1.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
2.Interpretation of Middle-regulating Formulas Based on Fuxing Jue
Junqiao AN ; Yixin MA ; Dongmei LI ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):265-272
The Dunhuang manuscript Fuxing Jue takes the "Tangye Jingfa Tu" as the core of its theory on prescription and compatibility. Its medication principles mainly include the "five elements principle of tonifying and purging" and the "five elements principle of elimination and transformation". Based on the differentiation of deficiency and excess in the five Zang organs, it flexibly applies medicinal properties, usage, and flavor transformation for tonifying and purging, forming its unique method of medication and compatibility. In Taiyin disease, "fullness syndrome" often occurs together with "diarrhea", and these two conditions also serve as the primary indications for the middle-regulating formulas. Among them, Lizhong Wan (Tang) mainly address Taiyin deficiency. The three Xiexin Tang (Banxia Xiexin Tang, Gancao Xiexin Tang, Shengjiang Xiexin Tang) address Taiyin deficiency accompanied by pathogenic excess. The Sini Tangand Tongmai Sini Tang primarily treat dysfunction of the liver, spleen, and kidney with impaired opening and closing of Taiyin, manifesting as diarrhea. The medicinal flavors of middle-regulating formulas are pungent, sweet, and bitter, acting directly on the spleen of Taiyin. The pungent flavor induces purging of the spleen, sweet flavor tonifies the spleen, and bitter flavor eliminates lumps. When the constituent medicinal units of middle-regulating formulas are unified, the ratio of pungent to sweet flavors reflects the tonic and purgative strength of the formula. In addition, the two decoction methods, "short-term decoction to extract Qi" and "long-term decoction to extract flavor", also influence the formula's tonifying and purgative effects. Based on the composition of flavors and special decoction methods, this article discusses the differences in the use of middle-regulating formulas for treating "“fullness syndrome" versus "diarrhea". Dysfunction of the spleen can give rise to various diseases. Therefore, middle-regulating formulas are not limited to treating "deficiency, cold, and dampness" syndromes. Later generations of physicians further modified Lizhong Tang to treat "excess, heat, and dryness" syndromes, laying a solid foundation for more flexible and effective clinical application of middle-regulating formulas.
3.Intervention Strategies for Heart Failure with Preserved Ejection Fraction Using Combined Classical Formulas Based on the Theory of "Disease of Both Blood and Water"
Yuzhi JIA ; Qingyong HE ; Jie WANG ; Xin ZHAO ; Ziyi WANG ; Dongmei LI ; Junqiao AN
Journal of Traditional Chinese Medicine 2026;67(4):370-374
Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet (《金匮要略》), and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction (HFpEF), this paper systematically clarifies the pathomechanism of HFpEF, characterized by yang deficiency as the root, blood stasis as the pivotal factor and water retention as the manifestation. Accordingly, the therapeutic principles have been proposed, which are warming yang and banking up original qi to consolidate the root, activating blood and unblocking collaterals to smooth the mechanism, and promoting urination and regulating pivot to remove the branch. On this basis, a compound formula structure of "one monarch, one minister and one assistant" is established, forming an integrated intervention strategy that synergistically combines the three methods of warming yang, activating blood, and promoting urination through combined classical formulas. Zhenwu Decoction (真武汤), which warms yang and dissolves rheum, is used to consolidate the root and directly target the source of yang deficiency, serving as the monarch; Guizhi Fuling Pills (桂枝茯苓丸), which activates blood, promotes urination and unblocks the pivot, assists in interrupting the binding of blood stasis and water retention, serving as the minister; Tingli Dazao Xiefei Decoction (葶苈大枣泻肺汤), which regulates qi, disperses retained fluids, and eliminates the manifestation, alleviates acute water-retention symptoms, serving as the assistant. This compound formula is warming without being drying, diuretic without being drastic, and dispels stasis without consuming blood, thereby achieving the therapeutic effects of warming yang, activating blood, and promoting urination.
