1.Reevaluation of systematic evluation of Xianling gubao capsules for knee osteoarthritis
Dongdong CAO ; Jixin CHEN ; Weijie YU ; Tianci GUO ; Yu ZHANG ; Puyu NIU ; Aifeng LIU
China Pharmacy 2025;36(2):232-238
OBJECTIVE To conduct a reevaluation of the systematic review (SR)/meta-analysis on the use of Xianling gubao capsules (XLGBC) for knee osteoarthritis (KOA), and provide evidence-based support for the clinical use of the drugs. METHODS Computerized searches including CNKI, Wanfang Data, VIP, China Biomedical Literature Database, the Cochrane Library, PubMed, Embase and Web of Science were conducted to collect systematic reviews (SR) or meta-analyses of XLGBC for the treatment of KOA from the inception to May 31st, 2024. The report quality, methodological quality, risk of bias and evidence quality were assessed using the PRISMA 2020 statement, AMSTAR 2 scale, ROBIS tool and GRADE tool, respectively. A comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed. RESULTS A total of five SR/meta-analyses were included. The evaluation results based on the PRISMA 2020 statement showed that one study report was relatively complete (21 points), while four studies had deficiencies (18-20 points). The assessment using the AMSTAR 2 scale indicated that the methodological quality of all five studies was rated as very low. According to the ROBIS tool evaluation, the risk of comprehensive bias in all five studies was classified as high. GRADE tool evaluation revealed that among 49 outcome indicators, 5 (10.2%) were rated as moderate-quality evidence (10.2%), 12 as low-quality evidence (24.5%), and 32 as very low-quality evidence (65.3%). The results of comprehensive quality analysis showed that the clinical efficacy, visual analogue scale score, pain relief time, comprehensive indexes of knee joint function, the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone (P<0.05). CONCLUSIONS Compared with conventional treatment, XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages. However, due to the low quality of evidence for the outcome indicators included in the studies, the conclusions should be interpreted with caution.
2.Reevaluation of systematic evluation of Xianling gubao capsules for knee osteoarthritis
Dongdong CAO ; Jixin CHEN ; Weijie YU ; Tianci GUO ; Yu ZHANG ; Puyu NIU ; Aifeng LIU
China Pharmacy 2025;36(2):232-238
OBJECTIVE To conduct a reevaluation of the systematic review (SR)/meta-analysis on the use of Xianling gubao capsules (XLGBC) for knee osteoarthritis (KOA), and provide evidence-based support for the clinical use of the drugs. METHODS Computerized searches including CNKI, Wanfang Data, VIP, China Biomedical Literature Database, the Cochrane Library, PubMed, Embase and Web of Science were conducted to collect systematic reviews (SR) or meta-analyses of XLGBC for the treatment of KOA from the inception to May 31st, 2024. The report quality, methodological quality, risk of bias and evidence quality were assessed using the PRISMA 2020 statement, AMSTAR 2 scale, ROBIS tool and GRADE tool, respectively. A comprehensive quality analysis of the quantitative results from the SR/meta-analysis was also performed. RESULTS A total of five SR/meta-analyses were included. The evaluation results based on the PRISMA 2020 statement showed that one study report was relatively complete (21 points), while four studies had deficiencies (18-20 points). The assessment using the AMSTAR 2 scale indicated that the methodological quality of all five studies was rated as very low. According to the ROBIS tool evaluation, the risk of comprehensive bias in all five studies was classified as high. GRADE tool evaluation revealed that among 49 outcome indicators, 5 (10.2%) were rated as moderate-quality evidence (10.2%), 12 as low-quality evidence (24.5%), and 32 as very low-quality evidence (65.3%). The results of comprehensive quality analysis showed that the clinical efficacy, visual analogue scale score, pain relief time, comprehensive indexes of knee joint function, the levels of inflammatory factors and the incidence of adverse events in patients with XLGBC combined with conventional treatment were significantly better than conventional treatment alone (P<0.05). CONCLUSIONS Compared with conventional treatment, XLGBC in combination with conventional treatment for KOA may have some efficacy and safety advantages. However, due to the low quality of evidence for the outcome indicators included in the studies, the conclusions should be interpreted with caution.
