1.Herbal Textual Research on Inulae Flos in Famous Classical Formulas
Caixia LIU ; Yue HAN ; Yanzhu MA ; Lei GAO ; Sheng WANG ; Yan YANG ; Wenchuan LUO ; Ling JIN ; Jing SHAO ; Zhijia CUI ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):210-221
In this paper, by referring to ancient and modern literature, the textual research of Inulae Flos has been conducted to clarify the name, origin, production area, quality evaluation, harvesting, processing and others, so as to provide reference and basis for the development and utilization of famous classical formulas containing this herb. After textual research, it could be verified that the medicinal use of Inulae Flos was first recorded in Shennong Bencaojing of the Han dynasty. In successive dynasties, Xuanfuhua has been taken as the official name, and it also has other alternative names such as Jinfeicao, Daogeng and Jinqianhua. The period before the Song and Yuan dynasties, the main origin of Inulae Flos was the Asteraceae plant Inula japonica, and from the Ming and Qing dynasties to the present, I. japonica and I. britannica are the primary source. In addition to the dominant basal species, there are also regional species such as I. linariifolia, I. helianthus-aquatili, and I. hupehensis. The earliest recorded production areas in ancient times were Henan, Hubei and other places, and the literature records that it has been distributed throughout the country since modern times. The medicinal part is its flower, the harvesting and processing method recorded in the past dynasties is mainly harvested in the fifth and ninth lunar months, and dried in the sun, and the modern harvesting is mostly harvested in summer and autumn when the flowers bloom, in order to remove impurities, dry in the shade or dry in the sun. In addition, the roots, whole herbs and aerial parts are used as medicinal materials. In ancient times, there were no records about the quality of Inulae Flos, and in modern times, it is generally believed that the quality of complete flower structure, small receptacles, large blooms, yellow petals, long filaments, many fluffs, no fragments, and no branches is better. Ancient processing methods primarily involved cleaning, steaming, and sun-drying, supplemented by techniques such as boiling, roasting, burning, simmering, stir-frying, and honey-processing. Modern processing focuses mainly on cleaning the stems and leaves before use. Regarding the medicinal properties, ancient texts describe it as salty and sweet in taste, slightly warm in nature, and mildly toxic. Modern studies characterize it as bitter, pungent, and salty in taste, with a slightly warm nature. Its therapeutic effects remain consistent across eras, including descending Qi, resolving phlegm, promoting diuresis, and stopping vomiting. Based on the research results, it is recommended that when developing famous classical formulas containing Inulae Flos, either I. japonica or I. britannica should be used as the medicinal source. Processing methods should follow formula requirements, where no processing instructions are specified, the raw products may be used after cleaning.
2.Herbal Textual Research on Inulae Flos in Famous Classical Formulas
Caixia LIU ; Yue HAN ; Yanzhu MA ; Lei GAO ; Sheng WANG ; Yan YANG ; Wenchuan LUO ; Ling JIN ; Jing SHAO ; Zhijia CUI ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):210-221
In this paper, by referring to ancient and modern literature, the textual research of Inulae Flos has been conducted to clarify the name, origin, production area, quality evaluation, harvesting, processing and others, so as to provide reference and basis for the development and utilization of famous classical formulas containing this herb. After textual research, it could be verified that the medicinal use of Inulae Flos was first recorded in Shennong Bencaojing of the Han dynasty. In successive dynasties, Xuanfuhua has been taken as the official name, and it also has other alternative names such as Jinfeicao, Daogeng and Jinqianhua. The period before the Song and Yuan dynasties, the main origin of Inulae Flos was the Asteraceae plant Inula japonica, and from the Ming and Qing dynasties to the present, I. japonica and I. britannica are the primary source. In addition to the dominant basal species, there are also regional species such as I. linariifolia, I. helianthus-aquatili, and I. hupehensis. The earliest recorded production areas in ancient times were Henan, Hubei and other places, and the literature records that it has been distributed throughout the country since modern times. The medicinal part is its flower, the harvesting and processing method recorded in the past dynasties is mainly harvested in the fifth and ninth lunar months, and dried in the sun, and the modern harvesting is mostly harvested in summer and autumn when the flowers bloom, in order to remove impurities, dry in the shade or dry in the sun. In addition, the roots, whole herbs and aerial parts are used as medicinal materials. In ancient times, there were no records about the quality of Inulae Flos, and in modern times, it is generally believed that the quality of complete flower structure, small receptacles, large blooms, yellow petals, long filaments, many fluffs, no fragments, and no branches is better. Ancient processing methods primarily involved cleaning, steaming, and sun-drying, supplemented by techniques such as boiling, roasting, burning, simmering, stir-frying, and honey-processing. Modern processing focuses mainly on cleaning the stems and leaves before use. Regarding the medicinal properties, ancient texts describe it as salty and sweet in taste, slightly warm in nature, and mildly toxic. Modern studies characterize it as bitter, pungent, and salty in taste, with a slightly warm nature. Its therapeutic effects remain consistent across eras, including descending Qi, resolving phlegm, promoting diuresis, and stopping vomiting. Based on the research results, it is recommended that when developing famous classical formulas containing Inulae Flos, either I. japonica or I. britannica should be used as the medicinal source. Processing methods should follow formula requirements, where no processing instructions are specified, the raw products may be used after cleaning.
