1.Traditional Chinese Medicine Treatment of Chronic Heart Failure Based on AMPK Signaling Pathway
Kun LIAN ; Lichong MENG ; Xueqin WANG ; Yubin ZHANG ; Lin LI ; Xuhui TANG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):139-148
Chronic heart failure (CHF) is a group of complex clinical syndromes caused by abnormal changes in the structure and/or function of the heart due to various reasons, resulting in disorders of ventricular contraction and/or diastole. CHF is a condition where primary diseases such as coronary heart disease, hypertension and pulmonary heart disease recur frequently and persist for a long time, presenting blood stasis in meridians and collaterals, stagnation of water and dampness, and accumulation of Qi in collaterals. Its pathogenesis is complex and may involve myocardial energy metabolism disorders, oxidative stress responses, myocardial cell apoptosis, autophagy, inflammatory responses, etc. According to the theory of restraining hyperactivity to acquire harmony, we believe that under normal circumstances, the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway functions normally, maintaining human physiological activities and energy metabolism. Under pathological conditions, the AMPK signaling pathway is abnormal, causing energy metabolism disorders, inflammatory responses, and myocardial fibrosis. Traditional Chinese medicine (TCM) can regulate the AMPK signaling pathway through multiple mechanisms, targets, and effects, effectively curbing the occurrence and development of CHF. It has gradually become a research hotspot in the prevention and treatment of this disease. Guided by the theory of TCM, our research group, through literature review, summarized the relationship between the AMPK pathway and CHF and reviewed the research progress in the prevention and control of CHF with TCM active ingredients, TCM compound prescriptions, and Chinese patent medicines via regulating the AMPK pathway. The review aims to clarify the mechanism and targets of TCM in the treatment of CHF by regulating the AMPK pathway and guide the clinical treatment and drug development for CHF.
2.Aluminum suppresses humoral immunity through counteracting oxidative stress and repair effects of iron supplementation
Yihuai LIANG ; Chuanxuan WANG ; Yubin ZHANG
Journal of Environmental and Occupational Medicine 2026;43(4):410-418
Background Aluminum (Al) is a lightweight metal that is widely present in the environment and the human body. It has been documented to cause various adverse health effects including the suppression of humoral immunity. Objective To investigate the role of oxidative stress in Al-induced humoral immunity suppression and to evaluate the possible protective effects of iron supplementation on this process. Methods Adult C57BL/6J mice were exposed to Al at concentrations of 0, 200, or 800 μg·mL−1 via drinking water for three consecutive months. The expression of major histocompatibility complex class Ⅱ (I-A), proliferating cell markr-67 (Ki-67), and 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) in splenic B cells was evaluated through flow cytometry. Splenic B cells from the mice treated with 800 μg·mL−1 Al or the control were sorted and treated in vitro with glutathione (GSH), N-Acetyl-L-cysteine (NAC), or a control vehicle. After 24 h, the expression of I-A was evaluated; and the hydroxyl radical (·OH)-generating potential, ·OH production, malondialdehyde (MDA) production, and iron content were assessed using commercial kits. Sixteen mice treated with 800 μg·mL−1 Al received an intravenous injection of either a ferric chloride solution containing 0.3 g·L−1 iron or a 0.9% sodium chloride solution, while eight control mice received 0.9% sodium chloride solution; the injection volume was 0.1 mL per mouse. Two and a half days after injection, I-A and Ki-67 expressions, ·OH-generating potential, ·OH production, and MDA production in splenic B cells were measured; and the concentrations of serum immunoglobulin (Ig) M and IgG were measured through (enzyme-linked immunosorbent assay) ELISA. The splenic B cells sorted from untreated mice were exposed to 0, 12.5, 25, or 50 μg·L−1 Al in vitro. The splenic B cells treated with 50 μg·L−1 Al and the splenic B cells sorted from 800 μg·mL−1 