The principle of "supplementing or draining by the preference and aversions of the the five zang organs" emphasizes that prescriptions should align the five flavors of medicinals with the needs of the five organs， achieving supplementation through harmonizing flavors and drainage through opposing flavors. This paper analyzed the formulas for regulating the spleen found in Wings of the Thousand Gold Pieces Formulary （《千金翼方》） from the perspective of "supplementing or draining by the preference and aversions"， to summarize SUN Simiao's prescription characteristics for treating spleen-related disorders. In terms of the combination rule of medicinal properties and flavors， formulas like Bupi Decoction （补脾汤） for supplementing the spleen use sweet and warm medicinals paired with bitter and drying medicinals； those for draining the spleen use acrid and warm medicinals paired with bitter and cold medicinals； those for warming the spleen employs acrid and hot medicinals with sweet and warm medicinals； those like Jianpi Decoction （建脾汤） for strengthening spleen combines sweet and warm with sour and bitter medicinals； Zhuanpi Pill （转脾丸） pairs acrid and warm medicinals with sweet and warm medicinals； and Roupi Decoction （柔脾汤） uses sweet and warm medicinals with sweet and bitter medicinals. Regarding the medicinal flavors， warm dominates the four qi （the four properties）， while sweet， bitter， and acrid are the main among the five flavors. Clinical practice involves applying comprehensive therapy methods such as the combination of sweet and bitter to harmonize， acrid and sweet to transform yang， pungent to disperse and bitter to descend， balancing cold and warm， and combining supplementation and drainage. The foundational principle is to tonify spleen qi and protect the middle jiao， and treatment is tailored based on the disease condition， location， nature， and the characteristics of the medicinals， with careful selection of suitable dosage forms and administration methods.

Emerging evidence suggests that dysbiosis of the gut microbiota is associated with the pathogenesis of Parkinson's disease (PD), a prevalent neurodegenerative disorder. The microbiota-gut-brain axis plays a crucial role in the development and progression of PD, and numerous studies have demonstrated the potential therapeutic benefits of modulations in the intestinal microbiota. This review provides insights into the characterization of the gut microbiota in patients with PD and highlights associations with clinical symptoms and underlying mechanisms. The discussion underscores the increased influence of the gut microbiota in the pathogenesis of PD. While the relationship is not fully elucidated, existing research demonstrates a strong correlation between changes in the composition of gut microbiota and disease development, and further investigation is warranted to explain the specific underlying mechanisms.
Humans ; Parkinson Disease/microbiology* ; Gastrointestinal Microbiome/physiology* ; Dysbiosis/microbiology*

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

ObjectiveTo understand the distribution of enrofloxacin (ENR) residues in freshwater fish, to evaluate the dietary exposure risk to ENR for consumers through the consumption of different freshwater fish in Shanghai, and to provide a reference for controlling antibiotic residues in freshwater fish. MethodsGrass carp, Wuchang bream, pond loach, and Asian swamp eels were purchased from the markets in Shanghai. After being fed with ENR, the fish were divided into 42 batches according to their species and weight, and thereafter ENR residues in the muscles and skin of the fish were measured. In addition, a total of 44 batches of Wuchang bream, pond loach, Asian swamp eels were purchased from the markets, and the ENR residues in the muscles with or without the fish skin were measured, and the exposure risk was evaluated. ResultsThe average residues of ENR in skin of the freshwater fish after being fed with drugs in the 42 groups were higher than those in muscles (M=659.38 μg·kg^-1, M=460.83 μg·kg^-1; z=-2.212, P=0.027). The over-standard rates of ENR residues in the muscles with or without skin 44 batches of freshwater fish of sold in Shanghai were 36.36% and 29.55%, respectively. The median exposure, P₉₅ exposure, and maximum exposure to ENR through the consumption of the muscles with the skin for adults and children in Shanghai were higher than those through the consumption of muscles without the skin. For children, the margin of safety (MOS) for the max exposure to ENR by consuming the muscles with the skin was more than 1, while the MOS was less than 1 in all other cases for both children and adults. ConclusionThe ENR residues in the skin of freshwater fish are generally higher than those in the muscles. The risk of ENR residues in freshwater fish sold in Shanghai is within a controllable range. However, there might be a certain risk of acute exposure to ENR for children by consuming muscles with the skin of freshwater fish.

