1.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.
2.Mechanism of Maimendong Yinzi in Alleviating Cough with Yin Deficiency and Lung Heat Syndrome by Modulating PAR1/Gαi/cAMP Signaling Pathway and TRPV1 Expression
Zihan ZHU ; Jiahui TANG ; Yuanyuan ZHANG ; Junping KOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):81-91
ObjectiveTo investigate the effects of Maimendong Yinzi (MMDYZ) on cough with Yin deficiency and lung heat syndrome and explore its potential mechanism of action. MethodsForty-eight Institute of Cancer Research (ICR) mice were randomly divided into a control group, a model group, a Baihe Gujin Tablet (BHGJP) group (1.36 g·kg-1), and low-dose, medium-dose, and high-dose MMDYZ groups (5, 10, 20 g·kg-1·d-1, based on the weight of crude drug), with eight mice in each group. The mouse model of cough with Yin deficiency and lung heat syndrome was prepared by a combination of smoke exposure, nasal drip of lipopolysaccharide (LPS), intragastric gavage with thyroxine, and capsaicin atomization. After successful modeling, drug interventions were administered for seven days. During modeling, the mice were observed for changes in general status, anal temperature, fecal water content, and water intake. After medication, the above indicators were evaluated again, along with assessments of spontaneous activity, cough sensitivity, lung function, lung index, and tracheal phenol red secretion. Bronchoalveolar lavage fluid (BALF) was analyzed for cell differential counts, and the level of cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in serum was measured via enzyme linked immunosorbent assay (ELISA). Lung injury was assessed via hematoxylin-eosin (HE) staining. Network pharmacology was employed to predict the potential mechanism of MMDYZ in alleviation cough with Yin deficiency and lung heat syndrome. Western blot (WB) was used to measure protease-activated receptor1 (PAR1) and GTPhase αi subunit (Gαi) protein expressions in lung tissue. ELISA was used to determine lung cAMP content, and immunohistochemistry (IHC) was employed to evaluate transient receptor potential vanilloid subtype 1 (TRPV1) expression. ResultsCompared with the control group, the model group exhibited significantly increased water intake and anal temperature and significantly decreased fecal water content (P<0.05). The total distance traveled in 5 min and the central zone duration were reduced, while standing frequency significantly increased (P<0.05). Cough sensitivity and enhanced pause (PenH) were elevated. Peak expiratory flow (PEF) significantly declined (P<0.05). BALF neutrophil (NEU) and white blood cell (WBC) counts rose. Serum cAMP and cAMP/cGMP ratio significantly increased, and cGMP significantly decreased (P<0.05). Serum TNF-α and IL-6 levels were significantly elevated (P<0.05). The lung injury was obvious, and the lung index was significantly elevated (P<0.05). Compared with the model group, the medium-dose and high-dose MMDYZ groups and the BHGJP group showed significantly improved indicators mentioned above. Additionally, network pharmacology suggested that MMDYZ might alleviate cough with Yin deficiency and lung heat syndrome via cAMP, hypoxia inducible factor-1 (HIF-1), and TNF signaling pathways. WB, ELISA, and IHC revealed that, compared with the control group, the model group exhibited significantly upregulated PAR1, Gαi, and TRPV1 expressions and significantly downregulated cAMP in lung tissue (P<0.05). Compared with the model group, MMDYZ reduced PAR1 (P<0.01), Gαi (P<0.05), and TRPV1 (P<0.01) while increasing cAMP level (P<0.01). ConclusionMMDYZ may alleviate cough with Yin deficiency and lung heat syndrome by modulating the PAR1/Gαi/cAMP pathway and TRPV1 expression.