Al-treated mice were additionally treated with GSH and NAC in vitro. The iron supplementation groups, which included the 50 μg·L−1 Al-treated group and splenic B cells sorted from 800 μg·mL−1 Al-treated mice, were treated with a culture medium containing 30 μmol·L−1 iron in vitro. I-A and Ki-67 expressions, ·OH-generating potential, ·OH production, and MDA production in B cells were detected after a 24-h treatment period. Results In the in vivo mouse model, exposure to 800 μg·mL−1 Al significantly inhibited the I-A and Ki-67 expressions (P<0.05), increased DCFH-DA expression and ·OH-generating potential (P<0.05, P<0.01), decreased iron content (P<0.01) and ·OH and MDA production (P<0.01, P<0.001) of splenic B cells, as well as serum IgM and IgG concentrations (P<0.05, P<0.01) in the mice. Exposure to 200 μg·mL−1 Al showed a tendency to decrease the I-A and Ki-67 expressions, and to increase the DCFH-DA expression in splenic B cells, but these differences were not significant. In the in vitro splenic B-cell model, Al (12.5, 25, and 50 μg·L−1) inhibited I-A and Ki-67 expressions (P<0.05, P<0.01) across all concentrations; 50 μg·L−1 Al increased the ·OH-generating potential (P<0.05), and decreased ·OH and MDA production (P<0.01, P<0.05) in B cells. Treatment with GSH and NAC further suppressed I-A expression (P<0.05) in B cells. Iron supplementation increased the ·OH and MDA production (P<0.05), restored I-A and Ki-67 expressions (P<0.05, P<0.01) in B cells, and elevated the serum IgM and IgG concentrations (P<0.05) in Al-treated mice. Conclusion Al suppresses humoral immunity and ·OH production in B cells. The underlying mechanism may involve the decreased iron content and the subsequent retardation of the Fenton reaction in B cells. Supplementing with iron can restore the Fenton reaction in B cells and potentially reverse Al-induced impairment of humoral immunity.
3.Exploring Pathogenesis and Treatment of Primary Osteoporosis from Theory of Qi Deficiency and Stagnation and Mitochondrial Autophagy
Jiali ZHANG ; Yubin ZHANG ; Ruoying SONG ; Jianqiang LI ; Feng LI ; Jiayi GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):230-241
Primary osteoporosis (POP) is a metabolic bone disease characterized by reduced bone mass, degenerated bone microstructure, and increased bone fragility. Its pathogenesis involves the interaction of multiple factors such as genetics, aging, endocrine, and environment, which remain incompletely elucidated. Mitochondrial dysfunction can lead to insufficient adenosine triphosphate (ATP) production and abnormal accumulation of reactive oxygen species (ROS), activating oxidative stress and inflammation pathways, thereby inhibiting osteoblast differentiation and promoting osteoclast activation, exacerbating the negative bone metabolism balance in POP. Mitochondrial autophagy, as the core mechanism of mitochondrial quality control, selectively identifies and clears damaged mitochondria to effectively reduce ROS accumulation and energy metabolism disorders, thus maintaining the balance between osteoblast and osteoclast differentiation. It plays a critical role in maintaining bone homeostasis and the prevention and treatment of POP. The traditional Chinese medicine (TCM) theory of Qi transformation shares similarities with the functions of mitochondria in energy generation and substance conversion. The pathological state of Qi deficiency and stagnation may be associated with mitochondrial autophagy dysfunction, and the pathogenic characteristics of combined phlegm and stasis align with the metabolic waste accumulation induced by obstructed autophagy flow. This article explores the correlation of the theory of Qi deficiency and stagnation with mitochondrial autophagy and elucidates its potential role in the pathogenesis of POP. Additionally, considering the pathogenesis features of POP, which involve deficiency causing stagnation and a mixture of deficiency and excess, this article proposes a novel therapeutic approach: tonifying Qi to support the body and unblocking collaterals to resolve stagnation from the perspective of mitochondrial autophagy. This article aims to provide theoretical support and research insights for further exploration of TCM in the prevention and treatment of POP.