3.Mechanisms of Huanglian Jiedutang and Its Major Active Constituents in Inhibiting LPS-induced M1 Polarisation of BV2 Microglia
Haojia ZHANG ; Kai WANG ; Kunjing LIU ; Xin LAN ; Zijin SUN ; Chunyu WANG ; Wenyuan MA ; Wei SHAO ; Jinhua HAN ; Liyang DONG ; Changxiang LI ; Xueqian WANG ; Youxiang CUI ; Fafeng CHENG ; Qingguo WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):44-55
ObjectiveTo investigate whether Huanglian Jiedutang (HLJD) and its major active constituents (geniposide, baicalin, and berberine) can inhibit the inflammatory response of BV2 cells under lipopolysaccharide (LPS) stimulation via the high-mobility group protein B1 (HMGB1)/Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway, and to explore differences in therapeutic efficacy among the three monomers, their combined formula, and HLJD under equal content ratios. MethodsBV2 microglial cells were used as the primary experimental model. Cell viability was assessed using the cell counting kit-8 (CCK-8) method to examine the effects of different concentrations of dimethyl sulfoxide (DMSO, 0.8%, 0.4%, 0.2%, 0.1%, and 0.05%) on cell viability. IncuCyte was employed to monitor the growth of cells under different concentrations of HLJD (200, 100, 50, 25, 12.5, 6.25 mg·L-1). Nitric oxide (NO) assay was used to screen the optimal HLJD concentration. High-performance liquid chromatography (HPLC) determined the content of geniposide, baicalin, and berberine in HLJD, and experimental groups were subsequently established according to the relative proportions of these constituents. CCK-8 assay evaluated cell viability under different treatments. Enzyme-linked immunosorbent assay (ELISA) measured levels of inflammatory factors (TNF-α, IL-1β, IL-6, IL-10) in the supernatant. Flow cytometry assessed the effects of treatments on M1-type polarization of BV2 cells. Western blot determined the expression levels of HMGB1, TLR4, and NF-κB-related proteins. ResultsCompared with the blank group, DMSO at concentrations ≤0.2% did not affect cell viability within 48 h. BV2 cell growth plateaued at 24 h after treatment with 200 mg·L-1 HLJD. Under stimulation with 2 mg·L-1 LPS, this concentration of HLJD effectively reduced NO release, and 6 h pre-treatment had a stronger inhibitory effect on NO than direct administration. HPLC results showed that 1 mg of HLJD freeze-dried powder contained approximately 24 μg of geniposide, 15 μg of baicalin, and 30 μg of berberine. Based on these ratios, experimental groups were blank, LPS (2 mg·L-1), HLJD (200 mg·L-1), monomer combination, geniposide (4.8 mg·L-1), baicalin (3 mg·L-1), and berberine (6 mg·L-1). The monomer combination group consisted of all three active constituents dissolved together. LPS and HLJD or its active constituents did not affect cell viability compared with the blank group. LPS significantly increased TNF-α, IL-1β, IL-6, and IL-10 in the supernatant (P<0.01). HLJD and its active constituents significantly reduced pro-inflammatory factors TNF-α, IL-1β, and IL-6 (P<0.05, P<0.01) while upregulating anti-inflammatory IL-10 (P<0.01), with the monomer combination showing the strongest effect (P<0.05, P<0.01). Compared with the blank group, LPS significantly increased the proportion of CD80⁺CD86⁺ (M1-type) BV2 cells (P<0.01). HLJD and its constituents partially inhibited M1 polarization (P<0.05, P<0.01), with the monomer combination exhibiting the most pronounced effect (P<0.05, P<0.01). Compared with the blank group, LPS upregulated HMGB1, TLR4, and NF-κB-related proteins (P<0.01), whereas HLJD and its active constituents significantly reduced their expression (P<0.05, P<0.01), with the monomer combination having the strongest regulatory effect (P<0.05, P<0.01). ConclusionHLJD and its major active constituents (geniposide, baicalin, berberine) can inhibit LPS-induced inflammatory responses in BV2 cells. The combination of the three active constituents demonstrates the most potent anti-inflammatory effect, significantly attenuating M1-type polarization of BV2 cells via the HMGB1/TLR4/NF-κB signaling pathway.
