1.Potential Toxicity of Traditional Chinese Medicine and Its Scientific Regulation
Ting WANG ; Can TU ; Lin ZHANG ; Zhaojuan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):1-9
In recent years, with the extensive application of traditional Chinese medicine (TCM) both domestically and internationally, safety concerns associated with TCM have been frequently reported. Notably, some TCM substances traditionally regarded as ''non-toxic'' have exhibited significant adverse reactions during clinical use, drawing substantial attention to TCM safety. This study first analyzed the risk factors contributing to the potential toxicity of TCM from perspectives such as drug properties, individual constitution, and clinical medication practices. Subsequently, it proposed research strategies and methodologies for investigating potential TCM toxicity: ① conduct studies under the guidance of TCM theory, adhering to the principle of diversity and unity. ② adopt an integrated research paradigm of ''originating from clinical practice-syndrome-based foundation-returning to clinical practice-serving supervision''. ③ implement a three-tier technical system of ''Mathematical modeling-high-throughput screening via liquid chromatography-mass spectrometry (LC-MS)-systems biology'' to systematically elucidate the causes, material basis, and mechanisms of toxicity. Finally, scientific regulatory recommendations for potential TCM toxicity are proposed: ① establish a multidimensional prevention and control system addressing drug properties, physical constitution factors, and clinical medication practices. ② address the impact of modern processing techniques on the safety of new TCM drugs. ③ strengthen the revision of standards for Chinese medicinal materials to ensure their safety. ④ account for disease-syndrome combination animal models and interspecies differences in safety assessment outcomes. This study aims to overcome critical challenges in TCM regulation by advancing evaluation through research and driving research through evaluation. By establishing a high-level scientific regulatory framework, it seeks to not only safeguard clinical medication safety but also propel the high-quality development of the TCM industry, thereby providing scientific support for the inheritance and innovative evolution of TCM.
2.Potential Toxicity of Traditional Chinese Medicine and Its Scientific Regulation
Ting WANG ; Can TU ; Lin ZHANG ; Zhaojuan GUO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):1-9
In recent years, with the extensive application of traditional Chinese medicine (TCM) both domestically and internationally, safety concerns associated with TCM have been frequently reported. Notably, some TCM substances traditionally regarded as ''non-toxic'' have exhibited significant adverse reactions during clinical use, drawing substantial attention to TCM safety. This study first analyzed the risk factors contributing to the potential toxicity of TCM from perspectives such as drug properties, individual constitution, and clinical medication practices. Subsequently, it proposed research strategies and methodologies for investigating potential TCM toxicity: ① conduct studies under the guidance of TCM theory, adhering to the principle of diversity and unity. ② adopt an integrated research paradigm of ''originating from clinical practice-syndrome-based foundation-returning to clinical practice-serving supervision''. ③ implement a three-tier technical system of ''Mathematical modeling-high-throughput screening via liquid chromatography-mass spectrometry (LC-MS)-systems biology'' to systematically elucidate the causes, material basis, and mechanisms of toxicity. Finally, scientific regulatory recommendations for potential TCM toxicity are proposed: ① establish a multidimensional prevention and control system addressing drug properties, physical constitution factors, and clinical medication practices. ② address the impact of modern processing techniques on the safety of new TCM drugs. ③ strengthen the revision of standards for Chinese medicinal materials to ensure their safety. ④ account for disease-syndrome combination animal models and interspecies differences in safety assessment outcomes. This study aims to overcome critical challenges in TCM regulation by advancing evaluation through research and driving research through evaluation. By establishing a high-level scientific regulatory framework, it seeks to not only safeguard clinical medication safety but also propel the high-quality development of the TCM industry, thereby providing scientific support for the inheritance and innovative evolution of TCM.
