1.Exploring the Generation and Academic Significance of the Nineteen New Pathogenic Factors Based on Zhou Zhongying's Ac-ademic Idea of"Identifying the Core Pathogenesis"
Ke LIU ; Pengfei XIE ; Huifang GUAN ; Qingwei LI ; Xiuyang LI ; Xiaotong YU ; Xiaolin TONG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):1-5
This article explores the application of Professor Zhou Zhongying's"focus on the core pathogenesis"concept in the con-text of epidemic hemorrhagic fever and examines how Academician Tong Xiaolin has inherited and developed Professor Zhou's experi-ences.Influenced by Professor Zhou Zhongying's academic thoughts and considering the contemporary context,Academician Tong Xia-olin,drawing on years of clinical experience,has proposed a new set of Nineteen Pathogenic Factors.Building upon the foundation of the Nineteen Pathogenic Factors in the The Yellow Emperor's Inner Classic,this new framework enriches and expands the understanding of disease location,etiology and pathogenesis,disease classification,and pays attention to a comprehensive understanding of diseases.It emphasizes that the process of seeking the underlying mechanisms should be approached from three aspects:dynamic,state,and condition,rather than solely focusing on the immediate clinical manifestations.This comprehensive approach to understand-ing disease development offers a fresh perspective and contributes to the application of traditional Chinese Medicine in the diagnosis and treatment of modern diseases.
2.Syndromes and Treatment of Shang Qi from Essentials from the Golden Cabinet
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):6-12
The term"shang qi"first appeared in The Yellow Emperor's Inner Classic,and Essentials from the Golden Cabinet made a systematic discussion on the syndromes and treatment of"shang qi",but later generations of physicians did not have a deep and uni-fied understanding of the meaning of"shang qi".By combining the relevant provisions of The Yellow Emperor's Inner Classic and Essen-tials from the Golden Cabinet,referring to medical texts and combining with clinical reality,the author believes that the"shang gi"in Essentials from the Golden Cabinet has dual meanings of disease name and syndrome.As a disease,it is a symptom of"qi rush"that occurs in the lungs,often causing cough or accompanying cough and wheezing.The pathogenesis of"shang qi"can be divided into cold,heat,deficiency and excess.Essentials from the Golden Cabinet focuses on the differentiation and treatment of the four syndromes of"shang gi":cold fluid stagnation of the lungs,fluid heat stagnation of the lungs,deficiency heat invasion of the lungs,and phlegm turbidity obstruction of the lungs,attaching importance to both the pathogenesis and the correspondence between medication and syn-drome.Therefore,the understanding of the treatment of classic prescriptions should be based on syndrome differentiation and mutual reference between formulas and syndromes,in order to integrate the principles,methods,and medicines of classic prescriptions.
3.Analysis of the System Construction and Differentiation and Treatment Model of"Common Medicines for Various Diseases"
Wenda JI ; Jun MA ; Zheng XIAO ; Min BAI ; Xiaoyi YANG ; Yingcun LI
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):13-17
The"common medicines for various diseases"in the preface of Collective Commentaries on the Classic of Materia Medica has been highly praised by medical practitioners for its unique"disease-medicine"outline and clinical practicality,and has continued to be included and developed in later works on materia medica and prescriptions,laying the foundation for the research and develop-ment of"specialized prescriptions for specialized diseases"and"specialized medicines for specialized diseases".Tao Hongjing used"the root of major diseases"in Shen Nong's Classic of the Materia Medica as the basic framework,referred to the prescriptions and med-icines in Treatise on Cold Damage and Miscellaneous Diseases,and expanded his own and other medical experience to create the"com-mon medicines for various diseases"system,relating and summarizing the representative diseases and main therapeutic effects of medi-cines,and creating a"disease-medicine"outline system.The construction of the"common medicines for various diseases"system has opened up the precedent of"specialized prescriptions for specialized diseases"and"specialized medicines for specialized diseases",providing new prescription ideas for clinical differentiation and treatment.
