1.DING Ying's Experience in Treating Children with IgA Nephropathy from the Perspective of "Wind-Induced Water Turbidity"
Yudi LI ; Yan XU ; Xiaodan REN ; Wenbo LIU
Journal of Traditional Chinese Medicine 2025;66(3):228-232
To summarize Professor DING Ying's clinical experience in treating children's IgA nephropathy from the perspective of "wind-induced water turbidity". It is believed that the core pathogenesis of IgA nephropathy in children is the wind stimμlating water to become turbidity, and the basic treatment principles are to eliminate wind and settle viscera, and to remove turbidity and drain water. For those with the syndrome of wind-heat invading the lungs and injury to blood collaterals, modified Yinqiao Powder (银翘散) combined with Xiaoji Decoction (小蓟饮子) could be used; for those with dampness-heat in Sanjiao, heavy dampness and light heat pattern, modified Sanren Decoction (三仁汤) combined with Bazheng Powder (八正散) could be used; for those with lung-spleen qi deficiency and kidney essence depletion pattern, modified Buzhong Yiqi Decoction (补中益气汤) combined with Wuzi Yanzong Pill (五子衍宗丸) could be used; for those with deficiency of both qi and yin, kidney deficiency with stasis pattern, self-prescribed Yishen Huazhuo Formula (益肾化浊方) could be used. Meanwhile on the basis of pattern identification and treatment, rattan-type herbs could be combined in use in order to unblock the meridians and collaterals.
2.Syndrome and Pathogenesis Treated by Mahuang Shengmatang
Xinyu WAN ; Yin CHENG ; Wenbo GAO ; Zhiguo ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):253-258
The prescription Mahuang Shengmatang in the Treatise on Cold Damage (《伤寒论》) has sparked considerable debate among medical practitioners throughout history, with varying opinions on its indications, pathogenesis described in the text, principle of compatibility, and clinical applications. Both ancient and modern interpreters of Mahuang Shengmatang often focus on herbal compatibility as a primary approach to deduce the pathogenesis and treatment methods. Building upon this foundation, this paper utilizes herbal dosage as a clue to discern the primary and secondary herbs in the prescription. It further analyzes the principle of compatibility based on herbal indications, summarizing the indications and therapeutic principles of this prescription. Ultimately, it reveals the underlying pathogenesis reflected in the text. The internal closure of heat and toxin leads to the stagnation of Qi, preventing Yang Qi from reaching the extremities and causing cold hands and feet. When the pathogenic Qi finds no outlet, it floods both the upper and lower regions of the body, attacking the throat and causing cough with expectoration of pus and blood, and descending to the large intestine to consume Yin fluids, resulting in persistent diarrhea. Based on this pathogenesis, the paper expands the scope of symptoms and signs associated with the prescription, providing a more detailed portrayal of the applicable patient population and enhancing the basis for clinical prescription references. Additionally, the paper presents considerations on several controversial topics, suggesting that the "lower pulse" described in the text refers to the lower limb arterial pulsation, and the symptoms and signs resemble those of septic shock in modern medicine. Therefore, Mahuang Shengmatang should be categorized as a prescription for treating warm diseases and it is not developed by ZHANG Zhongjing. By employing a detailed discussion on the syndrome, pathogenesis, and clinical application in the texts of Mahuang Shengmatang from the dosage, principle of compatibility, and herbal indications, this paper not only enriches the theoretical foundation of Mahuang Shengmatang but also provides a comprehensive perspective and fresh ideas for understanding its clinical application.
3.CMC considerations of manufacturing site changes for marketed therapeutic recombinant protein drugs from regulatory review
Chinese Journal of Biologicals 2025;38(02):252-256
With the continuous improvement of China's drug regulatory laws and regulations, Life-cycle regulatory management has become a key means and an inevitable development trend to ensure the safety of public drug use. The management of post-approval changes to biological products is gradually shifting towards the risk-based model from the item-based model.In recent years, there has been a significant increase in supplementary applications for manufacturing site changes of marketed therapeutic recombinant protein drugs. However, the risks associated with manufacturing site changes vary under different circumstances. Therefore, the research that needs to be carried out is also different. This paper provides an in-depth discussion on three key aspects: risk assessment and grading, general requirements and special considerations for pharmaceutical research, and common application issues. It outlines general requirements for manufacturing site change, aiming to offer valuable insights for industry needs. Through the collaborative efforts between regulatory authorities and the industry, patient rights and interests can be effectively protected, and high-quality drugs can be made available to the public.
