1.Expert Consensus on Clinical Application of Pingxuan Capsules
Yuer HU ; Yanming XIE ; Yaming LIN ; Yuanqi ZHAO ; Yihuai ZOU ; Mingquan LI ; Xiaoming SHEN ; Wei PENG ; Changkuan FU ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):201-210
As a patented characteristic medicine of Yi ethnic minority, Pingxuan capsules have the effects of nourishing the liver and kidney, pacifying the liver, and subduing Yang. With the main indications of dizziness, headache, palpitations, tinnitus, insomnia, dreaminess, waist and knee soreness caused by liver-kidney deficiency and liver Yang upward disturbance, Pingxuan capsules are widely used in the treatment of posterior circulation ischemic vertigo, vestibular migraine, benign paroxysmal positional vertigo. However, the current knowledge is limited regarding the efficacy, syndrome differentiation, and safety of this medicine. On the basis of summarizing the experience of clinicians and the existing evidence, this study invites clinical experts of traditional Chinese and Western medicine, pharmaceutical experts, and methodological experts from relevant fields across China to conduct evidence-based evaluation of Pingxuan capsules. The evaluation follows the Specifications for the Development of Clinical Expert Consensus on Chinese Patent Medicines issued by the Standardization Office of the China Association of Chinese Medicine, and reaches 5 recommendations and 16 consensus suggestions. The consensus clarifies the clinical applications, efficacy, dose, course of treatment, combination of medicines, precautions, and contraindications of Pingxuan capsules in the treatment of vertigo and explains the safety of clinical application. This consensus is applicable to clinicians (traditional Chinese medicine, Western medicine, and integrated traditional Chinese and Western medicine) and pharmacists in tertiary hospitals, secondary hospitals, and community-level medical and health institutions across China, providing a reference for the rational use of Pingxuan capsules in the treatment of vertigo. It is hoped that the promotion of this consensus can facilitate the rational use of drugs in clinical practice, reduce the risk of drug use, and give full play to the advantages of Pingxuan capsules in the treatment of vertigo diseases. This consensus has been reviewed and published by the China Association of Chinese Medicine, with the number GS/CACM330-2023.
2.Current Situation, Problems and Countermeasures of Experimental Research on Traditional Chinese Medicine Regulating PI3K/Akt Signaling Pathway in Rats with Polycystic Ovary Syndrome
Pengxuan YAN ; Yiqing LIU ; Nanxing XIAN ; Linjing PENG ; Kun LI ; Jingchun ZHANG ; Yukun ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):259-266
Polycystic ovary syndrome(PCOS) and its resulting infertility is one of the common diseases of gynecology and reproductive endocrinology. The phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt) signaling pathway is relatively well-studied in the development of intervention in PCOS, and the experiments on PCOS in rats conducted by traditional Chinese medicine through this signaling pathway is also the main direction of mechanistic research. In this paper, 20 articles published in academic journals in the past 5 years were selected through the corresponding criteria, and the objective situation and existing problems of the selected research projects were analyzed from five aspects, namely, baseline data, modeling and treatment, grouping, evaluative indexes, and pharmacodynamic indexes. It is found that there were different degrees of problems in each research project, such as the observation indicators of modeling, criteria for judging the success of the model, the treatment period, the calculation of dosage of prescription/active ingredients and specific dosage were not clearly defined, which could easily lead the bias of the results or reduce the validity of experimental data. Based on this, the list of PCOS rat experimental research operations was formed, involving five categories of experimental rats, model construction, study implementation, outcome measures and analysis and report with a total of 21 operation lists, with a view to provide a reference for the subsequent PCOS experiments related to scientific research and helping to form high-quality results.
