1.Kaixuan Jiedu Core Prescription Ameliorates Psoriasis Induced by IMQ Combined with Restraint Stress in Mice by Regulating Neuro-immune Axis and Inhibiting Skin Homing of Th17 Cells
Haoruo YANG ; Ningxin ZHANG ; Qiubai JIN ; Jiaqi LI ; Xue XIAO ; Meiqi SUN ; Bin YANG ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):55-68
ObjectiveTo observe the effect and therapeutic effect of Kaixuan Jiedu core prescription (KXJD) on skin homing of Th17 cells in the mouse model of imiquimod (IMQ) combined with restraint stress-induced psoriasis-like skin damage, and to explore its potential mechanism from the perspective of neuro-immune axis. MethodsThirty male C57BL/6J mice were randomly allocated into five groups (n=6): Control, model (IMQ), restraint stress model (IMQ+RS), KXJD, and methotrexate (MTX). The mouse model of psoriasis-like skin damage was established by 5% IMQ combined with restraint stress. At the same time of modeling, each treatment group was treated with corresponding doses of drugs, and the control, IMQ, and IMQ+RS groups were treated with the same amount of normal saline by gavage once a day for 5 days. Hematoxylin-eosin (HE) staining was used to observe the pathological changes in the skin tissue and Baker scoring was performed. Serum levels of interleukin-1β (IL-1β) and angiopoietin-2 (Ang-2) were measured by enzyme-linked immunosorbent assay (ELISA). The levels of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), C-C motif chemokine ligand 20 (CCL20), and C-C motif chemokine receptor 6 (CCR6) in the skin tissue were determined. Immunohistochemistry (IHC) was employed to determine the protein expression of cutaneous lymphocyte-associated antigen (CLA), integrin αE (CD103), cytokeratin 10 (CK10), and nuclear factor-kappa B (NF-κB) in the skin. Immunofluorescence double staining (DIF) was adopted to detect the expression and co-localization of vascular endothelial cadherin (VE-cadherin) and platelet-endothelial cell adhesion molecule (CD31), CCR6, CD103, substance P (SP), calcitonin gene-related peptide (CGRP), and protein gene product 9.5 (PGP9.5) in the skin tissue. Real-time PCR was employed to quantify the mRNA levels of IL-10, IL-17A, and IL-23. ResultsCompared with the control group, the IMQ group and IMQ+RS group showed significant inflammatory cell infiltration, abnormal proliferation of epidermal cells, keratinization and other pathological changes in the skin tissue, and a significant increase in Baker score, elevated levels of IL-1β and Ang-2 in the serum and MMP-9, CCL20 and CCR6 in the skin lesions, upregulated expression of CLA, CD103, CK10, NF-κB, IL-17A mRNA, and IL-23 mRNA in the skin lesions, and downregulated expression of TIMP-1 and IL-10 mRNA. In addition, the fluorescence intensities of VE-cadherin and CD31 co-localization, CCR6 and CD103 co-localization, SP and PGP9.5 co-localization, and CGRP and PGP9.5 co-localization were increased (P<0.05). Compared with the IMQ group, the above indicators in the IMQ+RS group were further aggravated. Compared with the IMQ group, the above indicators in the IMQ+RS group were further aggravated. Compared with the IMQ+RS group, KXJD and MTX significantly alleviated the pathological damage of skin lesions, significantly decreased the Baker score, lowered the levels of IL-1β and Ang-2 in the serum and MMP-9, CCL20 and CCR6 in skin lesions, downregulated the expression of CLA, CD103, CK10, NF-κB, IL-17A mRNA and IL-23 mRNA in skin lesions, and upregulated the expression of TIMP-1 and IL-10 mRNA. Furthermore, KXJD and MTX reduced the fluorescence intensities of VE-cadherin and CD31 co-localization, CCR6 and CD103 co-localization, CGRP and PGP9.5 co-localization, and SP and PGP9.5 co-localization (P<0.05). ConclusionKXJD can significantly ameliorate the psoriasis-like skin damage induced by IMQ combined with restraint stress in mice by regulating the neural-immune axis and inhibiting the skin homing of Th17 cells.