Objective:To investigate the risk factors of brain metastases in patients with limited-stage small cell lung cancer (SCLC) undergoing preventive brain radiotherapy after remission and to construct prediction model.Methods:A total of 231 patients with limited-stage SCLC who received chemoradiotherapy and achieved remission in 3201 Hospital from January 2015 to January 2023 were selected as the study objects. Logistic regression was used to analyze the influencing factors on the occurrence of brain metastases after remission in patients with limited-stage SCLC who received preventive brain radiotherapy. Binary logistic regression was used to construct a prediction model. Receiver operator characteristic (ROC) curve was used to evaluate the diagnostic efficacy of each indicator and the prediction model on the occurrence of brain metastases in patients.Results:The median follow-up time of the whole group was 73 months, and 42 cases of brain metastases occurred, with an incidence rate of 18.18%. There were statistically significant differences in the incidence of brain metastases among patients with different T stage ( Z=-4.97, P<0.001), clinical stage ( Z=-8.17, P<0.001), and time from initial treatment to thoracic radiotherapy ( χ2=21.38, P<0.001). Multivariate analysis showed that T stage (stage T 3: OR=6.29, 95% CI: 1.58-25.06, P=0.009; stage T 4: OR=12.91, 95% CI: 3.74-44.57, P<0.001), clinical stage (stageⅡ, OR=8.75, 95% CI: 2.89-26.51, P<0.001; stage Ⅲ, OR=18.43, 95% CI: 7.24-46.92, P<0.001), and time from initial treatment to thoracic radiotherapy ( OR=0.25, 95% CI: 0.11-0.56, P=0.001) were independent influencing factors on the occurrence of brain metastases after remission in patients with limited-stage SCLC who received preventive brain radiotherapy. The diagnostic prediction model based on the above indicators was logit ( P) =-19.91+1.84× stage T 3 +2.56× stage T 4+2.17× stage Ⅱ+2.91× stage Ⅲ-1.38× time from initial treatment to thoracic radiotherapy. ROC curve analysis showed that the area under the curve of T stage, clinical stage, time from initial treatment to thoracic radiotherapy, and the diagnostic prediction model for predicting the occurrence of brain metastasis after remission in patients with limited-stage SCLC who received preventive brain radiotherapy were 0.728, 0.660, 0.687, and 0.846, respectively, and the area under the curve of the diagnostic prediction model was significantly larger than those of the other indicators (all P<0.05) . Conclusion:T stage, clinical stage and the time from initial treatment to thoracic radiotherapy are all influential factors for the occurrence of brain metastases after remission in patients with limited-stage SCLC who received preventive brain radiotherapy. The diagnostic prediction model based on the above indicators can help to guide clinicians to accurately screen patients at high risk of brain metastases in the early stage.

