1.Therapeutic effect and mechanism by which Trichosanthis Fructus-Allii Macrostemonis Bulbus regulates gut microbiota in a rat model of coronary heart disease
Guanghan SUN ; Zhencong XIE ; Mi SUN ; Yang XU ; Dong GUO
Chinese Journal of Tissue Engineering Research 2025;29(5):917-927
BACKGROUND:A network-based pharmacological approach has identified multifunctional effects of the main bioactive compounds in the Trichosanthis Fructus-Allii Macrostemonis Bulbus on coronary heart disease;however,the mechanism of its therapeutic effect on coronary heart disease has not been fully elucidated. OBJECTIVE:To investigate the role and mechanism of Trichosanthis Fructus-Allii Macrostemonis Bulbus in improving coronary heart disease by regulating the composition of gut microbiota. METHODS:Forty Sprague-Dawley rats were randomly divided into four groups:blank control group(n=10),model group(n=10),positive drug group(n=10),and medicine pair group(n=10).A rat model of coronary heart disease was established by continuous gastric perfusion of fat emulsion and injection of pituitrin.After modeling,rats in the model group were gavaged with distilled water(10 mL/kg)for control,rats in the positive drug group were gavaged with simvastatin 4 mg/kg per day,and rats in the medicine pair group were gavaged with Trichosanthis Fructus-Allii Macrostemonis Bulbus pairs 7.56 g/kg per day.All interventions lasted for 14 days.Electrocardiograms and myocardial pathology were observed,and blood lipid levels were measured.The structure of gut microbiota was analyzed using 16S rDNA sequencing technology. RESULTS AND CONCLUSION:Electrocardiogram results showed ST segment elevation in the model group.There were no significant abnormalities in the electrocardiograms of the positive drug group and medicine pair group.Compared with the blank control group,the levels of total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol were significantly higher in the model group(P<0.05).Compared with the model group,the levels of total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol were significantly lower in the positive drug group and medicine pair group(P<0.05).Compared with the blank control group,focal myocardial cell necrosis was observed in the model group,while partial myocardial cell disarray was observed in the positive drug group and medicine pair group.Compared with the blank control group,the Ace,Shannon,and Chao indices were increased(P<0.05)and the Simpson index was decreased(P<0.05)in the model group,positive drug group and medicine pair group.Compared with the model group,the Ace and Chao indices were decreased(P<0.05),while the Shannon index showed no significant difference(P>0.05)and the Simpson index was also decreased(P<0.05)in the positive drug group and medicine pair group.Compared with the blank control group,the relative abundances of Desulfovibrionia,Muribaculaceae_norank,etc.were increased in the model group,while those of Clostridia,[Eubacterium]_coprostanoligenes_group_norank,etc.were decreased.Compared with the model group,the relative abundances of WPS-2_norank,Muribaculaceae_norank,etc.were increased in the medicine pair group,while those of Clostridia,[Eubacterium]_coprostanoligenes_group_norank,etc.were decreased;the relative abundances of Desulfobacterota,[Eubacterium]_coprostanoligenes_group_norank,etc.were increased in the positive drug group,while those of Firmicutes,Muribaculaceae_norank,etc.were decreased.Compared with the positive drug group,the relative abundances of Desulfobacterota,Bacteroides,etc.were increased in the medicine pair group,while those of Firmicutes,[Eubacterium]_coprostanoligenes_group_norank,etc.were decreased.The LEfSe results showed that the medicine pair group had the highest microbial enrichment,followed by the blank control group and positive drug group,with the model group having the lowest microbial enrichment.To conclude,Trichosanthis Fructus-Allii Macrostemonis Bulbus pairs can improve the development of coronary heart disease by regulating gut microbiota composition,providing new insights for further research and development of Trichosanthis Fructus-Allii Macrostemonis Bulbus pairs.
