1.Staged Characteristics of Mitochondrial Energy Metabolism in Chronic Heart Failure with Heart-Yang Deficiency Syndrome and Prescription Intervention from Theory of Reinforcing Yang
Zizheng WU ; Xing CHEN ; Lichong MENG ; Yao ZHANG ; Peng LUO ; Jiahao YE ; Kun LIAN ; Siyuan HU ; Zhixi HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):129-138
Chronic heart failure (CHF) is a complex clinical syndrome caused by ventricular dysfunction, with mitochondrial energy metabolism disorder being a critical factor in disease progression. Heart-Yang deficiency syndrome, as the core pathogenesis of CHF, persists throughout the disease course. Insufficiency of heart-Yang leads to weakened warming and propelling functions, resulting in the accumulation of phlegm-fluid, blood stasis, and dampness. This eventually causes Qi stagnation with phlegm obstruction and blood stasis with water retention, forming a vicious cycle that exacerbates disease progression. According to the theory of reinforcing Yang, the clinical experience of the traditional Chinese medicine (TCM) master Tang Zuxuan in treating CHF with heart-Yang deficiency syndrome, and achievements from molecular biological studies, this study innovatively proposes an integrated research framework of "TCM syndrome differentiation and staging-mitochondrial metabolism mechanisms-intervention with Yang-reinforcing prescriptions" which is characterized by the integration of traditional Chinese and Western medicine. Heart-Yang deficiency syndrome is classified into mild (Stage Ⅰ-Ⅱ), severe (Stage Ⅲ), and critical (Stage Ⅳ) stages. The study elucidates the precise correlations between the pathogenesis of each stage and mitochondrial metabolism disorders from theoretical, pathophysiological, and therapeutic perspectives. The mild stage is characterized by impaired biogenesis and substrate-utilization imbalance, corresponding to heart-Yang deficiency and phlegm-fluid aggregation. Linggui Zhugantang and similar prescriptions can significantly improve the expression of peroxisome proliferator-activated receptor gamma co-activator-1α(PGC-1α)/silent information regulator 2 homolog 1 (SIRT1) and ATPase activity. The severe stage centers on oxidative stress and structural damage, reflecting Yang deficiency with water overflow and phlegm-blood stasis intermingling. At this stage, Zhenwu Tang and Qiangxin Tang can effectively mitigate oxidative stress damage, increase adenosine triphosphate (ATP) content, and repair mitochondrial structure. The critical stage arises from calcium overload and mitochondrial disintegration, leading to the collapse of Yin-Yang equilibrium. At this stage, Yang-restoring and crisis-resolving prescriptions such as Fuling Sini Tang and Qili Qiangxin capsules can inhibit abnormal opening of the mitochondrial permeability transition pore (MPTP), reduce cardiomyocyte apoptosis rate, and protect mitochondrial function. By summarizing the characteristics of mitochondrial energy metabolism disorders at different stages of CHF, this study explores the application of the theory of reinforcing Yang in treating heart-Yang deficiency syndrome and provides new insights for the clinical diagnosis and treatment of CHF.
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.Analysis of the dilemmas of the simplified ethical review procedure in practice
Benze HU ; Yuhong HUANG ; Xufang GU ; Weihua GUO ; Siyuan HU ; Yaqing YANG
Chinese Medical Ethics 2025;38(1):46-51
In September 2023, the Measures for Scientific and Technological Ethics Review (Trial Implementation) was issued, revising the provisions related to the simplified procedure for ethical review in Chapter 3, Section 3. This revision of these provisions provides systematic guarantees for further optimizing ethical review work, ensuring that ethical review procedure is well-regulated, and improving scientific research efficiency. The “simplified procedure” does not mean reducing the quality and requirements of the review. Instead, based on always following internationally recognized ethical standards and emphasizing not violating national laws and regulations, improving the efficiency of ethical review and subsequent research work, and promoting the development of life sciences and medical research involving humans. In practical work, it introduces numerous new opportunities and challenges for the improvement of ethics review ability, such as new tests on the judgment and decision-making power of ethics committees, how to ensure the reliability and controllability of the conditions related to the simplified review procedure, and how to determine the basic conditions for adopting the simplified review procedure for review. Therefore, to actively respond to the challenges and possible risks brought by the simplified procedure review, efforts should be made to achieve three “unifications”, including the unification of researchers’ moral autonomy and the heteronomy of supervision implemented by relevant departments; the unification of the standard formulation of the simplified procedure review and the review work in practice; and the unification of ethical responsibility and legal responsibility.