3.Mechanism of Xiao Qinglongtang Intervening Ferroptosis in Allergic Rhinitis Rats via Regulating SIRT1/SLC7A11 Signaling Pathway
Yuanyuan JI ; Hong ZHU ; Jingjuan AN ; Heng XIN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):113-119
ObjectiveTo observe the effect of Xiao Qinglongtang on ferroptosis in allergic rhinitis rats and explore its specific mechanism of action. MethodsSixty SD rats were randomly divided into a blank group, a model group, a loratadine group (0.9 mg·kg-1), and low-, medium-, and high-dose Xiao Qinglongtang groups (2.14, 4.28, and 8.56 g·kg-1), 10 rats per group. After 2 weeks of drug treatment, behavioral scores were observed in 6 groups of rats. Hematoxylin-eosin (HE) staining was used to observe changes in nasal mucosal tissue morphology, and Prussian blue staining was used to observe iron deposition. Enzyme-linked immunosorbent assay (ELISA) was used to detect reactive oxygen species (ROS), Fe2+ ions, malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH) in each group. Immunofluorescence assay was used to detect ROS content and sirtuin 1 (SIRT1) expression in nasal mucosal tissue. Western blot was used to detect the expression of SIRT1, solute carrier family 7 member 11 (SLC7A11), p53 acyl-CoA synthetase long-chain family member 4 (ACSL4), and glutathione peroxidase 4 (GPX4) proteins in nasal mucosal tissue. ResultsCompared with the blank group, the model group exhibited obviously increased behavioral scores, severe nasal mucosal damage, obvious increase in iron deposition, significant decreases in GSH and SOD levels, obvious increases in MDA, Fe2+, and ROS fluorescence area proportions (P<0.05), decreased protein expression levels of GPX4, SLC7A11, and SIRT1, and obvious increases in p53 and ACSL4 expression (P<0.05). Compared with the model group, Xiao Qinglongtang groups of all doses showed reduced rat behavioral scores, obviously improved nasal mucosal damage, obviously reduced iron deposition (P<0.05), obviously increased GSH and SOD levels, obviously reduced MDA, Fe2+, ROS fluorescence area proportions (P<0.05), increased GPX4, SLC7A11, and SIRT1 protein expression levels, and obviously reduced p53 and ACSL4 (P<0.05). ConclusionXiao Qinglongtang may achieve the goal of treating allergic rhinitis by regulating the SIRT1/SLC7A11 signaling pathway and inhibiting lipid peroxidation and ferroptosis.
4.Bioinformatics Reveals Mechanism of Schisandrin B in Inhibiting Ferroptosis to Ameliorate Methionine and Choline Deficiency-induced Fatty Liver Disease in Mice
Zhifeng ZHU ; Wenting LI ; Yongjun CAO ; Yuanyuan LIN ; Yifei LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):74-83
ObjectiveNonalcoholic fatty liver disease (NAFLD) is a metabolic stress liver injury. Ferroptosis is involved in the occurrence and development of NAFLD. Exploring the efficacy and mechanism of schisandrin B in treating NAFLD facilitates the development of strategies for the prevention and treatment of NAFLD. MethodsThe molecular structure of schisandrin B was obtained by searching against PubChem, and the related targets were predicted by SwissTargetPrediction. The active ingredients and their targets were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the high-throughput experiment- and reference-guide database of traditional Chinese medicine (HERB). GeneCards and FerrDb were searched for the targets of NAFLD and ferroptosis. The common targets were taken as the core targets, and the protein-protein interaction network of the core targets was established. DAVID was used for gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Finally, molecular docking was performed between schisandrin B and core targets, and the binding energy was calculated. C57BL/6 mice were fed with a methionine and choline-deficiency (MCD) diet for the modeling of NAFLD. Mice were randomized into normal, model, positive drug (essentiale), and low- and high-dose schisandrin B groups. The body mass and liver index of mice were measured after drug administration. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the serum and those of total cholesterol (TC), triglyceride (TG), malondialdehyde (MDA), glutathione (GSH), and Fe2+ in the liver homogenate were measured by biochemical assay kits. The pathological changes of the liver tissue were observed by hematoxylin-eosin (HE) and red oil O staining. Enzyme-linked immunosorbent assay was employed to determine the levels of interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, and 4-hydroxynonenal (4-HNE) in the serum. Western blotting and real-time PCR were employed to determine the protein and mRNA levels, respectively, of solute carrier family 7 member 11 (SLC7A11), solute carrier family 3 member 2 (SLC3A2), glutathione peroxidase 4 (GPX4), transferrin, and ferritin heavy chain (FTH) in the liver tissue. ResultsA total of 2 370, 2 