2.Effect of transcranial magneto-acousto-electrical stimulation on the plasticity of the prefrontal cortex network in mice
Shuai ZHANG ; Zichun LI ; Yihao XU ; Xiaofeng XIE ; Zhongsheng GUO ; Qingyang ZHAO
Chinese Journal of Tissue Engineering Research 2025;29(6):1108-1117
BACKGROUND:Transcranial magneto-acoustic-electrical stimulation is a novel non-invasive neural regulation technique that utilizes the induced electric field generated by the coupling effect of ultrasound and static magnetic field to regulate the discharge activity of the nervous system.However,the mechanism by which it affects synaptic plasticity in the brain is still not enough. OBJECTIVE:To explore the effect of transcranial magneto-acoustic-electrical stimulation intensity on synaptic plasticity of the prefrontal cortex neural network in mice. METHODS:(1)Animal experiment:Twenty-four C57 mice were equally and randomly divided into four groups:the control group receiving pseudo-stimulation,the 6.35 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,6.35 W/cm2,the 17.36 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,17.36 W/cm2,and the 56.25 W/cm2 stimulation group receiving coupled stimulation of 0.3 T,56.25 W/cm2.The local field potential signals and behavioral correctness were recorded during the execution of T-maze in mice.(2)Modeling and simulation experiments:A neural network model of the prefrontal cortex in mice stimulated by transcranial magneto-acoustic-electrical stimulation was constructed to compare the structural connectivity characteristics of the neural network under different stimulation intensities. RESULTS AND CONCLUSION:Transcranial magneto-acoustic-electrical stimulation could effectively shorten the behavior learning time,improve the working memory ability of mice(P<0.05),and continue to stimulate the frontal lobe of mice after learning behavior.There was no significant difference in the accuracy of the T-maze behavioral experiment among the experimental groups(P>0.1).Analysis of local field potential signals in the frontal lobe of mice revealed that transcranial magneto-acoustic-electrical stimulation promoted energy enhancement of β and γ rhythms.As the stimulation intensity increased,there was an asynchronous decrease in β and γ rhythms.Through β-γ phase amplitude coupling,it was found that stimuli could enhance the neural network's ability to adapt to new information and task requirements.Modeling and simulation experiments found that stimulation could enhance the discharge level of the neural network,increase the long-term synaptic weight level,and decrease the short-term synaptic weight level only when the stimulation intensity was high.To conclude,there is a complex nonlinear relationship between different stimulus intensities and the functional structure of neural networks.This neural regulation technique may provide new possibilities for the treatment of related neurological diseases such as synaptic dysfunction and neural network abnormalities.
3.Mechanisms of different yin nourishing and kidney tonifying methods on osteoclastysis pathway in ovariectomized rats
Xiaobin HUANG ; Jirong GE ; Shengqiang LI ; Lihua XIE ; Jingwen HUANG ; Yanyan HE ; Lipeng XUE
Chinese Journal of Tissue Engineering Research 2025;29(6):1214-1219
BACKGROUND:Liuwei Dihuang Wan takes"three tonifying and three reducing effects"as its compatibility feature to nourish yin and tonify the kidneys,while Zuogui Wan takes"seeking yin in yang"as its compatibility feature to nourish yin and tonify the kidneys by promoting yang.Both of them belong to the same method of nourishing yin and tonifying the kidneys,and have better curative effects at the symptomatic and cellular molecular levels. OBJECTIVE:To observe the effects of Liuwei Dihuang Wan and Zuogui Wan in bone metabolism,and to explore their mechanism of action in the osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL)osteoblastic pathway. METHODS:Thirty-two Sprague-Dawley rats were randomized into model,Liuwei Dihuang Wan,Zuogui Wan,and sham operation group,with eight rats in each group.Osteoporosis models were prepared using removal of both ovaries in the first three groups.Starting at 30 days postoperatively,rats in the Liuwei Dihuang Wan group were gavaged with Liuwei Dihuang Wan 1.125 g/kg/d;rats in the Zuoqui Wan group were gavaged with Zuogui Wan 2.25 g/kg/d;and rats in the sham operation group and the model group were gavaged with saline 10 mL/kg/d.After 12 weeks of gavage,the rat tibia was taken to measure bone mineral density.The serum levels of estrogen,bone alkaline phosphatase,and cAMP/cGMP were measured using ELISA,and the expression of OPG/RANKL in the femur was detected using western blot. RESULTS AND CONCLUSION:Compared with the sham operation group,the model group showed a decrease in bone mineral density and levels of estrogen and bone alkaline phosphatase(P<0.05)and an increase in cAMP/cGMP level(P<0.05).Compared with the model group,the Liuwei Dihuang Wan group and the Zuogui Wan group significantly increased bone mineral density(P<0.05)and bone alkaline phosphatase levels(P<0.05);the Zuogui Wan group significantly decreased cAMP/cGMP levels(P<0.05)and upregulated OPG expression(P<0.05);the Liuwei Dihuang Wan group upregulated OPG expression and downregulated RANKL expression(P<0.05);and both groups were unable to significantly increase estrogen levels(P>0.05).To conclude,Zuogui Wan,which seeks yin from yang,can effectively increase the expression of OPG but cannot downregulate the expression of RANKL.However,Liuwei Dihuang Wan,which has three tonifying and three reducing effects,can bidirectionally regulate the expression of OPG and RANKL.This result suggests that Liuwei Dihuang Wan can significantly inhibit osteoclastic function compared with Zuogui Wan,and further research is needed to verify this conclusion.