3.Effect of Oral Sodium Butyrate on Skeletal Muscle Atrophy via The Gut-muscle Axis in Antibiotic-pretreated CT26 Tumor-bearing Mice and Its Mechanism
Shu-Ling ZHANG ; Jun-Wei WANG ; Shi-Liang HU ; Tu-Tu WANG ; Shun-Chang LI ; Jia FAN ; Jun-Zhi SUN
Progress in Biochemistry and Biophysics 2026;53(3):724-739
ObjectiveTo explore the effect of oral sodium butyrate on skeletal muscle atrophy in CT26 tumor mice through the gut microbiota-skeletal muscle axis and its potential mechanism. MethodsSixty SPF BALB/c male mice aged 8 weeks were randomly divided into a normal control group (NC, n=18) and a ABX-depleted group (ABX, n=42). The ABX mice were pretreated with a quadruple antibiotic cocktail via oral gavage (0.2 ml per administration, once daily, 6 d per week, for 2 weeks), whereas NC received an equal volume of sterile water. The quadruple antibiotic cocktail consisted of metronidazole (1 g/L), vancomycin (0.5 g/L), ampicillin (1 g/L), and gentamicin (1 g/L). Following successful pretreatment, six mice from each group were randomly selected for gut microbiota sequencing analysis and designated as the Abx group and the NC0 group, respectively. Theremaining mice in ABX were subcutaneously inoculated in the dorsum with 0.2 ml of CT26 cell suspension (at a cell density of 1×107/ml). Then these mice were randomly allocated into three subgroups: a control tumor bearing model group (0_NaB, n=12), a tumor-bearing model group receiving low-dose oral sodium butyrate (L_NaB, n=12), a tumor-bearing model group receiving high-dose oral sodium butyrate (H_NaB, n=12). And mice in NC were inoculated at the same site with 0.2 ml of normal saline. The administration dose for L_NaB was 0.3 g/(kg·d), that for H_NaB was 0.5 g/(kg·d), while NC and 0_NaB were given the same volume of normal saline (0.2ml per time, once daily, 6 d per week, for 4 weeks). The general condition of mice was monitored, and forelimb grip strength gastrocnemius muscle mass and its muscle fiber cross-sectional area were measured for each group. The structural changes in gut microbiota were assessed by 16S rRNA sequencing of cecal contents. Pathological alterations in the intestinal wall were examined via HE staining. Serum and gastrocnemius muscle levels of TNF‑α, IL-6, IL-1β, and LPS were quantified using ELISA. The protein expression of ZO-1 and occludin in the small intestine, as well as proteins associated with the TLR4/MyD88/NF-κB signaling pathway in the gastrocnemius muscle, were detected by Western blot analysis. Results(1) The alpha-diversity in Abx was significantly lower than that in NC0 (P<0.01), a significant decrease of the mass and muscle fiber cross-sectional area of the gastrocnemius (P<0.01), with the majority of gut microbiota being effectively depleted. (2) Compared with NC, the subcutaneous tumors of mice in 0_NaB were prominent, a significant increase of the mass and muscle fiber cross-sectional area of the gastrocnemius, accompanied by a significant decrease in body weight at the end of the 3th and 4th week (P<0.05), and a significant weakening of the forelimb grasping strength at the 5th and 6th week (P<0.01). Compared with 0_NaB, the tumor mass of mice in L_NaB and H_NaB showed a significant decreasing trend, and the grip strength of the forelimbs significantly increased at the 5th and 6th week (P<0.05, P<0.01). (3) Compared with 0_NaB, the Shannon and Observed species indices in α diversity of L_NaB and H_NaB were significantly increased (P<0.05). At the genus level, compared with 0_NaB, L_NaB exhibited a significant decrease in the relative abundance of Parasutterella (P< 0.01), while H_NaB showed significant reductions in the relative abundances of both Escherichia-Shigella and Parasutterella (P < 0.01). (4) Compared with 0_NaB, the small intestinal tissue structure in L_NaB and H_NaB was more intact, the infiltration of inflammatory cells was significantly reduced, and the capillaries were slightly dilated. The expression levels of ZO-1 and occludin proteins in L_NaB were significantly increased (P<0.01). (5) The LPS concentration in the gastrocnemius muscle and the protein expression levels of TLR4, MyD88, p-IκBα, and p-NF‑κB p65 in L_NaB and H_NaB were significantly lower than those in 0_NaB (P<0.05). The serum TNF‑α concentration in H_NaB and TNF-α concentration in the gastrocnemius muscle of the L_NaB and H_NaB were significantly lower than those in 0_NaB (P<0.05, P<0.01, P<0.01). ConclusionOral administration of NaB can improve gut microbiota α diversity, adjusting its composition, improving intestinal mucosal barrier function, reducing the LPS-induced pro-inflammatory response, and delaying skeletal muscle atrophy. The underlying mechanism may involve down regulation of TLR4/MyD88/NF-κB signaling in skeletal muscle.
