOU ; Dehua LI ; Yufeng ZHANG ; Zhuofan CHEN ; Guoli YANG ; Wei GENG ; Lin WANG ; Jian ZHANG ; Yuanding HUANG ; Baohong ZHAO ; Chunbo TANG ; Dong WU ; Shulan XU ; Cheng YANG ; Yongbin MOU ; Jiacai HE ; Xingmei YANG ; Zhen TAN ; Xiaoxiao CAI ; Jiang CHEN ; Hongchang LAI ; Zuolin WANG ; Quan YUAN
International Journal of Oral Science 2025;17(1):51-51
Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans
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Consensus
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Dental Implants
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Mouth Mucosa/surgery*
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Keratins
6.Ginsenosides in Treatment of Lung Cancer: A Review
Anqi LYU ; Yufeng SHI ; Jia KE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):270-280
Lung cancer is the leading cause of cancer-related death, characterized by high invasiveness, early metastasis and poor prognosis. It has the highest incidence and mortality rates among cancers in China. Currently, the treatment of lung cancer is still dominated by the classic therapies such as surgery, radiotherapy, chemotherapy and targeted therapy. However, the classic therapies are not suitable for all patients with lung cancer, so new treatment strategies and methods are needed to prevent and treat lung cancer. In recent years, Ginseng Radix et Rhizoma has attracted wide attention in the field of anti-lung cancer research, and traditional Chinese medicine has a substantial theoretical and practical foundation in treating lung cancer. Ginseng Radix et Rhizoma , as a commonly used Chinese herbal medicine, has the functions of replenishing vital Qi, replenishing veins, strengthening the spleen and lung, and nourishing body and blood. The main active components of Ginseng Radix et Rhizoma , known as ginsenosides, exhibit anti-cancer and anti-inflammatory activities. Therefore, the mechanism and pharmacological activity of ginsenosides in the intervention of lung cancer have been extensively studied by researchers worldwide. The results show that ginsenosides can effectively inhibit the proliferation, invasion, migration, epithelial-mesenchymal transition and angiogenesis of lung cancer cells. Additionally, they inhibit drug resistance, enhance chemotherapy sensitivity and efficacy, and promote apoptosis and autophagy of lung cancer cells. Ginsenosides also modulate the tumor microenvironment and regulate immunity, thereby delaying the occurrence and development of lung cancer. The rapid advancements in related research have outpaced previous literature review, creating challenges for scholars seeking the latest information. Based on this, this article summarizes recent findings on the mechanism and pharmacological activities of ginsenosides in lung cancer intervention, aiming to provide new insights for the development of molecular biology, drug treatment research and clinical new drug research in lung cancer. It also provides the reference for further mechanism research.
7.Exploring the Application of Phenomics in Traditional Chinese Medicine Syndromes Studies Based on the Relationship between Phenotypes and Syndromes
Jinhao HU ; Guiyan SUN ; Yufeng YANG ; Yan SHI
Journal of Traditional Chinese Medicine 2024;65(14):1514-1517
By analysing the conceptual connotations of phenotype and traditional Chinese medicine (TCM) symptoms, the relationship between TCM symptoms, phenotypes and diseases is explained. It is believed that phenotypes and TCM syndromes have certain similarities, both of which elaborate the physiological and pathological mechanisms of the human body through external manifestations, and have the temporal and spatial characteristics of both phases and wholeness, as well as focusing on the connection between the innate and the acquired. Summarising the current status of the application of phenomics technology in the studies of TCM syndromes, it is concluded that the study of the intrinsic biological mechanisms of TCM syndromes with the help of phenomics technology has achieved certain results, but there are still problems such as difficulties in matching between traditional Chinese medicine syndromes and phenotypes, the incompleteness of the existing disease phenotype system, and the inconsistency of the understanding about "syndromes". It is proposed that in the future, large-scale clinical databases could be used to collect a wide range of TCM syndromes and phenotypes that are closely related to specific diseases. The phenomics technology could make preliminary correspondence and identification between a single syndrome and the corresponding phenotype, and then further carry out a more accurate phenotypic detection of the composite syndromes, and finally realise the standardization and intelligence of the diagnosis of TCM syndromes with the help of the artificial intelligence technology. By elaborating the modern scientific connotation of TCM syndromes from the perspective of phenotypes, we can provide scientific basis for the determination of TCM syndromes and the clarification of modern biomarkers of syndromes, as well as ideas for the modernisation research of TCM syndromes.