4.Atelocollagen Improves Bone-to-Tendon Interface Healing in a Rabbit Model of Chronic Rotator Cuff Tear Compared with Polydeoxyribonucleotide
Jian HAN ; Zhan-Feng ZHANG ; Shen-Yun FANG ; Yun-Mei CUI ; Sheng Chen HAN
Clinics in Orthopedic Surgery 2026;18(1):167-175
Background:
Surgeons face challenges in selecting cost-effective and biologically active agents for rotator cuff healing, given the numerous commercial products available, such as polydeoxyribonucleotide (PDRN) and atelocollagen (ATC). However, the precise efficacy of PDRN and ATC in rotator cuff healing remains debatable, and there is currently a lack of studies directly comparing the effects of the 2 agents on repaired cuff tendons. Therefore, the purpose of this study was to compare the efficacy of PDRN and ATC on bone-to-tendon interface (BTI) healing using a chronic rotator cuff tear (RCT) model in rabbits.
Methods:
Forty-eight rabbits were randomly divided into 3 groups. To create chronic RCT models, transected tendons were left untreated for 6 weeks, and then were repaired in a transosseous manner with PDRN and ATC injection into the repair site according to group allocation (group A: saline, group B: PDRN, group C: ATC; n = 16 per group). Genetic and immunofluorescence analyses were performed at 4 weeks after surgery. Furthermore, genetic, histologic, and biomechanical analyses were performed at 12 weeks after surgery.
Results:
At 4 weeks after surgery, ATC-injected shoulders showed the highest mRNA expression levels of collagen type I alpha 1 and aggrecan compared to the other 2 groups (p < 0.001 and p = 0.002, respectively). Meanwhile, there was more preliminary fibrocartilaginous matrix formation in the ATC-injected group. At 12 weeks after surgery, ATC-injected shoulders demonstrated better collagen fiber continuity and orientation, denser collagen fibers, a more mature bone-to-tendon junction, and greater fibrocartilage layer formation compared to the other 2 groups (all p < 0.001). Furthermore, ATC-injected shoulders also demonstrated a significantly higher load-to-failure value (40.4 ± 4.5 N/kg) than the remaining groups (group A, 26.7 ± 3.0 N/kg; group B, 32.8 ± 4.2 N/kg; p < 0.001).
Conclusions
ATC demonstrated superior efficacy in promoting BTI healing following surgical repair in a chronic RCT model of rabbits.
