1.Effect of Shaoyao Gancaotang on Proliferation and Differentiation of Neural Stem Cells in Rats with Limb Spasticity of Cerebral Apoplexy
Runbo WU ; Chunxue MENG ; Fei WANG ; Qianxi NA ; Bin GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):11-20
ObjectiveThis paper aims to analyze the damage degree of muscle tone in rats with spasticity of cerebral apoplexy (SCA) and the expression of Nestin and β-catenin in the M1 region of the cerebral cortex, thereby investigating the action mechanism of different doses of Shaoyao Gancaotang on rats with SCA. MethodsThe rats were randomly divided into a blank group, a model group, a positive control group (baclofen, 5.25 mg·kg-1), and low, medium, and high-dose groups of Shaoyao Gancaotang (2.1, 4.2, 8.4 g·kg-1), with nine rats in each group. A rat model with SCA was established by using a modified phrenic nerve block combined with intraventricular injection of anhydrous ethanol. Following behavioral scoring to confirm model validity, drug interventions were conducted. Neurological deficits and muscle tone were evaluated by behavioral assessments. The open field test was used to measure locomotor distance. Transmission electron microscopy was employed to examine the synaptic structures. Skeletal muscle adenosine triphosphate (ATP)ase staining was used to analyze myofibrillar changes. Hematoxylin and eosin (HE) staining was used to observe the histomorphological changes. Immunohistochemistry, Real-time polymerase chain reaction (Real-time PCR), and Western blot were employed to detect mRNA levels and protein expressions of Nestin and β-catenin in the M1 region of the cerebral cortex. ResultsCompared with the blank group, rats in the model group exhibited significantly increased neurological deficit scores (P<0.01), markedly elevated muscle tone scores (P<0.01), substantially reduced locomotor distance (P<0.01), prominent structural swelling and blurring, severe destruction of cerebral cortical cells, a significant increase in the proportion of skeletal muscle ATPase type Ⅰ fibers (P<0.01), a significant decrease in mRNA levels and protein expression of Nestin (P<0.01), and a significant increase in mRNA levels and protein expression of β-catenin (P<0.01). Compared with the model group, the Shaoyao Gancaotang group exhibited reduced neurological deficit scores and muscle tone scores in rats with SCA (P<0.01) and increased locomotor distance (P<0.01). Transmission electron microscopy revealed clearer and more intact synaptic structures in the rats from the Shaoyao Gancaotang group, with increased vesicle numbers and improved morphology. HE staining revealed intact neuronal cell structures with regular arrangement and reduced vacuolated cells in the rats from Shaoyao Gancaotang. ATPase staining result indicated a decreased proportion of type Ⅰ muscle fibers in the rats from the Shaoyao Gancaotang group (P<0.01). Real-time PCR results demonstrated increased mRNA expressions of Nestin and β-catenin in the rats from the Shaoyao Gancaotang group (P<0.01). Immunohistochemistry and western blot analyses indicated elevated protein expressions of Nestin and β-catenin in rats with SCA from the Shaoyao Gancaotang group (P<0.05, P<0.01). ConclusionShaoyao Gancaotang may improve neurological function impairment and limb spasticity in model rats with SCA by regulating the proliferation and differentiation of neural stem cells in the cerebral cortex M1 region.