3.Advances in early diabetic neuroretinopathy
International Eye Science 2025;25(1):76-81
Diabetic retinopathy(DR)is a late-stage peripheral micro-neurovascular complication of chronic hyperglycemia, leading to blood-retinal barrier impairment and retinal dysfunction. Recent studies have found that diabetic neuroretinopathy(DN)may be one of the earliest events in diabetic retinal alterations. The main features include defective electroretinographic responses in newly diagnosed patients, early self-activation of microglia and Müller cells, reduced activity of neurotransmitters(e.g., DOPA/GABA), and early mitochondrial dysfunction, such as persistent Drp1-Fis1 fission and mtDNA methylation mismatches. Understanding the molecular basis of DN is essential for elucidating its pathogenesis and developing early treatments. This review summarizes pathological changes and mechanisms of retinal function, glial cells, neurotransmitters, mitochondria, and other factors in early diabetes mellitus, in order to provide a theoretical foundation for investigating early DN mechanisms and developing targeted therapies.
4.Analysis of Changes on Volatile Components of Ligusticum sinense cv. Chaxiong Rhizome Before and After Wine Processing Based on Electronic Nose and HS-GC-MS
Wen ZHANG ; Peng ZHENG ; Jiangshan ZHANG ; Xiaolin XIAO ; Zaodan WU ; Li XIN ; Wenhui GONG ; Jinlian ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):173-181
ObjectiveBy comparing the composition and content of volatile components in raw products, wine-washed products and wine-fried products of Ligusticum sinense cv. Chaxiong rhizome(LSCR), to investigate the influence of wine processing on the volatile components of LSCR, in order to provide a basis for the development of quality standards for LSCR and its processed products. MethodsElectronic nose was used to identify the odors of LSCR, wine-washed and wine-fried LSCR, and their volatile components were detected by headspace gas chromatography-mass spectrometry(HS-GC-MS), and the relative mass fractions of these components were determined by peak area normalization method. Principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were performed on the obtained sample data by SIMCA 14.1 software, and the differential components of LSCR, wine-washed and wine-fried LSCR were screened according to the variable importance in the projection(VIP) value>1. Pearson correlation analysis was used to explore the relationship between volatile differential flavor components and electronic nose sensors. ResultsElectronic nose detection results showed that there were significant differences in the odors of LSCR, wine-washed and wine-fried LSCR, mainly reflected in the sensors S2, S4, S5, S6, S11, S12, S13. And a total of 62 compounds were identified from LSCR and its wine-processed products, among which 46, 50 and 51 compounds were identified from LSCR, wine-fried and wine-washed LSCR, respectively. There were 21 differential components between the raw products and wine-fried products, of which 10 components were increased and 11 were decreased after processing. There were 20 differential components between the raw products and wine-washed products, of which 11 constituents increased and 9 decreased after processing. There were 17 differential components between the wine-wash products and wine-fried products. Compared with the wine-washed products, the contents of 13 components in the wine-fried products increased, and the contents of 4 components decreased. The increasing trend of the content of phthalides in the wine-washed products was more obvious than that in the wine-fried products, but the content of total volatile components was higher in the wine-fried products than the wine-washed products. Correlation analysis showed that there were different degrees of correlation between the 7 differential sensors of electronic nose and 24 differential volatile components, mainly phthalides and olefins. ConclusionThe odor and the content of volatile components in LSCR changed obviously after wine processing, and n-butylphthalide, Z-butylidenephthalide and E-ligustilide can be used as the candidate differential markers of volatile components in LSCR before and after wine processing.
