By reviewing the theory of the unyielding and the soft and analyzing the connotations of the three-her combination， this article has selected five representative three-herb combinations from Treatise on Febrile Disease （《伤寒论》） and deeply explored the combination rules of the medicinals with coordination between the unyielding and the soft. Xixin （Radix et Rhizoma Asari）， Ganjiang （Rhizoma Zingiberis） and Wuweizi （Fructus Schisandrae Chinensis） can open and close the lung qi， using the soft to balance the unyielding. The combination of Maziren （Fructus Cannabis）， Shaoyao （Radix Paeoniae Alba seu Rubra） and Dahuang （Radix et Rhizoma Rhei） embodies the principle of balancing the unyielding and the soft， enriching the spleen while draining the stomach. Fuzi （Radix Aconiti Lateralis Praeparata）， Fuling （Poria） and Shaoyao can warm the kidneys and soften the liver， rectify the healthy qi and promote urination. Huanglian （Rhizoma Coptidis）， Ejiao （Colla Corii Asini） and Jizihuang （Ovum Gallus） can clear the heart， enrich the kidneys， and restore the interaction between water and fire. Wumei （Fructus Mume）， Huanglian and Chuanjiao （Zanthoxylum bungeanum） control the unyielding with the soft， harmonizing and regulating jueyin （厥阴）. Through analyzing three-herb combinations， it is explained that the coordination between the unyielding and the soft is one of the key principles in the combination of medicinals of classical formulas， which offers insights into the interpretation of classic formulas and the clinical application of the theory of three-herb combination.

ObjectiveTo construct a large language model （LLM）-based intelligent pre-consultation system for traditional Chinese medicine （TCM） to improve efficacy of clinical practice. MethodsA TCM large language model was fine-tuned using DeepSpeed ZeRO-3 distributed training strategy based on YAYI 2-30B. A weighted undirected graph network was designed and an agent-based syndrome differentiation model was established based on relationship data extracted from TCM literature and clinical records. An agent collaboration framework was developed to integrate the TCM LLM with the syndrome differentiation model. Model performance was comprehensively evaluated by Loss function， BLEU-4， and ROUGE-L metrics， through which training convergence， text generation quality， and language understanding capability were assessed. Professional knowledge test sets were developed to evaluate system proficiency in TCM physician licensure content， TCM pharmacist licensure content， TCM symptom terminology recognition， and meridian identification. Clinical tests were conducted to compare the system with attending physicians in terms of diagnostic accuracy， consultation rounds， and consultation duration. ResultsAfter 100 000 iterations， the training loss value was gradually stabilized at about 0.7±0.08， indicating that the TCM-LLM has been trained and has good generalization ability. The TCM-LLM scored 0.38 in BLEU-4 and 0.62 in ROUGE-L， suggesting that its natural language processing ability meets the standard. We obtained 2715 symptom terms， 505 relationships between diseases and syndromes， 1011 relationships between diseases and main symptoms， and 1 303 600 relationships among different symptoms， and constructed the Agent of syndrome differentiation model. The accuracy rates in the simulated tests for TCM practitioners， licensed pharmacists of Chinese materia medica， recognition of TCM symptom terminology， and meridian recognition were 94.09%， 78.00%， 87.50%， and 68.80%， respectively. In clinical tests， the syndrome differentiation accuracy of the system reached 88.33%， with fewer consultation rounds and shorter consultation time compared to the attending physicians （P＜0.01）， suggesting that the system has a certain pre- consultation ability. ConclusionThe LLM-based intelligent TCM pre-diagnosis system could simulate diagnostic thinking of TCM physicians to a certain extent. After understanding the patients' natural language， it collects all the patient's symptom through guided questioning， thereby enhancing the diagnostic and treatment efficiency of physicians as well as the consultation experience of the patients.

Objective:To investigate the effect and mechanism of the gastric cancer cells-derived exosome miR-382-5p in-duced by Helicobacter pylori(H.pylori)on the autophagy and polarization of macrophages,providing new clues for further elucidating the carcinogenic mechanism of H.pylori.Methods:Ultracentrifugation and exosome extraction kit were used to extract the exosomes re-leased by the H.pylori stimulated group and the blank control group AGS cells cells,then transmission electron microscopy(TEM),nanoparticle tracking analysis(NTA)and Western blot were employed to identify exosomes.qRT-PCR was used to detect the expres-sion of miR-382-5p in H.pylori induced AGS-derived exosomes.miR-382-5p mimic was transfected into THP-1 macrophages,then the expressions of autophagy markers(LC3Ⅱ,p62,and Beclin-1)were evaluated by Western blot,the number of autophagosomes was detected by immunofluorescence.The expression levels of PTEN protein,downstream proteins PI3K,AKT,mTOR and its phosphory-lated proteins p-PI3K,p-AKT,p-mTOR were detected by Western blot.Flow cytometry was used to detect the expression levels of macrophage phenotypic molecules CD206 and HLA-DR.ELISA was used to detect the secretion of cytokines TNF-α,IL-6,IL-10 and Arginase1 in macrophage supernatants.Results:The extracted exosomes were consistent with exosome morphology and highly ex-pressed the surface marker proteins CD9,CD63 and TSG101.Compared with the blank control group,the expression level of exosom-al miR-382-5p in H.pylori-infected group was significantly increased.miR-382-5p mimic transfection resulted in decreased expression of LC3 Ⅱ and Beclin-1 in macrophages,increased expression of P62 and decreased number of autophagosomes.Moreover,the protein expression level of PTEN was significantly decreased in the miR-382-5p mimic transfection group,while the expression levels of p-PI3K,p-AKT and p-mTOR were significantly increased.miR-382-5p mimic transfection also resulted in increased expression of mac-rophage M2 type marker protein CD206 and decreased expression of M1 type marker protein HLA-DR,as well as increased expres-sions of IL-10 and Arginine1,whereas decreased expression of IL-6 and TNF-α.Pretreatment with the pathway inhibitor BEZ235 par-tially reverses the effects of miR-382-5p on macrophage autophagy and polarization.Conclusion:H.pylori-induced gastric cancer cells-derived exosomal miR-382-5p suppresses macrophage autophagy and induces M2 polarization through down-regulation of PTEN ex-pression and activation of the PI3K/AKT/mTOR signaling pathway.

Present study was focused on the chemical constituents of the stems and leaves of Salvia yunnanensis C . H. Wright and their anti-angiogeneic activities. The compounds were isolated by column chromatography over silica gel and Sephadex LH-20, and other isolation techniques. Their structures were elucidated on the basis of spectral analysis and chemical evidences. Their anti-angiogeneic activities were evaluated by the chicken chorioallantoic membrane (CAM) neovascularisation model. Seven compounds were separated and identified as ( + ) -spathulenol( 1), 5,7,4'-trihydroxyflavanone(2) , beta-amyrin(3), 3 beta-hydroxy-12-ursene(4), 2alpha,3 beta-dihydroxyursa-12-en-28-oic acid(5), ursolic acid (6) and 3-oxo-12-ursen-28-oic acid (7). Compounds 1, 2, 5 and 6 were obtained from this plant for the first time. Compounds 5 (an oleanane compound) and 6 (an ursane compound) could inhibit angiogenesis significantly in a dose-dependent manner.
Angiogenesis Inhibitors ; chemistry ; pharmacology ; Animals ; Chorioallantoic Membrane ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Salvia ; chemistry