4.Long-term survival outcomes and prognostic factors following radical resection of pancreatic body and tail cancer:a retrospective analysis of 992 patients
Dong XU ; Yang WU ; Kai ZHANG ; Nan LYU ; Qianqian WANG ; Pengfei WU ; Jie YIN ; Baobao CAI ; Guodong SHI ; Jianzhen LIN ; Yazhou WANG ; Lingdi YIN ; Zipeng LU ; Min TU ; Jianmin CHEN ; Feng GUO ; Jishu WEI ; Junli WU ; Wentao GAO ; Cuncai DAI ; Yi MIAO ; Kuirong JIANG
Chinese Journal of Surgery 2026;64(1):46-54
Objective:To investigate the survival outcomes and prognostic factors in patients undergoing radical resection for pancreatic body and tail cancer.Methods:A retrospective case series study was conducted on 992 patients who underwent radical resection for pancreatic body and tail cancer at the Pancreatic Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to June 2024. In this study, 577 (58.2%) were male and 415 (41.8%) were female,with an age of (65±9) years (range: 26 to 86 years). Follow-up continued until June 2024. Survival rates were estimated using the Kaplan-Meier method,and prognostic factors were identified using univariate and multivariate Cox proportional hazards models.Results:Among 992 patients,open surgery was the predominant approach (89.1%, 884/992), and radical antegrade modular pancreatosplenectomy (RAMPS) was performed in 317 patients (32.0%). Combined organ resection,venous resection,and arterial resection were performed in 23.5%, 9.3%,and 11.2% of patients,respectively. The rates of R0, R1-1 mm, and R1-direct resections were 49.8% (494/992),41.5% (412/992), and 8.7% (86/992),respectively. Stage ⅡB was the most common TNM stage (32.2%,319/992). A total of 801 patients (80.8%) received adjuvant chemotherapy. The median follow-up period was 32.0(8.8) months(range:3.2 to 105.3 months),during which 508 patients (51.2%) died. The overall median survival (OS) was 26.4 months,with 1-,3-, and 5-year survival rates of 79.0%,40.0%, and 29.0%, respectively. In the recent five years (from 2020 to 2024), the median OS improved significantly to 34.1 months compared to 20.0 months from 2016 to 2019 ( P<0.01). Histological subtype analysis showed that the median OS time was 26.7 months for pancreatic ductal adenocarcinoma (PDAC, n=855),58.9 months for invasive intraductal papillary mucinous carcinoma (IPMC, n=32),and 15.7 months for adenosquamous carcinoma of pancreas (ASCP, n=73) ( P=0.001). Among PDAC patients, adjuvant chemotherapy significantly improved survival (29.1 months vs. 14.4 months, P<0.01);in IPMC patients, adjuvant chemotherapy also extended survival (65.7 months vs. 58.9 months, P=0.047). Although ASCP patients receiving chemotherapy had a longer median OS time than those without (18.8 months vs. 8.9 months),the difference was not statistically significant ( P=0.151). Multivariate Cox regression analysis in PDAC patients indicated that adjuvant chemotherapy, R0 resection, T stage,N stage,and tumor differentiation were independent prognostic factors ( P<0.01). The median OS time by TNM stage was:not reached for stage ⅠA, 51.6 months for ⅠB, 25.5 months for ⅡA, 23.7 months for ⅡB, 23.0 months for Ⅲ, and 14.4 months for Ⅳ. The median OS time for R0,R1-1 mm,and R1-direct resections was 34.1,24.7,and 15.7 months,respectively ( P<0.01). Conclusion:Adjuvant chemotherapy,R0 resection,tumor stage,and differentiation are independent prognostic factors for pancreatic body and tail cancer.