4.Standardization Challenges in Outcome Evaluation Systems of Animal Experiments and Considerations for Core Outcome Set Construction Strategies
Qingyong ZHENG ; Yongjia ZHOU ; Tengfei LI ; Jianguo XU ; Chen TIAN ; Hui LIU ; Min TIAN ; Ziyu ZHOU ; Caihua XU ; Yating CUI ; Junfei WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2026;46(1):138-148
Animal experimentation constitutes a critical link between basic research and clinical application, making its research quality and translational efficiency paramount. Although considerable progress has been made in standardizing operational procedures and ethical guidelines, the standardization of outcome evaluation systems has significantly lagged, creating a key bottleneck that constrains the quality of biomedical research and evidence synthesis. This deficiency is manifested by pronounced heterogeneity in outcome selection across similar studies, incomplete methodological reporting, and disparate criteria for result interpretation, which severely impairs the comparability of findings and the evidence integration. To cope with this challenge, this paper systematically introduces a mature methodological tool from clinical research–the core outcome set (COS)–and explores its construction strategies and application potential in the field of animal experimentation. Given the extensive diversity of animal experiments, a pragmatic strategy of "focusing on key areas, implementing phased pilots, and promoting gradual expansion" should be adopted. This approach prioritizes the development of domain-specific COS for disease areas characterized by high research volume, urgent translational needs, and well-established animal models. A multi-source integration pathway for COS development is detailed, comprising systematic literature searches, methodological appraisals, and expert consensus, with the feasibility of leveraging artificial intelligence (AI) to enhance efficiency also being examined. The development and promotion of such COS are not intended to restrict scientific exploration; rather, they aim to establish a new, tiered evaluation paradigm consisting of "core outcomes" (mandatory), "recommended outcomes" (encouraged), and "exploratory outcomes" (optional). This framework is expected not only to enhance research quality through standardization and to adhere to the "3R" principles but also to accelerate the accumulation of high-quality evidence. This, in turn, provides a solid foundation for higher-level evidence synthesis, ultimately facilitating the effective translation of basic research findings into clinical practice and providing an essential methodological framework for scientific advancement in relevant disciplines.
5.Improving the Certainty of Evidence in Animal Experiment Systematic Review/Meta-Analysis: An Empirical Study of the GRADE Method
Tengfei LI ; Qingyong ZHENG ; Jianguo XU ; Yiyi LI ; Yongjia ZHOU ; Caihua XU ; Mingyue ZHANG ; Jiexiang TIAN ; Gang WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(1):101-111
Animal experiments are essential tools in biomedical research, serving as a bridge between basic research and clinical trials. Systematic reviews and meta-analyses (SRs/MAs) of animal experiments are crucial methods for integrating evidence from animal experiment, which can facilitate the translation of findings into clinical research, reduce translational risks, and promote resource integration in basic research. With the continuous development of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, its application in SRs/MAs of animal experiments has gained increasing attention. This article first outlines the principles and specific applications of the GRADE methodology in SRs/MAs of animal experiments, including qualitative descriptive systematic reviews, meta-analyses, and network meta-analyses. It then deeply analyzes the misuse of the GRADE methodology in practice, including incorrect evidence grading, improper classification of evidence, misapplication in qualitative systematic reviews, inconsistencies between the documentation of the upgrading and downgrading process and results, and inappropriate use for making recommendations. Furthermore, this article comprehensively discusses the factors influencing the grading of evidence certainty in SRs/MAs of animal experiments, including the impact of bias risk, indirectness, inconsistency, imprecision, and publication bias on evidence downgrading, as well as the role of large effect sizes and cross-species consistency in evidence upgrading. Finally, in response to the issues discussed, improvement strategies are proposed, including further research and optimization of the GRADE methodology for SRs/MAs of animal experiments, the development of reporting guidelines tailored to the characteristics of SRs/MAs in animal experiment research, and enhanced professional training for researchers in the GRADE methodology. This article aims to improve the quality of evidence in SRs/MAs of animal experiments, strengthen their reliability in clinical decision-making, and promote the more efficient translation of findings from animal experiment research into clinical practice.