4.Pathogenesis and treatment progress of flap ischemia-reperfusion injury
Bo HE ; Wen CHEN ; Suilu MA ; Zhijun HE ; Yuan SONG ; Jinpeng LI ; Tao LIU ; Xiaotao WEI ; Weiwei WANG ; Jing XIE
Chinese Journal of Tissue Engineering Research 2025;29(6):1230-1238
BACKGROUND:Flap transplantation technique is a commonly used surgical procedure for the treatment of severe tissue defects,but postoperative flap necrosis is easily triggered by ischemia-reperfusion injury.Therefore,it is still an important research topic to improve the survival rate of transplanted flaps. OBJECTIVE:To review the pathogenesis and latest treatment progress of flap ischemia-reperfusion injury. METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature published from 2014 to 2024.The search terms used were"flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca2+overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,shock wave,pretreatment"in Chinese and English.After elimination of irrelevant literature,poor quality and obsolete literature,77 documents were finally included for review. RESULTS AND CONCLUSION:Flap ischemia/reperfusion injury may be related to pathological factors such as inflammatory response,oxidative stress response,Ca2+overload,and apoptosis,which can cause apoptosis of vascular endothelial cells,vascular damage and microcirculation disorders in the flap,and eventually lead to flap necrosis.Studies have found that mesenchymal stem cell transplantation,platelet-rich plasma,signaling pathway modulators,shock waves,and pretreatment can alleviate flap ischemia/reperfusion injuries from different aspects and to varying degrees,and reduce the necrosis rate and necrosis area of the grafted flap.Although there are many therapeutic methods for skin flap ischemia/reperfusion injury,a unified and effective therapeutic method has not yet been developed in the clinic,and the advantages and disadvantages of various therapeutic methods have not yet been compared.Most of the studies remain in the stage of animal experiments,rarely involving clinical observations.Therefore,a lot of research is required in the future to gradually move from animal experiments to the clinic in order to better serve the clinic.
5.Effects of conditioned medium and exosomes of human umbilical cord mesenchymal stem cells on proliferation,migration,invasion,and apoptosis of hepatocellular carcinoma cells
Kai JIN ; Ting TANG ; Meile LI ; Yuan XIE
Chinese Journal of Tissue Engineering Research 2025;29(7):1350-1355
BACKGROUND:Mesenchymal stem cells can regulate the tumor microenvironment by secreting extracellular vesicles containing cytokines,growth factors and exosomes for the precise regulation of biological behavior of tumor cells. OBJECTIVE:To investigate the effects of human umbilical cord-derived mesenchymal stem cell conditioned medium and their released exosomes on the biological properties of hepatocellular carcinoma cells. METHODS:Human umbilical cord mesenchymal stem cell supernatant was collected,centrifuged and filtered at high speed to obtain human umbilical cord mesenchymal stem cell conditioned medium.Human umbilical cord mesenchymal stem cell supernatant was collected and human umbilical cord mesenchymal stem cell exosomes were extracted by ultra-high speed gradient centrifugation.Human umbilical cord mesenchymal stem cell exosomes were labeled with PKH26 and co-cultured with hepatocellular carcinoma cell MHCC97-H.The uptake of exosomes by MHCC97-H cells was observed by fluorescence microscopy.The effects of human umbilical cord mesenchymal stem cell conditioned medium and human umbilical cord mesenchymal stem cell exosomes on biological functions of hepatocellular carcinoma cells were assessed by the CCK-8 proliferation assay,Transwell migration and invasion assay,and the apoptosis assay. RESULTS AND CONCLUSION:(1)Human umbilical cord mesenchymal stem cell exosomes could be uptaken by MHCC97-H cells and was mainly distributed in the cytoplasm.(2)After treatment with human umbilical cord mesenchymal stem cell conditioned medium,MHCC97-H cells showed a significant increase in proliferation,migration,and invasion(P<0.001,P<0.05,P<0.01),and a significant decrease in apoptosis(P<0.001),while after treatment with human umbilical cord mesenchymal stem cell exosomes,MHCC97-H cells showed a decrease in proliferation(P<0.001)and migration,invasion,and apoptosis were significantly enhanced(P<0.001).(3)The results indicated that human umbilical cord mesenchymal stem cell conditioned medium had the ability to promote the proliferation,migration,invasion,and inhibit apoptosis of MHCC97-H cells,while human umbilical cord mesenchymal stem cell exosomes had the properties of promoting the migration,invasion and apoptosis of MHCC97-H cells,inhibiting the proliferation.
