1.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
2.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
3.Treatment Principles and Paradigm of Diabetic Microvascular Complications Responding Specifically to Traditional Chinese Medicine
Anzhu WANG ; Xing HANG ; Lili ZHANG ; Xiaorong ZHU ; Dantao PENG ; Ying FAN ; Min ZHANG ; Wenliang LYU ; Guoliang ZHANG ; Xiai WU ; Jia MI ; Jiaxing TIAN ; Wei ZHANG ; Han WANG ; Yuan XU ; .LI PINGPING ; Zhenyu WANG ; Ying ZHANG ; Dongmei SUN ; Yi HE ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):272-279
To explore the advantages of traditional Chinese medicine (TCM) and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications (DMC), refine key pathophysiological insights and treatment principles, and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine, hosted by the China Association of Chinese Medicine, was held in Beijing, 2024. Experts in TCM, Western medicine, and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis, diagnostic and treatment challenges, and mechanism research related to DMC, ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development, research prioritization, and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM, strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.
4.Intervention Strategies for Heart Failure with Preserved Ejection Fraction Using Combined Classical Formulas Based on the Theory of "Disease of Both Blood and Water"
Yuzhi JIA ; Qingyong HE ; Jie WANG ; Xin ZHAO ; Ziyi WANG ; Dongmei LI ; Junqiao AN
Journal of Traditional Chinese Medicine 2026;67(4):370-374
Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet (《金匮要略》), and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction (HFpEF), this paper systematically clarifies the pathomechanism of HFpEF, characterized by yang deficiency as the root, blood stasis as the pivotal factor and water retention as the manifestation. Accordingly, the therapeutic principles have been proposed, which are warming yang and banking up original qi to consolidate the root, activating blood and unblocking collaterals to smooth the mechanism, and promoting urination and regulating pivot to remove the branch. On this basis, a compound formula structure of "one monarch, one minister and one assistant" is established, forming an integrated intervention strategy that synergistically combines the three methods of warming yang, activating blood, and promoting urination through combined classical formulas. Zhenwu Decoction (真武汤), which warms yang and dissolves rheum, is used to consolidate the root and directly target the source of yang deficiency, serving as the monarch; Guizhi Fuling Pills (桂枝茯苓丸), which activates blood, promotes urination and unblocks the pivot, assists in interrupting the binding of blood stasis and water retention, serving as the minister; Tingli Dazao Xiefei Decoction (葶苈大枣泻肺汤), which regulates qi, disperses retained fluids, and eliminates the manifestation, alleviates acute water-retention symptoms, serving as the assistant. This compound formula is warming without being drying, diuretic without being drastic, and dispels stasis without consuming blood, thereby achieving the therapeutic effects of warming yang, activating blood, and promoting urination.
5.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
6.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
7.Mast Cell Activation Promotes Myocardial Remodeling in Alcoholic Cardiomyopathy
Qinglang LI ; Dongmei XIE ; Xiuren GAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(3):451-458
ObjectiveTo investigate the role and related mechanisms of mast cells (MCs) in alcoholic cardiomyopathy (ACM). MethodsAn ACM model was established in C57BL/6 mice by feeding them with alcohol liquid diet, and some model mice were intervened with cromolyn sodium, a mast cell stabilizer. Cardiac function, myocardial remodeling and the expression of related proteins were evaluated by echocardiography, tissue staining and Western blot. In vitro, neonatal rat ventricular cardiomyocytes (NRVCs) were stimulated with mast cell granules (MCGs) and/or alcohol, and pathway inhibitors were used to explore the underlying mechanisms. ResultsLong-term alcohol feeding caused significant cardiac dysfunction and mast cells activation in mice, accompanied by increased expressions of chymase, NOX2, NOX4 and apoptosis-related protein cleaved Caspase-3 (c-Caspase3) in myocardial tissues (P<0.05). Pretreatment with cromolyn sodium improved cardiac function, inhibited mast cell activation, and reduced the expressions of the above proteins. In vitro experiments showed that treatment with MCGs or alcohol alone up-regulated the expressions of c-Caspase3, NOX2, NOX4 and phosphorylated PKCβ1 (p-PKCβ1) in cardiomyocytes, and the combined stimulation of the two had a synergistic effect. Protease-activated receptor 2 (PAR2) inhibitor down-regulated the MCG-induced expressions of the above proteins. PKCβ1 inhibitor also inhibited the MCG-induced expressions of c-Caspase3, NOX2 and NOX4. Chymase inhibitor exerted a partial inhibitory effect on MCG-induced cardiomyocyte apoptosis. ConclusionDuring the development of ACM, mast cells are activated, and the released MCGs may promote cardiomyocyte apoptosis through the PAR2-PKCβ1-NOX2/NOX4 signaling pathway, in which chymase plays an important role.
8.A Full-Cycle Analysis of the EPIS Framework: Exploration, Preparation, Implementation, Sustainment
Zizhen HUANG ; Dong XU ; Dongmei ZHONG ; Zhiqing NING ; Junlin ZHU ; Qingqing LI ; Wanqing HUANG ; Kera SWANSON ; Gregory A. AARONS
Medical Journal of Peking Union Medical College Hospital 2026;17(5):1450-1460
Implementation science aims to facilitate the efficient dissemination and sustainable application of evidence based interventions, and has accordingly generated a variety of theories, models, and frameworks. Among these, the Exploration, Preparation, Implementation, and Sustainment (EPIS) frameworkfunctions both as a process model and a determinant framework, emphasizing the staged and iterative nature of implementation, and systematically explaining the influence of multilevel factors on implementation processes and outcomes through four dimensions: outer context, inner context, bridging factors, and innovation factors. The EPIS framework has been widely applied in health and public service settings internationally, yet its use in China based research remains relatively limited. This article systematically introduces the core components and application methods of the EPIS framework, and illustrates its value in identifying key influencing factors, developing implementation strategies, and optimizing implementation outcomes through case examples from the health sector, aiming to provide a methodological reference for implementation research and the promotion of evidence based interventions in China.
