1.Traditional Chinese Medicine Alleviates Dry Eye Disease by Regulating Tear Film Homeostasis: A Review
Sainan TIAN ; Bin'an WANG ; Yao CHEN ; Guicheng LIU ; Li TANG ; Pei LIU ; Genyan QIN ; Jun PENG ; Qinghua PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):172-181
Dry eye (DE) is a prevalent multifactorial disease of the ocular surface, clinically characterized by tear film homeostasis imbalance accompanied by related ocular surface symptoms. Specifically, the tear film is a thin liquid layer of tears covering the cornea and conjunctiva through blinking, while tear film homeostasis serves as the foundation for maintaining normal ocular surface structure and function. Insufficient tear secretion and excessive tear film evaporation lead to tear hyperosmolarity and the production of inflammatory mediators, disrupting tear film homeostasis and subsequently forming DE. Additionally, cascade reactions are triggered, resulting in a "vicious cycle of DE" that exacerbates the disease severity and prolongs its duration. Therefore, for DE treatment, it is crucial to restore tear film homeostasis and terminate this vicious cycle. Traditional Chinese medicine (TCM), which differentiates and treats DE based on systemic conditions, often achieves favorable therapeutic outcomes, offering additional treatment options for DE. Studies have demonstrated that TCM can alleviate DE by regulating tear film homeostasis and terminating the vicious cycle. This review systematically summarizes recent basic experimental research in China and abroad on TCM in alleviating DE by regulating tear film homeostasis, aiming to provide a theoretical basis for clinical treatment and an insight for research design.
2.Effect of Runmu Dihuang Decoction on Perimenopausal Dry Eye in Rats with Liver-kidney Yin Deficiency Syndrome Based on SIRT3/HIF-1α/NF-κB Signaling Pathway
Sainan TIAN ; Wei MA ; Yao CHEN ; Yu CAO ; Guicheng LIU ; Pei LIU ; Junxian LEI ; Qinghua PENG ; Jun PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):201-210
ObjectiveTo investigate the mechanisms of Runmu Dihuang decoction (RMDHD) in treating perimenopausal dry eye with liver-kidney Yin deficiency syndrome based on the silent information regulator 3 (SIRT3)/hypoxia-inducible factor-1α (HIF-1α)/nuclear factor-κB (NF-κB) signaling pathway. MethodsSixty female Sprague-Dawley rats were randomly divided into six groups (n=10 per group): Sham operation group, model group, sodium hyaluronate eye drop group, and low-, medium-, and high-dose RMDHD groups (5.625, 11.25, 22.50 g·kg-1). Except for the sham operation group, all rats underwent bilateral ovariectomy and were administered 0.1% benzalkonium chloride eye drops combined with long-term chronic irritation to establish a perimenopausal dry eye model with liver-kidney Yin deficiency syndrome. Drug administration began in the 11th week after modeling and continued for 21 days. General conditions, screen-grip test scores, tear secretion volume, tear film breakup time (TFBUT), and corneal fluorescein staining were recorded. Serum levels of reactive oxygen species (ROS), follicle-stimulating hormone (FSH), estradiol (E2), and progesterone (PROG) were measured by enzyme-linked immunosorbent assay (ELISA). Pathological changes in the lacrimal glands, corneas, and uteri were observed using hematoxylin-eosin (HE) staining. Protein expression levels of SIRT3, HIF-1α, phosphorylated NF-κB p65 (p-NF-κB p65), and total NF-κB p65 in the lacrimal glands were detected by Western blot. The expression of inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the lacrimal glands was assessed by immunohistochemistry (IHC). ResultsAfter model establishment, no significant differences were observed among the groups except the sham operation group. Compared with the sham operation group, the other groups exhibited slowed movement, dull responses, increased irritability, reduced body weight, elevated rectal temperature, decreased screen-grip test scores, reduced tear secretion, and significantly shortened TFBUT (P<0.05). After treatment, compared with the model group, the sodium hyaluronate eye drop group and all RMDHD groups showed improved general conditions, significantly increased tear secretion (P<0.05), prolonged TFBUT (P<0.05), and elevated screen-grip test scores (P<0.05). Serum ROS and FSH levels were significantly decreased, while E2 and PROG levels were significantly increased (P<0.05). Pathological damage to the cornea, lacrimal glands, and uterus was ameliorated. In addition, protein expression levels of SIRT3 and HIF-1α in the lacrimal glands were significantly upregulated (P<0.05), whereas the expression of p-NF-κB p65, IL-1β, and TNF-α was significantly downregulated (P<0.05). ConclusionRMDHD increases tear secretion and TFBUT, improves lacrimal gland and corneal injury, and alleviates dry eye symptoms in a perimenopausal dry eye rat model with liver-kidney Yin deficiency syndrome. The underlying mechanism may be related to regulation of the SIRT3/HIF-1α/NF-κB signaling pathway, inhibition of oxidative stress and inflammatory responses, and reduction of ocular surface tissue damage.