5.Study on the equivalence of different decoction processes for a shell-based traditional Chinese medicine drug pair based on rat model of hypertension with liver-yang hyperactivity
Minglu LI ; Yuhan CUI ; Fan WU ; Kexin HAN ; Li WU ; Zhuyuan FANG ; Yachun SHU
China Pharmacy 2026;37(10):1283-1289
OBJECTIVE To investigate the equivalence of different decoction processes based on rat model of hypertension with liver-yang hyperactivity. METHODS Inductively coupled plasma mass spectrometry (ICP-MS) was used to compare the dissolution differences of inorganic elements in the powder-directly-decocted decoction versus the pieces-decocted-first decoction of Ostreae Concha- Haliotidis Concha- Margaritifera Concha drug pair. Six SD rats were included in the normal group. The spontaneously hypertensive rats were given Aconite decoction for six weeks to induce the hypertension model with liver-yang hyperactivity. After successful modeling, 48 rats were randomly divided into the model group, the captopril group [positive control, 8 mL/(kg·d) ] , as well as low-, medium-, and high-dose groups of pieces decocted first or directly powder decocted [2.02, 4.05, 8.10 mL/(kg·d) ] , with 6 rats in each group. Each group received the corresponding drug or equal volume of pure water intragastrically, once a day, for two consecutive weeks. After the last administration, the degree of irritability, facial temperature, pressure pain threshold, blood pressure, and pathological changes of the thoracic aorta were observed in each group. Serum nitric oxide (NO) and plasma angiotensin Ⅱ (Ang Ⅱ), renin, and aldosterone (ALD) levels were also measured. RESULTS ICP-MS analysis results showed statistically significant differences in the contents of macroelements Li, Na, Mg, Ca, Mn, Ga, Sr, Mo, Cd, Sn, and Sb, between the powder-directly-decocted decoction and the pieces-decocted-first decoction ( P <0.05) ,the elements P, Cr, Fe, Ni, Zn, Hg, Tl, and Pb were not detected in either decoction. Animal experiments showed that after two weeks of administration, compared with the model group, the facial temperature, and blood pressure decreased in all treatment groups, while the pressure pain threshold increased; plasma levels of Ang Ⅱ, renin and ALD, as well as the serum level of NO were all decreased, and thoracic aortic media thickness was significantly reduced, most of the differences in the above indicators were statistically significant ( P <0.05 or P <0.01 or P <0.001). Pathological observation showed improvement in thoracic aortic pathological injury. CONCLUSIONS The powder-directly-decocted process for the Ostreae Concha- Haliotidis Concha- Margaritifera Concha drug pair significantly promotes the dissolution of key elements such as Ca, Mg, and Sr without increasing the dissolution of harmful elements. It is equivalent to the traditional pieces-decocted-first in alleviating liver-yang hyperactivity syndrome, lowering blood pressure, and protecting the vascular endothelium, and even shows better performance in some indicators.
6.Mechanism of Bushen huoxue formula in improving pregnancy outcomes in mice with antiphospholipid antibody-related recurrent spontaneous abortion
Yongmei HAN ; Tianwei CUI ; Jundan XIE ; Xinyu HE ; Yuting GONG ; Manman WANG
China Pharmacy 2026;37(11):1408-1415
OBJECTIVE To investigate the mechanism of Bushen huoxue formula in improving pregnancy outcomes in mice with antiphospholipid antibody-related recurrent spontaneous abortion (aPL-RSA). METHODS SPF female BALB/c mice were randomly divided into normal control group, adjuvant control group, model group, and Bushen huoxue formula group. The aPL-RSA mouse model was established by immunization with β 2 glycoproteinⅠcombined with Freund’s adjuvant. From gestational day 0, the Bushen huoxue formula group was administered 1.653 6 g/(kg·d) of the prescription by gavage, while the other three groups received an equal volume of normal saline, twice daily for 15 consecutive days. The uterine appearance of pregnant mice was observed; individual embryo weight was recorded, and the embryo resorption rate was calculated. The proportion of activated CD41 + CD62p + platelets in platelet-rich plasma (PRP) was detected. Serum levels of thromboxane B2 (TXB2) and platelet factor 4 (PF4) were measured. Morphological changes of placental tissue were observed. The cell apoptosis rate of placental tissue was detected. The levels of malondialdehyde (MDA) content, tot al superoxide dismutase (T-SOD) activity, the interleukin-1β (IL-1β) and IL-18, the protein expressions of matrix metalloproteinase-3 (MMP-3), MMP-9, nuclear proliferation antigen-67 (Ki67), superoxide dismutase 2 (SOD2), Nod-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), and caspase-1, as well as the mRNA expressions of superoxide dismutase 2(SOD2), NLRP3, ASC and caspase-1 of placental tissue were detected. RESULTS Compared with the normal control group and adjuvant control group, the model group showed significant decreases in individual embryo weight, T-SOD activity of placental tissue, and relative expression levels of SOD2 mRNA and protein ( P <0.05); while significant increases were observed in embryo resorption rate, proportion of activated CD41 + CD62p + platelets in PRP, serum levels of TXB2 and PF4, placental cell apoptosis rate, MDA content in placental tissue, relative protein expressions of MMP-3, MMP-9 and Ki67, relative protein and mRNA expression levels of NLRP3, ASC and caspase-1 as well as IL-1β and IL-18 levels ( P <0.05). The model group also exhibited irregular uterine morphology with localized atrophy in some uterine horns; placental tissue showed fragmentation of decidual cells, extensive vacuolization and necrosis of trophoblast cells in the labyrinthine zone, accompanied by vascular reduction. After intervention with Bushen huoxue formula, the above indicators were significantly reversed ( P <0.05), and uterine morphology and pathological damage were markedly improved. CONCLUSIONS Bushen huoxue formula can effectively improve pregnancy outcomes in aPL-RSA model mice, and its mechanism may be closely related to inhibiting platelet activation, reducing oxidative stress injury, enhancing trophoblast cell function, and suppressing the inflammatory response mediated by the NLRP3 inflammasome pathway.