9.Evaluation of the effect of integrated interventions on comorbidity of myopia and obesity among primary and secondary school students in Tongzhou District in Beijing
YANG Gang, YANG Dongmei, SONG Yi, LI Jing, WEN Han, CHE Jingyue, DONG Yanhui
Chinese Journal of School Health 2025;46(1):39-44
Objective:
To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students, so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity.
Methods:
From September 2022 to September 2023, a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District, Beijing. Participants were randomly assigned to an intervention group (914 before intervention and 754 after intervention) and a control group (868 before intervention and 652 after intervention), with an expected duration of one academic year. Based on the RE-AIM framework, integrate resources from families, schools, communities, and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children. The intervention group received intervention according to the comprehensive intervention technology package, while the control group did not receive any intervention measures. Relevant health indicators during the baseline period and after intervention were measured and collected, and groups were compared by Chi quest test, t-test and Wilcoxon rank sum test.
Results:
After intervention, the uncorrected visual acuity of primary and secondary school students in the intervention group (4.79±0.30) and the control group (4.77±0.33) both decreased compared to those before intervention (4.80±0.30, 4.90±0.32) ( t =-7.00,-5.24); the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group( t =5.33)( P <0.01). After intervention, body mass index, waist circumference, hip circumference, and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention. However, the changes in these indicators were not statistically significant ( t/Z =-0.03, - 0.36,- 0.30,- 0.01, P >0.05); the above indicators in the control group increased compared to those before intervention, but only hip circumference and body fat percentage showed statistically significant changes ( t/Z =2.17, 2.62, P <0.05). After intervention, both the intervention group and the control group showed increases in systolic and diastolic blood pressure compared to those before intervention(intervention group: t =2.16,5.29; control group: t =6.84,5.07); the intervention group had lower systolic and diastolic blood pressure than the control group( t = -5.27 , -2.08)( P <0.05). After intervention, the intervention and the control groups had statistically significant differences in cognitive accuracy(92.48%, 69.33%) in terms of "outdoor exercise can prevent myopia" and "having 5 servings of adult fist sized vegetables and fruits every day" ( χ 2=6.30, 7.86, P <0.05). There was a statistically significant difference in the proportion of primary and secondary school students in the intervention group (40.98%) and the control group (35.43%) for "who did not drink sugary drinks for every day in the past 7 days" ( χ 2=4.32, P <0.05). After intervention, the intervention group and the control group showed increases in "school outdoor activity duration on school days" and "outdoor activity duration on rest days" compared to those before intervention ( t/Z =-13.32,-9.71;- 2.59,-2.69);the behavior rate of "visual acuity measurement frequency at least once every 3 months" in the intervention group (46.68%) and the control group (52.76%) increased compared to those before intervention (36.43%, 44.01%), and the increases in the intervention group were greater than that in the control group ( χ 2=17.52,11.08) ( P <0.05).
Conclusions
Comprehensive intervention measures have significant intervention effects on controlling the occurrence and development of comorbidity of myopia and obesity in children. It could actively promote collaboration and cooperation among families, schools, communities and medical institutions to reduce the occurrence of myopia and obesity among primary and secondary school students.
10.Ursodeoxycholic acid inhibits the uptake of cystine through SLC7A11 and impairs de novo synthesis of glutathione
Fu'an XIE ; Yujia NIU ; Xiaobing CHEN ; Xu KONG ; Guangting YAN ; Aobo ZHUANG ; Xi LI ; Lanlan LIAN ; Dongmei QIN ; Quan ZHANG ; Ruyi ZHANG ; Kunrong YANG ; Xiaogang XIA ; Kun CHEN ; Mengmeng XIAO ; Chunkang YANG ; Ting WU ; Ye SHEN ; Chundong YU ; Chenghua LUO ; Shu-Hai LIN ; Wengang LI
Journal of Pharmaceutical Analysis 2025;15(1):189-207
Ursodeoxycholic acid(UDCA)is a naturally occurring,low-toxicity,and hydrophilic bile acid(BA)in the human body that is converted by intestinal flora using primary BA.Solute carrier family 7 member 11(SLC7A11)functions to uptake extracellular cystine in exchange for glutamate,and is highly expressed in a variety of human cancers.Retroperitoneal liposarcoma(RLPS)refers to liposarcoma originating from the retroperitoneal area.Lipidomics analysis revealed that UDCA was one of the most significantly down-regulated metabolites in sera of RIPS patients compared with healthy subjects.The augmentation of UDCA concentration(≥25 μg/mL)demonstrated a suppressive effect on the proliferation of liposarcoma cells.[15N2]-cystine and[13Cs]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione(GSH)synthesis.Mechanistically,UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis,leading to reactive oxygen species(ROS)accumulation and mitochondrial oxidative damage.Furthermore,UDCA can promote the anti-cancer effects of ferroptosis inducers(Erastin,RSL3),the murine double minute 2(MDM2)inhibitors(Nutlin 3a,RG7112),cyclin dependent kinase 4(CDK4)inhibitor(Abemaciclib),and glutaminase inhibitor(CB839).Together,UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity,and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA.More importantly,in combination with other antitumor chemotherapy or physiotherapy treatments,UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.


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