3.Establishment and evaluation of a rat model of perimenopausal dry eye with liver-kidney yin deficiency evidence
Sainan TIAN ; Guicheng LIU ; Yao CHEN ; Pei LIU ; Jun PENG ; Qinghua PENG ; Shujuan HU
Acta Laboratorium Animalis Scientia Sinica 2025;33(9):1270-1279
Objective To establish a rat model of perimenopausal dry eye with liver and kidney yin deficiency from the perspective of"measuring evidence by prescription"in Chinese medicine.Methods Thirty SPF-grade female SD rats were divided randomly into sham-operated,model,and Qiju Dihuang soup groups(n=10).Rats in the latter two groups underwent bilateral ovariectomy and were given 0.1%benzalkonium chloride eye drops combined with provocation for 10 weeks to establish a model of perimenopausal dry eye with liver and kidney yin deficiency.After modeling,rats in the Qiju Dihuang soup group were gavaged with Qiju Dihuang soup at a dose of 8.37 g/(kg·d),rats in the sham-operated and model groups were gavaged with saline at a rate of 1 mL/100(g·d)for 21 d.The general condition,retinal screen test scores,tear secretion,time of tear film rupture,and corneal fluorescein staining were observed and recorded in each group.Serum levels of follicle-stimulating hormone(FSH),estradiol(E2),and progesterone(PROG)were measured by enzyme-linked immunosorbent assay.Pathological damage to the cornea and lacrimal glands were detected by hematoxylin/eosin staining.Expression levels of the inflammatory factors interleukin(IL)-1β and tumor necrosis factor(TNF)-a in the cornea were detected by immunohistochemistry.Results Compared with the sham-operated group,rats in the model group showed behavioral signs of slow action and reaction,irritability,body mass loss,and increased anal temperature(P<0.05),decreased retinal screen test scores(P<0.05),tear secretion(P<0.05),and time of tear film rupture(P<0.05),and pathological damage to the cornea and lacrimal glands.FSH levels increased and E2 and PROG levels decreased(P<0.05)and expression levels of IL-1 and TNF-α increased in the model group compared with the sham group.All the above indexes were significantly improved in the Qiju Dihuang soup group compared with the model group.Conclusions From the perspective of"measuring evidence by formula"in Chinese medicine,we successfully established a rat model of perimenopausal dry eye with liver-kidney yin deficiency syndrome,which provides a theoretical and experimental basis for future systematic and in-depth research on the mechanism of perimenopausal dry eye with formula and evidence.