4.Exploring Effect of Traditional Chinese Medicine Interventions on Mitochondrial Quality Control in Chronic Heart Failure Based on Theory of "Mingmen Dongqi"
Yubin ZHANG ; Kun LIAN ; Jiahao YE ; Junyu ZHANG ; Weijun LI ; Jiali ZHANG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):269-280
Chronic heart failure (CHF), as the terminal stage of various cardiovascular diseases, is characterized by a prolonged course and a high mortality rate, posing a serious threat to human health and life. According to physician Sun Yikui's theory of "Mingmen Dongqi" (dynamic Qi of life gate) in the Ming Dynasty and the modern medicine concept of mitochondrial quality control (MQC), this paper systematically explores the pathogenic mechanisms and evolutionary patterns of CHF, as well as its intrinsic connection with microstructural homeostasis, and further proposes potential traditional Chinese medicine (TCM) intervention strategies. CHF is often caused by damage to the heart Qi at the early stage. As the disease progresses, prolonged illness affects the kidneys, leading to the dynamic Qi decline of life gate. Further, it results in the failure of the functions of sustaining and consolidating, causing the disintegration of the physical form, which corresponds to mitochondrial kinetic disorders. The deficiency in primary driving force results in impaired Qi transformation, corresponding to mitochondrial autophagy dysfunction, forming a pathological transmission chain of "life gate-mitochondrion" that ultimately leads to myocardial structural disintegration and energy metabolism failure. Modern research indicates that patients with CHF exhibit significant MQC imbalance. Disrupted mitochondrial dynamics lead to network fragmentation, and impaired autophagy causes metabolic blockage, constituting the key microscopic mechanisms underlying ventricular remodeling and pump failure. Chinese herbal medicines, such as those with the effects of warming and tonifying kidney Yang or reinforcing healthy Qi, can intervene in multiple signaling pathways-including PTEN-inducible kinase 1 (PINK1)/Parkin and AMP-activated protein kinase/dynamin-related protein 1 (AMPK/Drp1)-to regulate mitochondrial dynamics and autophagy activity. This repairs damaged MQC networks and improves the microenvironment of myocardial energy metabolism. These intervention strategies align closely with the TCM therapeutic principles of warming and tonifying life gate, replenishing Qi, and activating blood, demonstrating the advantages of holistic regulation based on kidney-centered treatment and mitochondrial-targeted approaches. By integrating the "Mingmen Dongqi" theory with the MQC mechanism, this paper establishes a theoretical framework for the integrated prevention and treatment of CHF, offering new perspectives and insights for clinical practice and future research.
5.Exploring Pathogenesis and Treatment of Primary Osteoporosis from Theory of Qi Deficiency and Stagnation and Mitochondrial Autophagy
Jiali ZHANG ; Yubin ZHANG ; Ruoying SONG ; Jianqiang LI ; Feng LI ; Jiayi GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):230-241
Primary osteoporosis (POP) is a metabolic bone disease characterized by reduced bone mass, degenerated bone microstructure, and increased bone fragility. Its pathogenesis involves the interaction of multiple factors such as genetics, aging, endocrine, and environment, which remain incompletely elucidated. Mitochondrial dysfunction can lead to insufficient adenosine triphosphate (ATP) production and abnormal accumulation of reactive oxygen species (ROS), activating oxidative stress and inflammation pathways, thereby inhibiting osteoblast differentiation and promoting osteoclast activation, exacerbating the negative bone metabolism balance in POP. Mitochondrial autophagy, as the core mechanism of mitochondrial quality control, selectively identifies and clears damaged mitochondria to effectively reduce ROS accumulation and energy metabolism disorders, thus maintaining the balance between osteoblast and osteoclast differentiation. It plays a critical role in maintaining bone homeostasis and the prevention and treatment of POP. The traditional Chinese medicine (TCM) theory of Qi transformation shares similarities with the functions of mitochondria in energy generation and substance conversion. The pathological state of Qi deficiency and stagnation may be associated with mitochondrial autophagy dysfunction, and the pathogenic characteristics of combined phlegm and stasis align with the metabolic waste accumulation induced by obstructed autophagy flow. This article explores the correlation of the theory of Qi deficiency and stagnation with mitochondrial autophagy and elucidates its potential role in the pathogenesis of POP. Additionally, considering the pathogenesis features of POP, which involve deficiency causing stagnation and a mixture of deficiency and excess, this article proposes a novel therapeutic approach: tonifying Qi to support the body and unblocking collaterals to resolve stagnation from the perspective of mitochondrial autophagy. This article aims to provide theoretical support and research insights for further exploration of TCM in the prevention and treatment of POP.