2.Diagnosis and Treatment of Chronic Heart Failure Based on Thinking of Five Differentiation
Kun LIAN ; Lichong MENG ; Manting YI ; Lin LI ; Fei WANG ; Siyuan HU ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):160-168
Chronic heart failure (CHF) refers to a clinical syndrome in which the function or structure of the heart is changed due to damage to the original myocardium, resulting in reduced pumping and/or filling functions of the heart. In recent years, the mechanisms, pathways, and targets of traditional Chinese medicine (TCM) in the treatment of CHF have been continuously confirmed, and the application of TCM theories in guiding the syndrome differentiation and precise treatment of CHF is currently a research hotspot. On the basis of the syndrome differentiation and treatment in TCM, Professor LI Candong innovatively proposed the thinking of five differentiation: Disease differentiation, syndrome differentiation, pathogenesis differentiation, symptom differentiation, and individual differentiation. This article explores the clinical diagnosis and treatment of CHF from this thinking, emphasizing comprehensive syndrome differentiation, objective analysis, dynamic assessment, and individualized treatment. In terms of diagnosis, the first is to identify the disease name, cause, location, severity, and type of CHF, determine the type and its evolution, and clarify the process of transmission and transformation between deficiency and excess. Secondly, it is necessary to distinguish the authenticity, severity, primary and secondary, urgency and complexity of CHF syndromes, providing scientific guidance for syndrome differentiation and treatment. Thirdly, according to the symptoms and the principles of deficiency and excess, the physician should identify the core pathogenesis of CHF from the perspectives of Qi, blood, Yin, Yang, deficiency, stasis, phlegm, water, and toxins. Fourthly, from the macro, meso and micro levels, the physician should carefully distinguish the presence or absence, severity, authenticity, and completeness of the symptoms to guide the diagnosis and treatment process of CHF. Finally, personalized medication for CHF should be promoted based on the patient's gender, age, constitution, and living habits. In terms of treatment, based on the thinking of five differentiation, we propose that the treatment of CHF should integrate the disease and syndrome, clarify the pathogenesis, and apply precise treatment. The treatment should be people-oriented, staged, and typed, and the medication should be adjusted according to symptoms. This diagnostic and therapeutic approach is based on the holistic concept and syndrome differentiation and treatment, and combines the three causes for appropriate treatment, providing new ideas and insights for the diagnosis and treatment of CHF.
3.The Diversity of Filamentous Morphologies and Magnetic Sensitivity Modulated by Diverse MagR Expression in Bacteria
Ya-Fei CHANG ; Jing ZHANG ; Peng ZHANG ; Xiu-Juan ZHOU ; Meng-Ke WEI ; Tian-Tian CAI ; Pei-Qi HE ; Jun-Feng WANG ; Can XIE
Progress in Biochemistry and Biophysics 2026;53(5):1439-1456
Objective Magnetoreception, the remarkable ability of diverse animals to sense and utilize the geomagnetic field for orientation and navigation, remains a molecularly unresolved mystery in sensory biology. The putative magnetoreceptor (MagR, previously known as IscA1) is a highly conserved iron-sulfur protein implicated in both magnetoreception and iron metabolism; however, the functional diversity among its cross-species homologs remains poorly understood. Cellular morphology is a key genetically determined trait that can be altered through genetic or environmental modifications—a process known as cell morphology engineering. Constructing engineered cells with specific morphological features and magnetic sensitivity to achieve remote, non-invasive magnetic modulation represents a crucial goal in this field with significant application potential. Therefore, this study aims to systematically investigate the effects of MagR heterologous expression on bacterial morphology and magnetic sensing capabilities, screen for MagR-based magnetically sensitive morphology engineering pathways, and reveal the underlying molecular mechanisms. Methods We systematically screened 28 MagR homologous genes from diverse prokaryotic and animal taxa to evaluate their expression and corresponding phenotypic effects in Escherichia coli (E. coli). To compare the differential magnetic responses among bacteria expressing various recombinant MagR proteins, we utilized high-throughput automated bright-field microscopic imaging and scanning electron microscopy (SEM). Furthermore, comprehensive biochemical and biophysical characterizations of iron and iron-sulfur cluster binding were performed using Ferrozine colorimetric assays, electron paramagnetic resonance (EPR) spectroscopy, ultraviolet-visible (UV-Vis) absorption, and circular dichroism (CD) spectroscopy. Additionally, 100 mT static magnetic field (SMF) exposure experiments were conducted to assess magnetically tunable phenotypes, while the intrinsic magnetic properties of purified MagR proteins were directly measured using a superconducting quantum interference device (SQUID) magnetometer. Results Our results demonstrated that the heterologous expression of MagR homologs induced varying degrees of bacterial filamentation. From this comprehensive screen, two distinct morphological patterns were identified: hydra (Hydra vulgaris) MagR (hyMagR) promoted uniform cell elongation and filamentation, exhibiting robust magnetic sensitivity manifested as significantly enhanced filamentation under the 100 mT SMF. In contrast, pigeon (Columba livia) MagR (clMagR) induced only low-frequency, extreme filamentation (sporadically exceeding 80 μm) with a relatively weaker magnetic morphological response. Mechanistically, our data unambiguously proved that these phenotypic differences are primarily driven by distinct iron redox preferences rather than total cellular iron accumulation. Specifically, hyMagR preferentially binds ferrous iron (Fe2+), whereas clMagR favors ferric iron (Fe3+) and forms more stable iron-sulfur clusters. Intriguingly, although SQUID magnetometry showed that purified clMagR exhibited approximately five-fold higher mass magnetic susceptibility than hyMagR, its cellular magnetic response was weaker. We hypothesize that the Fe2+-preferred intracellular environment associated with hyMagR overexpression primes the cell for enhanced generation of reactive oxygen species (ROS) via the Fenton reaction. Exposure to an SMF synergizes with this primed redox state, triggering the bacterial SOS response and upregulating cell division inhibitors to efficiently induce uniform filamentation. Conclusion Our findings identify the Fe2+/Fe3+ redox state as a critical determinant of MagR-mediated morphological remodeling and magnetic responsiveness. This discovery suggests a potential strategy for engineering magnetically responsive cellular systems for synthetic biology applications, and provides a plausible framework, which potentially combines intrinsic protein magnetism with redox-state modulation, for further investigating the evolutionary mechanisms of MagR-mediated magnetoreception.