4.Impact of ischemia time and storage periods on RNA quality of fresh-frozen breast cancer and esophageal cancer tissue samples in biobank
Yang-si ZHENG ; Xuan-hao LIN ; Fan LI ; Kun-sheng XIAO ; Xi-feng CHEN ; Chun-peng LIU ; Pei-xiu YAO ; Shao-hong WANG
Fudan University Journal of Medical Sciences 2025;52(3):437-445
Objective To investigate the effects of ischemia time and storage periods on RNA quality in fresh-frozen breast cancer(BC)and esophageal cancer(EC)tissue samples in order to establish evidence-based protocols for biobank sample management.Methods The tumor(T)and paired normal(N)tissue samples from 6 cases of BC and 6 cases of EC were collected and cryopreserved in Biobank,Shantou Central Hospital.Mirror paraffin-embedded tissues were simultaneously prepared into sections for morphological analysis.The samples were divided into two groups of<15 min and 15-30 min according to ischemia time,and RNA quality was analyzed at 4 storage periods of 8-10 months(T1),14-16 months(T2),26-28 months(T3)and 38-40 months(T4).Results In 96 analyzed samples,93.8%(90/96)exhibited high quality(RIN≥6),with 89.6%(43/48)in BC and 97.9%(47/48)in EC.Significant differences in RIN were observed between BC group and EC group(8.050 vs.8.600,P=0.009).In EC group,RIN value was significantly negatively correlated with RNA yield(P<0.001).Moreover,RIN values of tumor-normal pairs exhibited markedly significant differences(7.550 vs.9.000,P<0.001).In contrast,no significant difference was detected in BC group(8.200 vs.7.700,P=0.348).Statistical analysis showed that RIN value was positively correlated with 28S/18S(P<0.001),but had no correlation with tumor content(P=0.676)and necrotic content(P=0.055).Neither ischemia time(<15 min vs.15-30 min:8.200 vs.8.300,P=0.932)nor storage periods(T1-T4:8.400,7.700,8.450,8.600,P=0.163)compromised RNA quality.Conclusion Organ origin and tissue type could influence RNA quality of fresh-frozen tissue samples.However,limited ischemia time(≤30 min)and long-term storage period(38-40 months)do not adversely affect RNA quality in fresh-frozen breast cancer and esophageal cancer tissue samples.
5.Establishment and evaluation of a rat model of perimenopausal dry eye with liver-kidney yin deficiency evidence
Sainan TIAN ; Guicheng LIU ; Yao CHEN ; Pei LIU ; Jun PENG ; Qinghua PENG ; Shujuan HU
Acta Laboratorium Animalis Scientia Sinica 2025;33(9):1270-1279
Objective To establish a rat model of perimenopausal dry eye with liver and kidney yin deficiency from the perspective of"measuring evidence by prescription"in Chinese medicine.Methods Thirty SPF-grade female SD rats were divided randomly into sham-operated,model,and Qiju Dihuang soup groups(n=10).Rats in the latter two groups underwent bilateral ovariectomy and were given 0.1%benzalkonium chloride eye drops combined with provocation for 10 weeks to establish a model of perimenopausal dry eye with liver and kidney yin deficiency.After modeling,rats in the Qiju Dihuang soup group were gavaged with Qiju Dihuang soup at a dose of 8.37 g/(kg·d),rats in the sham-operated and model groups were gavaged with saline at a rate of 1 mL/100(g·d)for 21 d.The general condition,retinal screen test scores,tear secretion,time of tear film rupture,and corneal fluorescein staining were observed and recorded in each group.Serum levels of follicle-stimulating hormone(FSH),estradiol(E2),and progesterone(PROG)were measured by enzyme-linked immunosorbent assay.Pathological damage to the cornea and lacrimal glands were detected by hematoxylin/eosin staining.Expression levels of the inflammatory factors interleukin(IL)-1β and tumor necrosis factor(TNF)-a in the cornea were detected by immunohistochemistry.Results Compared with the sham-operated group,rats in the model group showed behavioral signs of slow action and reaction,irritability,body mass loss,and increased anal temperature(P<0.05),decreased retinal screen test scores(P<0.05),tear secretion(P<0.05),and time of tear film rupture(P<0.05),and pathological damage to the cornea and lacrimal glands.FSH levels increased and E2 and PROG levels decreased(P<0.05)and expression levels of IL-1 and TNF-α increased in the model group compared with the sham group.All the above indexes were significantly improved in the Qiju Dihuang soup group compared with the model group.Conclusions From the perspective of"measuring evidence by formula"in Chinese medicine,we successfully established a rat model of perimenopausal dry eye with liver-kidney yin deficiency syndrome,which provides a theoretical and experimental basis for future systematic and in-depth research on the mechanism of perimenopausal dry eye with formula and evidence.