4.Optimization of Processing Technology of Calcined Pyritum Based on QbD Concept and Its XRD Fingerprint Analysis
Xin CHEN ; Jingwei ZHOU ; Haiying GOU ; Lei ZHONG ; Tianxing HE ; Wenbo FEI ; Jialiang ZOU ; Yue YANG ; Dewen ZENG ; Lin CHEN ; Hongping CHEN ; Shilin CHEN ; Yuan HU ; Youping LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):197-205
ObjectiveBased on the concept of quality by design(QbD), the processing process of calcined Pyritum was optimized, and its X-ray diffraction(XRD) fingerprint was established. MethodsThe safety, effectiveness and quality controllability of calcined Pyritum were taken as the quality profile(QTPP), the color, hardness, metallic luster, phase composition, the contents of heavy metals and hazardous elements were taken as the critical quality attributes(CQAs), and the calcination temperature, calcination time, paving thickness and particle size were determined as the critical process parameters(CPPs). Differential thermal analysis, X-ray diffraction(XRD) and inductively coupled plasma mass spectrometry(ICP-MS) were used to analyze the correlation between the calcination temperature and CQAs of calcined Pyritum. Then, based on the criteria importance through intercriteria correlation(CRITIC)-entropy weight method, the optimal processing process of calcined Pyritum was optimized by orthogonal test. Powder XRD was used to analyze the phase of calcined Pyritum samples processed according to the best process, and the mean and median maps of calcined Pyritum were established by the superposition of geometric topological figures, and similarity evaluation and cluster analysis were carried out. ResultsThe results of single factor experiments showed that the physical phase of Pyritum changed from FeS2 to Fe7S8 during the process of temperature increase, the color gradually deepened from dark yellow, and the contents of heavy metals and harmful elements decreased. The optimized processing process of calcined Pyritum was as follows:calcination temperature at 750 ℃, calcination time of 2.5 h, paving thickness of 3 cm, particle size of 0.8-1.2 cm, vinegar quenching 1 time[Pyritum-vinegar(10∶3)]. After calcination, the internal structure of Pyritum was honeycomb-shaped, which was conducive to the dissolution of active ingredients. XRD fingerprints of 13 batches of calcined Pyritum characterized by 10 common peaks were established. The similarities of the relative peak intensities of the XRD fingerprints of the analyzed samples were>0.96, and it could effectively distinguish the raw products and unqualified products. ConclusionTemperature is the main factor affecting the quality of calcined Pyritum. After processing, the dissolution of the effective components in Pyritum increases, and the contents of heavy metals and harmful substances decrease, reflecting the function of processing to increase efficiency and reduce toxicity. The optimized processing process is stable and feasible, and the established XRD fingerprint can be used as one of the quality control standards of calcined Pyritum.
5.Optimization of Processing Technology of Calcined Pyritum Based on QbD Concept and Its XRD Fingerprint Analysis
Xin CHEN ; Jingwei ZHOU ; Haiying GOU ; Lei ZHONG ; Tianxing HE ; Wenbo FEI ; Jialiang ZOU ; Yue YANG ; Dewen ZENG ; Lin CHEN ; Hongping CHEN ; Shilin CHEN ; Yuan HU ; Youping LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):197-205
ObjectiveBased on the concept of quality by design(QbD), the processing process of calcined Pyritum was optimized, and its X-ray diffraction(XRD) fingerprint was established. MethodsThe safety, effectiveness and quality controllability of calcined Pyritum were taken as the quality profile(QTPP), the color, hardness, metallic luster, phase composition, the contents of heavy metals and hazardous elements were taken as the critical quality attributes(CQAs), and the calcination temperature, calcination time, paving thickness and particle size were determined as the critical process parameters(CPPs). Differential thermal analysis, X-ray diffraction(XRD) and inductively coupled plasma mass spectrometry(ICP-MS) were used to analyze the correlation between the calcination temperature and CQAs of calcined Pyritum. Then, based on the criteria importance through intercriteria correlation(CRITIC)-entropy weight method, the optimal processing process of calcined Pyritum was optimized by orthogonal test. Powder XRD was used to analyze the phase of calcined Pyritum samples processed according to the best process, and the mean and median maps of calcined Pyritum were established by the superposition of geometric topological figures, and similarity evaluation and cluster analysis were carried out. ResultsThe results of single factor experiments showed that the physical phase of Pyritum changed from FeS2 to Fe7S8 during the process of temperature increase, the color gradually deepened from dark yellow, and the contents of heavy metals and harmful elements decreased. The optimized processing process of calcined Pyritum was as follows:calcination temperature at 750 ℃, calcination time of 2.5 h, paving thickness of 3 cm, particle size of 0.8-1.2 cm, vinegar quenching 1 time[Pyritum-vinegar(10∶3)]. After calcination, the internal structure of Pyritum was honeycomb-shaped, which was conducive to the dissolution of active ingredients. XRD fingerprints of 13 batches of calcined Pyritum characterized by 10 common peaks were established. The similarities of the relative peak intensities of the XRD fingerprints of the analyzed samples were>0.96, and it could effectively distinguish the raw products and unqualified products. ConclusionTemperature is the main factor affecting the quality of calcined Pyritum. After processing, the dissolution of the effective components in Pyritum increases, and the contents of heavy metals and harmful substances decrease, reflecting the function of processing to increase efficiency and reduce toxicity. The optimized processing process is stable and feasible, and the established XRD fingerprint can be used as one of the quality control standards of calcined Pyritum.