6.Research hotspots and frontiers of stem cells for Alzheimer's disease
Liugang XIE ; Shuke CUI ; Nannan GUO ; Aoyu LI ; Jingrui ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(7):1475-1485
BACKGROUND:Stem cells can promote nerve regeneration,repair damaged nerves,inhibit inflammation and apoptosis of nerve cells,and provide a new way for the treatment of Alzheimer's disease. OBJECTIVE:To make a bibliometrical analysis of the articles on stem cell therapy for Alzheimer's disease published internationally from 2004 to 2023,in order to reveal the research hotspot and trend of stem cell therapy for Alzheimer's disease. METHODS:From the Web of Science Core Collection database,by using Excel,VOSviewer,and Citespace software,the annual number of publications,countries,institutions,journals/co-cited journals,authors,and keywords of articles related to stem cells and Alzheimer's disease published from January 1,2004 to October 31,2023 were visually analyzed. RESULTS AND CONCLUSION:A total of 3 521 core papers were included,and the number of published papers increased year by year.The United States is the country with the most papers.Harvard Medical School is the most prolific institution.Maiese kenneth is the author with the most papers.International Journal of Molecular Sciences has the most papers in this field.The journal PLoS One published the most citations.At present,the field of stem cell therapy for Alzheimer's disease focuses on pathophysiological mechanism and animal experimental research,and"neurogenesis","oxidative stress","extracellular vesicles",and"mesenchymal stem cells"are the research trends in this field.Stem cell therapy for Alzheimer's disease has broad prospects.In the future,exchanges and cooperation between institutions and authors should be strengthened to further explore the main mechanism of stem cell therapy for Alzheimer's disease,solve possible clinical problems such as immune rejection,effectiveness,and safety,and further tap the potential of stem cells in the treatment of Alzheimer's disease.
7.Suture tape and headless compression screws in treatment of Lisfranc injury with comminuted fractures of the first and second proximal metatarsal bones
Haobo HUANG ; Xinyuan LIANG ; Guozhong YE ; Qingxiang XIE ; Boyuan SU
Chinese Journal of Tissue Engineering Research 2025;29(9):1803-1809
BACKGROUND:Lisfranc ligament is an important structure to maintain the transverse and longitudinal arch of the foot.This injury is a serious middle-foot injury.Lisfranc ligamentous injuries are complex,and their treatment,along with the preferred method of fixation,is controversial. OBJECTIVE:To compare the short-term efficacy of plate combined with Suture tape versus plate combined with headless compression screw in the treatment of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones. METHODS:A retrospective analysis was performed on 48 patients with Lisfranc injury due to comminuted fractures of the 1st and 2nd proximal metatarsal bones in Seventh Department of Orthopedics,Dongguan Hospital of Traditional Chinese Medicine from January 2019 to June 2022.Among them,25 were fixed with plate combined with Suture tape(observation group)and 23 were fixed with plate combined with headless compression screw(control group).Preoperative classification was performed according to Myerson classification system based on preoperative imaging data.Postoperative follow-up was performed according to fracture healing time,visual analog scale,and American Orthopaedic Foot and Ankle Society(AOFAS)criteria to assess the recovery of foot functions.Postoperative complications were compared and analyzed between the two groups. RESULTS AND CONCLUSION:(1)All cases completed the operation successfully and obtained follow-up in the two groups.The postoperative follow-up time of the two groups was 12-36 months,with a mean of(18.0±5.42)months.(2)There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).(3)The fracture healing time of observation group was slightly longer than that of control group(P<0.05).(4)After 3,6,and 12 months of follow-up,the visual analog scale score of the observation group was significantly lower than that of the control group(P<0.05).(5)At 6 and 12 months after operation,AOFAS score of foot function in the observation group was significantly improved compared with the screw group at various time points after operation(P<0.05),and was significantly higher than that before operation(P<0.05).(6)The postoperative complications were 1 case of traumatic arthritis in the observation group and 1 case of incision infection,1 case of screw fracture,and 2 cases of traumatic arthritis in the control group.There was no significant difference between the two groups(P>0.05),considering the correlation with a small sample size.(7)It is indicated that as for the surgical method of Lisfranc injury with comminuted fractures of the 1st and 2nd proximal metatarsal bones,the application of plate combined with Suture tape internal fixation has a reliable effect in the treatment of Lisfranc joint injury,which can improve the function of the foot joint of patients,and has the advantages of less surgical trauma,fewer postoperative complications,and lower risk of long-term iatrogenic traumatic arthritis.Compared with headless compression screw,it is more beneficial to the recovery of foot function.