6.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
7.Therapeutic effect and mechanism of individualized treatment for hypertension patients with coronary heart disease under non-invasive cardiac output measurement
Haifen HUANG ; Qingyong CHEN ; Fang HE ; Ren LI
Journal of Clinical Medicine in Practice 2025;29(5):70-75,81
Objective To investigate the efficacy and mechanism of individualized treatment for hypertension patients with coronary heart disease under non-invasive cardiac output measurement.Methods A total of 94 hypertension patients with coronary heart disease in the hospital from January 2020 to August 2022 were selected and randomly divided into two groups,with 47 cases in each group.Control group was treated with conventional treatment,while observation group was treated with individualized treatment under non-invasive cardiac output measurement,and both group were continuously treated for 3 months.Clinical efficacy,the blood pressure control[diastolic blood pres-sure(DBP),systolic blood pressure(SBP)],cardiac ultrasound parameters[left ventricular end-systolic diameter(LVESD),left ventricular mass index(LVMI),interventricular septal thickness(IVS),left ventricular end-diastolic diameter(LVEDD)],heart rate variability[the standard devia-tion of the average RR interval(SDANN),the standard deviation of the RR interval of all sinus beats(SDNN),and the proportion of adjacent NN>50 ms in the number of sinus beats(PNN50)],indi-cators of myocardial injury[α-hydroxybutyrate dehydrogenase(α-HBDH),lactate dehydrogenase(LDH),creatine kinase(CK)],transforming growth factor-β1(TGF-β1)/pancreatic cancer-deficiency factor(Smads)signaling pathway,and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results The total effective rate of the observation group was 95.74%,which showed no significant difference compared with 85.11%of the control group(P>0.05).After 1 and 3 months of treatment,the levels of DBP and SBP in both groups were de-creased significantly compared with those before treatment(P<0.05),and the LVMI,IVS,LVEDD and LVESD in the observation group were significantly lower than those in the control group(P<0.05).After 3 months of treatment,the SDANN,PNN50 and SDNN in observation group were significantly higher than those in control group(P<0.05),while CK,α-HBDH and LDH as well as the expression levels of TGF-β1R Ⅰ,TGF-β1R Ⅱ,Smad1 and Smad2 were significantly lower than those in the control group(P<0.05).After 3 months of follow-up,the incidence rate of MACE in observation group was 6.38%,which showed no significant difference compared with 14.89%in control group(P>0.05).Conclusion Compared with conventional treatment regi-men,individualized treatment regimen with non-invasive cardiac output measurement can signifi-cantly alleviate myocardial injury,reverse ventricular hypertrophy and improve heart rate variability,and its mechanism may be related to the inhibition of the TGF-β1/Smads signaling pathway.
8.Clinical Efficacy Evaluation of Tanreqing Injection Combined with Ceftazidime in Treatment of Phlegm Heat Obstructing Lung Syndrome in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Mengmeng ZHANG ; Qiao LI ; Qingyong XIONG ; Jiayao LI ; Linna XIE ; Jiasheng LU ; Zegeng LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):170-175
ObjectiveTo explore the effect of Tanreqing injection combined with Ceftazide on the clinical efficacy, lung function, and laboratory inflammatory index of patients suffering from phlegm heat obstructing lung syndrome in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). MethodFrom June 2021 to June 2023, 76 patients diagnosed with phlegm heat obstructing lung syndrome in AECOPD were enrolled in the respiratory and critical medical department of Jieshou Hospital of Traditional Chinese Medicine. They were randomly divided into a control group and an observation group with 38 cases each. The control group used Ceftazidime intravenous drip and other conventional oxygen inhalation and antispasmodic treatment measures of western medicine. The observation group received Tanreqing injection intravenous drip based on the treatment of the control group, with a course of 10 days. The changes of laboratory indicators such as hs-CRP, calcitonin (PCT), and interleukin-6 (IL-6) before and after treatment were analyzed, and the improvement of forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), one second rate (FEV1/FVC), assessment and improvement of the British Medical Research Society’s dyspnea index (mMRC), self-evaluation test of chronic obstructive pulmonary disease patients (CAT), and traditional Chinese medicine syndrome score was compared. In addition, the total effective rate between the two groups after treatment was compared. ResultAfter treatment, the hs-CRP, PCT, IL-6, FEV1, FVC, FEV1/FVC, mMRC, CAT scores, and traditional Chinese medicine syndrome evaluation of both groups improved (P<0.01). After treatment, compared with the control group, the observation group showed more significant improvements in hs-CRP, PCT, IL-6, FEV1, FVC, FEV1/FVC, mMRC, CAT scores, and traditional Chinese medicine syndrome evaluation, and the difference was statistically significant (P<0.05,P<0.01). The total clinical effective rate of the control group was 86.84% (33/38), while that of the observation group was 94.74% (36/38). The therapeutic effect of the observation group was better than that of the control group (χ2=8.471, P<0.05). ConclusionTanreqing injection combined with Ceftazidime has obvious efficacy in the treatment of phlegm heat obstructing lung syndrome in AECOPD, which is better than the treatment of Ceftazidime antibiotics alone. It can reduce the risk of acute exacerbation, alleviate clinical symptoms, and delay the decline of lung function.