6.Exploring Effect of Traditional Chinese Medicine Interventions on Mitochondrial Quality Control in Chronic Heart Failure Based on Theory of "Mingmen Dongqi"
Yubin ZHANG ; Kun LIAN ; Jiahao YE ; Junyu ZHANG ; Weijun LI ; Jiali ZHANG ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):269-280
Chronic heart failure (CHF), as the terminal stage of various cardiovascular diseases, is characterized by a prolonged course and a high mortality rate, posing a serious threat to human health and life. According to physician Sun Yikui's theory of "Mingmen Dongqi" (dynamic Qi of life gate) in the Ming Dynasty and the modern medicine concept of mitochondrial quality control (MQC), this paper systematically explores the pathogenic mechanisms and evolutionary patterns of CHF, as well as its intrinsic connection with microstructural homeostasis, and further proposes potential traditional Chinese medicine (TCM) intervention strategies. CHF is often caused by damage to the heart Qi at the early stage. As the disease progresses, prolonged illness affects the kidneys, leading to the dynamic Qi decline of life gate. Further, it results in the failure of the functions of sustaining and consolidating, causing the disintegration of the physical form, which corresponds to mitochondrial kinetic disorders. The deficiency in primary driving force results in impaired Qi transformation, corresponding to mitochondrial autophagy dysfunction, forming a pathological transmission chain of "life gate-mitochondrion" that ultimately leads to myocardial structural disintegration and energy metabolism failure. Modern research indicates that patients with CHF exhibit significant MQC imbalance. Disrupted mitochondrial dynamics lead to network fragmentation, and impaired autophagy causes metabolic blockage, constituting the key microscopic mechanisms underlying ventricular remodeling and pump failure. Chinese herbal medicines, such as those with the effects of warming and tonifying kidney Yang or reinforcing healthy Qi, can intervene in multiple signaling pathways-including PTEN-inducible kinase 1 (PINK1)/Parkin and AMP-activated protein kinase/dynamin-related protein 1 (AMPK/Drp1)-to regulate mitochondrial dynamics and autophagy activity. This repairs damaged MQC networks and improves the microenvironment of myocardial energy metabolism. These intervention strategies align closely with the TCM therapeutic principles of warming and tonifying life gate, replenishing Qi, and activating blood, demonstrating the advantages of holistic regulation based on kidney-centered treatment and mitochondrial-targeted approaches. By integrating the "Mingmen Dongqi" theory with the MQC mechanism, this paper establishes a theoretical framework for the integrated prevention and treatment of CHF, offering new perspectives and insights for clinical practice and future research.
7.Exploring Clinical Application and Mechanism of Huangqi Guizhi Wuwutang Based on Theory of Treating Different Diseases with Same Method
Jiali ZHANG ; Yubin ZHANG ; Chuang GUO ; Ruoying SONG ; Zhipeng LI ; Yongbing WEN ; Feng LI ; Jiayi GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):224-235
Huangqi Guizhi Wuwutang was first documented in ZHANG Zhongjing's Synopsis of the Golden Chamber in the Eastern Han Dynasty as the principal formula for treating blood obstruction syndrome. It is composed of Astragali Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Zingiberis Rhizoma Recens, and Jujubae Fructus. This formula exhibits the effects of replenishing Qi, warming meridians, harmonizing blood, and relieving obstruction, being primarily indicated for blood obstruction syndrome characterized by diminished Yin and Yang functions with external manifestations of bodily numbness. Traditional Chinese medicine (TCM) emphasizes strict adherence to pathogenesis while applying tailored therapies, employing consistent treatment approaches for conditions with diverse clinical presentations but shared pathogenesis, which embodies the principle of treating different diseases with the same method. In modern clinical practice, Huangqi Guizhi Wuwutang is widely applied in multisystem disorders presenting with symptoms such as cutaneous numbness, cold-induced pain and stiffness, and soreness and weakness, including diabetic peripheral neuropathy, cervical radiculopathy, rheumatoid arthritis, coronary heart disease, pediatric spastic cerebral palsy, and recovery phases of cerebral infarction, demonstrating proven efficacy. Modern pharmacological studies confirm its anti-inflammatory, antioxidant-stress, hemorheological-improving, immunomodulatory, and neuroprotective effects by regulating multiple signaling pathways such as nuclear factor (NF)-κB/NOD-like receptor protein 3 (NLRP3) and nuclear factor erythroid 2-related factor 2 (Nrf2)-antioxidant response element (ARE), thereby addressing common pathological processes including inflammation, hypercoagulability, oxidative stress, immune dysregulation, and neural injury, highlighting the integrated regulatory advantages of TCM formulas with multi-target, multi-level, multi-component, and multi-pathway mechanisms. According to the theory of treating different diseases with the same method and focusing on three core syndromes of blood obstruction, this article systematically reviews and elucidates the clinical extensions and shared mechanisms of this formula, aiming to provide evidence-based insights for the modern adaptation and precise application of this classical formula in orthopedic and related disciplines for chronic musculoskeletal disorders.