2.Construction of Mouse Models of Psoriasis-like Lesions Induced by Cold Exposure Combined with Imiquimod and Evaluation of Therapeutic Efficacy of Kaixuan Jiedu Core Prescription
Meiqi SUN ; Xue XIAO ; Jiarong WU ; Jiaqi LI ; Ningxin ZHANG ; Mengyao JIANG ; Huan LIU ; Bin YANG ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):69-78
ObjectiveTo establish the mouse models of psoriasis-like lesions induced by continuous cold exposure or intermittent cold exposure combined with imiquimod (IMQ), and to evaluate the interventional effects of Kaixuan Jiedu core prescription (KXJD) on the two models. MethodsMale C57BL/6J mice were selected and classified into two experimental batches. The first batch of 36 mice was randomized into a room temperature group, a continuous cold exposure (10 ℃/24 h) group, and an intermittent cold exposure (10 ℃/6 h) group. Each group was further divided into a normal subgroup and a model subgroup (topical application of IMQ to induce skin lesions), with 6 mice in each subgroup, for modeling and evaluation. The second batch of 54 mice, with 6 in each group, were subjected to the same temperature grouping with an additional KXJD (30.42 g·kg-1, continuous gavage for 5 days) group. Comprehensive evaluation of model characteristics and KXJD efficacy was conducted through Psoriasis Area and Severity Index (PASI) scoring, skin temperature measurement by infrared thermography, histopathological observation by hematoxylin-eosin (HE) staining, detection of vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule 1 (CD31) by immunohistochemistry, detection of Claudin-1 and Occludin by immunofluorescence assay, determination of serum levels of tumor necrosis factor-α (TNF-α) and interleukin (IL)-10 by enzyme-linked immunosorbent assay (ELISA), and quantification of mRNA levels of IL-17A, IL-23, IL-6, and chemokine ligand 20 (CCL20) in skin lesions by quantitative Real-time polymerase chain reaction (Real-time PCR). ResultsModel mice in all temperature groups exhibited typical psoriasis-like skin lesions. Compared with the normal groups, the model groups showed increased PASI scores, decreased skin temperatures (P<0.05), obvious epidermal thickening, parakeratosis, and dermal inflammatory cell infiltration, as well as elevated mRNA levels of IL-17A, IL-23, IL-6, and CCL20 (P<0.05). Cold exposure further aggravated psoriasis. The total PASI score of the intermittent cold exposure model group was higher than that of the room temperature model group (P<0.05). The serum IL-10 did not show a compensatory elevation, and the blood vessels presented a characteristic of elevated CD31 expression (P<0.05) without a synchronous increase in VEGF. The continuous cold exposure model group exhibited more significant dermal capillary tortuosity and dilation, with the highest mRNA levels of IL-17A, IL-23, IL-6, and CCL20 among all groups. Compared with the respective model groups, KXJD intervention alleviated skin lesions, reduced epidermal thickness and inflammatory cell infiltration, and increased skin temperature, with the temperature increase being particularly significant in the intermittent cold exposure+KXJD group (P<0.05). Furthermore, KXJD down-regulated the expression of VEGF and CD31, restored the expression of Claudin-1 and Occludin, decreased the mRNA levels of IL-17A and IL-23 (P<0.05), and reduced the serum TNF-α level. ConclusionThis study successfully established compound psoriasis-like mouse models induced by cold exposure combined with IMQ. It confirms that cold aggravates the severity of psoriasis by exacerbating the closure of Xuanfu (sweat pores), microcirculation disorders, and immune imbalance. Moreover, different cold exposure patterns have distinct mechanism differences. Continuous cold exposure focuses on enhancing the inflammatory response via the IL-23/IL-17 axis and angiogenesis, simulating chronic aggravation under a long-term cold environment. Intermittent cold exposure tends to impair immune regulation and induce microvascular endothelial stress, corresponding to acute exacerbations caused by sudden temperature drops. KXJD can effectively alleviate psoriasis-like skin lesions under cold conditions by unblocking Xuanfu, regulating vasomotor function, and correcting abnormal immune-inflammatory responses.
