1.Mechanism of action of organelle interactions in the progression of liver fibrosis and traditional Chinese medicine prevention and treatment strategies
Yuanyuan ZHENG ; Chenlu ZHAO ; Lihui ZHANG ; Sutong LIU ; Wenxia ZHAO
Journal of Clinical Hepatology 2026;42(3):711-717
Liver fibrosis is the core pathological stage of the progression of various chronic liver diseases to liver cirrhosis, and hepatic stellate cell (HSC) activation and the abnormal accumulation of collagen fibers are important processes for the development and progression of liver fibrosis. In recent years, studies have shown that HSC activation is regulated by the complex interactions between various organelles (including mitochondria, endoplasmic reticulum, Golgi apparatus, lysosome, and peroxisomes), and such interactions affect the key cellular processes such as energy metabolism, protein synthesis and folding, reactive oxygen species balance, and autophagy, thereby participating in the progression of liver fibrosis. Meanwhile, traditional Chinese medicine and its active ingredients with multi-target synergistic effects have attracted wide attention. From the perspective of the interaction between organelles, this article systematically elaborates on the specific mechanism of such interactions in the progression of liver fibrosis and reviews how traditional Chinese medicine inhibits HSC activation and collagen production by regulating the function of these organelle and their interaction networks, thereby exerting an anti-liver fibrosis effect, in order to provide a theoretical basis for in-depth understanding of the pathological mechanism of liver fibrosis and the development of new traditional Chinese medicine intervention strategies.
2.Mechanism of Qingre antai decoction in improving pregnancy outcomes of threatened abortion rats with blood heat syndrome based on JAK2/STAT3 and PI3K/AKT dual signaling pathways
Liya MA ; Yanduo SHEN ; Jiale ZHANG ; Liujun WU ; Bingheng XIE ; Xingfei WU ; Chen LIU ; Minghao ZHANG ; Xuelin ZHANG ; Dawei ZHANG
China Pharmacy 2026;37(9):1127-1133
OBJECTIVE To explore the mechanism by which Qingre antai decoction improves pregnancy outcomes of threatened abortion rats with blood heat syndrome. METHODS The pregnant rats were randomly divided into normal group, model group, dydrogesterone group (0.002 g/kg), and Qingre antai decoction group (44.1 g/kg), with 13 rats in each group. Except for normal group, other groups were given warming-yang Chinese medicine and corresponding drugs intragastrically, once a day, for 12 consecutive days. On the 13th day of pregnancy, a single intragastric administration of mifepristone (5 mg/kg) was performed to establish a model of threatened abortion with blood heat syndrome. On the 14th day of pregnancy, the abortion rate and uterine coefficient were calculated; the pathological morphology of pregnant uterine was observed; the serum levels of 3,5,3′-triiodothyronine (T3), thyroid hormone (T4), thyroid stimulating hormone (TSH), as well as the levels of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in the pregnant uterus were all determined; the expressions of mRNA and protein related to Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathways were detected. RESULTS Compared with normal group, the model group exhibited endometrial tissue damage, a reduced number of decidual cells, and a significant presence of blood stasis within the uterus; abortion rate, the serum levels of T3, T4 and TSH, the mRNA expressions of JAK2, STAT3 and suppressor of cytokine signaling 3 (SOCS3) as well as protein expressions of p-JAK2, p-STAT3 and SOCS3 in the pregnant uterus were increased significantly ( P <0.05); uterine coefficient, the levels of VEGF and NO in pregnant uterus, mRNA expressions of VEGFR2, PI3K, AKT and endothelial nitric oxide synthase(eNOS), protein expressions of VEGFR2, PI3K and eNOS as well as phosphorylation level of AKT in the pregnant uterus were significantly reduced ( P <0.05). Compared with model group, the endometrial tissue damage and congestion in the Qingre antai decoction group were significantly improved, and the levels of the aforementioned quantitative indicators were significantly reversed ( P <0.05). CONCLUSIONS Qingre antai decoction can improve the pregnancy outcomes in rats with threatened abortion of blood heat syndrome, the mechanism of which may be associated with inhibiting JAK2/STAT3 pathway and activating PI3K/AKT pathway.