8.Successful Pregnancy after Autologous Cryopreserved Ovarian Tissue Transplantation in a Cervical Cancer Patient: the First Reported Case in China
Yubin LI ; Yang ZHANG ; Tian MENG ; Bing CAI ; Chuling WU ; Changxi WANG ; Hongwei SHEN ; Guofen YANG
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(3):498-505
ObjectiveTo investigate the efficacy of ovarian tissue cryopreservation and autologous transplantation in preserving fertility and ovarian endocrine function in patients with cervical cancer. MethodsA 26-year-old patient with stage ⅡA1 cervical cancer underwent ovarian tissue harvesting and cryopreservation during cancer surgery. Following complete remission of the cancer, autologous ovarian tissue transplantation was performed. Follow-up monitoring included assessment of menopausal symptoms, hormone levels, and follicular development. ResultsSix months after transplantation, follicle-stimulating hormone levels decreased to 6.60 U/L, and estradiol levels increased from <10.00 ng/L to 89.00 ng/L. At 10 months after transplantation, ultrasound monitoring confirmed follicular development and physiological ovulation in the transplanted ovarian tissue. By 15 months after transplantation, follicle-stimulating hormone levels remained stable at 7.24 U/L, and estradiol levels further increased to 368.00 ng/L. Over 2 years after transplantation, the patient successfully gave birth to a healthy baby through assisted reproductive technology. ConclusionThe restoration of endocrine and ovulation functions in the transplanted cryopreserved ovarian tissue, followed by successful pregnancy, demonstrates the clinical success of ovarian tissue transplantation.
9.Progress of Krüppel-like factor 5 in tumors
Yubin YANG ; Tao ZHANG ; Ruoqi WANG ; Juanjuan GUO ; Xiaoming HOU
Cancer Research and Clinic 2025;37(9):713-716
Krüppel-like factor 5 (KLF5) has been confirmed as a key transcription factor in the occurrence and development of tumors, which is closely related to the malignant biological behaviors such as the proliferation and migration of tumor cells. This article summarizes the latest progress of KLF5 in tumor research, explores the mechanism and role of KLF5 in promoting tumor progression, aiming to further explore the potential of KLF5 as a therapeutic target and bring new thinking to the research in this field.
10.Analysis on Characteristics of Peripheral Blood Recovery in Treatment of Aplastic Anemia with Bushen Shengxue Method and Yiqi Yangxue Method Combined with Western Medicine
Yaoyin ZHANG ; Jiaqi HE ; Chaochang ZHANG ; Wenru WANG ; Yubin DING ; Jinhuan WANG ; Ruirong XU ; Haixia DI ; Jiangwei WAN ; Qifeng LIU ; Haixia WANG ; Antao SUN ; Xudong TANG
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(1):151-157
Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8%(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9%)and the control group(61.7%),with statistical significance(P<0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P<0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P<0.001,P<0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P<0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P<0.01).25%of patients had HGB levels exceeding 20%of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25%of patients had an increase in HGB levels exceeding 50%of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20%and 50%of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P<0.05,P<0.001).25%of patients had white blood cell elevation exceeding 50%of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25%of patients showed an increase in platelet levels exceeding 100%of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20%of the baseline value was significantly higher than that in the control group(P<0.01,P<0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

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