9.Based on the correlation between "yang transforming qi,yin shaping up the body" and epicardial adipose tissue,discussing the prevention and treatment strategies of atrial fibrillation by traditional Chinese medicine
Jin LIU ; Qingyong HE ; Gaocan REN ; Yixiang LI
Journal of Beijing University of Traditional Chinese Medicine 2024;47(8):1131-1138
Epicardial adipose tissue (EAT) is a fat reservoir close to the myocardium and visceral pericardium. It has special anatomical and physiological characteristics. The volume and deposition site of EAT are closely related to the occurrence and development of atrial fibrillation (AF). This article discusses the connotation of the traditional Chinese medicine theory," yang transforming qi and yin shaping up the body",and holds that the essence of abnormal accumulation of EAT is "yang transforming qi deficiency and yin constituting form too much". Yin pathogen gradually accumulates,local yin and yang imbalance occurs,and abnormal secretion occurs. With the extension of time,the intrinsic yang heat is accompanied and becomes increasingly exuberant. Finally,yin is difficult to control yang,resulting in EAT infiltrating normal tissues,inducing and promoting the occurrence and progression of AF. Under the guidance of this theory,when distinguishing the amount of yin and yang between the body and EAT,considering the ability of "yang transforming qi" and "yin constituting form" in the whole and part,the method of supporting yang and eliminating yin should be reasonably selected. At the beginning of the disease,it is mainly to restore "yang transforming qi". By avoiding the accumulation of evil from the yin,it dissipates the body of the yin that has become. When the disease progresses,it is necessary to " eliminate pathogenic factor",supplemented by different treatment methods such as eliminating dampness,activating qi,and promoting blood circulation. Furthermore,the whole course of the disease should take care of the patient's deficiency,pay attention to strengthening yang and tonifying the healthy qi,and eliminate yin and evil promptly to improve clinical efficacy.
10.Advances and Challenges in the Research of Integration Methods of Animal Experimental Evidence
Qingyong ZHENG ; Tengfei LI ; Jianguo XU ; Yongjia ZHOU ; Zhichao MA ; Na WANG ; Molan LI ; Wenjing YANG ; Peirun WU ; Haidong WANG ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2024;44(5):567-576
Integrating evidence from animal experiments is a critical component of biomedical research, providing essential prior information for in-depth investigations of disease mechanisms and new drug development. Animal models have played an irreplaceable role in simulating human diseases. However, the integration of evidence from animal experiments has faced numerous challenges, including insufficient emphasis, significant heterogeneity in study designs, high publication bias, and discrepancies with clinical research practices. This paper first identifies existing issues in the original research evidence from animal experiments, such as the selection and applicability of animal models, considerations in the design of experimental studies, and factors influencing the translation of animal experimental evidence. It then discusses various methods for integrating this evidence, including systematic review and meta-analysis, overview of systematic review/umbrella review, scoping review, and evidence mapping, while highlighting recent advancements in their application. Finally, the paper addresses the main challenges currently encountered in the integration of evidence from animal experiments and proposes targeted improvement strategies aimed at enhancing the efficiency of translating research outcomes into clinical practice and promoting the advancement of evidence-based medicine. By continuously optimizing original experimental research protocols and evidence integration practices, this work aims to establish a more efficient and scientific environment for the synthesis of evidence from animal experiments, ultimately contributing to clinical trials and human health.

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