3.Expert Consensus on Clinical Application of Qidong Yixin Oral Liquid
Changkuan FU ; Xiaochang MA ; Mingjun ZHU ; Yue DENG ; Hongxu LIU ; Mingxue ZHANG ; Ying CHEN ; Yan ZHOU ; Ling ZHANG ; Jianhua FU ; Wei YANG ; Yu'er HU ; Ming CHEN ; Yanming XIE ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):147-158
The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis (VMC). It has the functions of tonifying Qi, nourishing the heart,calming the mind, and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However,the understanding of its efficacy evidence, advantageous aspects, dosage and administration, and medication safety remains insufficient in clinical practice. Therefore,the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid (hereinafter referred to as consensus) was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine,successively completing multiple tasks such as the consensus project initiation,determination of clinical problems,evidence search and evaluation,formation of recommendation opinions and consensus suggestions,solicitation of opinions,peer review, submission for review and release, and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions,clarifying the clinical positioning,efficacy advantages,syndrome differentiation,dosage and administration,combination therapy,timing of medication,adverse reactions,contraindications, and precautions of Qidong Yixin oral liquid,indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease,providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23, 2024. Standard number:GSCACM-376-2024.
4.Improvement effects and mechanism of Achyranthes bidentata total saponins extract on vascular endothelial dysfunction in spontaneously hypertensive rats
Ruifeng LIANG ; Wenjing GE ; Xiaobo KOU ; Ping TIAN ; Hongzhi AN ; Zheng WEI ; Mingli ZHANG
China Pharmacy 2026;37(3):331-337
OBJECTIVE To investigate the improvement effects and mechanism of Achyranthes bidentata total saponins (ABS) extract on vascular endothelial dysfunction in spontaneously hypertensive rat (SHR) based on cytochrome P450 4A (CYP4A)/20-hydroxyeicosatetetraenoic acid (20-HETE)/G protein-coupled receptor 75 (GPR75) axis. METHODS Ten Wistar- Kyoto rats were taken as the normal control group. Forty SHR were first stratified by systolic blood pressure and then, within each stratum, randomly assigned using a random-number table to the model group (MOD group), captopril positive control group (CAP group, 10 mg/kg), ABS low- and high-dose extract groups (ABS-L group, ABS-H group, 60 and 120 mg/kg), with 10 rats in each group. Animals in each group were given the corresponding drug or equal volume of pure water by gavage, once a day, for 28 consecutive days. After the last administration, systolic blood pressure of rats was measured. The levels of vasoactive substances, inflammatory factors and oxidative stress indicators in serum were measured. The pathological changes of rat thoracic aorta were observed. The level of reactive oxygen species (ROS) in aortic tissue was analyzed. The expressions of endothelial nitric oxide synthase (eNOS), CYP4A, GPR75, nuclear factor-κB p65 (NF-κB p65), phosphorylated NF-κB p65, p22phox, and reduced nicotinamide adenine dinucleotide phosphate oxidase 4(NOX4) in thoracic aorta tissue were detected. RESULTS After 28 d of treatment, compared with MOD group, the systolic blood pressure of rats in the ABS-L and ABS-H groups decreased significantly. The levels of 20-HETE, angiotensin Ⅱ, interleukin-1β, interleukin-6, tumor necrosis factor-α, intercellular cell adhesion molecule-1 and malondialdehyde in serum were significantly reduced (P<0.05 or P<0.01), while the levels of nitric oxide, superoxide dismutase, glutathione peroxidase and catalase were significantly increased (P<0.05 or P<0.01). Intimal damage of thoracic aorta was reduced, and endothelial cell morphology was improved. The expressions of ROS, CYP4A, GPR75, p22phox, NOX4 and the phosphorylation level of NF-κB p65 protein in thoracic aorta were down-regulated or reduced (P<0.05 or P<0.01), while the expression of eNOS was up-regulated (P<0.05 or P<0.01). CONCLUSIONS ABS extract may alleviate the inflammatory response and oxidative stress in SHR effectively by down-regulating the expression of CYP4A, reducing the production of 20-HETE, inhibiting the activation of GPR75, and subsequently suppressing the activation of downstream NF-κB and NOX4, thereby improving hypertension-related vascular endothelial dysfunction.
