1.Exploring the Biological Connotation of "Invisible Phlegm" from the Perspective of Brain Fluid Exchange and Extracellular Microenvironment Regulation
Yiming REN ; Yueyang LU ; Guoyuan ZHANG ; Weiyi CAO ; Zongliang YU ; Haoling ZHANG ; Rui GAO
Journal of Traditional Chinese Medicine 2026;67(15):1592-1598
Based on the traditional Chinese medicine (TCM) theories of body fluid metabolism and turbid phlegm obstructing the orifices, and drawing on recent advances in cerebrospinal fluid-interstitial fluid (CSF-ISF) exchange, glymphatic clearance, and extracellular matrix (ECM) regulation, this article discusses the possible scientific connotation of "invisible phlegm" from the perspectives of pathogenesis, clinical manifestations, and therapeutic implications. Impaired brain fluid exchange may lead to reduced clearance, the retention of metabolic wastes and pathological proteins. Abnormal ECM remodeling may further disrupt molecular diffusion and local microenvironmental homeostasis, resulting in a pathological process characterized by slowed fluid movement, reduced clearance, and abnormal retention. This process bears a certain functional resemblance to the TCM pathogenesis of impaired distribution of body fluids, endogenous formation of turbid phlegm and obstruction of the brain orifices, and may also be associated with manifestations such as a clouded sensation in the head, cognitive abnormalities, and emotional disturbances. On this basis, the potential effects of certain phlegm-dissolving Chinese medicines in improving brain clearance function and extracellular microenvironmental homeostasis warrant further investigation. We therefore propose that, the "invisible phlegm" of TCM in brain tissue may manifest as a pathological retention state characterized by restricted fluid exchange, impaired clearance function, and extracellular microenvironmental imbalance. This perspective may provide a new avenue for investigating TCM treatment of neurological and psychiatric disorders from the perspective of phlegm.
2.Exploring the Biological Connotation of "Invisible Phlegm" from the Perspective of Brain Fluid Exchange and Extracellular Microenvironment Regulation
Yiming REN ; Yueyang LU ; Guoyuan ZHANG ; Weiyi CAO ; Zongliang YU ; Haoling ZHANG ; Rui GAO
Journal of Traditional Chinese Medicine 2026;67(15):1592-1598
Based on the traditional Chinese medicine (TCM) theories of body fluid metabolism and turbid phlegm obstructing the orifices, and drawing on recent advances in cerebrospinal fluid-interstitial fluid (CSF-ISF) exchange, glymphatic clearance, and extracellular matrix (ECM) regulation, this article discusses the possible scientific connotation of "invisible phlegm" from the perspectives of pathogenesis, clinical manifestations, and therapeutic implications. Impaired brain fluid exchange may lead to reduced clearance, the retention of metabolic wastes and pathological proteins. Abnormal ECM remodeling may further disrupt molecular diffusion and local microenvironmental homeostasis, resulting in a pathological process characterized by slowed fluid movement, reduced clearance, and abnormal retention. This process bears a certain functional resemblance to the TCM pathogenesis of impaired distribution of body fluids, endogenous formation of turbid phlegm and obstruction of the brain orifices, and may also be associated with manifestations such as a clouded sensation in the head, cognitive abnormalities, and emotional disturbances. On this basis, the potential effects of certain phlegm-dissolving Chinese medicines in improving brain clearance function and extracellular microenvironmental homeostasis warrant further investigation. We therefore propose that, the "invisible phlegm" of TCM in brain tissue may manifest as a pathological retention state characterized by restricted fluid exchange, impaired clearance function, and extracellular microenvironmental imbalance. This perspective may provide a new avenue for investigating TCM treatment of neurological and psychiatric disorders from the perspective of phlegm.
3.Interpretation and Elaboration for the ARRIVE Guidelines 2.0—Animal Research: Reporting In Vivo Experiments (V)
Zhengwen MA ; Xiaying LI ; Xiaoyu LIU ; Yao LI ; Jian WANG ; Jin LU ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Xuancheng LU ; Yonggang LIU ; Yufeng TAO ; Wanyong PANG
Laboratory Animal and Comparative Medicine 2024;44(1):105-114
Improving the reproducibility of biomedical research results is a major challenge. Transparent and accurate reporting of the research process enables readers to evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist that is applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as enhance the reliability, repeatability, and clinical translation of animal experimental results. The use of the ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and completeness of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is based on the best practices following the ARRIVE 2.0 guidelines in international journals, and it interprets, explains, and elaborates in Chinese the fifth part of the comprehensive version of the ARRIVE 2.0 guidelines published in PLoS Biology in 2020 (the original text can be found at
4.Drug Resistance and Prognosis of 150 Cases of Peritoneal Dialysis-associated Peritonitis
Yueyuan WU ; Xiaohua DAI ; Jie XU ; Xianfeng ZHANG ; Deyu XU ; Kun HU ; Lei SHEN ; Guoyuan LU ; Qiang HAN ; Yongfu HANG
Herald of Medicine 2024;43(2):287-291
Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33%,including 65 cases(70.65%)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39%),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96%)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00%),and were sensitive to linezolid(100.00%),teicoplanin(100.00%)and rifampicin(100.00%).The sensitivity rate to vancomycin was 98.59%.G-strains were sensitive to ceftazidime(86.36%),ceftizoxime(88.89%)and amikacin(100.00%).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33%in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23%vs.36.36%,P<0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.