5.Immunity-inflammation Mechanism of Viral Pneumonia and Traditional Chinese Medicine Treatment Based on Theory of Healthy Qi and Pathogenic Qi
Zheyu LUAN ; Hanxiao WANG ; Xin PENG ; Yihao ZHANG ; Yunhui LI ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):239-247
Viral pneumonia is an infectious disease caused by virus invading the lung parenchyma and interstitial tissue and causing lung inflammation, with the incidence rising year by year. Traditional Chinese medicine (TCM) can treat viral pneumonia in a multi-component, multi-target, and holistic manner by targeting the core pathogenesis of pneumonia caused by different respiratory viruses, demonstrating minimal side effects and significant advantages. According to the theory of healthy Qi and pathogenic Qi in TCM, the struggle between healthy Qi and pathogenic Qi and the imbalance between immunity and inflammation run through the entire process of viral pneumonia, and the immunity-inflammation status at different stages of the disease reflects different relationships between healthy Qi and pathogenic Qi. Immune dysfunction leads to the deficiency of healthy Qi, causing viral infections. The struggle between healthy Qi and pathogenic Qi causes immunity-inflammation imbalance, leading to the onset of viral pneumonia. Inflammatory damage causes persistent accumulation of phlegm and stasis, leading to the progression of viral pneumonia. The cytokine storm causes immunodepletion, leading to the excess of pathogenic Qi and diminution of healthy Qi and the deterioration of viral pneumonia. After the recovery from viral pneumonia, there is a long-term imbalance between immunity and micro-inflammation, which results in healthy Qi deficiency and pathogenic Qi lingering. Healthy Qi deficiency and pathogenic Qi excess act as common core causes of pneumonia caused by different respiratory viruses. Clinical treatment should emphasize both replenishing healthy Qi and eliminating pathogenic Qi, helping to restore the balance between healthy Qi and pathogenic Qi as well as between immunity and inflammation, thus promoting the recovery of patients from viral pneumonia. According to the TCM theory of healthy Qi and pathogenic Qi, this article summarizes the immunity-inflammation mechanisms at different stages of viral pneumonia, and explores the application of the method of replenishing healthy Qi and eliminating pathogenic Qi in viral pneumonia. The aim is to probe into the scientific connotation of the TCM theory of healthy Qi and pathogenic Qi in viral pneumonia and provide ideas for the clinical application of the method of replenishing healthy Qi and eliminating pathogenic Qi to assist in the treatment of viral pneumonia.
6.Traditional Chinese Medicine Treats Sepsis by Regulating PI3K/Akt Pathway: A Review
Zhu LIU ; Jiawei WANG ; Jing YAN ; Jinchan PENG ; Mingyao XU ; Liqun LI ; Sheng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):314-322
Sepsis is a systemic inflammatory response syndrome caused by the invasion of pathogenic microorganisms such as bacteria. In addition to the manifestations of systemic inflammatory response syndrome and primary infection lesions, critical cases often have manifestations of organ hypoperfusion. The morbidity and mortality of sepsis have remained high in recent years, which seriously affect the quality of life of the patients. The pathogenesis of sepsis is complicated, in which uncontrollable inflammation is a key mechanism. The phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway plays a key role in mediating inflammation in sepsis. The available therapies of sepsis mainly include resuscitation, anti-infection, vasoactive drugs, intensive insulin therapy, and organ support, which show limited effects of reducing the mortality. Therefore, finding new therapeutic drugs is a key problem to be solved in the clinical treatment of sepsis. In recent years, studies have shown that traditional Chinese medicine (TCM) can regulate the PI3K/Akt pathway via multiple pathways, multiple effects, and multiple targets to inhibit inflammation and curb the occurrence and development of sepsis, which has gradually become a hot spot in the prevention and treatment of sepsis. Moreover, studies have suggested that TCM has unique advantages in the treatment of sepsis. TCM can regulate the PI3K/Akt signaling pathway to inhibit inflammation, reduce oxidative stress, and control apoptosis in the prevention and treatment of sepsis. Despite the research progress, a systematic review remains to be performed regarding the TCM treatment of sepsis by regulating the PI3K/Akt signaling pathway. After reviewing relevant papers published in recent years, this study systematically summarizes the relationship between PI3K/Akt pathway and sepsis and the role of TCM in the treatment of sepsis, aiming to provide new ideas for the potential treatment of sepsis and the development of new drugs.