6.Exploring mechanism of action of hypericin in antidepressant effects based on single-cell sequencing
Hui-xin NI ; Hai-xin LIU ; Bing-can ZHOU ; Ming-heng CHEN ; Ping-yan LIN ; Zheng-tao GAO ; Xin-pei LIN ; Yao LIN ; Fang-zhen WU ; Qian XU
Chinese Pharmacological Bulletin 2025;41(5):837-843
Aim To investigate the antidepressant mechanism of hyperforin via the utilization of single-cell sequencing technology.Methods C57BL/6 mice were randomly divided into the control group,depres-sion model group,and hyperforin intervention group.The chronic unpredictable mild stress(CUMS)model was induced and drug interventions were administered for 28 d.Behavioral experiments were conducted to as-sess depressive symptoms,and hippocampal tissue was collected for single-cell RNA sequencing.Key cell populations and differentially expressed genes across groups were identified,followed by PPI network,GO,and KEGG enrichment analysis.Results Behavioral experiments indicated that CUMS successfully induced depressive symptoms in mice,while hyperforin im-proved depressive behavior.In the depression model group,the proportion of brain perivascular macrophages(PVM)increased,and this proportion decreased after hyperforin intervention,approaching the level seen in the control group.The top 20 common differentially ex-pressed genes in the PVM subpopulation were Saa3,Hbb-bs and Ccl24.PPI network analysis identified core targets,including Ccl2,Dhx9,C3,Msr1,Cxcl2 and Cx3cr1.KEGG enrichment analysis revealed pathways related to chemokines,phagosome formation,and inosi-tol phosphate metabolism.Conclusion The antide-pressant mechanism of hyperforin may be related to the regulation of Ccl24 and its related chemokine signaling pathway by PVM.
7.Predicting Clinically Significant Prostate Cancer Using Urine Metabolomics via Liquid Chromatography Mass Spectrometry
Chung-Hsin CHEN ; Hsiang-Po HUANG ; Kai-Hsiung CHANG ; Ming-Shyue LEE ; Cheng-Fan LEE ; Chih-Yu LIN ; Yuan Chi LIN ; William J. HUANG ; Chun-Hou LIAO ; Chih-Chin YU ; Shiu-Dong CHUNG ; Yao-Chou TSAI ; Chia-Chang WU ; Chen-Hsun HO ; Pei-Wen HSIAO ; Yeong-Shiau PU ;
The World Journal of Men's Health 2025;43(2):376-386
Purpose:
Biomarkers predicting clinically significant prostate cancer (sPC) before biopsy are currently lacking. This study aimed to develop a non-invasive urine test to predict sPC in at-risk men using urinary metabolomic profiles.
Materials and Methods:
Urine samples from 934 at-risk subjects and 268 treatment-naïve PC patients were subjected to liquid chromatography/mass spectrophotometry (LC-MS)-based metabolomics profiling using both C18 and hydrophilic interaction liquid chromatography (HILIC) column analyses. Four models were constructed (training cohort [n=647]) and validated (validation cohort [n=344]) for different purposes. Model I differentiates PC from benign cases. Models II, III, and a Gleason score model (model GS) predict sPC that is defined as National Comprehensive Cancer Network (NCCN)-categorized favorable-intermediate risk group or higher (Model II), unfavorable-intermediate risk group or higher (Model III), and GS ≥7 PC (model GS), respectively. The metabolomic panels and predicting models were constructed using logistic regression and Akaike information criterion.