3.Efficacy Mechanism of Xianlian Jiedu Prescription Against Colorectal Cancer Recurrence vias Regulating Angiogenesis
Yanru XU ; Lihuiping TAO ; Jingyang QIAN ; Weixing SHEN ; Jiani TAN ; Chengtao YU ; Minmin FAN ; Changliang XU ; Yueyang LAI ; Liu LI ; Dongdong SUN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):79-87
ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer (CRC) and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit, followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group, low-dose Xianlian Jiedu prescription (XLJDP-L) group (6.45 g·kg-1·d-1), medium-dose Xianlian Jiedu prescription (XLJDP-M) group (12.9 g·kg-1·d-1), high-dose Xianlian Jiedu prescription (XLJDP-H) group (25.8 g·kg-1·d-1), and 5-fluorouracil (5-FU) group (1×10-3 g·kg-1·d-1). The mice were euthanized after 14 days of continuous intervention, and recurrent tumor tissue was harvested. Hematoxylin and eosin (HE) staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry (IHC) was employed to assess the expression of proliferating cell nuclear antigen (Ki67), vascular endothelial growth factor (VEGF), and platelet-endothelial cell adhesion molecule (CD31) in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 (ANG-2), VEGF, phosphorylated-protein kinase B (p-Akt), protein kinase B (Akt), phosphorylated-phosphatidylinositol 3-kinase (p-PI3K), and phosphatidylinositol 3-kinase (PI3K) in recurrent tumor tissue. ResultsBefore treatment, there were no statistical differences in tumor volume, tumor weight, and body mass among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group, indicating model stability. After treatment, compared with those in the model group, the tumor volume and tumor weight in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01), showing dose dependency. Meanwhile, there were no significant differences in body weight among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group, tumor tissue in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group had loosely arranged cells, increased intercellular spaces, small and shriveled nuclei, light staining, fewer mitotic figures and atypical nuclei, and increased necrotic areas. IHC showed that compared with those of the model group, the positive rates of Ki67, VEGF, and CD31 in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01) in a dose-dependent manner. Western blot results showed that compared with those of the model group, the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly downregulated (P<0.05, P<0.01), and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner (P<0.05, P<0.01). ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2, VEGF, and CD31.
4.Application of Anti-tumor Compatibility Structure of Chinese Medicine
Lanpin CHEN ; Feng TAN ; Xiaoman WEI ; Junyi WANG ; Liu LI ; Mianhua WU ; Haibo CHENG ; Dongdong SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):198-208
Malignant tumors are one of the major diseases that endanger human life and health. Chinese medicine has unique advantages in clinical anti-tumor treatment. However, how to translate the anti-tumor effects of Chinese medicine into clinical practice is the core issue that must be addressed in the process of treating malignant tumors with traditional Chinese medicine (TCM). Unlike modern chemical drugs, the compatibility application of Chinese medicine is the key factor that determines whether Chinese medicine can achieve optimal anti-tumor efficacy and realize the goal of "enhancing efficacy and reducing toxicity". The formulation structure based on this compatibility is the basic form for the safe, efficient, and rational clinical use of anti-tumor Chinese medicine, and it mainly includes three categories: herb pairs, tri-herbal combinations, and compound compatibility. Although herb pairs have the characteristics of a simple structure and strong targeting (enhancing efficacy and reducing toxicity), they often have a single effect and cannot fully address the complex pathogenesis of tumors. As a result, herb pairs are rarely used alone in practice. Compared to herb pairs, tri-herbal combinations broaden the application scope of herbs in clinical treatment, but their therapeutic range remains limited. The traditional "sovereign, minister, assistant, and guide" compound prescription, which includes herb pairs and tri-herbal combinations, improves the efficacy of herbs in treating serious diseases, hypochondriasis, chronic diseases, and miscellaneous disorders. However, due to the limitations of its historical background, it has not been integrated with modern clinical practice and modern pharmacological research, which restricts the development of compound compatibility theory. With the emergence of modern medical technology, it has been combined with traditional compatibility theory of Chinese medicine to create an innovative modern compatibility theory. This includes the "aid medicine" theory derived from modern Chinese medicine pharmacology, which compensates for the inability of the "sovereign, minister, assistant, and guide" theory to accurately apply medicine. Additionally, the "state-targeted treatment based on syndrome differentiation" theory, developed from pharmacology and modern medicine, addresses the deficiency in disease cognition in the "sovereign, minister, assistant, and guide" theory. Under the guidance of these compatibility forms and theories, clinical anti-tumor Chinese medicine can exert its maximum anti-tumor efficacy, which is of great significance for the application of Chinese medicine in clinical tumor treatment.