547, and 1 451 targets of schisandrin B, NAFLD, and ferroptosis were obtained, in which 90 common targets were shared by the three. Enrichment analyses predicted 505 GO terms and 92 KEGG pathways. Molecular docking suggested that schizandrin B had strong binding affinity with the key targets of ferropstosis (SLC7A11 and SLC3A2). Animal experiments showed that schizandrin B significantly decreased the liver index, lowered the levels of ALT, AST, TC, TG, IL-6, IL-1β, and TNF-α, alleviated hepatocyte ballooning and inflammatory cell infiltration, and reduced lipid accumulation in the liver of NAFLD mice. In addition, schisandrin B significantly lowered the levels of MDA, 4-HNE, and Fe2+, elevated the level of GSH, up-regulated the protein and mRNA levels of SLC7A11, SLC3A2, and GPX4, and down-regulated the protein and mRNA levels of transferrin in the liver tissue. ConclusionSchisandrin B can alleviate NAFLD by inhibiting ferroptosis in hepatocytes.
5.STAR Guideline Terminology(Ⅱ): Clinical Question Formulation, Evidence Retrieval and Appraisal, and Recommendation Development
Di ZHU ; Haodong LI ; Zijun WANG ; Qianling SHI ; Hui LIU ; Yishan QIN ; Yuanyuan YAO ; Zhewei LI ; Hongfeng HE ; Jinhui TIAN ; Long GE ; Yaolong CHEN ;
Medical Journal of Peking Union Medical College Hospital 2025;16(3):756-764
To introduce and analyze guideline terminology related to clinical question formulation, evidence retrieval and appraisal, and recommendation development. A systematic search was conducted in guideline development manuals and relevant methodological literature, covering publications up to October 25, 2024. Terminology related to the three aforementioned stages of related to guideline development was extracted from the included literature, standardized, and refined through consensus meetings to finalize a comprehensive terminology list and definitions. A total of 30 guideline development manuals and 15 methodological articles were included, and 23 core terms were identified. It is recommended to develop a standardized and scientifically sound guideline terminology system with unified naming, clear definitions, and alignment with the linguistic environment and usage habits in China. At the same time, it is essential to strengthen terminology training for both guideline developers and users based on this system, in order to deepen their correct understanding and proper application of guideline terminology.
6.Textual Research on Key Information of Classic Formula Shengma Gegentang
Yuli LI ; Ping JIANG ; Zhenyi YUAN ; Yuanyuan HE ; Ya'nan MAO ; Shasha WANG ; Wenyan ZHU ; Zhouan YIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):187-197
Shengma Gegentang is one of the classic formulas in the Catalogue of Ancient Classic Prescriptions (Second Batch). This study reviewed ancient and modern literature and used literature tracing and bibliometric methods to analyze the historical evolution, efficacy, indications, dosage decoctions, and modern clinical disease spectrum of Shengma Gegentang. The results indicated that the earliest record of Shengma Gegentang can be found in the Taiping Huimin Heji Jufang of the Song dynasty, but its origin can be traced back to the Shaoyao Siwu Jiejitang in the Beiji Qianjin Yaofang of the Tang dynasty. The composition dosage of Shengma Gegentang is 413 g of Cimicifugae Rhizoma, 619.5 g of Puerariae Lobatae Radix, 413 g of Paeoniae Radix Alba, and 413 g of Glycyrrhizae Radix et Rhizoma, which are ground into coarse powder. Each dose is 12.39 g, and the amount of water added is 300 mL. 100 mL of solution is decocted and taken at the right time. The four drugs in the formula play the role of relieving exterior syndrome, penetrating pathogenic factors, and detoxicating together. Its indications are widely involved in internal medicine, pediatrics, surgery, ophthalmology and otorhinolaryngology, obstetrics and gynecology, sexually transmitted diseases, and other diseases, such as measles, sores, acne, spots, surgical gangrene, red eyes, toothache, chancre, and fetal poison. The epidemic diseases treated by Shengma Gegentang are complicated, including rash, pox, macula, numbness, summer diarrhea, dysentery, sha disease, febrile symptoms, spring warmth, winter warmth, and cold pestilence. At the same time, it is a plague prevention formula. Although Shengma Gegentang has a wide range of indications, it cannot be separated from the pathogenic mechanism of evil Qi blocking the muscle surface and heat in the lungs and stomach. The modern clinical disease spectrum of Shengma Gegentang involves the ophthalmology and otorhinolaryngology system, nervous system, pediatric-related diseases and syndromes, skin system, hepatobiliary system, and digestive system. It plays a key role in the treatment of epidemic diseases such as measles, chronic hepatitis B, dysentery, and tetanus.