4.The Diversity of Filamentous Morphologies and Magnetic Sensitivity Modulated by Diverse MagR Expression in Bacteria
Ya-Fei CHANG ; Jing ZHANG ; Peng ZHANG ; Xiu-Juan ZHOU ; Meng-Ke WEI ; Tian-Tian CAI ; Pei-Qi HE ; Jun-Feng WANG ; Can XIE
Progress in Biochemistry and Biophysics 2026;53(5):1439-1456
Objective Magnetoreception, the remarkable ability of diverse animals to sense and utilize the geomagnetic field for orientation and navigation, remains a molecularly unresolved mystery in sensory biology. The putative magnetoreceptor (MagR, previously known as IscA1) is a highly conserved iron-sulfur protein implicated in both magnetoreception and iron metabolism; however, the functional diversity among its cross-species homologs remains poorly understood. Cellular morphology is a key genetically determined trait that can be altered through genetic or environmental modifications—a process known as cell morphology engineering. Constructing engineered cells with specific morphological features and magnetic sensitivity to achieve remote, non-invasive magnetic modulation represents a crucial goal in this field with significant application potential. Therefore, this study aims to systematically investigate the effects of MagR heterologous expression on bacterial morphology and magnetic sensing capabilities, screen for MagR-based magnetically sensitive morphology engineering pathways, and reveal the underlying molecular mechanisms. Methods We systematically screened 28 MagR homologous genes from diverse prokaryotic and animal taxa to evaluate their expression and corresponding phenotypic effects in Escherichia coli (E. coli). To compare the differential magnetic responses among bacteria expressing various recombinant MagR proteins, we utilized high-throughput automated bright-field microscopic imaging and scanning electron microscopy (SEM). Furthermore, comprehensive biochemical and biophysical characterizations of iron and iron-sulfur cluster binding were performed using Ferrozine colorimetric assays, electron paramagnetic resonance (EPR) spectroscopy, ultraviolet-visible (UV-Vis) absorption, and circular dichroism (CD) spectroscopy. Additionally, 100 mT static magnetic field (SMF) exposure experiments were conducted to assess magnetically tunable phenotypes, while the intrinsic magnetic properties of purified MagR proteins were directly measured using a superconducting quantum interference device (SQUID) magnetometer. Results Our results demonstrated that the heterologous expression of MagR homologs induced varying degrees of bacterial filamentation. From this comprehensive screen, two distinct morphological patterns were identified: hydra (Hydra vulgaris) MagR (hyMagR) promoted uniform cell elongation and filamentation, exhibiting robust magnetic sensitivity manifested as significantly enhanced filamentation under the 100 mT SMF. In contrast, pigeon (Columba livia) MagR (clMagR) induced only low-frequency, extreme filamentation (sporadically exceeding 80 μm) with a relatively weaker magnetic morphological response. Mechanistically, our data unambiguously proved that these phenotypic differences are primarily driven by distinct iron redox preferences rather than total cellular iron accumulation. Specifically, hyMagR preferentially binds ferrous iron (Fe2+), whereas clMagR favors ferric iron (Fe3+) and forms more stable iron-sulfur clusters. Intriguingly, although SQUID magnetometry showed that purified clMagR exhibited approximately five-fold higher mass magnetic susceptibility than hyMagR, its cellular magnetic response was weaker. We hypothesize that the Fe2+-preferred intracellular environment associated with hyMagR overexpression primes the cell for enhanced generation of reactive oxygen species (ROS) via the Fenton reaction. Exposure to an SMF synergizes with this primed redox state, triggering the bacterial SOS response and upregulating cell division inhibitors to efficiently induce uniform filamentation. Conclusion Our findings identify the Fe2+/Fe3+ redox state as a critical determinant of MagR-mediated morphological remodeling and magnetic responsiveness. This discovery suggests a potential strategy for engineering magnetically responsive cellular systems for synthetic biology applications, and provides a plausible framework, which potentially combines intrinsic protein magnetism with redox-state modulation, for further investigating the evolutionary mechanisms of MagR-mediated magnetoreception.