5.Research Progress on Antitumor Effect of AMPK/mTOR Signaling Pathway Regulated by Traditional Chinese Medicine
Xiafei ZHENG ; Dongdong LI ; Peimin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):268-276
With the increasing incidence and mortality of malignant tumors year by year, the prevention and treatment of malignant tumors has become a hot field of research. Although the existing anti-tumor treatment methods such as surgery, radiotherapy, chemotherapy, immunity and targeting have achieved some results, there are also obvious shortcomings, which are not conducive to the improvement of patients' quality of life and long-term treatment. Therefore, seeking a new efficient and safe treatment has become a hot topic of concern for many oncologists. adenosine monophosphate activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR) signaling pathway can participate in intracellular energy metabolism and affect the pathogenesis and outcome of tumors through multiple mechanisms. It is widely mentioned in the occurrence and development of many tumors. The activity level of this pathway is closely related to the abnormal proliferation and invasion of tumor cells, and is considered as an important pathway for anti-tumor therapy research. The anti-tumor treatment of traditional Chinese medicine(TCM) has significant advantages such as syndrome differentiation and treatment and sample consideration. The study found that flavonoids, alkaloids, polyphenols, saponins and other active components of traditional Chinese medicine, as well as the traditional Chinese medicine compound Xiangbei San, Yiqi Fuzheng Jiedu decoction, Yiqi Fuzheng prescription, etc can activate the AMPK/ mTOR signaling pathway by regulating the expression of AMPK/mTOR signaling pathway and upstream and downstream proteins, thereby inducing tumor cell autophagy and apoptosis, inhibiting tumor angiogenesis and epithelial mesenchymal transformation, regulating aerobic glycolysis and energy metabolism, and reversing drug resistance to exert anti-tumor effects. In this paper, by summarizing the research achievements of TCM anti-tumor in recent years, the specific mechanism of action of TCM regulating AMPK/ mTOR signaling pathway against tumor was discussed, aiming to provide ideas and references for the research and development of anti-tumor new drugs.
6.TCM Treatment of Lung Cancer Based on AMPK Signaling Pathway: A Review
Chengzhi WANG ; Yifan LIU ; Zhenyao YANG ; Wenjun LI ; Xiaoqing ZHANG ; Dongdong LI ; Peimin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):291-298
As a common malignant tumor of the respiratory system, the incidence and mortality of lung cancer are still rising year by year. Its pathogenesis is complex, the prognosis is poor, and it seriously affects human physical and mental health. Although existing Western medical treatments can inhibit tumor growth to a certain extent and relieve patients' painful symptoms, problems such as postoperative recurrence and metastasis, numerous adverse reactions, and the tendency to develop drug resistance make the overall therapeutic effect unsatisfactory. Therefore, it is urgent to seek more efficient and safer treatments. Adenosine monophosphate-activated protein kinase (AMPK) signaling pathway can regulate the growth, differentiation, apoptosis, and autophagy of lung cancer cells, and is extensively involved in the occurrence and development of lung cancer, thus being regarded as an important target for anti-lung cancer therapy. Traditional Chinese medicine (TCM) exerts anti-lung cancer effects through multiple pathways, mechanisms, and targets, with advantages such as preventing postoperative recurrence and metastasis, alleviating the adverse reactions of radiotherapy and chemotherapy, and improving quality of life. TCM has therefore become a key approach in current anti-lung cancer treatment. Studies have found that active components of Chinese medicine, including flavonoids, saponins, polyphenols, and terpenes, as well as Chinese medicine compound prescriptions such as Guiqi Yiyuan extract, Qingzao Jiufei decoction, and Yiqi Fuzheng formula, have significant regulatory effects on AMPK and its interacting signaling pathways. These effects include inducing autophagy and apoptosis of lung cancer cells, modulating macrophage polarization, inhibiting epithelial-mesenchymal transition, reversing drug resistance, and blocking the cell cycle, thereby exerting anti-lung cancer activity. This article reviews and summarizes recent studies on the anti-lung cancer effects of TCM, and discusses the mechanisms by which TCM regulates the AMPK signaling pathway in the treatment of lung cancer, with the aim of providing ideas and references for the development of new clinical anti-lung cancer drugs.