5.Mechanisms of Xiaozhi Qinggan Decoction in Treatment of Metabolic Dysfunction-associated Steatotic Liver Disease by Regulating Ferroptosis
Haihang DONG ; Yuying TU ; Xingrong LI ; Yujie CAI ; Yi REN ; Huiqin ZHANG ; Yinqiang ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):109-119
ObjectiveTo investigate the mechanism of Xiaozhi Qinggan decoction (XQD) in preventing and treating metabolic dysfunction-associated steatotic liver disease (MASLD) by regulating ferroptosis, network pharmacology, in vitro and in vivo experiments. MethodsIn the in vivo experiment, mouse MASLD models were established by high-fat diet (HFD) induction. The model mice were randomly assigned to a positive control group (silybin, 50 mg·kg-1), low-, medium- and high-dose XQD groups (4.725, 9.45, 18.9 g·kg-1), with a normal control group. After 4 weeks of modeling, mice except the normal group were administered intragastrically for 8 consecutive weeks. Liver function, serum lipid levels, hepatic histopathology, as well as the levels of malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH) and oxidized glutathione (GSSG) and Fe2+ were detected. The mRNA and protein expression of p53, SLC7A11 and GPX4 were determined by quantitative Real-time quantitative polymerase chain reaction(Real-time PCR) and Western blot. In the network pharmacology analysis, active components and potential targets of XQD for MASLD were screened, followed by functional and pathway enrichment analyses, and molecular docking was performed to verify the target binding activity. In the in vitro experiment, the optimal concentration of XQD-containing serum was screened by cytotoxicity assay. HepG2 cells were transfected with ov-NC or ov-p53 plasmid, and a lipid accumulation model was induced by free fatty acid (FFA, 1.0 mmol·L-1). Cells were divided into a normal group, FFA model group, ov-NC+XQD (15%) group and ov-p53+XQD (15%) group. Intracellular Fe2+ level and lipid accumulation were evaluated, and the protein expression of p53, SLC7A11 and GPX4 was measured by Western blot. ResultsCompared with the normal group, the model group exhibited markedly elevated body weight, liver weight, liver index, fasting blood glucose, AUC of glucose tolerance test, serum liver function and blood lipid levels at week 12 (P<0.01). Hepatic steatosis and inflammatory infiltration were observed by pathological staining. Additionally, hepatic levels of MDA, SOD and Fe2+ were increased (P<0.01), while GSH, GSSG and the GSH/GSSG ratio were decreased (P<0.01). The mRNA and protein expression of hepatic p53 was upregulated (P<0.01), whereas the expression of SLC7A11 and GPX4 was downregulated (P<0.01). Compared with the model group, the low- and medium-dose XQD groups showed significantly decreased body weight at week 12 (P<0.05). The silybin group, together with the medium- and high-dose XQD groups, presented reduced liver weight and liver index (P<0.05). Fasting blood glucose and the AUC of glucose tolerance test were lowered in all four treatment groups (P<0.05, P<0.01). Pathological staining revealed alleviated hepatic steatosis and inflammation, accompanied by decreased serum liver function and blood lipid levels (P<0.05, P<0.01). Moreover, hepatic MDA and SOD levels were markedly reduced, while GSH, GSSG and the GSH/GSSG ratio were significantly elevated (P<0.05, P<0.01). Hepatic Fe2+ level was decreased (P<0.01). The mRNA and protein expression of hepatic p53 was downregulated, and the expression of SLC7A11 and GPX4 was upregulated (P<0.05, P<0.01). Network pharmacology analysis identified quercetin, kaempferol, luteolin, tanshinone IIA and isorhamnetin as the core active components of XQD, with p53 serving as the key target. Stable binding was verified between these active components and the p53 protein. The optimal concentration of XQD-containing serum in vitro was determined to be 15%. Compared with the normal group, the model group showed increased intracellular Fe2+ and lipid accumulation, significantly upregulated p53 protein expression (P<0.01), and markedly downregulated SLC7A11 and GPX4 protein expression (P<0.01). Compared with the model group, the ov-NC group exhibited reduced Fe2+ and lipid accumulation, downregulated p53 expression, and upregulated SLC7A11 and GPX4 expression. In the ov-p53 group, p53 expression was upregulated (P<0.01), while SLC7A11 and GPX4 expression was downregulated (P<0.01). ConclusionXQD inhibits ferroptosis by downregulating p53 and upregulating SLC7A11 and GPX4, thereby alleviating oxidative stress and lipid peroxidation in hepatocytes and improving MASLD.