Results:
The best metabolomic panels from the HILIC column include 25, 27, 28 and 26 metabolites in Models I, II, III, and GS, respectively, with area under the curve (AUC) values ranging between 0.82 and 0.91 in the training cohort and between 0.77 and 0.86 in the validation cohort. The combination of the metabolomic panels and five baseline clinical factors that include serum prostate-specific antigen, age, family history of PC, previously negative biopsy, and abnormal digital rectal examination results significantly increased AUCs (range 0.88–0.91). At 90% sensitivity (validation cohort), 33%, 34%, 41%, and 36% of unnecessary biopsies were avoided in Models I, II, III, and GS, respectively. The above results were successfully validated using LC-MS with the C18 column.
Conclusions
Urinary metabolomic profiles with baseline clinical factors may accurately predict sPC in men with elevated risk before biopsy.
8.Predicting Clinically Significant Prostate Cancer Using Urine Metabolomics via Liquid Chromatography Mass Spectrometry
Chung-Hsin CHEN ; Hsiang-Po HUANG ; Kai-Hsiung CHANG ; Ming-Shyue LEE ; Cheng-Fan LEE ; Chih-Yu LIN ; Yuan Chi LIN ; William J. HUANG ; Chun-Hou LIAO ; Chih-Chin YU ; Shiu-Dong CHUNG ; Yao-Chou TSAI ; Chia-Chang WU ; Chen-Hsun HO ; Pei-Wen HSIAO ; Yeong-Shiau PU ;
The World Journal of Men's Health 2025;43(2):376-386
Purpose:
Biomarkers predicting clinically significant prostate cancer (sPC) before biopsy are currently lacking. This study aimed to develop a non-invasive urine test to predict sPC in at-risk men using urinary metabolomic profiles.
Materials and Methods:
Urine samples from 934 at-risk subjects and 268 treatment-naïve PC patients were subjected to liquid chromatography/mass spectrophotometry (LC-MS)-based metabolomics profiling using both C18 and hydrophilic interaction liquid chromatography (HILIC) column analyses. Four models were constructed (training cohort [n=647]) and validated (validation cohort [n=344]) for different purposes. Model I differentiates PC from benign cases. Models II, III, and a Gleason score model (model GS) predict sPC that is defined as National Comprehensive Cancer Network (NCCN)-categorized favorable-intermediate risk group or higher (Model II), unfavorable-intermediate risk group or higher (Model III), and GS ≥7 PC (model GS), respectively. The metabolomic panels and predicting models were constructed using logistic regression and Akaike information criterion.
Results:
The best metabolomic panels from the HILIC column include 25, 27, 28 and 26 metabolites in Models I, II, III, and GS, respectively, with area under the curve (AUC) values ranging between 0.82 and 0.91 in the training cohort and between 0.77 and 0.86 in the validation cohort. The combination of the metabolomic panels and five baseline clinical factors that include serum prostate-specific antigen, age, family history of PC, previously negative biopsy, and abnormal digital rectal examination results significantly increased AUCs (range 0.88–0.91). At 90% sensitivity (validation cohort), 33%, 34%, 41%, and 36% of unnecessary biopsies were avoided in Models I, II, III, and GS, respectively. The above results were successfully validated using LC-MS with the C18 column.
Conclusions
Urinary metabolomic profiles with baseline clinical factors may accurately predict sPC in men with elevated risk before biopsy.