7.Rho/ROCK:key Mediator of Pulmonary Fibrosis and New Target of TCM for IPF Prevention and Treatment
Yuanyuan WU ; Kangchen LI ; Mingyan LI ; Xiling PENG ; Feifan ZHANG ; Han LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):256-265
Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease characterized by dyspnea and progressive deterioration of lung function, which significantly impacts patients' quality of life and imposes a major burden on society. Although modern medicine has increasingly enriched the treatment options for pulmonary fibrosis, unfavorable factors such as high costs and significant side effects contribute to the persistently low survival rate of patients. Studies have shown that the occurrence and development of pulmonary fibrosis are closely related to abnormalities in multiple pathways. Among these, Rho/Rho-associated coiled-coil protein kinase (ROCK) plays a key role in the disease progression of IPF by regulating the cytoskeleton. This pathway not only transmits biochemical molecular signals that promote the progress of fibrosis but also responds to the biomechanical environment, such as the increased lung tissue stiffness caused by the deposition of extracellular matrix (ECM) during the process of pulmonary fibrosis. Therefore, research on this pathway is of great significance for the prevention and treatment of IPF. In recent years, traditional Chinese medicine (TCM) has shown remarkable effects in preventing and treating IPF. Many TCM compounds and active components can reduce the production of α-smooth muscle actin (α-SMA), CollagenⅠ (ColⅠ), ColⅢ, and inflammatory factors in lung tissue by regulating the Rho/ROCK signaling pathway. These compounds inhibit the transformation of fibroblasts (FBs) into myofibroblasts (MyoFBs), intervening in the process of pulmonary fibrosis. Based on this, the article briefly reviews relevant research from recent years, discusses the key role of the Rho/ROCK pathway in pulmonary fibrosis from an interdisciplinary perspective, and summarizes the mechanisms through which TCM regulates Rho/ROCK to prevent and treat IPF, based on resources from PubMed, CNKI, and other databases, in order to provide important references for the broader clinical application of TCM in the prevention and treatment of IPF.
8.Interpretation of 2024 ESC guidelines for the management of elevated blood pressure and hypertension
Yu CHENG ; Yiheng ZHOU ; Yao LÜ ; ; Dongze LI ; Lidi LIU ; Peng ZHANG ; Rong YANG ; Yu JIA ; Rui ZENG ; Zhi WAN ; Xiaoyang LIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):31-40
The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."
9.Changes in hemoglobin and related influencing factors in patients with liver failure undergoing artificial liver support therapy
Ying LIN ; Li CHEN ; Fei PENG ; Jianhui LIN ; Chuanshang ZHUO
Journal of Clinical Hepatology 2025;41(1):104-109
ObjectiveTo investigate the changing trend of hemoglobin (Hb) and related influencing factors in patients with liver failure after artificial liver support system (ALSS) therapy. MethodsA total of 106 patients with liver failure who were hospitalized and received ALSS therapy in our hospital from January to December 2018 were enrolled and analyzed in terms of clinical data and red blood cell parameters such as Hb, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red blood cell distribution width-coefficient of variation (RDW-CV). A one-way repeated-measures analysis of variance was used for comparison of continuous data with repeated measurement between groups, and the paired t-test was used for comparison between two groups. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups, the Mann-Whitney U test was used for further comparison between two groups. Univariate and multivariate linear regression analyses were used to identify the influencing factors for the reduction in Hb after ALSS therapy. ResultsThe 106 patients with liver failure received 606 sessions of ALSS therapy, and Hb was measured for 402 sessions before and after treatment. There was a significant reduction in Hb after ALSS therapy in the patients with liver failure (97.49±20.51 g/L vs 109.38±20.22 g/L, t=32.764, P<0.001). Longitudinal observation was further performed for 14 patients with liver failure, and the results showed that the level of Hb was 108.50±21.61 g/L before the last session of ALSS therapy, with certain recovery compared with the level of Hb (103.14±19.15 g/L) on the second day after ALSS, and there was an increase in Hb on day 3 (102.57±21.73 g/L) and day 7 (105.57±22.04 g/L) after surgery. The level of Hb in patients with liver failure on the second day after ALSS decreased with the increase in the number of ALSS sessions (F=8.996, P<0.001), while MCV and MCH gradually increased with the increase in the number of ALSS sessions (F=9.154 and 13.460, P=0.004 and P<0.001), and RDW-CV first gradually increased and then gradually decreased (F=4.520, P=0.032); MCHC showed fluctuations with no clear trend (F=0.811, P=0.494). The multivariate linear regression analysis showed that the duration of ALSS therapy, the mode of ALSS therapy, and initial treatment were independent risk factors for the reduction in Hb after ALSS therapy. ConclusionALSS therapy can influence the level of peripheral blood Hb in patients with liver failure, and patient blood management should be strengthened for patients with liver failure who are receiving ALSS therapy.