3.Kaixuan Jiedu Core Prescription Alleviates Psoriatic Skin Lesions in Mice by Modulating Cold-sensitive TRPM8 Neuron-derived Signaling
Xue XIAO ; Bin YANG ; Meiqi SUN ; Haoruo YANG ; Ningxin ZHANG ; Jiaqi LI ; Huan LIU ; Mengyao JIANG ; Yuanyao SHE ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):89-101
ObjectiveTo investigate the ameliorative effects of Kaixuan Jiedu core prescription (KXJD) on skin lesions in psoriasis-like mouse models under cold environment exposure, and to analyze its influences on transient receptor potential (TRP) channels and related neuroimmune regulatory factors. MethodsThirty-six C57BL/6J mice were randomized into 6 groups, with 6 mice in each group. Two feeding conditions were set: Normal temperature and cold [simulating a cold environment at (10±0.5) ℃, for 6 h daily]. Mice were induced to develop psoriasis-like lesions by applying imiquimod externally. The model mice were allocated into model groups and KXJD (30.42 g·kg-1, continuous gavage for 5 days) groups. Normal mice were used as the control group. Specifically, mice were allocated into normal temperature, normal temperature model, normal temperature+KXJD, cold exposure control, cold exposure model, and cold exposure+KXJD groups. The pathological changes in skin lesions were observed by hematoxylin-eosin (HE) staining. The expression of cluster of differentiation (CD) 3+ T lymphocytes, CD11c+ dendritic cells (DCs), phosphorylated extracellular signal-regulated kinase (p-ERK), and substance P (SP) were detected by immunofluorescence assay. The protein level of transient receptor potential cation channel subfamily M member 8 (TRPM8) in the skin tissue was determined by Western blot. The expression of TRPM8, transient receptor potential cation channel subfamily V member 1 (TRPV1), transient receptor potential cation channel subfamily A member 1 (TRPA1), and transient receptor potential cation channel subfamily V member 2 (TRPV2) at the protein and mRNA levels was determined by immunohistochemistry and Real-time PCR, respectively. The levels of calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY) in the serum were analyzed by enzyme-linked immunosorbent assay (ELISA). The enrichment analysis of differentially expressed genes (DEGs) and TRP pathway network construction were conducted based on the GEO database. The co-expression of TRPM8 and CGRP in the skin lesions was verified by immunofluorescence double labeling. ResultsBoth the normal temperature and cold exposure model groups showed typical psoriasis-like skin lesions. Compared with the normal temperature and cold exposure control groups, the model groups had excessive epidermal keratinization, thickened spinous layer, and inflammatory infiltration in the dermis, with increased pathological scores (P<0.05), increased infiltration of CD3+ and CD11c+ cells and expression of p-ERK and SP, upregulated mRNA levels of TRPM8, TRPA1, and TRPV2, downregulated mRNA level of TRPV1 (P<0.05), and reduced content of CGRP and increased content of NPY in the serum. Compared with the normal temperature and cold exposure model groups, KXJD reduced the pathological manifestations and pathological scores of psoriasis-like skin lesions (P<0.05), and inhibited the infiltration of CD3+ and CD11c+ cells and the expression of p-ERK and SP. Gene enrichment analysis suggested that the DEGs of psoriasis were significantly enriched in the interleukin (IL)-17 signaling pathway and TRP channel inflammatory regulation. Compared with the normal temperature and cold exposure model groups, KXJD reversed the abnormal mRNA levels of genes related to the TRP channel subfamilies (P<0.05), increased the CGRP level, and decreased the NPY level. Immunofluorescence double labeling further confirmed that compared with the model groups, KXJD down-regulated the co-expression of TRPM8 and CGRP in the skin lesions. ConclusionKXJD may ameliorate psoriasis-like skin lesions by downregulating the overexpressed cold-sensitive receptor TRPM8 in skin lesions and correcting the disorder of neuropeptide (such as SP and CGRP) release mediated by it, thereby inhibiting the IL-23/helper T cell 17 (Th17) core inflammatory pathway, suppressing the infiltration of inflammatory cells and the activation of the ERK signaling pathway, and regulating the Xuanfu (sweat pore)-TRPM8-neuroimmune response axis.