8.Study on the role of health culture moistening Xinjiang in ensuring people’s well-being
Weiguo XIE ; Binfeng MA ; Jian LIU
Chinese Medical Ethics 2025;38(3):392-397
The construction of health culture is a crucial factor for the sustainable development of public health. It is also one of the key driving forces for consolidating the achievements of poverty alleviation, effectively linking rural revitalization, and benefiting the well-being work in Xinjiang’s people. To play the role of health culture in shaping the soul and cultivating the foundation of well-being work in Xinjiang’s people, it is necessary to clarify the necessity of integrating health culture into Xinjiang’s governance strategy and medical assistance, and to analyze the logical causes of cultivating people through culture and nourishing the essence through literature. This paper specifically analyzed and sorted out the development process and achievements of the Party Central Committee’s medical and health assistance to Xinjiang during the socialist construction period, the reform and opening-up, and the new era. It also dissected the problems and challenges of healthy cultural moistening Xinjiang from the perspective of cultural moistening Xinjiang in the new era, such as weak medical conditions, prominent health problems, a lack of health awareness among grassroots people, as well as insufficient emphasis on education, construction, training, and development of the “great health” culture. The convergence and integration of Xinjiang’s governance strategy and health culture moistening Xinjiang will be realized, thereby safeguarding the well-being of Xinjiang’s people through implementing the national health plan, strengthening the education of public health and wellness skilled personnel, establishing and perfecting the training and continuing education system for health technicians in Xinjiang, and establishing the concept of a “great health” culture.
9.Analysis of the efficacy of traditional Chinese medicine for diabetic retinopathy based on evidence body quality assessment
Juan LING ; Zhuolin XIE ; Xiangxia LUO ; Wanying GUO ; Jiajin LI ; Jun ZHOU ; Xufei LUO
China Pharmacy 2025;36(7):863-866
OBJECTIVE To evaluate the quality of evidence in the systematic evaluation/meta-analysis of traditional Chinese medicine (TCM) for diabetes retinopathy (DR) based on the GRADE system. METHODS Chinese and English databases were searched to obtain the relevant studies of systematic evaluation/meta-analysis of traditional Chinese medicine in the treatment of DR. The search time was from the establishment of each database to January 13th, 2024. According to the inclusion and exclusion criteria, literature screening was conducted. After extracting relevant information from the included literature, the GRADE system was used to evaluate the quality level of the evidence body in the included studies, and the evidence of the outcome indicators was integrated and summarized. RESULTS A total of 51 studies were ultimately included, encompassing 135 outcome indexes. Among these, 19 indicators (14.1%) were of high quality, 87 (64.4%) were of medium quality, 26 (19.3%) were of low quality, and 3 (2.2%) were of very low quality. Overall, the evidence quality of the outcome indicators in the included studies was medium to low quality. The integrated results of evidence on the efficacy of outcome indexes showed that compared with conventional Western medicine, calcium dobesilate or placebo, TCM had significant advantages in improving overall efficacy, reducing bleeding spot area, reducing macular foveal thickness, and increasing visual improvement rate. In addition,the combination of TCM and conventional Western medicine or calcium dobesilate was significantly more effective than using conventional Western medicine or calcium dobesilate alone. CONCLUSIONS The overall quality of the evidence in the systematic evaluation/meta-analysis study on the treatment of DR with TCM is medium to low quality. Based on existing research findings, TCM demonstrates good clinical efficacy in the treatment of DR.