Objective:To discuss the alleviative effect of ginsenoside Rg1 on chronic intermittent hypoxia(CIH)-induced brain injury in the mice,and to clarify its possible mechanism.Methods:Forty male C57BL/6 mice were randomly divided into control group,model group,inhibitor group(treated with calpain-1 inhibitor),low dose of ginsenoside Rg1 group(treated with 10 mg·kg-1 ginsenoside Rg1),and high dose of ginsenoside Rg1 group(treated with 20 mg·kg-1 ginsenoside Rg1).Except for the control group,the mice in all other groups were placed in a hypoxic chamber with automatically regulated oxygen concentration to induce hypoxic brain injury.The peripheral blood oxygen saturation(SpO2)of tail of the mice in various groups was detected;the escape latencies and path lengths and the frequency of swimming route crossing the target quadrant of the mice in various groups were determined by Morris water maze test;the levels of blood urea nitrogen(BUN),lactate(LA),malondialdehyde(MDA),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)and the activities of superoxide dismutase(SOD)and lactate dehydrogenase(LDH)in serum of the mice in various groups were detected by kits;the degrees of brain tissue injury of the mice in various groups were observed by HE staining.The levels of reactive oxygen species(ROS)in CA1 region of hippocampus tissue of the mice in various groups were detected by dihydroethidium(DHE)probe;the expression levels of calpain-1,IL-6,and TNF-α proteins in brain tissue of the mice in various groups were detected by Western blotting method.Results:Compared with control group,the SpO2 of the mice in model group was significantly decreased(P＜0.01),indicating that the model was successfully established.Compared with model group,the SpO2 of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly increased(P＜0.01).The Morris water maze test results showed that compared with control group,the escape latency and path length of the mice in model group were significantly prolonged(P＜0.01),and the frequency of swimming route of crossing the target quadrant was significantly decreased;compared with model group,the escape latencies and path lengths of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly shortened(P＜0.01),and the frequency of swimming route of crossing the target quadrant was significantly increased.Compared with control group,the levels of BUN,LA,MDA,IL-6,and TNF-α in serum of the mice in model group were significantly increased(P＜0.01),while the activity of LDH was significantly increased(P＜0.01),and the activity of SOD was significantly decreased(P＜0.01);compared with model group,the levels of BUN,LA,MDA,IL-6,and TNF-α in serum of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly decreased(P＜0.01),while the activities of LDH were significantly decreased(P＜0.01),and the activities of SOD were significantly increased(P＜0.01).The HE staining results showed that compared with control group,the pyramidal neurons in CA1 region of hippocampus tissue of the mice in model group were loosely arranged,while some neurons were triangular,with nuclear pyknosis,cytoplasmic hyperchromasia,and a few neurons were lost,indicating obvious hypoxic neuronal injury;compared with model group,the hypoxic neuronal injury in CA1 region in hippocampus tissue of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group was effectively alleviated.The DHE probe detection showed that compared with control group,the level of ROS in CA1 region in hippocampus tissue of the mice in model group was significantly increased(P＜0.01);compared with model group,the levels of ROS in CA1 region in hippocampus tissue of the mice in inhibitor group,low dose of ginsenoside Rg1 group and high dose of ginsenoside Rg1 group were significantly decreased(P＜0.01).The Western blotting results showed that compared with control group,the expression levels of calpain-1,TNF-α,and IL-6 proteins in hippocampus tissue of the mice in model group were significantly increased(P＜0.01);compared with model group,the expression levels of calpain-1,TNF-α,and IL-6 proteins in hippocampus tissue of the mice in inhibitor group,low dose of GRg1 group and high dose of GRg1 group were significantly decreased(P＜0.01).Conclusion:Ginsenoside Rg1 can alleviate brain tissue injury of the mice induced by CIH;its mechanism may be related to the inhibition of brain tissue inflammatory response and oxidative stress,and the downregulation of calpain-1 expression.

Essential oils (EOs) are natural, volatile substances derived from aromatic plants. They exhibit multiple pharmacological effects, including antibacterial, anticancer, anti-inflammatory, and antioxidant properties, with broad application prospects in health care, food, and agriculture. However, the instability of volatile components, which are susceptible to deterioration under light, heat, and oxygen exposure, as well as limited water solubility, have significantly impeded the development and application of EOs. Porous nanoclays are natural clay minerals with a layered structure. They possess unique structural characteristics such as large pore size, regular distribution, and tunable particle size, which are extensively utilized in drug delivery, adsorption separation, reaction catalysis, and other fields. Natural-derived porous nanoclays have garnered considerable attention for the encapsulation and delivery of EOs. This review comprehensively summarizes the structure, types, and properties of natural-derived porous nanoclays, focusing on the structural characteristics of porous nanoclays such as montmorillonite, palygorskite, halloysite, kaolinite, vermiculite, and natural zeolite. It also examines research advances in their delivery of EOs and explores engineering strategies to enhance the delivery of EOs by natural-derived porous nanoclays. Finally, various applications of natural-derived porous nanoclays for EOs in antibacterial, food preservation, repellent, and insecticide aspects are presented, providing a reference for the development and application of EOs.
Humans ; Nanoparticles/chemistry* ; Oils, Volatile/administration & dosage* ; Porosity ; Nanoparticle Drug Delivery System/chemistry*