4.Mechanism of Kaixuan Jiedu Core Prescription in Ameliorating Psoriasis-like Inflammation via TrkA Receptor-mediated Regulation of CGRP Expression and Dendritic Cell Activation
Huan LIU ; Mengyao JIANG ; Jiaqi LI ; Meiqi SUN ; Xue XIAO ; Ningxin ZHANG ; Bin YANG ; Ping SONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):102-110
ObjectiveTo investigate the ameliorative effects and mechanisms of Kaixuan Jiedu core prescription (KXJD) on neuroimmunological inflammation in imiquimod (IMQ)-induced psoriasis-like mice. MethodsA total of 24 C57BL/6J mice were randomly divided into four groups (n=6): Normal, model, KXJD, and tropomyosin receptor kinase A (TrkA) inhibitor GW441756 groups. The mice in the model, KXJD, and GW441756 groups were topically treated with 5% IMQ cream (62.5 mg·d-1) on the back to induce psoriasis-like inflammation. The KXJD group received KXJD by gavage (30.42 g·kg-1), the GW441756 group received intraperitoneal injection of GW441756 (10 mg·kg-1), and the normal and model groups received an equal volume of normal saline by gavage, with continuous intervention for 5 days. The severity of skin lesions was evaluated using the psoriasis area and severity index (PASI). Hematoxylin-eosin (HE) staining was used to measure epidermal thickness and observe pathological changes in the lesioned skin. Immunohistochemistry was employed to detect the expression of proliferating cell nuclear antigen (Ki67) and interleukin-17A (IL-17A) in the lesioned skin. Enzyme-linked immunosorbent assay (ELISA) was used to quantify the levels of interleukin-23 (IL-23) and calcitonin gene-related peptide (CGRP) in the lesioned tissues. Western blot was used to detect the expression of TrkA and phosphorylated TrkA (p-TrkA). Immunofluorescence assay was performed to detect the expression of TrkA receptor, protein gene product 9.5 (PGP9.5), cluster of differentiation 11c (CD11c), and CGRP in the lesions. Flow cytometry was used to detect the activation of splenic dendritic cells (DCs). ResultsCompared with the normal group, the model group exhibited typical psoriasis-like inflammation, characterized by erythema, infiltration and scaling, with histopathological findings of epidermal hyperkeratosis and acanthosis. The model group showed significantly increased expression of Ki67, IL-17A, IL-23 and p-TrkA (P<0.05, P<0.01), increased fluorescence intensity of CD11c, and significantly decreased CGRP expression (P<0.05). The splenic DC activation was significantly enhanced, as indicated by the increased mean fluorescence intensity (MFI) of CD86 (P<0.05). Compared with the model group, both the KXJD and GW441756 groups showed amelioration of the psoriasis-like skin inflammation, with significantly down-regulated expression of IL-17A, IL-23 and p-TrkA (P<0.05, P<0.01), significantly up-regulated expression of CGRP (P<0.01), reduced CD11c+ DC infiltration, and restored splenic DC activation balance (down-regulated CD86 MFI and up-regulated CD80 and CD40 MFI). Furthermore, the inhibitory effect of KXJD on Ki67 was significantly superior to that of the GW441756 group (P<0.01). ConclusionKXJD may alleviate IMQ-induced psoriasis-like inflammation in mice by targeting and inhibiting TrkA receptor phosphorylation, regulating CGRP expression in the lesions, and ameliorating aberrant activation of dendritic cells, while also significantly inhibiting keratinocyte proliferation.
5.Antipyretic effects of ethanol extracts of Arisaematis Rhizoma fermented with bile from different sources.
Run ZOU ; Fa-Zhi SU ; En-Lin ZHU ; Chen-Xi BAI ; Yan-Ping SUN ; Hai-Xue KUANG ; Qiu-Hong WANG
China Journal of Chinese Materia Medica 2025;50(7):1781-1791
This study aims to investigate the antipyretic effects and mechanisms of ethanol extracts from Arisaematis Rhizoma fermented with bile from different sources on a rat model of fever induced by a dry-yeast suspension. The rat model of fever was established by subcutaneous injection of 20% dry-yeast suspension into the rat back. The levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6) in the serum, as well as prostaglandin E_2(PGE_2) and cyclic adenosine monophosphate(cAMP) in the hypothalamus, were determined by ELISA. Metabolomics analysis was then performed on serum and hypothalamus samples based on UPLC-Q-TOF MS to explore the potential biomarkers and metabolic pathways. The results showed that the body temperatures of rats significantly rose 4 h after modeling. After oral administration of high-dose ethanol extracts of Arisaematis Rhizoma fermented with bovine bile(NCH) and porcine bile(ZCH), the body temperatures of rats declined(P<0.05), and the NCH group showed better antipyretic effect than the ZCH group. Additionally, compared with the model group, the NCH and ZCH groups showed lowered levels of IL-1β, IL-6, TNF-α, PGE_2, and cAMP(P<0.01). The results of serum and hypothalamus metabolomics analysis indicated that both NCH and ZCH exerted antipyretic effects by regulating phenylalanine metabolism, sphingolipid metabolism, arachidonic acid metabolism, and steroid hormone biosynthesis. Collectively, both NCH and ZCH can play an obvious antipyretic role in the rat model of dry yeast-induced fever, and the underlying mechanism might be closely associated with inhibiting inflammation and regulating metabolic disorders. Moreover, NCH demonstrates better antipyretic effect.