7.Convergent modulation of default mode network effective connectivity by modified Suanzaoren Decoction and estazolam in patients with chronic insomnia disorder
Ke WANG ; Yiding HAN ; Haohao YAN ; Xingyan GUO ; Wuhong LIN ; Ping YAO ; Min LIU ; Min CHEN ; Longbiao CUI ; Wenbin GUO ; Dongsheng LYU
Sichuan Mental Health 2026;39(4):356-366
BackgroundBoth modified Suanzaoren Decoction and estazolam serve as effective treatments for chronic insomnia disorder (CID). Default mode network (DMN) dysfunction is recognized as the primary pathophysiological mechanism underlying CID. However, it remains unclear whether the two treatments exert their therapeutic effects via convergent modulation of DMN functional connectivity. ObjectiveTo investigate the convergent remodeling characteristics of bidirectional effective connectivity (EC) of core DMN nodes with both the intra-network and the remaining whole-brain regions in CID patients with Yin-deficiency and fire-hyperactivity syndrome following the treatment with modified Suanzaoren Decoction or estazolam, so as to provide neuroimaging evidence for the convergent neural mechanisms underlying the therapeutic effects of both therapies in treating CID. MethodsEighty-two patients diagnosed with CID according to the International Classification of Sleep Disorder, third edition (ICSD-3) were consecutively recruited from the outpatient clinic of the Inner Mongolia Autonomous Region Mental Health Center from October 2020 to September 2023. Based on treatment preference, patients were assigned to receive a 6-week intervention in either the modified Suanzaoren Decoction group (n=52) or the estazolam group (n=30). Ultimately, 66 patients completed follow-up assessments (modified Suanzaoren Decoction group, n=41; estazolam group, n=25). All CID patients underwent resting-state functional magnetic resonance imaging scanning before and after treatment. Core DMN nodes including medial prefrontal cortex (mPFC), bilateral inferior parietal lobule (IPL), and precuneus (PCUN) were selected as seed regions. Granger causality analysis (GCA) was employed to assess bidirectional EC between the seed regions and both the other intra-DMN nodes and the remaining whole-brain regions. Hepatic and renal function indices were detected pre- and post-treatment to evaluate the safety profiles of both treatments. ResultsAt baseline, significant between-group differences were identified in EC from the left IPL to the left middle fronto-orbital gyrus/gyrus rectus (t=5.24, Z=4.84, voxel-level P<0.001, cluster-level P<0.05, GRF-corrected), with the modified Suanzaoren Decoction group exhibiting stronger EC than the estazolam group. No significant between-group differences were observed in EC between other core DMN nodes and remaining whole-brain regions (P>0.05). Within-group pre- to post-treatment comparisons demonstrated consistent connectivity alterations in both groups. Specifically, EC from the left IPL to the supplementary motor area (SMA) decreased after treatment (modified Suanzaoren Decoction group: t=-6.28, Z=5.208; estazolam group: t=-5.58, Z=4.425). Conversely, EC from the SMA to the left IPL increased (modified Suanzaoren Decoction group: t=5.89, Z=4.968; estazolam group: t=6.15, Z=4.720). Furthermore, both groups demonstrated reduced EC from the PCUN to the left IPL (modified Suanzaoren Decoction group: t=-5.85, Z=4.94; estazolam group: t=-5.75, Z=4.515), and elevated EC from the left IPL to the PCUN (modified Suanzaoren Decoction group: t=5.29, Z=4.579; estazolam group: t=4.55, Z=3.826) (voxel-level P<0.001, cluster-level P<0.05, GRF-corrected). No significant pre- to post-treatment differences were observed in hepatic or renal function indices in either group (P>0.05). ConclusionIn CID patients with Yin-deficiency and fire-hyperactivity syndrome, both modified Suanzaoren Decoction and estazolam induce convergent bidirectional remodeling of EC between the left IPL and the SMA and the PCUN. [Funded by Natural Science Fund Project of Inner Mongolia Autonomous Region (number, 2019MS08099); ClinicalTrials.gov number, NCT06452953]
8.Chronic Morphine Induces Downregulation of GIRK1 and GIRK2 Membrane Expression in HEK293 Cells
Bingke LIU ; Yu CUI ; Xue HAN ; Li XIAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):251-258