6.Pathophysiological Evolution and Syndrome-Based Stratified Treatment of Qi Deficiency with Stagnation in Chemotherapy-Induced Myelosuppression
Jing LONG ; Hengzhou LAI ; Wenbo HUANG ; Feng YU ; Yifang JIANG ; Zhuoling DAI ; Chong XIAO ; Fengming YOU
Journal of Traditional Chinese Medicine 2025;66(11):1109-1113
The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi, impaired qi transformation, and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology, chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi, blood, and essence, while "stagnation" refers to the accumulation of phlegm, turbid dampness, and blood stasis. These two components interact reciprocally, forming a vicious cycle where deficiency leads to stagnation, and stagnation further damages the healthy qi. In the early stage of mild myelosuppression, chemotoxicity begins to accumulate in the bone marrow, leading to qi consumption, blood deficiency, yin injury, and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression, the accumulation of toxicity causes qi sinking, exhaustion of essence, and marrow depletion, along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation, with an emphasis on assessing the severity of the condition, balancing deficiency and excess, and achieving both symptomatic relief and root cause resolution.
7.Differentiation and Treatment of Pediatric Allergic Rhinitis Based on the Theory of "Spleen Fuctions as Wei Qi"
Haoyu DU ; Yongbin YAN ; Ying DING ; Wenbo LIU ; Yudi LI
Journal of Traditional Chinese Medicine 2025;66(15):1610-1613
Based on the theory of "spleen functions as wei qi", this paper believes that the disease mechanism of allergic rhinitis (AR) in children is the nasal dysfunction caused by the loss of spleen's wei qi. The root cause of AR is the failure of splenic transportation as well as its inability to properly distribute nutrients. The inducement of AR is the invasion of pathogenic qi coupled with insecurity of the wei exterior. The key to AR recurrence lies in the deficiency of healthy qi and lingering of pathogenic qi, with pathogenic qi lodging inside the body. The treatment should adhere to the principle of helping the spleen restore wei qi. During the acute phase, the treatment should dispel wind, conso-lidate the wei qi, and relieve stuffy orifices, and the modified Qufeng Tongqiao Decoction (祛风通窍汤) is used. During the remission phase, the treatment should fortify the spleen, raise the clear, and harmonize the wei qi, and the modified Yuhan Decoction (御寒汤) is applied. During the recovery phase, the treatment should reinforce the healthy qi, consolidate the constitution, and strengthen the wei qi, and the modified Huangqi Jianzhong Decoction (黄芪建中汤) is employed.
8.Effects of Shenling Guben Granules on Quality of Life of and Immune Function in HIV Patients Classified as Immunological Non-responders
Jianing KE ; Wenbo GAO ; Ying LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):135-142
ObjectiveTo evaluate the effects of Shenling Guben Granules on quality of life and immune function in patients with HIV classified as immunological non-responders (INRs). MethodsA prospective, multicenter, randomized, double-blind, controlled trial was conducted from August 21, 2018, to January 6, 2021, across eight hospitals in China. A total of 300 INR patients, diagnosed with spleen-kidney yang deficiency or lung-spleen Qi deficiency syndromes, were enrolled and randomly assigned to either the observation group or the control group, with 150 patients in each group. The control group received antiretroviral therapy (ART) combined with placebo, while the observation group received ART combined with Shenling Guben Granules. After 72 consecutive weeks of treatment, the World Health Organization Quality of Life for HIV brief version (WHOQOL-HIV BREF) was used to assess quality of life before and after treatment in both groups. Immune indicators (CD4+ and CD8+ T cell counts), complete blood count, liver and renal function, and adverse events during treatment were also evaluated to assess safety. ResultsA total of 279 patients were included in the final analysis (140 in the observation group and 139 in the control group). After treatment, CD4+ T cell counts in the observation group increased significantly compared to baseline (P< 0.05), whereas the control group showed an upward trend without statistical significance. Compared with the control group after treatment, the observation group showed a significantly greater increase in CD4+ levels (P<0.05). There were no significant differences in the total score or domain scores of quality of life (physical, psychological, independence, social relationships, environment, and spirituality), or in CD8+ T cell counts, before and after treatment in either group. The incidence of adverse events during treatment was 10% (14/140) in the observation group and 10.07% (14/139) in the control group, with no statistically significant difference between the two groups. ConclusionAlthough Shenling Guben Granules did not significantly improve quality of life in INR patients, they significantly increased CD4+ cell counts and demonstrated good safety, providing scientific evidence to support their use as a treatment option for INR patients.