Animals
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Rats
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Male
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Fermentation
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Rats, Sprague-Dawley
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Rhizome/metabolism*
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Drugs, Chinese Herbal/chemistry*
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Bile/chemistry*
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Antipyretics/chemistry*
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Fever/metabolism*
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Cattle
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Swine
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Tumor Necrosis Factor-alpha/metabolism*
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Ethanol/chemistry*
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Interleukin-6/blood*
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Interleukin-1beta/blood*
6.Hypolipidemic effect and mechanism of Arisaema Cum Bile based on gut microbiota and metabolomics.
Peng ZHANG ; Fa-Zhi SU ; En-Lin ZHU ; Chen-Xi BAI ; Bao-Wu ZHANG ; Yan-Ping SUN ; Hai-Xue KUANG ; Qiu-Hong WANG
China Journal of Chinese Materia Medica 2025;50(6):1544-1557
Based on the high-fat diet-induced hyperlipidemia rat model, this study aimed to evaluate the lipid-lowering effect of Arisaema Cum Bile and explore its mechanisms, providing experimental evidence for its clinical application. Biochemical analysis was used to detect serum levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), triglycerides(TG), and total cholesterol(TC) to assess the lipid-lowering activity of Arisaema Cum Bile. Additionally, 16S rDNA sequencing and metabolomics techniques were employed to jointly elucidate the lipid-lowering mechanisms of Arisaema Cum Bile. The experimental results showed that high-dose Arisaema Cum Bile(PBA-H) significantly reduced serum ALT, AST, LDL-C, TG, and TC levels(P<0.01), and significantly increased HDL-C levels(P<0.01). The effect was similar to that of fenofibrate, with no significant difference. Furthermore, Arisaema Cum Bile significantly alleviated hepatocyte ballooning and mitigated fatty degeneration in liver tissues. As indicated by 16S rDNA sequencing results, PBA-H significantly enhanced both alpha and beta diversity of the gut microbiota in the model rats, notably increasing the relative abundance of Akkermansia and Subdoligranulum species(P<0.01). Liver metabolomics analysis revealed that PBA-H primarily regulated pathways involved in arachidonic acid metabolism, vitamin B_6 metabolism, and steroid biosynthesis. In summary, Arisaema Cum Bile significantly improved abnormal blood lipid levels and liver pathology induced by a high-fat diet, regulated hepatic metabolic disorders, and improved the abundance and structural composition of gut microbiota, thereby exerting its lipid-lowering effect. The findings of this study provide experimental evidence for the clinical application of Arisaema Cum Bile and the treatment of hyperlipidemia.
Animals
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Gastrointestinal Microbiome/drug effects*
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Rats
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Male
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Metabolomics
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Hyperlipidemias/microbiology*
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Drugs, Chinese Herbal/administration & dosage*
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Rats, Sprague-Dawley
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Hypolipidemic Agents/pharmacology*
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Liver/metabolism*
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Humans
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Alanine Transaminase/metabolism*
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Triglycerides/metabolism*
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Aspartate Aminotransferases/metabolism*
7.Comparison on chemical components of Angelicae Sinensis Radix before and after wine processing by HS-GC-IMS, HS-SPME-GC-MS, and UPLC-Q-Orbitrap-MS combined with chemometrics.