5.Mechanism of NAFLD-associated Intestinal Barrier Damage and Traditional Chinese Medicine Intervention Strategies Based on "Turbid Pathogenic Factors Entering the Blood" Theory
Haoyang QIN ; Lei LUO ; Mengge LI ; Xueqian KONG ; Fanghua ZHANG ; Zhongqin DANG ; Zhibo DANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):277-287
Intestinal barrier damage is a prominent feature of non-alcoholic fatty liver disease (NAFLD) and serves as a critical factor driving the progression from simple fatty liver to non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. The "turbid pathogenic factors entering the blood" theory integrates classical traditional Chinese medicine (TCM) principles with contemporary disease evolution trends and research findings. It posits that endogenous turbid pathogenic factors within the body infiltrate the blood vessels, leading to impure and viscous blood quality, thereby triggering various diseases. Based on this theory, this article elucidated the pathogenic mechanism of NAFLD-associated intestinal barrier damage. It argued that in NAFLD, the liver loses its dredging function, and the spleen becomes obstructed and dysfunctional. Moreover, essential nutrients fail to be properly transformed, resulting in the internal generation of turbid pathogenic factors. This subsequently initiates a series of pathological changes, namely, "infiltration of phlegm-turbidity into the blood, eroding the intestinal mucosa", "infiltration of glucose-turbidity into the blood, macerating and eroding the intestinal mucosa", "infiltration of heat-turbidity into the blood, scorching and eroding the intestinal mucosa", and "infiltration of stasis-turbidity into the blood, stagnating and eroding the intestinal mucosa", ultimately causing intestinal barrier damage. Furthermore, guided by the "turbid pathogenic factors entering the blood" theory, this article explored TCM intervention strategies: employing medicinals targeting the liver meridian to address the root cause and reduce the generation and deposition of turbid pathogenic factors in the liver, administering blood-system medicinals to clear the blood and purge turbidity, thereby intercepting the progression of the disease mechanism, and applying tonifying medicinals to bolster healthy Qi and defend against turbid invasion, allowing the damaged intestinal mucosa to gradually heal. This article presented novel theoretical and medicinal perspectives for analyzing NAFLD-associated intestinal barrier damage based on the "turbid pathogenic factors entering the blood" theory, aiming to provide new entry points and broader horizons for related research and clinical practice.
6.Microscopic Mechanism of Ulcerative Colitis and New Ideas on Medicine Management Based on Theory of Mutual Interference Between Lucidity and Turbidity
Yuying XU ; Changpu ZHAO ; Lei LUO ; Renwu CHEN ; Zishun LI ; Meiling LI ; Rongzhi LI ; Yu ZHANG ; Guangjie SHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):288-299
The chapter Zhouyu in Guoyu says "Qi of the heaven and the earth moves without losing its order." With lucidity ascending and turbidity descending, Qi moves in a normal state, and Yin and Yang consolidate the foundation of the body. The mutual interference between lucidity and turbidity leads to the disorder of Qi movement, thus causing diseases. It is a pathological state of disorder between ascending and descending, as well as between entering and exiting, gradually evolving into a state of turbidity affecting lucidity and transforming into pathogen, which can be used to interpret and analyze the core of disease pathogenesis. The theory of lucidity and turbidity is connected with the harmony of nutrient and defensive aspects, Qi circulation, and sweat pore associating with Qi movement, and it has common implications with immune responses and nutrient metabolism system, intestinal mucosal barrier function, and mitochondrial energy synthesis. Modern studies have shown that intestinal flora imbalance, bile acid receptor inactivation, macrophage polarization imbalance, epithelial-mesenchymal transition, ferroptosis and other related microscopic pathological mechanisms are involved in the development and progression of ulcerative colitis. By delving into the common meaning of the classic theory of mutual interference between lucidity and turbidity in traditional Chinese medicine and modern medical pathological mechanisms, this paper summarizes the correspondence between the micropathological mechanism and the theory of mutual interference between lucidity and turbidity in the regulation and mamagement of ulcerative colitis. The combined use of sweet and warm medicinal materials consolidates the middle Qi and activates Qi circulation, thus ascending lucidity and descending turbidity. The combined use of pungent medicinal materials for dispersing and bitter medicinal materials for descending simultaneously raises warm and clear Qi. Wind-extinguishing medicinal materials facilitate the ascending of Qi and the opening of sweat pores. Accordingly, turbidity descends and lucidity ascends. The prescriptions incorporating these medication principles are in agreement with the therapeutic approach of following the normal flow of lucidity and turbidity. This paper clarifies the scientific connotation and micropathologic mechanism of ulcerative colitis from the perspective of mutual interference between lucidity and turbidity, providing new theories and prescriptions for the clinical diagnosis, treatment, and prevention of ulcerative colitis.