4.Prevention and Treatment Ideas of Epileptogenesis in Children under the Perspective of Traditional Chinese Medicine and Western Medicine
Hanjiang CHEN ; Ping RONG ; Xilian ZHANG ; Siyuan HU ; Rong MA
Journal of Traditional Chinese Medicine 2025;66(3):251-255
Epileptogenesis is a dynamic process of gradual progression from normal developing brain to pathological epileptic brain, which is the latent and budding stage of epilepsy. Combining the understanding of epileptogenesis in children from Western medicine and traditional Chinese medicine (TCM), we proposed that the viewpoints of constitutional transformation, phlegm pathogen inducing epilepsy, and brain collateral damage, which correspond to key pathological mechanisms, namely gene polymorphism, immunoinflammation, and microvascular dysfunction of the blood-brain barrier, respectively. Based on these insights, strategies for prevention and treatment of epileptogenesis in children, as well as potential research directions are explored.
5.Research on cardiometabolic risk factors of workers in new forms of employment
Siyuan WANG ; Xiaoshun WANG ; Rui GUAN ; Hong YU ; Xin SONG ; Binshuo HU ; Zhihui WANG ; Xiaowen DING ; Dongsheng NIU ; Tenglong YAN ; Huadong XU
China Occupational Medicine 2025;52(2):150-154
Objective To analyze the prevalence status of cardiometabolic risk factor (CMRF) and its aggregation among workers engaged in new forms of employment. Methods A total of 5 429 new employment workers (including couriers, online food delivery workers, and ride hailing drivers) who underwent health medical examinations at a tertiary hospital in Beijing City were selected as the research subjects using the judgment sampling method. Data on waist circumference, blood pressure, blood glucose, and blood lipid levels were collected to analyze their CMRF [central obesity, elevated blood pressure, elevated blood glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol (HDL-C)] and their aggregation (with ≥ 2 of the above 5 risk factors) status. Results The detection rates of central obesity, elevated blood pressure, elevated blood glucose, elevated triglycerides, and reduced HDL-C were 61.2%, 38.2%, 29.5%, 40.9% and 22.6%, respectively. The detection rates of CMRF aggregation was 57.8%. The result of multivariable logistic regression analysis showed that male, age ≥45 years, smoking, overweight, and obesity were risk factors for CMRF aggregation (all P<0.05). Conclusion The detection rate of CMRF and its aggregation among workers with new forms of employment in Beijing City is relatively high. Targeted prevention and control efforts should be strengthened for high-risk populations, especially males, workers aged ≥45 years, smokers, and those who are overweight or obese.
6.The Guideline for the Diagnosis and Treatment of Pediatric Food Accumulation and Stagnation in Chinese Medicine
Xia ZHAO ; Mengting QIU ; Siyuan HU ; Yanhong QIN ; Zheng XUE ; Liqun WU
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(4):531-537
Following the evidence-based diagnosis and treatment guideline development method for common pediatric diseases,the The Guideline for the Diagnosis and Treatment of Pediatric Food Accumulation and Stagnation in Chinese Medicine was formed through literature retrieval,expert questionnaire survey,expert discussion meeting,and solicitation of opinions.The revised content includes the scope of the guideline,normative reference documents,terms and definitions,diagnosis,syndrome differentiation,treatment,pre-vention and nursing suggestions,etc.,aiming to update the clinical diagnosis and treatment plan of Chinese medicine for accumulation and provide important clinical decision-making references for clinical physicians to rationally apply the diagnosis and treatment plan of Chinese medicine in the prevention and treatment of accumulation and stagnation in Children.
7.Study on the mechanism of endurance exercise regulating miR-378 to improve cardiac fibrosis in rats with pressure overload-induced heart failure
Siyuan HU ; Xiajun XIONG ; Senjie ZHONG
Chinese Journal of Rehabilitation Medicine 2025;40(2):180-187
Objective:To explore the mechanism of exercise on improving cardiac fibrosis in heart failure,and the role of miR-378 in regulating Cardiac fibrosis by endurance exercise.Method:Twenty-four SD rats were selected and used transverse aortic constriction(TAC)to replicate the rat model of heart failure with cardiac fibrosis.They were randomly divided into the sham group,the TAC group and the exercise group.The exercise group performed swimming endurance exercise for 6 weeks.After train-ing,the rats in each group were analyzed by echocardiography and pathological morphology,and the serum NT-proBNP concentration was detected by ELISA.Western Blot and qPCR were used to detect the expression of α-SMA,Col Ⅰ,Col Ⅲ,TGF-β1,miR-378,TGF-β1 mRNA,Col1a1,and Col3a1 in heart tissue.Result:Compared with the sham group,left ventricular ejection fraction(LVEF),left ventricular short-axis shortening(LVFS),and output per beat(SV)were significantly decreased(P<0.05)in TAC group,and there were no significant differences in left ventricular end-diastolic volume(EDV)and left ventricular end-systolic volume(ESV)(P>0.05),and the serum NT-proBNP concentration was increased significantly(P<0.01).Patho-logical staining in TAC group showed that cardiomyocytes were obviously edematous and disorganzied,and col-lagen volume fraction(CVF)was significantly increased(P<0.05);the expression of fibrosis-related factors α-SMA,Col Ⅰ,Col Ⅲ,TGF-β1,TGF-β1 mRNA,Col1a1 and Col3a1 was significantly up-regulated(P<0.05),and the expression of miR-378 was significantly down-regulated(P<0.05).Compared with the TAC group,in the Ex group,LVEF,LVFS,SV increased significantly(P<0.05),LVIDs,ESV decreased significantly(P<0.01),NT-proBNP concentration decreased(P<0.05);CVF decreased significantly(P<0.05).The expressions of Col Ⅰ,Col Ⅲ,Col1a1 and Col3a1 in heart tissues were significantly reduced(P<0.05),α-SMA was not significantly different,and the expression of miR-378 increased(P<0.05).The expression of TGF-β1 and mRNA was reduced(P<0.05).Conclusion:TAC can better replicate the cardiac fibrosis model of pressure-overload heart failure.Endurance exercise can up-regulate miR-378 expression,which can effectively improve the level of cardiac fibrosis,slow down the degree of heart failure,and restore cardiac function.This mechanism of action may be related to the inhibition of cardiac fibroblast activation by exercise-regulated miR-378.