Xue-Hao SUN ; Jia-Xuan CHEN ; Jia-Xin YIN ; Xiao HAN ; Zhi-Ying DOU ; Zheng LI ; Li-Ping KANG ; He-Shui YU
China Journal of Chinese Materia Medica 2025;50(14):3909-3917
The study investigated the intrinsic changes in material basis of Angelicae Sinensis Radix during wine processing by headspace-gas chromatography-ion mobility spectrometry(HS-GC-IMS), headspace-solid phase microextraction-gas chromatography-mass spectrometry(HS-SPME-GC-MS), and ultra-high performance liquid chromatography-quadrupole-orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS) combined with chemometrics. HS-GC-IMS fingerprints of Angelicae Sinensis Radix before and after wine processing were established to analyze the variation trends of volatile components and characterize volatile small-molecule substances before and after processing. Principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were employed for differentiation and difference analysis. A total of 89 volatile components in Angelicae Sinensis Radix were identified by HS-GC-IMS, including 14 unsaturated hydrocarbons, 16 aldehydes, 13 ketones, 9 alcohols, 16 esters, 6 organic acids, and 15 other compounds. HS-SPME-GC-MS detected 118 volatile components, comprising 42 unsaturated hydrocarbons, 11 aromatic compounds, 30 alcohols, 8 alkanes, 6 organic acids, 4 ketones, 7 aldehydes, 5 esters, and 5 other volatile compounds. UPLC-Q-Orbitrap-MS identified 76 non-volatile compounds. PCA revealed distinct clusters of raw and wine-processed Angelicae Sinensis Radix samples across the three detection methods. Both PCA and OPLS-DA effectively discriminated between the two groups, and 145 compounds(VIP>1) were identified as critical markers for evaluating processing quality, including 4-methyl-3-penten-2-one, ethyl 2-methylpentanoate, and 2,4-dimethyl-1,3-dioxolane detected by HS-GC-IMS, angelic acid, β-pinene, and germacrene B detected by HS-SPME-GC-MS, and L-tryptophan, licoricone, and angenomalin detected by UPLC-Q-Orbitrap-MS. In conclusion, the integration of the three detection methods with chemometrics elucidates the differences in the chemical material basis between raw and wine-processed Angelicae Sinensis Radix, providing a scientific foundation for understanding the processing mechanisms and clinical applications of wine-processed Angelicae Sinensis Radix.
Wine/analysis*
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Gas Chromatography-Mass Spectrometry/methods*
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Chromatography, High Pressure Liquid/methods*
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Angelica sinensis/chemistry*
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Solid Phase Microextraction/methods*
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Drugs, Chinese Herbal/isolation & purification*
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Chemometrics
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Volatile Organic Compounds/chemistry*
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Principal Component Analysis
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Ion Mobility Spectrometry/methods*
8.Shexiang Tongxin Dropping Pill Improves Stable Angina Patients with Phlegm-Heat and Blood-Stasis Syndrome: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial.
Ying-Qiang ZHAO ; Yong-Fa XING ; Ke-Yong ZOU ; Wei-Dong JIANG ; Ting-Hai DU ; Bo CHEN ; Bao-Ping YANG ; Bai-Ming QU ; Li-Yue WANG ; Gui-Hong GONG ; Yan-Ling SUN ; Li-Qi WANG ; Gao-Feng ZHOU ; Yu-Gang DONG ; Min CHEN ; Xue-Juan ZHANG ; Tian-Lun YANG ; Min-Zhou ZHANG ; Ming-Jun ZHAO ; Yue DENG ; Chang-Jiang XIAO ; Lin WANG ; Bao-He WANG
Chinese journal of integrative medicine 2025;31(8):685-693
OBJECTIVE:
To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents.
METHODS:
This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs).
RESULTS:
This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed.
CONCLUSION
STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans
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Double-Blind Method
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Drugs, Chinese Herbal/adverse effects*
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Male
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Female
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Middle Aged
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Angina, Stable/physiopathology*
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Aged
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Syndrome
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Treatment Outcome
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Placebos
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Tablets
9.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.
10.Discriminating Tumor Deposits From Metastatic Lymph Nodes in Rectal Cancer: A Pilot Study Utilizing Dynamic Contrast-Enhanced MRI
Xue-han WU ; Yu-tao QUE ; Xin-yue YANG ; Zi-qiang WEN ; Yu-ru MA ; Zhi-wen ZHANG ; Quan-meng LIU ; Wen-jie FAN ; Li DING ; Yue-jiao LANG ; Yun-zhu WU ; Jian-peng YUAN ; Shen-ping YU ; Yi-yan LIU ; Yan CHEN
Korean Journal of Radiology 2025;26(5):400-410
Objective:
To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer.
Materials and Methods:
A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs.
Results:
All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027).
Conclusion
The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

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