7.Clinical observation of sacubitril/valsartan versus benazepril in perimenopausal hypertensive patients
Xiaoxia ZHANG ; Bolin SHAO ; Yingkun ZHOU ; Zhanhai ZHANG ; Zhiying LI
China Pharmacy 2026;37(4):476-479
OBJECTIVE To compare the antihypertensive efficacy of sacubitril/valsartan versus benazepril in patients with perimenopausal hypertension, as well as their impacts on ventricular remodeling and inflammatory fibrosis. METHODS A total of 206 perimenopausal hypertensive patients in our hospital from January 1, 2023 to December 30, 2024 were retrospectively included.These patients were enrolled and divided into benazepril group (105 cases) and sacubitril/valsartan group (101 cases). Benazepril group received Benazepril hydrochloride tablet, and sacubitril/valsartan group received Sacubitril valsartan sodium tablet. All patients were treated for 6 months. The blood pressure(systolic blood pressure and diastolic blood pressure) and blood pressure control status before and after treatment, echocardiographic indicators (left ventricular ejection fraction, left ventricular mass index, relative wall thickness, and early-diastolic peak transmitral flow velocity/early-diastolic peak velocity of the mitral annulus), inflammatory fibrosis related indicators(high-sensitivity C-reactive protein,ratio of monocytes to lymphocytes,and ratio of neutrophils to lymphocytes), as well as the occurrence of adverse reactions(hypotension,hyperkalemia,and angioedema) were observed in both groups before and after treatment. RESULTS The blood pressure control rate was significantly higher in the sacubitril/valsartan group than in benazepril group ( P <0.05). After treatment, the blood pressure, echocardiographic indicators(except for left ventricular ejection fraction) ,and inflammatory fibrosis related indicators were significantly lower than those before treatment within the same group, and the sacubitril/valsartan group were significantly lower than the benazepril group ( P <0.05). There were no statistically significant differences in the incidence of hypotension, hyperkalemia, angioedema, and overall adverse drug reactions between the two groups ( P >0.05). CONCLUSIONS Compared with benazepril, sacubitril/valsartan provides superior blood-pressure control, reverses ventricular remodeling, attenuates inflammatory fibrosis in perimenopausal hypertensive patients, while maintaining a similar safety profile.
8.Research progress on the intervention of traditional Chinese medicine in lipid metabolism for obesity treatment via cAMP signaling pathway
Yu ZHANG ; Xiaoran WANG ; Yiping FU ; Yuting LIU ; Quanyou ZHAO ; Linna CUI ; Mingsan MIAO
China Pharmacy 2026;37(4):522-527
Obesity, a global chronic disease, is associated with adipose tissue dysfunction, which is one of the contributing factors to obesity. The cyclic adenosine monophosphate (cAMP) signaling pathway, a key regulator of lipid metabolism, plays a pivotal role in obesity development. Various of traditional Chinese medicine monomers, such as flavonoids, lignans, phenols, and terpenoids, as well as traditional Chinese medicine compound formulas like Xiaoyao powder, Shengmai powder, and Zexie decoction, can maintain energy homeostasis, balance adipose tissue function, regulate glucose metabolism, improve insulin resistance, and suppress inflammatory responses through cAMP signaling pathway regulation, thereby intervening in lipid metabolism for obesity treatment. Although a substantial amount of basic research has preliminarily elucidated the potential mechanisms by which traditional Chinese medicine intervenes in obesity through the cAMP signaling pathway, clinical translational research remains inadequate. There is an urgent need for large-sample, high-quality randomized controlled trials to validate these findings.
