This article systematically reviews and verifies the medicinal materials of Dioscoreae Hypoglaucae Rhizoma（DHR）， Dioscoreae Spongiosae Rhizoma（DSR）， Smilacis Chinae Rhizoma（SCR） and Smilacis Glabrae Rhizoma（SGR） from the aspects of name， origin， producing area， quality， harvesting， processing and efficacy by consulting historical literature， in order to provide reference for the development and utilization of famous classical formulas containing the four medicinal materials. DHR， DSR， SCR and SGR have a long history of application as medicinal materials. However， due to their similar growth environment and medicinal properties， as well as their functions of promoting dampness， dispelling wind and removing numbness， there have been instances of homonymous foreign objects and homonymous synonyms throughout history， resulting in confusion of the origin. Therefore， it is necessary to conduct comparative analysis and systematic research for clarifying the historical development and changes of the four， in order to provide a basis for safe and effective medication. According to research， Bixie was first recorded in Shennong Bencaojing and has been historically known as Baizhi， Chijie， Zhumu， and other aliases. From ancient times to the mid-20th century， there has always been a situation where the rhizomes of Dioscorea plants and Smilax plants， and even the rhizomes of Heterosmilax plants， were mixed together to be used as medicinal herbs for Bixie. However， since the Tang dynasty， it has been clearly advocated that the rhizomes of Dioscorea plants have excellent quality and have been the mainstream throughout history. The 2020 edition of Chinese Pharmacopoeia categorized it into two types of medicinal herbs（DHR and DSR）. Among them， the origin of DHR is the dry rhizomes of Dioscorea hypoglauca， and the origins of DSR are the dry rhizomes of D. spongiosa and D. futschauensis. In ancient times， due to different types， the corresponding production areas of DHR and DSR were also different. Nowadays， They are mainly produced in the southern region of the Yangtze River. Since the Tang dynasty， the quality of Bixie has been characterized by its white color and soft nature. In modern times， it has been summarized that those with white color， large and thin pieces， powdery texture， tough and elastic texture， and neat and unbreakable are the best. The harvesting times of DHR and DSR are in spring or autumn， with the best quality harvested in autumn. The mainstream processing methods of them are slicing and then using the raw products or wine-processed products. SCR was first recorded in Mingyi Bielu and has been known as Jinganggen， Tielingjiao， Tieshuazi， and other aliases in history. The mainstream source is the dry rhizomes of Smilax china in the past dynasties， with the best quality being those that are tough and rich in powder. The harvesting time is from the late autumn to the following spring， and the main processing method throughout history has been slicing for raw use. SGR was first recorded under the item of Yuyuliang in Variorum of Shennong's Classic of Materia Medica. It was listed as an independent medicinal material from Bencao Gangmu. In history， there were such aliases as Cao Yuyuliang， Lengfantuan， Xianyiliang， Tubixie， etc. The main source of the past dynasties was dry rhizomes of S. glabra. In history， there have also been instances of multiple plants belonging to the same genus， and even cases of mixing the rhizomes of plants in the genus Heterosmilax. It is mainly produced in Guangdong， Hunan， Hubei， Zhejiang， Sichuan， Anhui and other regions， its quality has been summarized as large in size， powdery in texture， with few veins， and light brown in cross-section since modern times. The harvesting time is in spring or autumn， and the main processing method throughout history has been slicing for raw use. DHR， DSR， SCR and SGR all have the effects of promoting dampness， dispelling wind， relieving rheumatism and detoxifying. However， their detoxification abilities are ranked as follows：SGR>SCR>Bixie（DHR and DSR）. Especially for the treatment of limb spasms， arthralgia and myalgia， scrofula， and scabies caused by syphilis and mercury poisoning， SGR has a unique effect. Based on the research results， DHR is recommended to develop the famous classical formulas containing Bixie as the first choice for medicinal herbs. It should be harvested in autumn， sliced thinly while fresh， and processed according to the requirements of the famous classical formulas， without any requirements for raw use. Selecting the rhizomes of S. china， harvested in late autumn， and thinly sliced while fresh. If there are no special processing requirements in the formulas， use it raw. Selecting the rhizomes of S. glabra， it is harvested in autumn and thinly sliced while fresh. If there are no special processing requirements in the formulas， raw products can be used.

ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis （AE） model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group，model group，single Puerariae Lobatae Radix group，non-Puerariae Lobatae Radix group，regular dose Gegen Qinliantang group （regular dose group），half-dose Puerariae Lobatae Radix group，and doubled-dose Puerariae Lobatae Radix group， with 16 mice in each group. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 （a protein in the tight junction） and Occludin in the colon tissue， as well as the changes of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. ResultsCompared with the blank group，the DAI scores of the mice in the model group were significantly higher （P<0.05），and the histopathological sections of their colon tissues showed mucosal damage，glandular atrophy，disordered arrangement，and a large number of inflammatory cells infiltration，and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated （P<0.05，P<0.01）. The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated （P<0.05，P<0.01）. Compared with the model group，the DAI scores of mice in all dosing groups decreased significantly （P<0.05），with the most significant effect in the regular dose group. After 7 d of drug administration，the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α （P<0.05） and significantly up-regulated the expression of ZO-1 protein （P<0.05）. The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein （P<0.01），and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration，the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α （P<0.01）. Meanwhile，the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein （P<0.01）. The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein （P<0.05） and up-regulated ZO-1 protein expression （P<0.05）. ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue， protect the barrier function and structure of intestinal epithelial cells， and reduce the expression of inflammatory factors， so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents， Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.

ObjectiveTo investigate whether there are differences in the efficacy of Gegen Qinliantang with different contents of Puerariae Lobatae Radix on the acute enteritis （AE） model mice and provide a scientific basis for the interpretation of Gegen Qinliantang in the treatment of "Xie Re Li". MethodsA total of 112 male BALB/c mice were randomly divided into a blank group，model group，single Puerariae Lobatae Radix group，non-Puerariae Lobatae Radix group，regular dose Gegen Qinliantang group （regular dose group），half-dose Puerariae Lobatae Radix group，and doubled-dose Puerariae Lobatae Radix group， with 16 mice in each group. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of the colon tissue. Western blot was employed to detect the expression of ZO-1 （a protein in the tight junction） and Occludin in the colon tissue， as well as the changes of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）. ResultsCompared with the blank group，the DAI scores of the mice in the model group were significantly higher （P<0.05），and the histopathological sections of their colon tissues showed mucosal damage，glandular atrophy，disordered arrangement，and a large number of inflammatory cells infiltration，and the expression of ZO-1 and Occludin proteins in their colon tissues was significantly down-regulated （P<0.05，P<0.01）. The expression of inflammatory factors TNF-α and IL-1β was significantly up-regulated （P<0.05，P<0.01）. Compared with the model group，the DAI scores of mice in all dosing groups decreased significantly （P<0.05），with the most significant effect in the regular dose group. After 7 d of drug administration，the regular dose group had the best impact on the repair of colonic mucosa in the AE mouse model. The regular dose group significantly down-regulated the expression of TNF-α （P<0.05） and significantly up-regulated the expression of ZO-1 protein （P<0.05）. The doubled-dose Puerariae Lobatae Radix group significantly down-regulated the expression of IL-1β protein （P<0.01），and there was no significant difference between all dosing groups and the model group in terms of the expression of Occludin protein. After 14 d of drug administration，the best effect on the repair of colonic mucosa in the AE mouse model was observed in the doubled dose Puerariae Lobatae Radix group. All groups except the non-Puerariae Lobatae Radix group significantly down-regulated the expression of TNF-α （P<0.01）. Meanwhile，the regular dose group and doubled-dose Puerariae Lobatae Radix group significantly elevated the expression level of Occludin protein （P<0.01）. The doubled-dose Puerariae Lobatae Radix group also significantly inhibited the expression of IL-1β protein （P<0.05） and up-regulated ZO-1 protein expression （P<0.05）. ConclusionGegen Qinliantang can reduce the pathological damage of colon tissue， protect the barrier function and structure of intestinal epithelial cells， and reduce the expression of inflammatory factors， so as to achieve the therapeutic effect of AE model mice. When comparing the therapeutic efficacy of Gegen Qinliantang containing different Gegen contents， Gegen Qinliantang with the proportion of the original formula of Zhongjing was the most effective in AE model mice.