9.Comparison of the agreement of measurements between the ARK Biometer Combo and OA 2000 in patients wearing orthokeratology lenses
Li DING ; Linlin DU ; Xiaoyu ZHU ; Meng CHEN ; Wenbo YAO ; Xiangui HE ; Mengjun ZHU
International Eye Science 2025;25(9):1541-1546
AIM: To compare the agreement between the ARK Biometer Combo and OA 2000 in patients wearing orthokeratology lenses.METHODS: A prospective study. A total of 148 patients(148 eyes)who were wearing orthokeratology lenses and returned for follow-up at the Shanghai Eye Disease Prevention and Treatment Center from August to September 2024 were included. Biometric measurements were performed using both the ARK Biometer Combo and OA 2000. Parameters including axial length(AL), corneal central thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal curvature(Kf and Ks), astigmatism(AST), white-to-white corneal diameter(WTW)and pupil diameter(PD)were obtained. Differences in measurement parameters between the two biometers were compared, and agreement was assessed.RESULTS: There were no statistically significant differences in the measurements of Kf, Ks and AST between the two biometers(P>0.05). Statistically significant differences were found in the measurements of AL, CCT, ACD, LT, WTW and PD(t=2.559, P=0.012; t=16.771, P<0.0001; t=4.749, P<0.0001; t=-15.212, P<0.0001; t=-14.915, P<0.0001; t=-2.402, P=0.018). ICC ranged from 0.615 to 0.999. Bland-Altman analysis showed that the maximum absolute values of the 95% limits of agreement(LoA)of AL, CCT, ACD, LT, Kf, Ks, AST, WTW and PD were 0.07 mm, 35.07 μm, 0.07 mm, 0.12 mm, 0.66 D, 1.14 D, 1.00 D, 0.76 mm, and 0.98 mm, respectively.CONCLUSION: In orthokeratology patients, the ARK Biometer Combo and OA 2000 showed good agreement in measuring AL, CCT, ACD, Kf and LT, and can be used interchangeably.
10.Comparison of Histopathological and Molecular Pathological Phenotypes in Mouse Models of Intrauterine Adhesions Induced by Two Concentrations of Ethanol Perfusion
Juan JIANG ; Ning SONG ; Wenbo LIAN ; Congcong SHAO ; Wenwen GU ; Yan SHI
Laboratory Animal and Comparative Medicine 2025;45(4):393-402
Objective To construct intrauterine adhesion (IUA) mouse models induced by two different concentrations of ethanol injury, compare the phenotypes, and optimize a more stable IUA modeling method. Methods Twenty 8-week-old female C57BL/6N mice were randomly divided into two groups: the 95% ethanol injury group and the 50% ethanol injury group. Using a self-control method, the left uterine horn was infused with ethanol to establish the IUA model, while the right uterine horn was infused with saline as the sham operation. Five mice from each group were euthanized on day 7 and 15 after modeling, and uterine tissues were collected. Hematoxylin-eosin (HE) staining was used to observe the endometrial pathology, and Masson staining was used to assess the degree of endometrial fibrosis. Quantitative real-time PCR was employed to detect the expression levels of fibrosis markers and pro-inflammatory factors in the uterine tissues. Results Compared to the sham operation, these two ethanol injury led to a significant reduction in elasticity of the uterus, an increase in inflammatory infiltration, and a marked increase in the degree of fibrosis on day 7 after modeling (P<0.05). The 95% ethanol injury group showed a significant decrease in endometrial thickness (P<0.05), whereas no significant change was observed in the 50% ethanol injury group when compared to the sham operation (P>0.05). The expression levels of fibrotic marker molecules collagen type Ⅳ alpha 1 chain (Col4A1), α-smooth muscle actin (α-SMA), transforming growth factor-β (TGF-β), and pro-inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were significantly elevated in the 50% ethanol injury group when compared to the sham operation (P<0.05), although there was an increasing trend of the same markers in the 95% ethanol injury group, the differences were not statistically significant (P>0.05). On day 15 after modeling, the histopathological changes in both ethanol injury groups were not significant when compared to the sham operation, the expression levels of Col4A1, TGF-β, TNF-α and IL-1β remained significantly higher in the 50% ethanol injury group (P<0.05), while only IL-1β was significantly elevated in the 95% ethanol injury group (P<0.05). Conclusion Uterine infusion with 95% ethanol results in more marked histopathological changes in the IUA mouse model compared to the 50% ethanol injury group. The 95% ethanol injury model is suitable for histopathological studies. However, the 50% ethanol injury group shows higher expression levels of fibrosis markers and pro-inflammatory factors compared to the 95% ethanol injury group, suggesting that the 50% ethanol injury model is more suitable for molecular pathological study.


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