7.Effect of Wenshen Tongluo Zhitong formula on mouse H-type bone microvascular endothelial cell/bone marrow mesenchymal stem cell co-culture system
Shijie ZHOU ; Muzhe LI ; Li YUN ; Tianchi ZHANG ; Yuanyuan NIU ; Yihua ZHU ; Qinfeng ZHOU ; Yang GUO ; Yong MA ; Lining WANG
Chinese Journal of Tissue Engineering Research 2025;29(1):8-15
BACKGROUND:Bone relies on the close connection between blood vessels and bone cells to maintain its integrity.Bones are in a physiologically hypoxic environment.Therefore,the study of angiogenesis and osteogenesis in hypoxic environment is closer to the microenvironment in vivo. OBJECTIVE:To explore the influence of Wenshen Tongluo Zhitong(WSTLZT)formula on H-type bone microvascular endothelial cell/bone marrow mesenchymal stem cell co-culture system in hypoxia environment and its related mechanism. METHODS:Enzyme digestion method and flow sorting technique were used to isolate and identify H-type bone microvascular endothelial cells.Mouse bone marrow mesenchymal stem cells were isolated and obtained by bone marrow adhesion method.H-type bone microvascular endothelial cell/bone marrow mesenchymal stem cell hypoxic co-culture system was established using Transwell chamber and anoxic culture workstation.WSTLZT formula powder was used to intervene in each group at a mass concentration of 50 and 100 μg/mL.The angiogenic function of H-type bone microvascular endothelial cells in the co-culture system was evaluated by scratch migration test and tube formation test.The osteogenic differentiation ability of bone marrow mesenchymal stem cells in the co-cultured system was evaluated by alkaline phosphatase staining and alizarin red staining.The protein and mRNA expression changes of PDGF/PI3K/AKT signal axis related molecules in H-type bone microvascular endothelial cells in the co-cultured system were detected by Western Blotting and q-PCR,respectively. RESULTS AND CONCLUSION:(1)Compared with the normal oxygen group,the scratch mobility and new blood vessel length of H-type bone microvascular endothelial cells were significantly higher(P<0.05);the osteogenic differentiation capacity of bone marrow mesenchymal stem cells was higher(P<0.05);the expression of PDGF/PI3K/AKT axis-related molecular protein and mRNA increased(P<0.05)in the hypoxia group.(2)Compared with the hypoxia group,scratch mobility and new blood vessel length were significantly increased in the H-type bone microvascular endothelial cells(P<0.05);bone marrow mesenchymal stem cells had stronger osteogenic function(P<0.05);the expression of PDGF/PI3K/AKT axis-related molecular proteins and mRNA further increased(P<0.05)after treatment with different dose concentrations of WSTLZT formula.These findings conclude that H-type angiogenesis and osteogenesis under hypoxia may be related to the PDGF/PI3K/AKT signaling axis,and WSTLZT formula may promote H-type vasculo-dependent bone formation by activating the PDGF/PI3K/AKT signaling axis,thereby preventing and treating osteoporosis.
8.Oxidative stress in diabetes mellitus and its complications: From pathophysiology to therapeutic strategies.