ObjectiveTo investigate the expression and distribution changes of G protein-gated inwardly rectifying potassium (GIRK) channel subunits GIRK1 and GIRK2 following morphine tolerance using human embryonic kidney 293 (HEK293) cells. MethodsHEK293 cells were transfected with the lentiviral vector pLV-CMV-GIRK1-T2A-GIRK2-P2A-MOR to establish a stable cell line overexpressing GIRK1, GIRK2, and the μ-opioid receptor (MOR).Morphine (1 μmol/L, 24 h) was applied to these stable cells to construct a morphine-tolerant HEK293 cell model.Cellular immunofluorescence was used to examine the distribution and co-localization of MOR with GIRK1 and GIRK2.ELISA was performed to measure cAMP levels to confirm the establishment of the morphine-tolerant model.Cellular immunofluorescence and Western blot were employed to analyze the distribution and protein expression changes of GIRK1 and GIRK2 after morphine tolerance.A multimode microplate reader was used to measure fluorescence intensity for detecting changes in cellular membrane potential following morphine tolerance. ResultsIn the stable HEK293 cells, immunohistochemistry showed that GIRK1 and GIRK2 were primarily expressed on the plasma membrane, with minimal presence in the cytoplasm.Both GIRK1 and GIRK2 co-localized with MOR and with each other.Compared with the control group, cAMP levels significantly decreased after 1 h of morphine treatment (1.42±0.07 vs.0.72±0.12, P=0.001 0), while they significantly increased after 24 h of treatment (0.72±0.12 vs.1.98±0.17, P=0.000 5).Fluorescence double staining revealed that after 24 h of morphine treatment, the morphine-tolerant group showed a significant increase in cytoplasmic GIRK1 (13.76±7.67 vs.63.72±16.02, P<0.000 1) and GIRK2 (7.16±2.61 vs.32.92±7.67, P=0.002 9).Western blot analysis indicated that the expression of membrane proteins GIRK1 (1.11±0.14 vs.0.85±0.01, P=0.004 5) and GIRK2 (1.32±0.02 vs.0.86±0.08, P=0.000 1) was significantly downregulated after morphine tolerance.Membrane potential measurements showed that the hyperpolarization response in morphine-tolerant cells was significantly attenuated (-15.53±0.12) % vs.(-8.17±0.11) %, P<0.000 1. ConclusionChronic morphine treatment can induce downregulation of GIRK1 and GIRK2 expression on the plasma membrane in stable HEK293 cells.
9.Clinical application of hemostatic drugs in special populations:an expert consensus
Lizhu HAN ; Yuan BIAN ; Qinan YIN ; Siying CHEN ; Feifei YU ; Jing CHEN ; Xingxing CUI ; Yiding TANG ; Xin YAO ; Hongxi LIU ; Shuhong LIANG ; Nan LIU
China Pharmacy 2026;37(20):2628-2639
OBJECTIVE To develop evidence-based clinical practice recommendations for the use of hemostatic drugs in special populations, so as to improve the efficacy and safety of medication.METHODS Led by the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, a working group of 79 experts covering clinical pharmacy, obstetrics and gynecology, pediatrics and other fields was established. Clinical questions regarding the efficacy and safety of hemostatic drugs in special populations were screened through literature review and two rounds of Delphi questionnaire surveys. Intervention questions were structured using the population, intervention, comparison, and outcome framework, while management questions were additionally described using the population, clinical setting, management measure, and outcome framework. Databases including Medline, Embase, Cochrane Library, CNKI, Wanfang Data, and VIP were systematically searched to collect and screen relevant evidence. Recommendations were formulated through recommendation questionnaire surveys and expert consensus meetings, and the quality of evidence and strength of recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS &CONCLUSIONS A total of 8 clinical questions were finally determined, the consensus rates of all clinical questions and recommendations were more than 90%, and 8 recommendations on the use of hemostatic drugs in special populations were formulated. These recommendations cover special populations including children, women during pregnancy/puerperium/lactation, the elderly, patients with hepatic impairment, patients in the perioperative period of liver transplantation, patients with renal impairment/on dialysis/in the perioperative period of kidney transplantation, immunocompromised patients, and patients with hematological diseases. The recommendations specify the applicable scenarios, dose adjustment principles, monitoring indicators, and safety management strategies of hemostatic drugs in different special populations, which can provide a reference for the clinical application of hemostatic drugs in special populations and help clinicians and pharmacists develop individualized medication plans.