7.TCM Treatment of Lung Cancer Based on AMPK Signaling Pathway: A Review
Chengzhi WANG ; Yifan LIU ; Zhenyao YANG ; Wenjun LI ; Xiaoqing ZHANG ; Dongdong LI ; Peimin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):291-298
As a common malignant tumor of the respiratory system, the incidence and mortality of lung cancer are still rising year by year. Its pathogenesis is complex, the prognosis is poor, and it seriously affects human physical and mental health. Although existing Western medical treatments can inhibit tumor growth to a certain extent and relieve patients' painful symptoms, problems such as postoperative recurrence and metastasis, numerous adverse reactions, and the tendency to develop drug resistance make the overall therapeutic effect unsatisfactory. Therefore, it is urgent to seek more efficient and safer treatments. Adenosine monophosphate-activated protein kinase (AMPK) signaling pathway can regulate the growth, differentiation, apoptosis, and autophagy of lung cancer cells, and is extensively involved in the occurrence and development of lung cancer, thus being regarded as an important target for anti-lung cancer therapy. Traditional Chinese medicine (TCM) exerts anti-lung cancer effects through multiple pathways, mechanisms, and targets, with advantages such as preventing postoperative recurrence and metastasis, alleviating the adverse reactions of radiotherapy and chemotherapy, and improving quality of life. TCM has therefore become a key approach in current anti-lung cancer treatment. Studies have found that active components of Chinese medicine, including flavonoids, saponins, polyphenols, and terpenes, as well as Chinese medicine compound prescriptions such as Guiqi Yiyuan extract, Qingzao Jiufei decoction, and Yiqi Fuzheng formula, have significant regulatory effects on AMPK and its interacting signaling pathways. These effects include inducing autophagy and apoptosis of lung cancer cells, modulating macrophage polarization, inhibiting epithelial-mesenchymal transition, reversing drug resistance, and blocking the cell cycle, thereby exerting anti-lung cancer activity. This article reviews and summarizes recent studies on the anti-lung cancer effects of TCM, and discusses the mechanisms by which TCM regulates the AMPK signaling pathway in the treatment of lung cancer, with the aim of providing ideas and references for the development of new clinical anti-lung cancer drugs.
8.Regulation of Gastrointestinal Tumor Stem Cells by Traditional Chinese Medicine: A Review
Chenglei ZHENG ; Chengzhi WANG ; Zhenyao YANG ; Mingyang HE ; Wenjun LI ; Dongdong LI ; Peimin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):280-287
Gastrointestinal tumors (GTs), including colorectal cancer, gastric cancer, liver cancer, pancreatic cancer, and esophageal cancer, are increasing in incidence worldwide and have become one of the major diseases threatening human health. Tumor stem cells (TSCs), an undifferentiated subpopulation within tumor tissues, possess biological characteristics such as self-renewal, multidirectional differentiation, high tumorigenicity, and resistance to radiochemotherapy. They play an important role in the occurrence, progression, recurrence, and metastasis of GTs and have increasingly become a research hotspot in GT treatment. Although modern medicine has made remarkable progress, there remain many problems in therapeutic approaches targeting TSCs. In this context, traditional Chinese medicine (TCM), with its favorable safety profile and multi-target mechanisms, has shown potential advantages and value in regulating TSCs. It can reduce TSC drug resistance, enhance the sensitivity of tumor cells to chemotherapeutic agents, inhibit tumor growth and metastasis, and has shown unique advantages in improving the quality of life and prolonging the survival of GT patients. Studies have found that active components of Chinese medicine, such as terpenoids, polyphenols, flavonoids, glycosides, and quinones, and Chinese medicine compound formulas, including Zuojin pills, Sijunzi decoction, Biejiajian pills, and Xuanfu Daizhe decoction, can inhibit TSCs-related signaling pathways such as the Notch signaling pathway, the Wnt/β-catenin signaling pathway, the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, and the Hippo signaling pathway. They also reduce the expression of TSC surface markers, including sex-determining region Y-box 2 (SOX2), sex-determining region Y-box 9 (SOX9), octamer-binding transcription factor 4 (OCT4), prominin-1 (CD133), cluster of differentiation 44 (CD44), cluster of differentiation 24 (CD24), and thyroid transmembrane protein 1 (CD90), thereby hindering TSC differentiation, accelerating their metabolic processes, improving the tumor microenvironment, and consequently inhibiting GT growth. This study collects and analyzes recent research on the regulation of TSCs by TCM in the treatment of GT, aiming to provide a new theoretical basis for tumor therapy with TCM, expand its application in the comprehensive treatment of GT, and offer new therapeutic ideas and methods for clinical practice.