Xingyu CHEN ; Na XIE ; Lixiang FENG ; Yujing HUANG ; Yuyao WU ; Huili ZHU ; Jing TANG ; Yuanyuan ZHANG
Chinese Medical Journal 2025;138(1):15-27
Oxidative stress due to aberrant metabolism is considered as a crucial contributor to diabetes and its complications. Hyperglycemia and hyperlipemia boost excessive reactive oxygen species generation by elevated mitochondrial respiration, increased nicotinamide adenine dinucleotide phosphate oxidase activity, and enhanced pro-oxidative processes, including protein kinase C pathways, hexosamine, polyol, and advanced glycation endproducts, which exacerbate oxidative stress. Oxidative stress plays a significant role in the onset of diabetes and its associated complications by impairing insulin production, increasing insulin resistance, maintaining hyperglycemic memory, and inducing systemic inflammation. A more profound comprehension of the molecular processes that link oxidative stress to diabetes is crucial to new preventive and therapeutic strategies. Therefore, this review discusses the mechanisms underlying how oxidative stress contributes to diabetes mellitus and its complications. We also summarize the current approaches for prevention and treatment by targeting the oxidative stress pathways in diabetes.
Oxidative Stress/physiology*
;
Humans
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Diabetes Mellitus/physiopathology*
;
Diabetes Complications/metabolism*
;
Reactive Oxygen Species/metabolism*
;
Glycation End Products, Advanced/metabolism*
;
Animals
9.Advancements in herbal medicine-based nanozymes for biomedical applications.
Mei YANG ; Zhichao DENG ; Yuanyuan ZHU ; Chenxi XU ; Chenguang DING ; Yujie ZHANG ; Mingxin ZHANG ; Mingzhen ZHANG
Chinese Medical Journal 2025;138(9):1037-1049
Nanozymes are a distinct category of nanomaterials that exhibit catalytic properties resembling those of enzymes such as peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx). Nanozymes derived from Chinese herbal medicines exhibit the catalytic functions of their enzyme mimics, while retaining the specific medicinal properties of the herb (termed "herbzymes"). These nanozymes can be categorized into three main groups based on their method of synthesis: herb carbon dot nanozymes, polyphenol-metal nanozymes, and herb extract nanozymes. The reported catalytic activities of herbzymes include POD, SOD, CAT, and GPx. This review presents an overview of the catalytic activities and potential applications of nanozymes, introduces the novel concept of herbzymes, provides a comprehensive review of their classification and synthesis, and discusses recent advances in their biomedical applications. Furthermore, we also discuss the significance of research into herbzymes, including the primary challenges faced and future development directions.
Nanostructures/chemistry*
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Humans
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Herbal Medicine/methods*
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Superoxide Dismutase/chemistry*
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Catalase/chemistry*
;
Drugs, Chinese Herbal/chemistry*
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Catalysis
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Glutathione Peroxidase/chemistry*
10.A case of cardiac arrest and spontaneous renal hemorrhage in a male patient with persistent eosinophilia: highlighting the importance of early diagnosis of eosinophilic granulomatosis with polyangiitis.
Jinya LIN ; Rending WANG ; Yuanyuan ZHU ; Weijia HUANG ; Jie SUN
Journal of Zhejiang University. Science. B 2025;26(7):708-712
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence (White and Dubey, 2023). It affects males and females equally, though males may exhibit more active disease at diagnosis and often require more aggressive treatment (Liu et al., 2023). The hallmark features of EGPA include delayed-onset asthma, eosinophilia in tissues and blood, and vasculitis affecting small to medium-sized arteries (White and Dubey, 2023). EGPA falls under the category of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), whereas only about half of EGPA patients test positive for ANCA (Khoury et al., 2023).
Humans
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Male
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Hemorrhage/etiology*
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Granulomatosis with Polyangiitis/complications*
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Heart Arrest/etiology*
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Early Diagnosis
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Eosinophilia/diagnosis*
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Kidney Diseases/etiology*
;
Churg-Strauss Syndrome/complications*
;
Middle Aged

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