10.Therapeutic Effect of Cranial Painkiller Pills' Extract Powder in Treatment of Trigeminal Neuralgia Induced by Injection of Talci Pulvis into Infraorbital Foramen of Model Rats Based on OTULIN-regulated Neuroinflammation
Shuran LI ; Xinwei WANG ; Jing SUN ; Dan XIE ; Ronghua ZHAO ; Lei BAO ; Zihan GENG ; Qiyue SUN ; Jingsheng ZHANG ; Yaxin WANG ; Xihe CUI ; Xinying LI ; Bing HAN ; Tianjiao LU ; Xiaolan CUI ; Liying LIU ; Shanshan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):21-28
ObjectiveThis paper aims to verify the therapeutic effect of Cranial Painkiller pills' extract powder prepared by the new process on the rat's trigeminal neuralgia model caused by infraorbital injection of Talci Pulvis, evaluate its potential clinical application value, and compare the therapeutic effect with that of Cranial Painkiller granules, so as to provide data support for the application of the Cranial Painkiller pills' extract powder and precise treatment. MethodsThe rat's trigeminal neuralgia model was constructed by infraorbital injection of Talci Pulvis, and the rats were randomly divided into the normal group, model group, carbamazepine group (60 mg·kg-1), Cranial Painkiller granules group (2.70 g·kg-1), and low, medium, and high dosage groups of Cranial Painkiller pills' extract powder (1.35, 2.70, 5.40 g·kg-1) according to the basal mechanical pain thresholds, and there were 10 rats in each group. The drug was administered by gavage to each group 2 h after modeling, and distilled water was given by gavage to the normal and model groups under the same conditions once a day for 10 d. Von Frey brushes were used to measure mechanical pain thresholds in rats. Hematoxylin-eosin (HE) staining was used to detect pathological changes in the trigeminal ganglion, and enzyme-linked immunosorbent assay (ELISA) was used to detect the inflammatory factors interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) levels in rat serum, as well as neuropeptide substance P (SP) and β-endorphin (β-EP) levels in rat brain tissue. Western blot technique was used to detect the levels of NLRP3, ASC, Caspase-1, and OTULIN proteins in rat brain tissue. ResultsCompared with the normal group, the pain threshold of rats in the model group showed a continuous significant decrease (P<0.01). The pathological damage of brain tissue was significant (P<0.01), and the inflammatory levels of IL-1, IL-6, IL-8, and TNF-α in serum were significantly elevated (P<0.01). The level of the SP in the brain tissue was significantly elevated (P<0.01), and the level of β-EP was significantly reduced (P<0.01), while the level of OTULIN was significantly reduced, and NLRP3, ASC, and Caspase-1 protein levels were significantly elevated (P<0.01). After administration of the drug, compared with the model group, the pain threshold of each dose group of the Cranial Painkiller pills' extract powder and the Cranial Painkiller granules group significantly increased (P<0.01). The inflammatory levels of IL-1, IL-6, IL-8, and TNF-α and SP levels significantly decreased (P<0.01), and the β-EP levels were significantly elevated (P<0.01), while the levels of OTULIN protein were significantly elevated (P<0.05, P<0.01), and the levels of NLRP3, ASC proteins were decreased (P<0.01)in high dose Cranial Painkiller pills' extract powder. Meanwhile, compared with those in the model group, the trigeminal ganglion lesions of rats in the Cranial Painkiller pills' extract powder and Cranial Painkiller granules groups showed different degrees of improvement (P<0.05, P<0.01). ConclusionThe Cranial Painkiller pills' extract powder has significant therapeutic effects on the rat model of trigeminal neuralgia induced by infraorbital injection of Talci Pulvis, and its mechanism is related to the improvement of OTULIN-regulated neuroinflammation.

Result Analysis
Print
Save
E-mail