4.Simulation Study on Color Matching of Traditional Chinese Medicine Compound Placebo Based on Neural Network Optimi-zation Model
Hang LI ; Shengqiang LI ; Enli ZHOU ; Tuanjie WANG ; Chenfeng ZHANG ; Xin ZHANG ; Wei XIAO ; Zhenzhong WANG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):18-25
OBJECTIVE To predict the amount of colorants used in the preparation of placebo of Chinese medicine by construc-ting particle swarm optimization-back propagation neural network PSO-BPNN compound granules,and to provide a new idea for the simulation of placebo color of Chinese medicine compound granules.METHODS The BP neural network was used to establish the model of sample color parameters L,a?,b?and pigment mass fraction.The global search ability of particle swarm optimization algo-rithm was used to optimize the weight and bias of BP neural network to prevent the local minimum value of the model.The linear reduc-tion weight coefficient method and the introduction of mutation operator were used to improve the global optimization ability of particle swarm optimization algorithm.The color comprehensive evaluation index(ΔE)was used as the objective evaluation standard to verify the test results.RESULTS The training results show that the fitting accuracy of the improved PSO-BP neural network was up to 98.31%.The prediction results show that the prediction error of the improved PSO-BP neural network was the smallest,and the mean absolute percentage error(MAPE),root mean square error(RMSE)and mean color difference(ΔE)were 0.411 5,2.164 6 and 2.56,respectively.The verification samples of three kinds of particles were prepared for verification.The ΔE of the verification sample and the model drug were 1.73,2.63 and 4.11,respectively.The color difference between the two groups and the model drug was small by visual evaluation.CONCLUSION The BP neural network based on the improved particle swarm optimization algorithm can simulate the prediction of the amount of colorants used in the preparation of Chinese medicine compound granules,and can be used as a recommended optimization model for placebo color matching research.
5.Study on the Effect of Moslae Herba Oil on the Percutaneous Absorption of Active Ingredient of Evodia Rutaecarpa in vitro
Qiujuan LI ; Yafang LIANG ; Juan SHU ; Congling JIA ; Chanchan LIU ; Qinan WU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):26-36
OBJECTIVE To investigate whether Moslae herba oil has penetration enhancing effect on the active components of Evodia rutaecarpa and its ability to promote transdermal absorption.METHODS In vitro transdermal experiments were performed u-sing the diffusion pool and the isolated skin of rats.Using various components of Evodia rutaecarpa as indicators,HPLC was deter-mined to calculate the umulative penetration amount of each component.Changes in the skin and cuticle layers were observed by HE staining,immunohistochemical staining,and ATR-FTIR.GC-MS was used to measure Moslae herba oil components after administration.RESULTS Moslae herba oil showed the penetration-enhancing effect on various components in Evodia rutaecarpa.Compared with the postive drug nitrogenone,the cumulative penetration amounts of hyperoside,evodiamine and rutae-carpine were greater.In addition,the sesquiterpene composition and thymol in the Moslae herba oil were more likely to be stored in the skin,which could disturb the lipid structure of the cuticle layer and promote the penetration of drugs.CONCLUSION The results provide reference for the selection of transdermal absorption agent.
6.Characteristic Chromatogram and Index Component Contents of Substance Benchmark of Classic Formula Qingwei Power
Jienan CAO ; Si LI ; Hua SHENG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):37-46
OBJECTIVE To establish an HPLC characteristic spectrum and content determination method for the reference mate-rial of the classic formula Qingwei Powder,and control its quality to ensure subsequent preparation.METHODS Following ancient books and combining with the investigation of the previous preparation process,15 batches of Qingwei Powder material standards were prepared.HPLC was used to establish the material standard feature map,and the similarity was calculated using the Chinese medicine chromatographic fingerprint similarity evaluation system(2012 version);seven indicator components from five medicinal herbs were used as the reference content determination indicators for Qingwei Powder,and an HPLC content determination method was established for 15 batches of samples.RESULTS The similarity of the characteristic spectra was≥0.975;13 common peaks were calibrated;and 7 common peaks were identified for chemical composition,including catalpol(peak 1),ferulic acid(peak 5),isoferulic acid(peak 6),berberine hydrochloride(peak 7),palmatine hydrochloride(peak 8),paeonol(peak 12),and ligustilide(peak 13).Two sets of indicator component content determination methods have been established.Firstly,the contents of catalpol,ferulic acid,isoferulic acid,and paeonol were determined,and the four component contents were specified to be 1.48-2.76、0.14-0.26、0.48-0.90、1.72-3.19 mg·g-1,respectively;secondly,the contents of coptisine hydrochloride,palmatine hydrochloride,and ber-berine hydrochloride was determined,and it was specified that the content of the three components should be 0.65-1.21、0.57-1.07、1.86-3.45 mg·g-1,respectively.CONCLUSION A quality control method for the reference material of Qingwei Powder has been established through the characteristic spectrum and content determination method.This method is simple and reliable,providing a basis and foundation for subsequent quality control and formulation development.