8.Relationship between "Nutrients-intestinal Flora" and Type 2 Diabetes Mellitus Based on Theory of "Linkage between Spleen and Small Intestine"
Zhichao CHEN ; Qiaoni LIN ; Jinxi WANG ; Zishan FU ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(15):206-214
The theory of "linkage between spleen and small intestine" has been put forward by doctors as early as the Ming dynasty. In traditional Chinese medicine, the spleen and small intestine cooperate and work together physiologically, and they are also closely related and interact with each other pathologically. The spleen governs transportation and transformation, which involves the function of the small intestine in transforming water and grain. The small intestine, governing the receiving and transformation of substances, depends on the normal transportation of the spleen. At the same time, it provides guarantee for the spleen to transform Qi and generate blood as well as ascend lucidity and descend turbidity. The dysfunction of spleen in transportation is closely related to the dysfunction of small intestine. The stability of intestinal microecology necessitates the normal functioning of the spleen. When the original balance of intestinal flora is disturbed, the spleen functioning will be affected. This study explored the pathogenesis and treatment of diabetes based on the physiological functions of the spleen and small intestine and the Western medicine targets of "nutrients-intestinal flora". According to modern medicine, nutrients are essential to maintain the normal physiological activities of the human body. Proper intake of nutrients can affect the absorption and metabolism of the human body for nutrients by regulating the composition and function of intestinal flora, so as to prevent the occurrence of diabetes. The imbalance of intestinal flora which harbors rich microorganisms may lead to the disturbance of energy metabolism and the dysfunction of the immune system, eventually leading to diabetes. As a metabolic disease, diabetes is closely related to the imbalance of intestinal flora and nutrient intake. Based on the theory of "linkage between spleen and small intestine", this paper discusses the relationship between spleen and small intestine. Furthermore, this paper discusses the correlation between "spleen-small intestine" and "nutrients-intestinal flora" by reviewing the latest progress in modern medicine and clinical research, aiming to provide a theoretical basis and new ideas for the clinical prevention and treatment of type 2 diabetes mellitus.
9.Discussion on the diabetic lower extremity vascular disease from the theory of"dryness-heat and stagnation"
Ruodi YANG ; Juntong LIU ; Jiaxin LI ; Ying ZHOU ; Ziyu JIAO ; Yufeng YANG ; Yan SHI
Journal of Beijing University of Traditional Chinese Medicine 2024;47(4):472-477
Diabetic lower extremity vascular disease is one of the common chronic complications of diabetes,which has a strong disabling effect,clinically,it is of great significance to actively and effectively control the progression of the disease and improve the quality of life of patients.In Sanxiao Lun,LIU Wansu put forward the theory of"dryness-heat and stagnation"according to the pathogenesis of consumptive thirst,and thought that the dryness-heat and stagnation in the stomach and intestines of sanjiao were too severe,the xuanfu was blocked,and the qi and liquid failed to diffuse,which caused diabetes.Vascular endothelial injury and inflammatory reaction are important factors in the development of vascular disease,the pathogenesis evolution of"dryness-heat and stagnation"conforms to the pathological characteristics of inflammatory reaction in western medicine,and the dryness-heat runs through the diabetic lower extremity vascular disease throughout.In this paper,it is believed that diabetic lower extremity vascular disease belongs to the category of"flaccidity and paralysis"in traditional Chinese medicine,and lung scorched by heat is the cause of flaccidity."Dryness-heat and stagnation"is the source of invading heat(dryness-heat),lung scorched by heat,pulse failure and vein stasis occurred,which causes diabetic lower extremity vascular disease.Treatment should be based on flaccidity,combined with the viewpoint of LIU Wansu's Sanxiao Lun,taking yangming as the top priority,regulating the triple diabetes,solving the problem of dryness-heat and stagnation,combined with the method of purging the south and supplementing the north,so that the invading heat is cleared,lung heat is diminished,and flaccidity disease cannot occur,in order to provide new ideas for the clinical prevention and treatment of diabetic lower extremity vascular disease.
10.TU Jinwen's Experience in the Treatment of Severe Influenza Based on the “Heat Toxin Theory”
Anqi LYU ; Yufeng SHI ; Yi YANG ; Jia KE ; Jinwen TU
Journal of Traditional Chinese Medicine 2024;65(7):674-677
To summarize Professor TU Jinwen's clinical experience in the treatment of severe influenza based on the “heat toxin theory”. He believed that “heat toxin” is the main disease mechanism of severe influenza, emphasized the pathogenesis process that toxin enters with the pathogenic qi, heat generates by the toxin, and changes initiate from the toxin, and proposed simultaneous treatment of warmth and toxin and combination of multiple methods as the treatment principles. Syndrome differentiation in clinic should combine with wei-qi-ying-blood. The disease in the early stage located in wei (defensive) and qi level, treated by clearing heat and resolving toxins, releasing the exterior and expelling pathogen, harmonizing the exterior and interior, dredging the bowels with diarrhea, and combining other methods to get rid of the heat and toxin, and modified Self-Prescribed Tuire No. 1 Formula (自拟退热1号方) is recommended; the disease in progression stage located in ying-blood, treated by relieving heat and resolving toxins, and clearing the ying level and cool the blood, with prescriptions as modified Self-Prescribed Tuire No. 1 Formula plus Qingying Decoction (清营汤), or Xijiao Dihuang Decoction (犀角地黄汤); the disease in the late stage with of yin fluid consumption, and heat toxin in the blood level, treated by eliminating heat and resolving toxins, and enriching yin and cooling the blood, with prescriptions as modified Shashen Maidong Decoction (沙参麦冬汤) and Zhuye Shigao Decoction (竹叶石膏汤). At the same time, it is emphasised that heat-clearing and fire-draining method and harmonising methods are important, and that dispelling pathogen should not injure healthy qi, and that the selection of prescriptions and medicines need consider syndrome differentiation and treatment.


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