6.Long-term survival outcomes and prognostic factors following radical resection of pancreatic body and tail cancer:a retrospective analysis of 992 patients
Dong XU ; Yang WU ; Kai ZHANG ; Nan LYU ; Qianqian WANG ; Pengfei WU ; Jie YIN ; Baobao CAI ; Guodong SHI ; Jianzhen LIN ; Yazhou WANG ; Lingdi YIN ; Zipeng LU ; Min TU ; Jianmin CHEN ; Feng GUO ; Jishu WEI ; Junli WU ; Wentao GAO ; Cuncai DAI ; Yi MIAO ; Kuirong JIANG
Chinese Journal of Surgery 2026;64(1):46-54
Objective:To investigate the survival outcomes and prognostic factors in patients undergoing radical resection for pancreatic body and tail cancer.Methods:A retrospective case series study was conducted on 992 patients who underwent radical resection for pancreatic body and tail cancer at the Pancreatic Center of the First Affiliated Hospital of Nanjing Medical University from January 2016 to June 2024. In this study, 577 (58.2%) were male and 415 (41.8%) were female,with an age of (65±9) years (range: 26 to 86 years). Follow-up continued until June 2024. Survival rates were estimated using the Kaplan-Meier method,and prognostic factors were identified using univariate and multivariate Cox proportional hazards models.Results:Among 992 patients,open surgery was the predominant approach (89.1%, 884/992), and radical antegrade modular pancreatosplenectomy (RAMPS) was performed in 317 patients (32.0%). Combined organ resection,venous resection,and arterial resection were performed in 23.5%, 9.3%,and 11.2% of patients,respectively. The rates of R0, R1-1 mm, and R1-direct resections were 49.8% (494/992),41.5% (412/992), and 8.7% (86/992),respectively. Stage ⅡB was the most common TNM stage (32.2%,319/992). A total of 801 patients (80.8%) received adjuvant chemotherapy. The median follow-up period was 32.0(8.8) months(range:3.2 to 105.3 months),during which 508 patients (51.2%) died. The overall median survival (OS) was 26.4 months,with 1-,3-, and 5-year survival rates of 79.0%,40.0%, and 29.0%, respectively. In the recent five years (from 2020 to 2024), the median OS improved significantly to 34.1 months compared to 20.0 months from 2016 to 2019 ( P<0.01). Histological subtype analysis showed that the median OS time was 26.7 months for pancreatic ductal adenocarcinoma (PDAC, n=855),58.9 months for invasive intraductal papillary mucinous carcinoma (IPMC, n=32),and 15.7 months for adenosquamous carcinoma of pancreas (ASCP, n=73) ( P=0.001). Among PDAC patients, adjuvant chemotherapy significantly improved survival (29.1 months vs. 14.4 months, P<0.01);in IPMC patients, adjuvant chemotherapy also extended survival (65.7 months vs. 58.9 months, P=0.047). Although ASCP patients receiving chemotherapy had a longer median OS time than those without (18.8 months vs. 8.9 months),the difference was not statistically significant ( P=0.151). Multivariate Cox regression analysis in PDAC patients indicated that adjuvant chemotherapy, R0 resection, T stage,N stage,and tumor differentiation were independent prognostic factors ( P<0.01). The median OS time by TNM stage was:not reached for stage ⅠA, 51.6 months for ⅠB, 25.5 months for ⅡA, 23.7 months for ⅡB, 23.0 months for Ⅲ, and 14.4 months for Ⅳ. The median OS time for R0,R1-1 mm,and R1-direct resections was 34.1,24.7,and 15.7 months,respectively ( P<0.01). Conclusion:Adjuvant chemotherapy,R0 resection,tumor stage,and differentiation are independent prognostic factors for pancreatic body and tail cancer.
7.Facial and tongue features in traditional Chinese medicine for coronary artery stenosis warning and their association chain with cardiac biomarkers
Yu Wang ; Pengcheng Ding ; Zhentao Li ; Jiyu Zhang ; Liping Tu ; Jijie Xu ; Jiatuo Xu
Digital Chinese Medicine 2026;9(2):184-196
Objective:
To explore whether digital facial and tongue diagnostic technologies can support the assessment of coronary heart disease (CHD) patients for coronary artery stenosis severity, and examine potential associations between digital tongue diagnosis features and myocardial biomarkers.
Methods:
The TFDA-1 face and tongue diagnosis instrument and the TDAS analysis system were used to perform intelligent visual examination and analysis of the facial and tongue in CHD patients who attended the Department of Cardiology at Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine between October 2, 2023 and July 31, 2024. Variables were screened using principal component analysis (PCA) and multicollinearity analysis to construct four machine learning models, including random forest, LightGBM, decision tree, and naive Bayes, for the early prediction of coronary artery stenosis severity. Model performance metrics, including sensitivity, specificity, precision, F1 score, accuracy, and the area under the receiver operating characteristic (ROC) curve (AUC), were evaluated. Visual analyses were performed using the SHapley Additive exPlanations (SHAP) interpreter and decision curve analysis. For patients after percutaneous coronary intervention (PCI), a conceptual model linking cardiac biomarkers and tongue diagnosis was constructed using the partial least squares structural equation modeling (PLS-SEM), and its validity was assessed.
