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.Oxidative Stress-related Signaling Pathways in Lung Cancer and Chinese Medicine Intervention: A Review
Anqi LYU ; Yufeng SHI ; Cheng JIANG ; Jia KE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):228-237
Lung cancer has the highest incidence and mortality rate among all cancers in China, with its complex and variable nature, long treatment duration, and often poor prognosis. Currently, the treatment of lung cancer mainly employs classical therapies such as surgery, radiotherapy, and chemotherapy, but some patients may experience a series of adverse reactions, which affect their quality of life, survival period, and treatment outcomes. As reported, oxidative stress is one of the important pathogenic factors of lung cancer, affecting its occurrence and development. Oxidative stress is a state of imbalance between oxidative products and antioxidant defense mechanisms in the body. The intervention of oxidative stress in the occurrence and development of lung cancer is related to multiple signaling pathways, including the Kelch-like ECH-associated protein 1 (Keap1)-nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and nuclear factor-κB (NF-κB) signaling pathway. Currently, researchers in China and abroad have conducted extensive studies on the occurrence and development of lung cancer and the pathophysiological mechanisms of drug intervention. The results have shown that oxidative stress plays an important role in the occurrence and development of lung cancer. Chinese medicine monomers and compounds can regulate oxidative stress levels and intervene in related signaling pathways, thereby inhibiting or delaying the occurrence and development of lung cancer. Based on this, this article mainly summarized the relevant signaling pathways regulating oxidative stress intervention in lung cancer in recent years, and also reviewed the latest research on Chinese medicine monomers and compounds in regulating oxidative stress to treat lung cancer, aiming to provide new ideas for research on drug treatment of lung cancer and clinical drug development, as well as to provide references and guidance for further in-depth mechanistic studies in the future.
6.Application status and prospect of Indocyanine green in radical prostatectomy
Yufeng ZHANG ; Hongchen SONG ; Boyu YANG ; Mingjun SHI ; Peiqian YANG ; Zhengguo JI
International Journal of Surgery 2024;51(2):129-133
Prostate cancer is a common malignant tumor in male genitourinary system, and radical prostatectomy is one of the important methods to treat prostate cancer. Indocyanine green is a non-radioactive, water-soluble compound, which can help identify anatomical structures and visualize blood vessels through near-infrared fluorescence. The role and injection techniques of Indocyanine green in radical prostatectomy in sentinel lymph node identification, pelvic lymph node dissection and neurovascular bundle preservation are reviewed, so as to provide a reference for improving the surgical effect, reducing the difficulty of surgery, and prolonging the survival period of patients, and evaluate the potential research field of this technology in the future.
7.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.
8.Abibliometric analysis of the current state of research on project management practices in hospital management
Dechao CHEN ; Yufeng SHI ; Lu YE ; Zhiming YANG ; Liming HE ; Lisha WU ; Guiyang ZHOU
Modern Hospital 2024;24(1):117-119,122
Objective To explore the research dynamics and hotspots of project management in the field of hospital man-agement,and analyze the contents that still need to be improved,so as to provide references for the subsequent research,and provide hospital managers with practical experience in hospital management.Methods Based on the PubMed database,we used the citexs data analysis platform to analyze the literature and big data from January 2012 to December 2022 on the application of project management in the field of hospital management.Results The effective literature was retrieved from 4236 articles,and the analysis found thatthe annualnumberofpublicationsinthisfield hasbeenincreasing,2021 sawthe highestannualnumberof 573 articles,and the fastest growth rate was 20.36% in 2017.The country with the most publications is the United States(1 546 articles,36.5% ),the research institution with the most publications is Monash University,Australia,the journal with the most publications is BMJ Open(124 articles),and the key words with the highest frequency of occurrence in the retrieved literature are quality improvement,primary care improvement,covid-19,telemedicine.Conclusion The research in this field has been rapidly developed and is in a fast rising phase.In almost every organization and industry,the share of project management or"projectization"is increasing,and project management has become an important part of hospital management research and prac-tice.In the context of building a modern hospital management system,the application of project management to hospital manage-ment is an effective means of improving the level of fine hospital management.
9.A bibliometric analysis of exploring the optimization path and theoretical basis of the management sys-tem of traditional Chinese medicine nursing technology in medical institutions
Xin CAO ; Yufeng SHI ; Lu YE ; Zhiming YANG ; Liming HE ; Guiyang ZHOU
Modern Hospital 2024;24(3):384-390
Objective To sort out and summarize the research hotspots and trends of Chinese medicine nursing technolo-gy at the present stage.Methods We searched the research literature on TCM nursing technology included in China Knowledge,Wanfang,and Wipu build-up to November 30,2023,and used CiteSpace 6.1.R6 software to perform co-occurrence analysis of research institutions and keyword clustering,timeline,and emergence analysis.Results A total of 5 771 documents were in-cluded,with a general upward trend in the number of publications,peaking at 692 publications in 2021.5 206 documents from 673 journals were included in the research literature,of which 19 journals had ≥50 publications(35.47%).2 087 research or-ganizations were involved,of which 27 had ≥20 publications(13.24%).Involving 9 484 authors,there were a total of 8 au-thors ≥5 in the cluster,indicating the existence of stable teamwork in the cluster.The keyword co-occurrence analysis yielded the research hotspots of TCM nursing technology as TCM nursing,training,nursing management,clinical efficacy,complica-tions,and quality of life.Conclusion Based on the econometrics and visualization analysis of the literature on TCM nursing technology,we explored the research hotspots and trends in this field,and provided two theoretical paths for medical institution managers to construct and optimize the management system of TCM nursing technology:to standardize the TCM nursing technology in hospitals and establish a clinical access management system;and based on the multidimensional management method,to inno-vate the training system of TCM nursing technology.
10.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.


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