Objective:To investigate the role and mechanisms of cellular FLICE-like inhibitory protein (cFLIP) in mediating oxidative stress induced by myocardial ischemia-reperfusion injury (MI/RI) in rats.Methods:Forty-eight male Sprague-Dawley rats with body weight of 180-200 g, were randomly divided into 4 groups ( n=12 per group) using a random number table: sham operation group (sham group), ischemia-reperfusion group (I/R group), virus control group (I/R+Ad-NC group), and cFLIPL-overexpressing group (I/R+Ad-cFLIPL group). A myocardial ischemia-reperfusion injury (MI/RI) model was established by ligating the left anterior descending coronary artery for 30 min followed by 3 h of reperfusion. The left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) in rats were evaluated via echocardiography, and a biochemical analyzer was used to measure the serum lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MB) levels to evaluate the extent of myocardial injury. The 2,3,5- triphenyl tetrazolium chloride (TTC) staining method was used to detect the infarct area of the rat myocardium, and hematoxylin and eosin (HE) staining was performed to observe the morphology of the rat myocardial tissue. Commercial kits were used to measure the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and malondialdehyde (MDA). Dihydroethidium (DHE) staining was used to assess the number of reactive oxygen species (ROS)-positive cells in the myocardial tissue. Western blot analysis was performed to evaluate the protein expression of cFLIPL, Nrf2, and HO-1. Results:During MI/RI, compared with the sham group, the protein expression of cFLIPL was significantly decreased in the I/R group, and compared with the I/R+Ad-NC group, the protein expression of cFLIPL was significantly increased in the I/R+Ad-cFLIPL group (both P<0.05). Compared with sham group, the level of LDH, CK-MB, MDA, ROS-positive cell count, and myocardial infarct size were significantly increased, whereas the LVEF, LVFS, SOD, and GSH-px were significantly decreased in I/R group (all P<0.05). Compared to the I/R+Ad-NC group, the level of LDH, CK-MB, MDA, ROS-positive cell count, and myocardial infarct area were significantly decreased, whereas the LVEF, LVFS, SOD, and GSH-px were significantly increased in I/R+Ad-cFLIPL group (all P<0.05). Western blot revealed that compared with the sham group, the protein expression of Nrf2 and HO-1 in I/R group were significantly increased, and compared with the I/R+Ad-NC group, the protein expression of Nrf2 and HO-1 in the I/R + Ad-cFLIPL group were significantly increased (all P<0.05). Conclusion:Overexpression of cFLIPL can alleviate myocardial ischemia-reperfusion injury (MI/RI) in rats by activating the Nrf2/HO-1 signaling pathway to inhibit oxidative stress.