10.Effect of Bushen Huoxue Granules (补肾活血颗粒) on the Nrf2/NLRP3 Inflammasome Axis in the Brain Substantia Nigra of Parkinson's Disease Model Mice
Qi CHEN ; Peng WANG ; Yingfan CHEN ; Shaodan LI ; Minghui YANG
Journal of Traditional Chinese Medicine 2025;66(4):390-398
ObjectiveTo explore the possible mechanism of action of Bushen Huoxue Granules (补肾活血颗粒, BHG) in the treatment of Parkinson's disease (PD) through the Nrf2/NLRP3 inflammasome axis. MethodsA total of 84 male C57/BL 6 mice were randomly divided into blank group, model group, Madopar group, dimethyl fumarate group, and low-, medium, and high-dose BHG group, with 12 mice in each group. Except for the blank group, all groups were induced into PD models by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) at a concentration of 30 mg/ml for 7 consecutive days. The blank group received an equal volume of saline. After model establishment, the low-, medium, and high-dose BHG groups were treated with 1.5, 3, and 6 g/(kg·d) of the BHG by gavage, respectively. The Madopar group was given 0.113 g/(kg·d) of Madopar tablets by gavage, and the dimethyl fumarate group was given 50 mg/(kg·d) of dimethyl fumarate solution. The blank group and the model group were given 10 ml/(kg·d) of distilled water by gavage. Gavage was administered once daily for 14 days. Behavioral changes were evaluated using the open field test (total distance, central area distance, and average speed), rotarod test (time on the rod), and climbing pole test (climbing time). Serum levels of interleukin-1β (IL-1β), interleukin-18 (IL-18), and myeloperoxidase (MPO) were measured by ELISA. Immunohistochemistry was used to detect tyrosine hydroxylase (TH) expression in the brain substantia nigra. Immunofluorescence was used to detect α-synuclein (α-syn) expression. Western Blot was used to detect Nrf2, NLRP3, Caspase-1, and α-syn protein levels in the brain substantia nigra. RT-PCR was used to detect mRNA expression levels of Nrf2, NLRP3, and Caspase-1 in the brain substantia nigra. ResultsCompared with the blank group, the model group showed decreased total distance, central area distance, and average speed, reduced time on the rotarod, prolonged climbing time, reduced TH expression, increased α-syn expression, decreased Nrf2 protein and mRNA expression, increased NLRP3 and Caspase-1 protein and mRNA expression, and elevated serum IL-1β, IL-18, and MPO levels (P<0.05). Compared with the model group, all drug interventions significantly improved the above indicators (P<0.05). There was no significant differences in all indicators between the high-dose BHG group and the Madopar group (P>0.05). Compared with the dimethyl fumarate group, the medium and high-dose BHG groups showed increased Nrf2 mRNA expression in the brain substantia nigra (P<0.05). Compared with the high-dose BHG group, the low-dose group showed decreased total distance, central area distance, and average speed, reduced serum IL-18 levels, decreased α-syn, Nrf2, NLRP3, and Caspase-1 protein levels, and lower Nrf2 mRNA expression (P<0.05). ConclusionThe mechanism by which BHG treat PD may involve activating the Nrf2/NLRP3 inflammasome axis in the brain substantia nigra, thereby reducing neuroinflammation and α-syn aggregation. The high-dose group showed the best effects.

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