Objective To explore the medication rules of clinical prescriptions of Chinese medicine in the treatment of heart failure with diuretic resistance based on data mining method.Methods Seven domestic and foreign databases,including CNKI and Wanfang,were searched for literature on Chinese medicine for heart failure with diuretic resistance from the establishment of the database to October 2021.Frequency analysis,association rule analysis and cluster analysis were used for statistical analysis.Results A total of 41 literatures were included,including 39 prescriptions.Yang deficiency and water retention were the main symptoms of the disease.A total of 72 single herbs were used,with a total of 438 times of use.There are 30 Chinese medicines with a frequency of more than 5 times,involving 9 efficacy categories,mainly tonic medicines,diuresis and dampness medicines,blood-activating and stasis-removing medicines,and interior-warming medicines.The association rule analysis yielded drug compatibility with Poria as the core,such as Atractylodis Macrocephalae Rhizoma→Poria and Cinnamomi Ramulus→Poria.Cluster analysis yielded six new formula combinations with efficacy in warming Yang,inducing diuresis,benefiting qi and invigorating Blood.Conclusion Heart failure with diuretic resistance is a syndrome of root vacuity and tip repletion,cold-heat complex,and the core pathogenesis is"deficiency","water"and"stasis".The treatment of this disease occurs by warming yang and excreting water,supplemented by replenishing qi and activating blood circulation.Poria with Atractylodis Macrocephalae Rhizoma and Cinnamomi Ramulus are commonly used combinations,and Zhen Wu Decoction is the basic formula for the treatment of this disease.

Red blood cells(RBCs)are an excellent choice for cell preparation research because of their biocom-patibility,high drug loading,and long half-life.In this study,doxorubicin(DOX)was encapsulated with RBCs as the carrier.The biotin-avidin system binding principle was used to modify biotinylated cyclic arginine-glycine-aspartic acid(cRGD)onto RBC surfaces for accurate targeting,high drug loading,and sustained drug release.The RBC drug delivery system(DDS)was characterized,and the concentration of surface sulfur in the energy spectrum was 6.330％.The physical and chemical properties of RBC DDS were as follows:drug content,0.857 mg/mL;particle size,3339 nm;potential value,-12.5 mV;and cumu-lative release rate,81.35％.There was no significant change in RBC morphology for up to seven days.The results of the targeting and cytotoxicity studies of RBC DDS showed that many RBCs covered the surfaces of U251 cells,and the fluorescence intensity was higher than that of MCF-7 cells.The IC50 value of un-modified drug-loaded RBCs was 2.5 times higher than that of targeted modified drug-loaded RBCs,indicating that the targeting of cancer cells produced satisfactory inhibition.This study confirms that the RBC DDS has the characteristics of accurate targeting,high drug loading,and slow drug release,which increases its likelihood of becoming a clinical cancer treatment in the future.

Objective    To systematically evaluate the efficacy of tubular stomach and whole stomach reconstruction in the treatment of esophageal cancer. Methods    We searched PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM databases to collect the randomized controlled trial (RCT) studies on the efficacy comparison between tubular stomach and total gastric reconstruction of esophagus in esophagectomy from their date of inception to May 2019. Then meta-analysis was performed by using RevMan 5.3 software. Results    A total of Twenty-nine RCTs were included, and 3 012 patients were involved. The results of meta-analysis showed that the postoperative complications such as anastomotic fistula [RR=0.64, 95%CI (0.50, 0.83), P=0.000 6], anastomotic stenosis [RR=0.65, 95%CI (0.50, 0.86), P=0.002], thoracic gastric syndrome [RR=0.19, 95%CI (0.13, 0.27), P<0.001], reflux esophagitis [RR=0.23, 95%CI (0.19, 0.30), P<0.001], gastric emptying disorder [RR=0.39, 95%CI (0.27, 0.57), P<0.001] and pulmonary infection [RR=0.44, 95%CI (0.31, 0.62), P<0.001] were significantly reduced, and the postoperative quality of life score and satisfaction were higher at 6 months and 1 year in the tubular stomach group (P<0.05). In terms of intraoperative blood loss and postoperative hospital stay, they were better in the tubular stomach group than those in the whole stomach group (P<0.05). However, there was no statistically significant difference between the two groups in operation time, postoperative gastrointestinal decompression time, postoperative closed drainage time, postoperative 1-year, 2-year and 3-year survival rate, postoperative quality of life score at 3 weeks and 3 months, and postoperative life satisfaction at 3 weeks. Conclusion    The tubular stomach is more advantageous than the whole stomach in the reconstruction of esophagus after esophagectomy.