9.Mechanistic study of Tripterygium wilfordii multiglucoside in improving nephrotic syndrome via regulating the HIF-1α/miR-155-5p/Nrf2 pathway
Yifan TAO ; Chundong SONG ; Xu WANG ; Chong ZHANG ; Ying SU ; Xidong JIA ; Haoran JIANG
China Pharmacy 2026;37(5):602-606
OBJECTIVE To study the improvement effect and mechanism of Tripterygium wilfordii multiglucoside (TWM) on nephrotic syndrome in rats. METHODS The nephrotic syndrome model was established by intravenous injection of adriamycin via the tail vein. The modeling rats were randomly divided into the model group (distilled water), prednisone group (10 mg/kg), and TWM high- and low-dose groups (10 and 5 mg/kg, respectively). Additionally, blank group (distilled water) without model induction was established. Each group consisted of 9 rats. Rats in each group were administered the corresponding drugs or distilled water by gavage, once a day, for 6 consecutive weeks. The histopathological morphology of kidney tissues in rats was observed; the levels of 24-hour urinary protein (24 h-UTP) and serum biochemical indicators [albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), cholesterol (CHOL), and triglyceride (TG)] in rats were determined; the levels of oxidative stress indicators [superoxide dismutase (SOD), malondialdehyde (MDA)] in kidney tissue of rats were determined; expressions of hypoxia-inducible factor-1α (HIF-1α)/microRNA-155-5p (miR-155-5p)/nuclear factor erythriod 2- related factor 2 (Nrf2) signaling pathway-related mRNA and protein in the renal tissues of rats were detected. RESULTS Compared with the blank group, the rats in the model group exhibited disordered renal tissue structure, with a small amount of glomerular necrosis and edema of the renal tubular epithelial cells. 24 h-UTP, serum levels of SCr, BUN, CHOL and TG, MDA content, mRNA and protein expressions of HIF-1α and Keap1 as well as the expression of miR-155-5p in renal tissues were increased significantly ( P <0.05). Serum level of ALB, SOD level in renal tissue as well as mRNA and protein expressions of Nrf2 were decreased significantly ( P <0.05). Compared with the model group, TWM high-dose and low-dose groups exhibited significant improvements in renal injury, with notable reversals in the levels of the above quantitative indicators ( P <0.05). CONCLUSIONS TWM can alleviate oxidative stress-induced damage and thereby improve nephrotic syndrome in rats by regulating the HIF-1α/miR-155-5p/Nrf2 signaling pathway.
10.Research progress on the mechanisms of Tibetan medicine Gentianopsis paludosa and its chemical components against ulcerative colitis and associated fibrosis
Huan LI ; Qing NIE ; Yongkang AN ; Shuangxi ZHANG ; Xiang’an ZHANG
China Pharmacy 2026;37(5):676-681
Ulcerative colitis (UC) is a chronic and relapsing inflammatory disease of the intestine. Intestinal fibrosis represents a severe co mplication and a potential risk factor for malignant transformation. Gentianopsis paludosa is one of the traditional Tibetan medicines commonly used for treating gastrointestinal disorders such as damp-heat diarrhea and dysentery. Its chemical composition is complex, encompassing xanthones, flavonoids, terpenoids, and other bioactive components, and it exhibits properties such as clearing heat, eliminating dampness, and detoxifying. This article reviews the research progress on the pharmacodynamic material basis and mechanisms of G. paludosa against UC and associated fibrosis. Findings suggest that its extracts (e.g., aqueous extract, ethyl acetate extract) and active constituents (e.g., 1-hydroxy-3,7,8-trimethoxyxanthone, ursolic acid, swertiamarin, luteolin) may inhibit inflammatory cytokines, combat oxidative stress, suppress cell apoptosis, regulate intestinal microbiota and their metabolites, protect the intestinal mucosal barrier, modulate immune responses, and inhibit epithelial-mesenchymal transition, through modulating relevant signaling pathways, such as nuclear factor-kappa B, B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X protein, and transforming growth factor-β 1 /Smad, thus exerting therapeutic effects against UC and its related fibrosis via these seven aspects.

Result Analysis
Print
Save
E-mail