8.Development of a classification system for nursing science and directions of future development
Ying WU ; Lanshu ZHOU ; Siyuan TANG ; Changrong YUAN ; Hongying PI ; Xiuying HU ; Hong LU ; Jingli CHEN ; Yanling WANG ; Mei SUN ; Guihua XU
Chinese Journal of Nursing 2025;60(13):1541-1547
As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.
9.Research progress in pathogenesis and diagnosis of pulmonary oxygen toxicity
Bohao REN ; Yi MIN ; Siyuan WU ; Haoyang WEI ; Jiale HU ; Guoyang HUANG
Military Medical Sciences 2025;49(5):391-395
High partial pressure oxygen is widely used in the treatment of ischemic and hypoxic diseases and in diving.However,chronic inhalation of gas with high oxygen partial pressure can have a toxic effect on the body,that is,oxygen toxicity.The lung is one of the target organs where injury is the most pronounced and direct after exposure to high partial pressure oxygen.This article reviews the research progress in pathogenesis and diagnosis of pulmonary oxygen toxicity in the hope of providing a reference for related prevention and treatment.
10.Construction of myeloid specific nuclear factor ⅠB conditional gene knockout mice and its intestinal inflammation manifestation
Manqiu HU ; Li ZHOU ; Siyuan CHEN ; Hongtao LIU ; Hao ZHANG ; Song HE ; Zhihang ZHOU
Academic Journal of Naval Medical University 2025;46(2):215-222
Objective To investigate the relationship between the expression of nuclear factor ⅠB(NFⅠB)in myeloid cells and intestinal inflammation by constructing NFⅠB conditional gene knockout(cKO)mice.Methods Human Protein Atlas database,Genotype-Tissue Expression database,and FANTOM5 database were used to investigate the expression of NFⅠB in inflammatory cells.NFⅠB-floxed mice were constructed using CRISPR/Cas9 technology and hybridized with LyZ2-Cre transgenic mice.Myeloid specific NFⅠB cKO mice(NFⅠBfl/flLyz2-Cre)were obtained by self-crossing the progeny.After the genotype identification of mice by agarose gel electrophoresis,4 NFⅠB cKO mice of C57BL/6N strain were selected as experimental group,and 4 non-cKO mice were selected as control group.Both groups were induced with 2.5%dextran sulfate sodium salt(DSS)under the same condition to establish a chronic colitis model,and the severity of colitis was evaluated by clinical manifestations and histopathology.Results Analysis showed that NFⅠB was expressed in both myeloid granulocytes and monocytes,and the highest expression was found in neutrophils.NFⅠB cKO mice were successfully constructed using CRISPR/Cas9 technology and Cre-loxP system.DSS-induced enteritis NFⅠB cKO mice developed diarrhea,gross blood stools,reduced activity,and weight loss in a short time.The gross examination of the intestines showed that the colon of the NFⅠB cKO mice was significantly shorter than that of the non-cKO mice([8.23±0.35]cm vs[10.30±0.36]cm,P<0.01).Intestinal H-E staining showed changes in mucosal glandular structure and connective tissue hyperplasia with extensive inflammatory cell infiltration in NFⅠB cKO mice.The histological score of NFⅠB cKO mice was significantly higher than that of non-cKO mice(4.25±0.50 vs 0.50±0.58,P<0.01).Intestinal immunohistochemical staining showed that more CD11b positive cells were recruited in NFⅠB cKO mice than non-cKO mice.Conclusion Myeloid specific NFⅠB cKO mice have been successfully constructed,and NFⅠB in myeloid cells can reduce infiltration of immune cells(granulocytes or/and monocytes)to inhibit intestinal inflammation.

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