Background: Salvia miltiorrhiza Bunge, commonly known as “Danshen” in China due to the distinctive red color of its roots, is one of the most widely used traditional Chinese medicines. It is cultivated in various regions across China, and environmental differences among these regions can affect the secondary metabolites of plants, thereby influencing the quality of S. miltiorrhiza. In recent years, increasing demand for S. miltiorrhiza has exacerbated the problem of origin fraud. Therefore, ensuring the authenticity of its geographical origin is crucial for the sustainable development of the industry. Objective: The red coloration of S. miltiorrhiza is closely associated with the content of its primary active compounds, particularly tanshinones. Therefore, both its internal chemical composition and external color characteristics serve as key indicators for quality assessment. This study utilized hyperspectral imaging technology to evaluate its potential in classifying the geographical origin of S. miltiorrhiza. Methods: Spectral data reflecting the internal chemical properties of S. miltiorrhiza were integrated with color information representing its external features through 3 levels of data fusion. These fused datasets were then combined with deep learning algorithms to achieve accurate origin classification. Results: The results demonstrated that the Transformer model combined with soft-voting decision-level fusion achieved the highest classification accuracy of 98.72% by integrating image color and short-wave infrared spectral data. Conclusion: This study demonstrates that integrating hyperspectral imaging spectral data with color information provides a reliable and innovative approach for verifying the authenticity and traceability of S. miltiorrhiza.

Objective To explore the characteristics of high-frequency users of pediatric telemedicine outpatient services and analyze the factors influencing the frequency of use,providing theoretical support for the promotion and broader application of pediatric telemedicine outpatient services.Methods 197 parents of patients were randomly selected for telephone questionnaire survey by cross-sectional research method,and were divided into high frequency and low frequency users according to their frequency of use.Based on annual usage frequency,participants were divided into high-frequency and low-frequency groups.Mann-Whitney U test and x2 test or Fisher exact probability method were used for univariate analysis,and multiple logistic regression model was used to analyze the independent influencing fac-tors of the difference in the frequency of pediatric outpatient telemedicine use.Results A total of 165 questionnaires were completed.Among high-frequency users,the proportion of provinces outside Beijing was higher than that of low-frequency users,the overall knowledge level of information was better than that of low-frequency users,the overall satisfaction evaluation was better than that of low-frequency users,and the proportion of gastroenterology pa-tients was higher than that of low-frequency users.Conclusion Pediatric medical institutions need to strengthen the pub-licity of the platform,improve service quality,improve user experience by optimizing technical means,further pro-mote Internet outpatient services,and expand its application potential in children's health management.

OBJECTIVE: To observe the clinical efficacy and safety of acupuncture combined with blade needle therapy for knee osteoarthritis (KOA). METHODS: A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. The control group received acupuncture at Neixiyan (EX-LE4)，Dubi (ST35), Yinlingquan (SP9), Liangqiu (ST34), Xuehai (SP10), Yanglingquan (GB34) and Zusanli (ST36) on the affected side, once every other day, 3 times a week. The observation group received blade needle therapy on the basis of the treatment in the control group, once every 3 days, 2 times a week. Both groups were treated for 4 weeks. Before treatment, after 2, 4 weeks of treatment, and after 1 month of treatment completion (in follow-up), the scores of pain visual analogue scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Lequesne index were observed in the two groups, and the clinical efficacy and safety were evaluated. RESULTS: After 2, 4 weeks of treatment and in follow-up, the pain VAS scores, Lequesne index scores, and pain, stiffness, function scores of WOMAC in both groups were decreased compared with those before treatment (P<0.05), and the VAS scores, Lequesne index scores and pain, function scores of WOMAC in the observation group were lower than those in the control group (P<0.05). The effective response rate in the observation group was 76.7% (23/30), while that in the control group was 70.0% (21/30), there was no statistically significant difference in the effective response rates between the two groups (P>0.05). No adverse reactions were observed in either group. CONCLUSION Acupuncture combined with blade needle therapy could alleviate pain and promote functional recovery in KOA patients, and achieve long-lasting improvements.
Humans ; Osteoarthritis, Knee/physiopathology* ; Acupuncture Therapy/instrumentation* ; Male ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Needles ; Combined Modality Therapy