5.The role of low-frequency ultrasound on antibiotic sensitivity and biofilm formation of methicillin-resistant Staphylococcus aureus and Escherichia coli: an in vitro effect study
Dewen XUE ; Yicheng LI ; Baochao JI ; Fei WANG ; Xingbu MENG ; Bo LIU ; Li CAO
Chinese Journal of Orthopaedic Trauma 2025;27(6):512-520
Objective:To evaluate the effects of low-frequency ultrasound on antibiotic susceptibility and biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli).Methods:After MRSA and E. coli were treated with low-frequency ultrasound with different parameters, they were divided into a group with different ultrasound durations and a group with different ultrasound powers. With the power parameter set at 100%, the former was divided into 5 subgroups: control, 1.0 min, 2.5 min, 5.0 min, and 10.0 min subgroups. The bacteria were sonicated for 0, 1.0, 2.5, 5.0, 10.0 min, respectively. The group with different ultrasound powers was also divided into 5 subgroups: control, 25% power, 50% power, 75% power, and 100% power subgroups. The bacteria were treated with ultrasonic powers of 0, 25%, 50%, 75%, and 100% for 5.0 min. The MRSA and E. coli corresponded to antibiotic susceptibility testing using vancomycin and meropenem. The number of bacteria surviving was assessed by colony counts. Confocal microscopy was used to observe the changes in biofilms co-cultured with 1/2 minimum inhibitory concentration (MIC) antibiotics after sonication.Results:The E. coli enhanced its susceptibility to meropenem after 5.0 min of high-power sonication while the susceptibility of MRSA to vancomycin was unaffected. The number of E. coli decreased significantly with increasing ultrasound time and power: the numbers of E. coli in the 1.0 min, 2.5 min, 5.0 min, and 10.0 min subgroups [(51.00±18.73), (30.00±9.17), (5.33±4.04), and (0.23±0.03)×10 4 CFU/mL] were significantly smaller than that in the control subgroup [(120.00±7.81)×10 4 CFU/mL], and the numbers of E. coli in the 25%, 50%, 75%, and 100% subgroups [(25.00±3.00), (8.00±2.65), (5.00±2.00), and (5.33±4.04)×10 4 CFU/mL] were significantly smaller than that in the control subgroup [(120.00±7.81)×10 4 CFU/mL] ( P<0.05). However, the number of MRSA was not significantly affected. After treatment with ultrasound combined with 1/2 MIC meropenem, the ratio of live/dead biofilm areas of E. coli decreased significantly with increasing ultrasound time and power: the proportions of E. coli in the 1.0 min, 2.5 min, 5.0 min and 10.0 min subgroups (66.10%±1.78%, 50.84%±7.99%, 60.98%±2.23%, and 29.20%±16.49%) were significantly smaller than those in the control subgroup (93.73%±0.44%), and the proportions of E. coli in the 25%, 50%, 75%, and 100% subgroups (75.23%±2.21%, 65.10%±1.25%, 57.34%±11.21%, and 60.98%±2.23%) were significantly smaller than that in the control subgroup (93.73%±0.44%) ( P<0.05). However, the MRSA live/dead biofilm area ratio was not significantly affected by the treatment with ultrasound combined with 1/2 MIC vancomycin. Conclusions:Low frequency ultrasound can effectively inhibit the growth of E. coli and significantly enhance its sensitivity to antibiotics, and its combination with antibiotics can inhibit the formation of bacterial biofilm. However, low frequency ultrasound or its combination with antibiotics has no significant effect on MRSA.