7.Research on Water Extraction Process of Flos Lonicerae-Fructus Forsythuae Based on Network Pharmacology and Design Space
Ting CUI ; Meizhou LI ; Lifan GAN ; Jiaming LIN ; Lijin LIANG ; Xingpeng HUANG ; Zhipeng ZHANG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):47-60
OBJECTIVE To optimize the water extraction process of Flos Lonicerae-Fructus Forsythuae and determine the range of water extraction process parameters.METHODS The active components were screened by network pharmacology,and the indica-tor ingredients were determined in combination with the quality markers under the relevant terms of Chinese Pharmacopoeia 2020 edition and the literature.Take extraction yield and the extraction rate of the indicative component as the critical quality attributes of the water extraction process to screen critical process parameters.The mathematical model was established by Box-Behnken experimental design to investigate the interaction between CQAs and CPPs and build the design space of the water extraction process of Flos Lonicerae-Fruc-tus Forsythuae.RESULTS The extraction percentages of phenolic acids,forsythoside A and forsythin were screened as the index components;specifications of medicinal slices,extraction time and water addition were the key process parameters.Based on the estab-lishment and optimization of the design space,the optimum water extraction process was obtained as follows:the medicinal slice of Lian-Qiao was broken into 0.8-1.2 cm,adding 12 times the amount of water in the first and extract for 30-50 min,10 times the a-mount of water in the second and extract for 25-30 min.CONCLUSION The verification results show that the measured value ob-tained by using the design space method to optimize the water extraction process is close to the predicted value,indicating that the method is stable and reliable,which can provide ideas for its further process development and quality control for the couple medicines of Flos Lonicerae-Fructus Forsythuae.
8.Effects of Tuoli Xiaodusan on Ischemia-Reperfusion Injury of Rat Skin Flaps by Regulating NF-κB Signaling Pathway
Hao CHEN ; Tianqi ZHANG ; Xiao MA ; Qiuyue FU ; Shan ZHANG ; Su YAN ; Gang CHEN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):61-67
OBJECTIVE To explore the effect of Tuoli Xiaodusan(MDX)on ischemia-reperfusion injury of rat skin flaps and its potential mechanism.METHODS Rats were randomly divided into sham operation group(Sham group),Model group,MDX high-dose group(MDX-H group)and MDX low-dose group(MDX-L group),with 10 rats in each group.After the rat back skin flap model was successfully constructed,the drug was administered by gavage immediately,once a day for 14 consecutive days.The changes of rat skin flaps in each group after surgery were observed,and the survival rate of rat skin flaps in each group was measured on the 14th day after surgery;the histopathological changes of rat skin flaps were observed by HE staining;the protein expression of p-p65 and p-IκBα in the rat skin flap tissue was detected by Western blot;ELISA method was used to detect the expression of TNF-α,IL-1β,and IL-6 cytokines;Ki67 and CD31 immunohistochemical staining were used to observe epidermal basal layer cell prolifera-tion and vascular regeneration.RESULTS Compared with Model group,MDX-H group and MDX-L group had a small amount of e-dema and inflammatory fluid exudation after surgery,and the scab removal time was advanced;the ischemic necrosis of the skin flap was significantly improved,the area of skin flap necrosis was significantly decreased,and the survival rate of rat skin flaps was signifi-cantly increased(P<0.01).In addition,MDX could significantly improve the pathological morphology of ischemia-reperfusion injury in rat back skin flaps,reduce the expression of p-p65 and p-IκBα proteins(P<0.001),and decrease the levels of TNF-α,IL-1β,IL-6 inflammatory factor levels(P<0.05,P<0.01,P<0.001,P<0.000 1).The differences in Ki67 and CD31 also suggested that treatment with MDX accelerate re-epithelialization and blood vessel formation after ischemic flap injury.CONCLUSION MDX plays a role in improving ischemia-reperfusion injury of skin flaps by regulating the NF-κB signaling pathway and accelerating epithelializa-tion and angiogenesis.