9.Predicting Clinically Significant Prostate Cancer Using Urine Metabolomics via Liquid Chromatography Mass Spectrometry
Chung-Hsin CHEN ; Hsiang-Po HUANG ; Kai-Hsiung CHANG ; Ming-Shyue LEE ; Cheng-Fan LEE ; Chih-Yu LIN ; Yuan Chi LIN ; William J. HUANG ; Chun-Hou LIAO ; Chih-Chin YU ; Shiu-Dong CHUNG ; Yao-Chou TSAI ; Chia-Chang WU ; Chen-Hsun HO ; Pei-Wen HSIAO ; Yeong-Shiau PU ;
The World Journal of Men's Health 2025;43(2):376-386
Purpose:
Biomarkers predicting clinically significant prostate cancer (sPC) before biopsy are currently lacking. This study aimed to develop a non-invasive urine test to predict sPC in at-risk men using urinary metabolomic profiles.
Materials and Methods:
Urine samples from 934 at-risk subjects and 268 treatment-naïve PC patients were subjected to liquid chromatography/mass spectrophotometry (LC-MS)-based metabolomics profiling using both C18 and hydrophilic interaction liquid chromatography (HILIC) column analyses. Four models were constructed (training cohort [n=647]) and validated (validation cohort [n=344]) for different purposes. Model I differentiates PC from benign cases. Models II, III, and a Gleason score model (model GS) predict sPC that is defined as National Comprehensive Cancer Network (NCCN)-categorized favorable-intermediate risk group or higher (Model II), unfavorable-intermediate risk group or higher (Model III), and GS ≥7 PC (model GS), respectively. The metabolomic panels and predicting models were constructed using logistic regression and Akaike information criterion.
Results:
The best metabolomic panels from the HILIC column include 25, 27, 28 and 26 metabolites in Models I, II, III, and GS, respectively, with area under the curve (AUC) values ranging between 0.82 and 0.91 in the training cohort and between 0.77 and 0.86 in the validation cohort. The combination of the metabolomic panels and five baseline clinical factors that include serum prostate-specific antigen, age, family history of PC, previously negative biopsy, and abnormal digital rectal examination results significantly increased AUCs (range 0.88–0.91). At 90% sensitivity (validation cohort), 33%, 34%, 41%, and 36% of unnecessary biopsies were avoided in Models I, II, III, and GS, respectively. The above results were successfully validated using LC-MS with the C18 column.
Conclusions
Urinary metabolomic profiles with baseline clinical factors may accurately predict sPC in men with elevated risk before biopsy.
10.Analysis of Dry Eye Animal Models Based on Clinical Disease and Syndrome Characteristics in Traditional Chinese and Western Medicine
Guicheng LIU ; Yao CHEN ; Binan WANG ; Pei LIU ; Jun PENG ; Sainan TIAN ; Qinghua PENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):200-208
ObjectiveAccording to the etiology, pathogenesis, and clinical characteristics of dry eye (DE), this paper aims to analyze existing DE animal models to provide recommendations for building more clinically relevant DE models that integrate traditional Chinese and Western medicine. MethodsBy the retrieval and analysis of relevant literature on DE animal experiments, combined with expert consensus, an evaluation scale was created to assess relevance from the perspectives of pathogenesis, diagnostic criteria, and traditional Chinese medicine (TCM) differentiation. On the basis of data provided by the literature, the clinical relevance was evaluated for the animal models constructed in the literature. ResultsAmong the existing methods for establishing a DE animal model, benzalkonium chloride eye-drop induction showed the highest clinical relevance, demonstrating 98% alignment with Western medicine. However, current models generally showed higher relevance to Western medicine than to TCM, and there was a lack of models integrating disease with syndrome. ConclusionAs DE involves diverse causes and pathogenesis, single-factor models cannot fully simulate the complex pathology of DE. Future research should focus on building multi-mechanism DE models, exploring new etiological directions, standardizing model evaluation systems, and promoting integration of traditional Chinese and Western medicine. This will help precisely simulate the pathophysiological process of human DE and provide more valuable guidance for clinical diagnosis and treatment, ultimately enhancing patient outcomes and satisfaction.

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