6.Transition pattern of health status among middle-aged and elderly population in China based on the frailty index
Fei XU ; Xinlei MIAO ; Yangxuan HE ; Guimin TANG ; Qianqian WANG ; Meng LI ; Jiayi DENG ; Song LENG
Chinese Journal of Health Management 2025;19(10):823-829
Objective:To investigate transition pattern of health status among middle-aged and elderly population in China based on frailty index.Methods:In this retrospective cohort study, middle-aged and elderly people were selected from the China Health and Retirement Longitudinal Study (CHARLS) in 2011; and 1 434 subjects were followed up to 2015. The frailty index was calculated from the prevalence of chronic diseases, daily activity ability and blood biomarkers, and the frailty state was divided by quartiles of the frailty index. Markov models were constructed to determine the transition probabilities of different frailty states.Results:The mean age of the 1 434 subjects was (59.0±9.4) years and the mean frailty index was 0.11±0.05. In the healthy individuals, 63.0% remained healthy after a four-year follow-up; during the same follow-up period, 40.9% of the mildly frail individuals and 23.0% of the moderately frail individuals remained in their baseline frailty status. Increasing age leaded to a gradual increase in the probability of the population shifting to a severely frailty state. Women were more likely to shift to severe frailty status than men (0.029 vs 0.019, Z=3.03, P=0.002). Conclusion:Among middle-aged and elderly population in China, the transition of health states follows a pattern where higher frailty levels are associated with lower stability. Advanced age and female gender are identified as risk factors for progression to severe frailty.
7.Mechanism of Qitu Erzhi Decoction against chemotherapy-induced myelosuppression based on network pharmacology and experimental validation.
Meng-Meng WANG ; Hao SUN ; Gao-Biao LI ; Yu-Fei YANG ; Bin HE
China Journal of Chinese Materia Medica 2025;50(3):719-731
To investigate the mechanism of Qitu Erzhi Decoction(QTEZ) in ameliorating chemotherapy-induced myelosuppression and the focus of its decomposed formulae on the effects of hematopoietic cells of the three lineages, respectively. Ultra performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS) was used to identify the components of QTEZ intestinal absorption liquid and obtain the target sites, which were intersected with chemotherapy-induced myelosuppression targets collected from several databases, including OMIM, and an interaction network was established based on network pharmacology for Gene Ontology(GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis. Hematopoietic stem cells of mice were taken after intraperitoneal injection of 5-fluorouracil for myelosuppression modeling and randomly divided into the model group, Qitu Erzhi group, Astragali Radix-Angelicae Sinensis Radix group, Ligustri Lucidi Fructus-Ecliptae Herba group, Psoraleae Fructus-Cuscutae Semen group, and positive drug group, which were given the corresponding traditional Chinese medicine intestinal absorption liquid and the positive drug granulocyte colony-stimulating factor, respectively. The normal hematopoietic stem cells were taken as the control group and were given the intervention of normal saline. The proliferation of hematopoietic progenitor cells of three lineages was observed by flow cytometry, and the cell cycle and colony formation assay were observed. Western blot was used to verify the effect of QTEZ on the pathway proteins including phosphoinositide 3-kinase(PI3K), phosphorylated PI3K(p-PI3K), protein kinase B(AKT), and phosphorylated AKT(p-AKT). RT-qPCR and Western blot were used to detect the effects of QTEZ on cell cycle-related targets such as CDK inhibitor 1(P21), cyclin D1(CCND1), and cyclin-dependent kinase 4(CDK4). The results showed that a total of 158 components were identified by QTEZ, and 375 component and disease intersecting targets were obtained, 21 core components and 40 core targets were obtained after constructing the network, and GO and KEGG enrichment showed signaling pathways such as PI3K/AKT. QTEZ and its decomposed formulae could promote the 5-fluorouracil-blocked cell cycle to resume operation, and all of them had different degrees of restoration effects on the set of colonies, among which QTEZ had the best restoration effect, and the Astragali Radix-Angelicae Sinensis Radix group had a focused effect on colony forming unit-erythrocyte. Western blot results indicated that there was no significant difference in the expression levels of pathway proteins among the groups. RT-qPCR and Western blot results showed that QTEZ could down-regulate P21 and up-regulate the protein and mRNA expression of CDK4 and CCND1. In conclusion, QTEZ and its decomposed formulas can exert a protective effect on hematopoietic stem cells with 5-fluorouracil-induced myelosuppression by promoting the normal operation of the cell cycle and colony formation, and the mechanism may be related to the down-regulation of the cell cycle-related targets of P21 and the up-regulation of CDK4 and CCND1. In addition, Astragali Radix-Angelicae Sinensis Radix can have a targeted protective effect on erythrocytes.