5.A case of podocyte infolding glomerulopathy
Mengting JIA ; Ling ZHOU ; Jianzhong LI ; Lei SHEN ; Guoyuan LU ; Yanping SHEN
Chinese Journal of Nephrology 2023;39(2):142-144
Podocyte infolding glomerulopathy (PIG) is a pathologic type of podocyte glomerulopathy reported recently. The characteristic is that the ultrastructure related to podocytes, such as microspheres and microtubules, are folded into the glomerular basement membrane (GBM) under electron microscope. At present, there are few reports about this disease at home and abroad, and most of them are concentrated in Japan. The clinical characteristics and pathogenesis of PIG are still unclear. In this paper, we report a case of clinical manifestations of nephrotic syndrome, renal biopsy indicated PIG, after the treatment of glucocorticoid, hydroxychloroquine and tacrolimus, the patient's clinical symptoms were relieved and urinary protein decreased.
6.Explanation and Elaboration for the ARRIVE Guidelines 2.0—Reporting Animal Research and In Vivo Experiments (Ⅳ)
Xiaying LI ; Yonglu TIAN ; Xiaoyu LIU ; Xuancheng LU ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Jing GAO ; Yao LI ; Yufeng TAO ; Wanyong PANG ; Yusheng WEI
Laboratory Animal and Comparative Medicine 2023;43(6):659-668
Improving the reproducibility of biomedical research results is a major challenge.Transparent and accurate reporting of the research process enables readers to evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as the reliability, repeatability, and clinical translatability of animal experimental results. The use of ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and integrity of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is a Chinese translation based on the best practices of international journals following the ARRIVE 2.0 guidelines in international journals, specifically for the complete interpretation of the ARRIVE 2.0 guidelines published in the PLoS Biology journal in 2020 (original text can be found at
7.Explanation and Elaboration for the ARRIVE Guidelines 2.0—Reporting Animal Research and In Vivo Experiments (Ⅲ)
Xiaoyu LIU ; Xuancheng LU ; Xiaomeng SHI ; Yuzhou ZHANG ; Chao LÜ ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Jing GAO ; Yao LI ; Yonggang LIU ; Yufeng TAO ; Wanyong PANG
Laboratory Animal and Comparative Medicine 2023;43(4):446-456
Improving the reproducibility of biomedical research results is a major challenge.Researchers reporting their research process transparently and accurately can help readers evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as the reliability, repeatability, and clinical translatability of animal experimental results. The use of ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and integrity of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is a Chinese translation based on the best practices of international journals following the ARRIVE 2.0 guidelines in international journals, specifically for the complete interpretation of the ARRIVE 2.0 guidelines published in the PLoS Biology journal in 2020 (original text can be found at
8.Explanation and Elaboration of the ARRIVE Guidelines 2.0—Reporting Animal Research and In Vivo Experiments (Ⅱ)
Guoyuan CHEN ; Xiao LU ; Yu BAI ; Lingzhi YU ; Ying QIAO ; Jian WANG ; Jin LU ; Xiaoyu LIU ; Xuancheng LU ; Jing GAO ; Yao LI ; Wanyong PANG
Laboratory Animal and Comparative Medicine 2023;43(3):323-331
Improving the reproducibility of biomedical research results remains a major challenge. Transparent and accurate reporting of progress can help readers evaluate the reliability of research results and further explore an experiment by repeating or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement, and Reduction of Animals in Research (NC3Rs), provide a checklist applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as the reliability, repeatability, and clinical translatability of animal experimental results. The use of the ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and integrity of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is the second part of the Chinese translation of the complete interpretation of the ARRIVE 2.0 guidelines published in PLoS Biology in 2020 (original text can be found at
9.Explanation and Elaboration for the ARRIVE Guidelines 2.0—Reporting Animal Research and In Vivo Experiments (Ⅰ)
Jian WANG ; Jin LU ; Zhengwen MA ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Xiaoyu LIU ; Xuancheng LU ; Jing GAO ; Yao LI ; Wanyong PANG
Laboratory Animal and Comparative Medicine 2023;43(2):213-224
Improving the reproducibility of biomedical research results is a major challenge. Researchers reporting their research process transparently and accurately can help readers evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as the reliability, repeatability, and clinical translatability of animal experimental results. The use of ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and integrity of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. this article is a Chinese translation based on the best practices of international journals following the ARRIVE 2.0 guidelines in international journals, specifically for the complete interpretation of the ARRIVE 2.0 guidelines published in the PLoS Biology journal in 2020 (original text can be found at
10.Introduction to the International Guide for Animal Research Reporting ARRIVE 2.0, and Its Implementation Plan in the Journal
Junyan ZHANG ; Xiaoyu LIU ; Yao LI ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Xuancheng LU ; Wanyong PANG ; Baojin WU
Laboratory Animal and Comparative Medicine 2023;43(1):86-94
Animal experiments play an important role in the process of biomedical research, and is a necessary way to transform basic medicine into clinical medicine. The standardization of animal experimental studies and reports determines the reliability and reproducibility of research results, and is also the key to transforming the results of animal experiments into clinical trials. In view of how to design and implement animal experiments, write animal experiment reports, and publish relevant academic papers in a more standardized way, LACM (Laboratory Animal and Comparative Medicine) has launched a new column of comparative medical research and reporting standards from 2023, focusing on the introduction and interpretation of international general norms related to laboratory animal and comparative medicine, such as ARRIVE 2.0 guidelines (Animal Research: Reporting of In Vivo Experiments). This article focuses on the development and application, basic content and priority of ARRIVE 2.0, as well as the scheme of implementing ARRIVE 2.0 guidelines in international biomedical journals, and explains the current situation and future plans of LACM following ARRIVE 2.0 guidelines. The research and report of animal experimental medicine following the ARRIVE 2.0 guidelines and other international norms is one of the important driving forces to promote the high-quality development of experimental animal science and biomedicine in China, and also a powerful means to implement the 3R principle and improve the welfare of laboratory animals. Through this article, we hope the majority of scientific researchers and editors will attach great importance and actively implement these international standards.

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