Results:
A total of 459 CHD patients were enrolled and assigned to a PCI group and a non-PCI group (which comprised two subgroups: mild stenosis or less group, moderate stenosis or greater group). For sublingual vein (SV) features, the PCI group had lower SV-a and SV-b than the other groups (P < 0.01 and P < 0.05, respectively). For tongue surface features, the PCI group had significantly higher tongue body (TB)-L, TB-a, and TB-b (P < 0.05, P < 0.01, and P < 0.001, respectively), as well as higher tongue coating (TC)-a and TC-b (P < 0.01 and P < 0.001, respectively). Age, SV-a, SV-b, creatine kinase-myocardial band (CK-MB), CK, TC-a, lip-L, and lip-b were incorporated in the machine learning models. The random forest model performed best, with an AUC of 0.924, an F1 score of 0.839, precision of 0.807, accuracy of 0.864, sensitivity of 0.873, and specificity of 0.839. Decision curve analysis indicated that both LightGBM and random forest had clinical utility. PLS-SEM confirmed the pathway relationships: myocardial biomarkers → TB and myocardial biomarkers → TC (coefficient = – 0.238, t = 2.239, P = 0.025, and coefficient = – 0.270, t = 2.522, P = 0.012, respectively).
Conclusion
This study developed a noninvasive early warning model for coronary artery stenosis in patients with CHD. It applied PLS-SEM to investigate the association between post-PCI cardiac biomarkers and tongue diagnosis, and validated the proposed association chain. These findings suggest that intelligent traditional Chinese medicine (TCM) visual diagnosis integrated with modern digital technology may support CHD risk assessment and comprehensive health management.
8.Guidelines for establishing animal models of rheumatoid arthritis with cold dampness obstruction pattern and damp heat obstruction pattern (2024 Version)
Na LIN ; Yanqiong ZHANG ; Changhong XIAO ; Shenghao TU ; Jianning SUN ; Shijun XU ; Xia MAO
Science of Traditional Chinese Medicine 2026;4(2):174-180
Rheumatoid arthritis belongs to arthralgia in the theory of traditional Chinese medicine, with cold dampness obstruction pattern (CDO) and damp heat obstruction pattern (DHO) as the main pattern types. Fine therapeutic effects have been obtained in clinical practice following the differentiation of CDO and DHO. However, suitable animal models are not available currently. For adapting to the clinical diagnosis, as well as carrying out basic research of integrated Chinese and Western medicine and preclinical study on new Chinese medicine in a better way, the “Guidelines for Establishing Animal Models of Rheumatoid Arthritis with Cold Dampness Obstruction Pattern and Damp Heat Obstruction Pattern” (referred to as “Guidelines”) were compiled by our research group in cooperation with renowned experts in clinical, pharmaceutical, zoological, and methodological research fields. According to the theory of disease and syndrome integration, experts standardized the establishment methods for animal models of rheumatoid arthritis with CDO and DHO. The Guidelines were compiled via the nominal group method according to the principle of evidence coming in main place, consensus as the auxiliary, and experience as the references. Contents such as animal species, arthritis induction methods, external stimulation conditions, and assessment indicators were specified in the Guidelines based on the comprehensive evaluation of pathogenesis homology, behavioral phenotypic consistency, and drug therapy predictability between animal models and human diseases. The Guidelines will be applicable to the research on syndromes in rheumatoid arthritis, elucidation of acting mechanism, and development of new medicine, and provide reference for standardizing other types of animal models with the integration of disease and syndrome, to promote the modernization of Chinese medicine research.