9.Research on the Protective Effects and Mechanisms of Cycloartenol,the Effective Component of Pinellia Ternata,on Myo-cardial Ischemia-Reperfusion Injury in Mice
Yating LIANG ; Yaning JIANG ; Yongning SUN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):68-77
OBJECTIVE To explore the effects and mechanisms of cycloartenol on myocardial ischemia-reperfusion injury in mice.METHODS In vitro experiments,primary cardiomyocytes were extracted from 1-3 days SD mice.The hypoxia/reoxygenation model was established by incubating cells in a hypoxic culture box for 3 hours followed by reoxygenation in a normal culture box for 3 hours.The primary cardiomyocytes were divided into Control group,H/R group,low-dose(3 μmol·L-1)and high-dose(10 μmol·L-1)cycloartenol groups,and SB203580 group.CCK-8 was used to detect cell viability,the apoptosis rate was detected by flow cytometry,and Western blot was used to detect the expression levels of p38 MAPK and p-p38 MAPK in each group.In an in vi-vo experiment,7-week-old male C57BL/6J mice were randomly divided into a Control group,an I/R group,and three doses of cyclo-artenol(0.2,0.5,1.0 mg·kg-1)groups.The mice were continuously administered for seven days before the surgery.The model was prepared by ligation of the left anterior descending coronary artery(LAD)for 30 minutes,followed by reperfusion for 24 hours to in-duce myocardial ischemia-reperfusion injury.Left ventricular ejection fraction(LVEF),cardiac output(CO),left ventricular fractional shortening(LVFS)of each group of mice were detected by small animal ultrasound.TTC staining was used to detect the changes of is-chemic infarct size in each group.The changes of myocardial tissue in each group were observed by HE staining.The expression levels of p38 MAPK,p-p38 MAPK,IL-6 and TNF-α in myocardial tissue of mice were detected by Western blot.Serum levels of creatine ki-nase isoenzyme(CK-MB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI),interleukin-6(IL-6),and tumor necrosis fac-tor-α(TNF-α)were measured using ELISA kits.RESULTS In vitro experiments demonstrated that compared with the H/R group,both the cycloartenol and SB203580 pretreatment groups showed a significant increase in myocardial cell viability and the apoptosis rate decrease,which can downregulate the protein expression level of p-p38 MAPK and decrease the ratio of p-p38 MAPK/p38 MAPK(P<0.05).In vivo experiments confirmed that compared with the I/R group,cycloartenol pretreatment significantly improved LVEF,LVFS,and CO values(P<0.05),reduce myocardial ischemic infarct size,thereby enhancing myocardial function.The protein ex-pression level of p-p38 MAPK in myocardial tissue was down-regulated,the ratio of p-p38 MAPK/p38 MAPK was decreased,and the expression levels of IL-6 and TNF-α were decreased.Additionally,cycloartenol pretreatment reduced the levels of CK-MB,LDH,cT-nI,IL-6,and TNF-α in mouse serum(P<0.05).CONCLUSION Pre-treatment with cycloartenol can protect mouse cardiac func-tion and alleviate myocardial ischemia-reperfusion injury.Its mechanism of action may be related to the inhibition of p38 MAPK phos-phorylation,reducing inflammatory reactions.
10.A Randomized Double-Blind Controlled Clinical Study of Bushen Yuyin Tiaochong Decoction in the Treatment of Diminished Ovarian Reserve Infertility with Kidney-Yin Deficiency
Ling XU ; Xuemei PENG ; Lei DENG ; Jianju HU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(1):78-82
OBJECTIVE To evaluate the clinical effect of Bushen Yuyin Tiaochong Decoction in the treatment of diminished o-varian reserve(DOR)infertility with kidney-yin deficiency.METHODS 60 DOR infertility patients with kidney-yin deficiency from the gynecology outpatient department of the Second Affiliated Hospital of Jiangxi University of Chinese Medicine from October 2020 to April 2023 were selected and divided into the placebo group and the kidney-tonifying group using the random number table method,with 30 cases in each group.Patients in both groups were given oral treatment with dehydroepiandrosterone(DHEA).The placebo group was additionally given placebo.The Bushen Yuyin group was additionally given Bushen Yuyin Tiaochong Decoction.The treat-ment course for both groups was 3 months.Changes in TCM syndrome scores and reproductive life quality scores were observed before and after treatment.Changes in serum follicle-stimulating hormone(FSH),anti-Mullerian hormone(AMH)and estradiol(E2)levels in patients were detected by ELISA.The occurrence of adverse reactions during treatment was observed,and the pregnancy rates of the two groups of patients after treatment were recorded.RESULTS After treatment,the total TCM syndrome scores of patients in the Bushen Yuyin group were significantly reduced(P<0.01),which was better than that of the placebo group(P<0.01);the reproduc-tive life quality scores of patients in both groups were significantly increased(P<0.05,P<0.01),the Bushen Yuyin group was better than the placebo group(P<0.05);the number of AFC in the Bushen Yuyin group was significantly increased(P<0.01),which was better than the control group(P<0.01);the serum AMH levels of patients in both groups were significantly increased(P<0.05,P<0.01),and the Bushen Yuyin group was higher than that of the placebo group(P<0.01);the serum E2 level of patients in both groups was significantly decreased(P<0.05,P<0.01),the Bushen Yuyin group was lower than the placebo group(P<0.01);the serum FSH level of patients in Bushen Yuyin group was significantly decreased(P<0.01),which was better than that of the placebo group(P<0.01);the total pregnancy rate of the Bushen Yuyin group was better than that of the placebo group(P<0.05);no significant ad-verse reactions were observed in both groups during the treatment period.CONCLUSION Bushen Yuyin Tiaochong Decoction can significantly improve the pregnancy rate of DOR infertile patients,enhance ovarian function while reducing TCM syndrome scores,im-prove the quality of reproductive life,and is highly safe.

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