10.Literature Data Analysis on the Evolution Pattern of Traditional Chinese Medicine Syndromes in Psoriasis Vulgaris
Kewen GUAN ; Xiuli XIE ; Chuanjian LU
Journal of Traditional Chinese Medicine 2025;66(8):834-840
ObjectiveTo explore the distribution and evolution patterns of traditional Chinese medicine (TCM) syndromes and syndrome elements in psoriasis vulgaris (PV). MethodsLiterature related to TCM syndromes of PV published in databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), VIP Chinese Technology Periodical Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Embase, and Web of Science from their inception to December 31, 2023, was retrieved. Statistical analysis was conducted on the distribution of TCM syndromes and syndrome elements in the included studies. The data were further categorized into five-year periods to analyze the dynamic changes in syndromes and syndrome elements over time. ResultsA total of 2,853 studies were included, with 5,896 syndrome occurrences. The most common TCM syndromes in PV were blood-heat syndrome (2,167 occurrences, 36.75%), blood-stasis syndrome (1,219 occurrences, 20.68%), blood-dryness syndrome (1,124 occurrences, 19.06%), and damp-heat syndrome (263 occurrences, 4.46%). The most frequent syndrome categories included blood syndromes (4,680 occurrences, 79.38%) and dampness syndromes (347 occurrences, 5.89%). The most common syndrome elements related to disease location were blood division (4,874 occurrences, 94.38%) and spleen (99 occurrences, 1.92%). The most common syndrome elements related to disease nature were blood-heat (2,213 occurrences, 25.96%), blood-dryness (1,434 occurrences, 16.82%), and blood-stasis (1,330 occurrences, 15.60%). Except for the period 1978-1983, blood-heat, blood-stasis, and blood-dryness syndromes consistently ranked among the top three, with their combined proportion showing an overall upward trend (from 67.65% to 81.69%). The proportion of spleen deficiency with damp obstruction syndrome also increased (from 0.24% to 1.46%). In terms of syndrome classification, the proportion of blood syndromes showed an overall upward trend (from 67.65% to 83.46%), ranking first in all periods. The proportion of dampness syndromes showed a general downward trend (from 17.65% to 4.54%), ranking second after blood syndromes in most periods except for 1994-1998 and 1999-2003. The proportion of spleen-related syndromes showed an overall increase (from 0.24% to 1.85%). Regarding disease location elements, the proportion of blood division remained stable above 90%, while the proportion of spleen involvement increased (from 0.68% to 3.23%). As for disease nature elements, blood-heat (from 19.23% to 33.27%) and blood-stasis (from 1.92% to 20.83%) significantly increased, while dampness initially decreased and then slightly increased (from 11.54% to 5.73%). ConclusionIn the distribution of PV-related TCM syndromes, blood-heat, blood-stasis, and blood-dryness syndromes are the most common. Blood syndromes dominate syndrome classification, with disease location primarily in the blood division and disease nature characterized by blood-heat, blood-stasis, and blood-dryness. Evolutionary trends indicate that blood-heat, blood-stasis, and blood-dryness syndromes remain predominant and are increasing in proportion, while spleen deficiency with damp obstruction syndrome is also rising. Among syndrome classifications, the proportion of blood syndromes is increasing, dampness syndromes are decreasing, and spleen-related syndromes are on the rise. In terms of syndrome elements, blood division remains dominant, while spleen involvement is increasing. The proportion of blood-heat and blood-stasis is significantly increasing, while dampness first declines and then slightly rebounds. Overall, the mainstream TCM perspective of treating PV based on blood differentiation remains unchanged, with syndrome distribution focusing on blood division. The increasing importance of spleen deficiency and dampness in disease pathogenesis represents a new trend.

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