9.Treating Lean Metabolic Associated Fatty Liver Disease from the Perspective of "Spleen Failing to Disperse Essence and Kidney Failing to Transform Qi"
Xingrong LI ; Haihang DONG ; Huiqin ZHANG ; Ya YOU ; Yuying TU ; Yinqiang ZHANG
Journal of Traditional Chinese Medicine 2026;67(13):1446-1450
It is considered that lean metabolic associated fatty liver disease (MAFLD) is characte-rized by a state of "lean body but fatty liver". From the perspective of the pathomechanism evolution of "spleen failing to disperse essence, while kidney failing to transform qi", the disease is systematically treated under the principle that spleen and kidney deficiency as the root and liver constraint with phlegm stasis as the branch. Spleen deficiency with impaired transformation and transportation leads to failure in the distribution of refined substances, initiating lipid turbidity accumulation and obstruction. Kidney dysfunction in qi transformation results in insufficient essence and blood, forming the root of bodily malnourishment. Over time, this further gives rise to liver constraint and loss of dispersing function, disorder in the movement of essential substances, and congealing of phlegm and stasis within hepatic collaterals. The dysfunction of three organs including spleen, kidney and liver constitutes the pathological basis of metabolic disturbances involving qi, blood, body fluids and essence. Treatment should follow the principle of "nourishing the healthy qi leads to spontaneous resolution of pathogenic accumulation", with three approaches. First, fortifying the spleen and eliminating dampness, using Sini Powder (四逆散) and Erchen Pingwei Powder (二陈平胃散) to restore the transport and transformation function of the middle jiao (焦), thereby guiding essential substances back to their proper physiological pathways. Second, tonifying the kidney and resolving turbidity, using Jinkui Shenqi Pill (金匮肾气丸) and Effective Integration Decoction (一贯煎) to replenish the lower jiao, promoting the restoration of essence and the transformation of turbid pathogen. Third, soothing the liver and resolving stasis, using Liujunzi Decoction (六君子汤) and Xiaozhi Qinggan Decoction (消脂清肝汤) to vent qi and blood stagnation, thereby interrupting disease progression. Together, these three methods reinforce healthy qi while eliminating pathogen, facilitating the restoration of proper essence transformation and the resolution of lipid turbidity.
10.PRMT5 promotes angiogenesis in colorectal cancer via the JAK2/STAT3 signaling pathway
Wen ZHANG ; Yongyong GENG ; Xijiang TU ; Qianhui YAO ; Wenlong GUO ; Bogang YAO ; Xuling SUN
Acta Universitatis Medicinalis Anhui 2026;61(5):803-811
ObjectiveTo investigate the effect of protein arginine methyltransferase 5 (PRMT5) on the angiogenesis of colorectal cancer (CRC) through the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway. MethodsThe expression and prognostic value of PRMT5 in CRC tissues were analyzed based on the cancer genome atlas (TCGA) and gene expression omnibus (GEO) databases. A total of 105 pairs of cancer tissues and matched adjacent non-tumor tissues were collected from CRC patients, and PRMT5 expression was detected by immunohistochemistry (IHC); Western blot was used to detect the PRMT5 protein level in normal colonic epithelial cells (FHC) and CRC cell lines (including RKO, SW480). SW48 and LoVo cells were divided into negative control (NC) group and PRMT5 knockdown interference group. After the stable knockdown cell models were successfully constructed, the effects of conditioned medium on the proliferation, cell cycle, migration and tube formation abilities of human umbilical vein endothelial cells (HUVECs) were detected; the correlation between PRMT5 and vascular endothelial growth factor A (VEGFA) was analyzed by real-time quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA). Gene set enrichment analysis (GSEA) and cytoplasm-nucleus separation assay were performed to verify the regulatory pathway. ResultsPRMT5 was highly expressed in CRC tissues and cell lines, which was significantly correlated with poor prognosis and pathological characteristics of patients (all P<0.05); PRMT5 knockdown could significantly inhibit the angiogenesis-related abilities of HUVECs (all P<0.05) and down-regulate the expression of VEGFA (all P<0.01). GSEA results indicated that PRMT5 expression was significantly associated with the activation of JAK2/STAT3 signaling pathway (all P<0.001). PRMT5 knockdown could inhibit the activation of JAK2/STAT3, the nuclear translocation of STAT3 and the protein level of phosphorylated STAT3 (p-STAT3) in the nucleus, thus inhibiting the expression of VEGFA. ConclusionPRMT5 is highly expressed in CRC tissues and indicates poor prognosis of patients. It promotes the nuclear translocation and transcriptional activity of STAT3 by activating the JAK2/STAT3 pathway and drives the expression of VEGFA to promote tumor angiogenesis.

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