9.Application of the comprehensive index method in occupational health risk assessment on chemical hazards in a metal product enterprise
Dongdong CAO ; Zihuan WANG ; Xiaoyu HU ; Lei ZHONG ; Lixia LIU ; Jia FU ; Li HU ; Liu LIU ; Yan YE
China Occupational Medicine 2024;51(5):533-538
Objective To evaluate the applicability of the comprehensive index method for assessing occupational health risks on chemical hazards in key work sites of a metal product enterprise. Methods A metal product enterprise in Beijing City was chosen as the research subject using the convenience sampling method. Occupational health investigations and chemical hazard monitoring were conducted at four work sites: grinding machine operation, welding, cutting, and painting. The comprehensive index method was used to determine the risk levels of chemical hazards. Results The grinding dust in the grinding machine operation work site was assessed as moderate risk. The nitrogen oxides and ozone in the welding (southeast) work sites were assessed as moderate risk. The nitrogen oxides ozone and welding fumes in the welding (northwest) and cutting work site were assessed as moderate risk. Benzene in the painting work site was assessed as moderate risk. All chemical hazards in other work sites were determined to pose low risks. Co-exposures to nitrogen oxides and ozone in the two welding work sites and cutting work site were classified as moderate risk. Co-exposure to ethylbenzene, xylene, methanol, ethyl acetate, and butyl acetate in the painting work site also posed moderate risk, while the co-exposure to toluene and methanol in the painting work site was assessed as low risk. Conclusion The comprehensive index method could be used for the occupational health risk assessment in the metal product enterprise. The enterprise should strengthen hazard control measures for exposure to grinding dust, welding fumes, nitrogen oxides, ozone, and benzene, and closely monitor the health risks associated with co-exposures of chemical hazards.
10.Prevention and Treatment of Knee Osteoarthritis by Targeted Mitochondrial Quality Control with Traditional Chinese Medicine: A Review
Jixin CHEN ; Qinxin ZHOU ; Weijie YU ; Tianci GUO ; Dongdong CAO ; Puyu NIU ; Yuntian YE ; Aifeng LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):245-253
Knee osteoarthritis (KOA) is a common degenerative joint disease characterized primarily by the degeneration and damage of knee joint cartilage, accompanied by osteophyte formation and inflammation. In recent years, the prevalence of KOA has been increasing globally, significantly impacting the quality of life patients. However, the pathogenesis of KOA remains not fully understood, and current treatment methods are limited. Therefore, finding new therapeutic strategies is a research hotspot. Previous studies have found that the onset of KOA is related to abnormal mitochondrial regulation. Mitochondria, functioning as secondary messengers, play crucial roles in cellular respiration, reactive oxygen species (ROS) generation, and adenosine triphosphate (ATP) production through oxidative phosphorylation. Mitochondrial quality control is a pivotal mechanism for maintaining the morphology, quantity, and quality of mitochondria. The connection between mitochondrial quality control and the pathogenesis of KOA involves several factors, such as mitochondrial oxidative stress, mitophagy, imbalances in mitochondrial biogenesis, abnormal mitochondrial dynamics (fission and fusion), and dysregulation of calcium ions. Metabolic abnormalities in the body lead to mitochondrial structural damage, which in turn contributes to the onset and progression of KOA. Traditional Chinese medicine (TCM) has made some progress in intervening in mitochondrial quality control, employing multi-faceted, multi-pathway, and multi-target strategies to treat KOA. Several studies have shown that mitochondrial quality control may be one of the therapeutic targets of TCM in treating KOA. However, there is currently a lack of comprehensive reviews summarizing the TCM interventions in mitochondrial quality control for treating KOA. This paper systematically reviewed the research progress in TCM treatment of KOA based on five aspects of mitochondrial quality control, aiming to provide a theoretical basis for the clinical prevention and treatment of KOA.

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