This paper aims to contribute to guaranteeing the stable development and enhancing the understanding of ecological agriculture of Chinese materia medica so that the national strategy and industrial demand can be better served. It first introduces current traditional Chinese medicine(TCM)policy and industrial development status from five aspects, including policy guarantee, theoretical support, technological innovation, standardization system, and brand influence. Then, the paper analyzes the development dilemma of TCM agriculture in production and quality increase and ecological environment protection. It also proposes the development goals of ecological agriculture of Chinese materia medica that meet the current industrial development demand, which are reducing chemical fertilizers, pesticides, and carbon emissions, improving quality, increasing efficiency, and protecting ecological environment. In addition, the new development goals are interpreted through case studies. Finally, this paper proposes four development strategies for ecological agriculture of Chinese materia medica: conducting research on the pattern and spatial and temporal variations of nationwide TCM production areas; studying the internal and external ecological memories of medicinal plant growth from the perspectives of genetic variations and environmental adaptation variations and elucidating their contributions to the formation of quality; carrying out selection and breeding of stress-resistant varieties for ecological agriculture of Chinese materia medica, the optimization of key technologies for soil improvement and restoration and green prevention and control against diseases and pests, and the improvement of quality; carrying out research on the quality assurance and value realization of ecological products made from TCM. This research can provide guidance for policy formulation, theoretical development of the discipline, and the enhancement of industrial technology for ecological agriculture of Chinese materia medica.
Agriculture/methods* ; China ; Drugs, Chinese Herbal ; Plants, Medicinal/chemistry* ; Ecosystem ; Materia Medica ; Medicine, Chinese Traditional

In this study, potential quality markers(Q-markers) of Schisandrae Chinensis Fructus for treating bronchial asthma were predicted based on analytic hierarchy process(AHP), entropy weight method(EWM), fingerprint, and network pharmacology. AHPEWM was employed to quantitatively identify the Q-markers of Schisandrae Chinensis Fructus. AHP was used to weight the primary indicators(effectiveness, measurability, and specificity), while EWM was employed to analyze the secondary indicators of each primer indicator. Further, through fingerprint combined with network pharmacology, a ″component-target-pathway″ network was constructed to screen the components of Schisandrae Chinensis Fructus for treating bronchial asthma. It was finally determined that schisandrol A,schisandrin A, and schisandrin B were potential Q-markers of Schisandrae Chinensis Fructus in the treatment of bronchial asthma. This study is the first to comprehensively use AHP-EWM, fingerprint, and network pharmacology to screen the key Q-markers of Schisandrae Chinensis Fructus in the treatment of bronchial asthma. This study provides a scientific basis for improving the quality standard of Schisandrae Chinensis Fructus and lays a foundation for studying its material basis in treating bronchial asthma.
Schisandra/chemistry* ; Asthma/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Network Pharmacology ; Humans ; Entropy ; Lignans/analysis* ; Fruit/chemistry* ; Quality Control ; Cyclooctanes ; Polycyclic Compounds/analysis*

We report a case involving an 85-year-old man who underwent laparoscopic radical prostatectomy for prostate cancer in 2011. During follow-up, he required long-term use of a penile clamp to manage urination due to permanent severe stress incontinence. In February 2023, he presented with a painless cystic mass in the scrotum. Upon pressing the mass with hand, fluid drained from the external urethral orifice, causing the mass to shrink in size, although it returned to its original size a few hours later. Urography and cystoscopy showed a globular urethral diverticulum located anteriorly. The patient underwent surgical excision of the diverticulum along with urethroplasty. Postoperatively, the urinary stress incontinence persisted, but he declined any further surgical intervention. An artificial urinary sphincter is currently the first-line treatment for male urinary incontinence. However, devices such as penile clamps can serve as an alternative when considering surgical suitability or cost. It is important to note that these devices can lead to serious complications such as urethral erosion, stricture, or diverticulum. Therefore, caution is advised when using such devices, and they should be removed periodically at short intervals.
Humans ; Male ; Diverticulum/surgery* ; Prostatectomy/adverse effects* ; Aged, 80 and over ; Urethral Diseases/surgery* ; Urinary Incontinence/surgery* ; Urinary Incontinence, Stress/surgery*