Animals
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Drugs, Chinese Herbal/chemistry*
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Network Pharmacology
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Mice
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Fluorouracil/adverse effects*
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Male
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Antineoplastic Agents/adverse effects*
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Hematopoietic Stem Cells/cytology*
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Humans
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Signal Transduction/drug effects*
8.Research progress in pharmacological effects of puerarin.
Xiao-Wei MENG ; Feng-Mei GUO ; Qian-Qian WANG ; Jia-Rong LI ; Ni ZHANG ; Fei QU ; Rong-Hua LIU ; Wei-Feng ZHU
China Journal of Chinese Materia Medica 2025;50(11):2954-2968
Traditional Chinese medicine(TCM), a treasure of the Chinese nation, contains abundant chemical components and demonstrates unique pharmacological activities, showing important values in clinical applications. With profound connotations and broad application prospects, TCM urgently needs us to further explore and conduct systematic research. Puerarin is a small-molecule natural isoflavonoid carbon glycoside extracted from plants of Pueraria. It is also the main active ingredient of Puerariae Lobata Radix, a Chinese herbal medicine with both medicinal and edible values. Puerarin has a variety of pharmacological effects such as blood pressure-lowering, anti-atherosclerosis, anti-ischemia-reperfusion injury, antithrombotic, anti-tumor, anti-inflammatory, liver-protecting, nerve cell-protecting, and intestinal microbiota-regulating effects. It is also an active ingredient that has been widely studied. This article comprehensively reviews the research progress in the pharmacological effects and molecular mechanisms of puerarin over the years, aiming to provide references and theoretical support for the in-depth research and development as well as clinical application of puerarin.
Isoflavones/chemistry*
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Humans
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Animals
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Drugs, Chinese Herbal/chemistry*
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Pueraria/chemistry*
9.Advances in target-guided discovery technologies for active components in traditional Chinese medicine.
Meng DING ; Wang-Xiao TAN ; Xiao ZHANG ; Peng-Fei TU ; Yong JIANG
China Journal of Chinese Materia Medica 2025;50(13):3645-3656
Traditional Chinese medicine(TCM), with diverse structural types of active components and remarkable clinical efficacy, holds a significant position in the pharmacological research. As the key substances, active components of TCM are of great importance in revealing the material basis of TCM efficacy and mechanism of action. However, the conventional approaches of discovering active components in TCM are characterized by tedious procedures, lengthy cycles, and unclear mechanisms, which struggle to meet the current demands for drug development. In recent years, major breakthroughs have been made in target discovery technologies, and new drug targets are constantly being discovered, which has facilitated the development of target-driven approaches. The target-guided active component discovery strategy provides a new paradigm for discovering active components in TCM. This article systematically summarizes two mainstream target-based technologies-virtual screening and ligand fishing-for TCM active component discovery. By analyzing relevant application cases, this article evaluates the strengths and limitations of each technology. The review aims to provide frameworks for expediting bioactive component discovery in complex systems like TCM, so as to accelerate the development of innovative drugs based on the active components of TCM and promote the modernization and internationalization of TCM.
Drugs, Chinese Herbal/pharmacology*
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Humans
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Medicine, Chinese Traditional
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Drug Discovery/methods*
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Animals
10.Comparison of efficacy of anterolateral tibial plateau fracture line and anterior tibial fenestration for the treatment of anterolateral tibial plateau column fracture combined with posterolateral column collapse.
Cheng-Fei MENG ; Guan-Qing WANG ; Cheng LUO ; Xiu-Hua LIU ; Ze-Xi LING
China Journal of Orthopaedics and Traumatology 2025;38(3):265-272
OBJECTIVE:
To compare clinical effect of anterior tibial plateau fracture line and anterior tibial fenestration reduction in treating anterolateral tibial plateau column fracture combined with posterior lateral column collapse.
METHODS:
Fifty-two patients with Schatzker typeⅡ tibial plateau anterolateral column fracture combined with posterolateral column collapse admitted from January 2016 to December 2021 were retrospectively analyzed and divided into two groups according to fracture reduction methods. There were 27 patients in fracture line group, including 19 males and 8 females, aged from 26 to 62 years old with an average of (43.2±11.4) years old;the time from injury to operation ranged from 4 to 8 days with an average of (5.8±1.5) days;treated with reduction and internal fixation via fracture line of lateral platform front. There were 25 patients in fenestrate group, including 13 males and 12 females, aged from 22 to 69 years old with an average of (40.8±11.1) years old;the time from injury to operation ranged from 4 to 8 days with an average of (6.0±1.4) days;treated with tibial fenestration reduction and internal fixation. The amount of bone graft, operation time, fracture healing time and complications were compared between two groups. Posterior slope angle (PSA) and posterior slope angle of the lateral tibial plateau was compared before surgery, 2 days and 6 months after surgery. The knee function was evaluated by Hospital for Speical Surgery (HSS) at 2 days and 6 months after surgery, respectively. Fracture reduction was evaluated by Rasmussen anatomic score of knee joint.
RESULTS:
Both of group were followed up from 12 to 24 months (16.0±3.4) months. No redisplacement of fracture, internal and external inversion deformity of knee joint, or instability of knee joint were found between two groups during follow-up. In fracture line group, 1 patient occurred wound fat liquefaction and 2 patients occurred lower limb intermuscular venous thrombosis occurred. In fenestration group, 1 patient occurred joint stiffness, 1 patient occurred lower limb intermuscular venous thrombosis, and 1 patient occurred superficial wound infection;there were no significant difference in complications between two groups (P>0.05). Bone graft volume, operative time and fracture healing time in fracture line group were (3.6±2.3) cm3, (123.4±18.2) min and (13.8±1.8) weeks, while in feneplast group were (4.8±1.8) cm3, (135.5±22.5) min and (15.2±2.0) weeks, respectively;the difference between two groups was statistically significant (P<0.05). The collapse depth of lateral platform articular surface at 2 days and 6 months after surgery were (0.8±0.1) and (0.9±0.1) mm in fracture line group, which were lower than those in fenestration group (0.9±0.1) and (1.1±0.1) mm, respectively (P<0.05). After 2 days and 6 months, , PSA in fracture line group were (9.4±1.5) ° and (10.1±1.9) °, respectively, which were lower than those in fenestration group (10.5±1.5) ° and (11.3±1.9) ° (P<0.05). Rasmussen anatomical scores in fracture line group at 2 days and 6 months were 16(16, 18) and 16(14, 16) points, respectively, which were better than those in fenestrated group (16, 16) and 14(14, 16) points (P< 0.05). The collapse depth, PSA and Rasmussen anatomical score between two groups were better than those before surgery (P<0.05). There was no significant difference in HSS score between two groups at 2 days after surgery (P>0.05). At six months after surgery, HSS score in fracture line group (86.7±3.6) was higher than that in fenestration group (84.1±3.91) (P<0.05). HSS score at 6 months after surgery was better than that at 2 days after surgery (P<0.05).
CONCLUSION
Both anterior tibial plateau fracture line and anterior tibial fenestration could be used to treat anterolateral tibial plateau column fracture with posterior lateral column collapse. Compared with fenestration group, transfracture line group had advantages of less intraoperative bone grafting, shorter operative time, shorter fracture healing time, better articular surface reduction effect and better knee functional recovery.
Humans
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Male
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Female
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Middle Aged
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Tibial Fractures/physiopathology*
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Adult
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Fracture Fixation, Internal/methods*
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Aged
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Retrospective Studies
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Tibia/injuries*
;
Tibial Plateau Fractures

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