1.Treatment Principles and Paradigm of Diabetic Microvascular Complications Responding Specifically to Traditional Chinese Medicine
Anzhu WANG ; Xing HANG ; Lili ZHANG ; Xiaorong ZHU ; Dantao PENG ; Ying FAN ; Min ZHANG ; Wenliang LYU ; Guoliang ZHANG ; Xiai WU ; Jia MI ; Jiaxing TIAN ; Wei ZHANG ; Han WANG ; Yuan XU ; .LI PINGPING ; Zhenyu WANG ; Ying ZHANG ; Dongmei SUN ; Yi HE ; Mei MO ; Xiaoxiao ZHANG ; Linhua ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):272-279
To explore the advantages of traditional Chinese medicine (TCM) and integrative TCM-Western medicine approaches in the treatment of diabetic microvascular complications (DMC), refine key pathophysiological insights and treatment principles, and promote academic innovation and strategic research planning in the prevention and treatment of DMC. The 38th session of the Expert Salon on Diseases Responding Specifically to Traditional Chinese Medicine, hosted by the China Association of Chinese Medicine, was held in Beijing, 2024. Experts in TCM, Western medicine, and interdisciplinary fields convened to conduct a systematic discussion on the pathogenesis, diagnostic and treatment challenges, and mechanism research related to DMC, ultimately forming a consensus on key directions. Four major research recommendations were proposed. The first is addressing clinical bottlenecks in the prevention and control of DMC by optimizing TCM-based evidence evaluation systems. The second is refining TCM core pathogenesis across DMC stages and establishing corresponding "disease-pattern-time" framework. The third is innovating mechanism research strategies to facilitate a shift from holistic regulation to targeted intervention in TCM. The fourth is advancing interdisciplinary collaboration to enhance the role of TCM in new drug development, research prioritization, and guideline formulation. TCM and integrative approaches offer distinct advantages in managing DMC. With a focus on the diseases responding specifically to TCM, strengthening evidence-based support and mechanism interpretation and promoting the integration of clinical care and research innovation will provide strong momentum for the modernization of TCM and the advancement of national health strategies.
2.Discussion on processing time for Polygonatum kingianum based on analysis of correlation between sugar components and color changes
GUO Hong ; YAO Rui ; LI Zhe ; FAN Jing ; WANG Ying ; GUO Xiaohan ; CHEN Jia ; DUAN Baozhong ; YANG Jianbo ; JING Wenguang ; CHENG Xianlong ; WEI Feng
Drug Standards of China 2026;27(1):0083-0091
Objective: To investigate the correlation between color parameters (L*, a*, b*, Eab*) and the contents of reducing sugars, total polysaccharides, total oligosaccharides, as well as four saccharides (fructose, glucose, sucrose, and kestose) during the nine cycles of steaming and sun-drying processing of Polygonatum kingianum, and to preliminarily explore the optimal processing duration.
Methods: The color changes were objectively evaluated using a colorimeter. The anthrone-sulfuric acid method was employed to determine total polysaccharides and oligosaccharides. The 3,5-dinitrosalicylic acid (DNS) colorimetric method was used to measure total reducing sugar content. High-performance liquid chromatography coupled with charged aerosol detection (HPLC-CAD) was applied for quantitative analysis of fructose, glucose, sucrose, and kestose. Multivariate statistical analysis was conducted to assess samples from different processing stages.
Results: Significant variations in color and component contents were observed across processing stages. The herbal pieces progressively darkened with increased processing cycles: brightness (L*) and total color difference (Eab*) initially decreased then stabilized, while a* (red-green) and b* (yellow-blue) values first increased then declined. Total polysaccharides and oligosaccharides showed overall decreasing trends, whereas reducing sugars initially increased before stabilizing. Fructose and glucose levels rose continuously, while sucrose and kestose decreased progressively, becoming undetectable after five cycles.
Conclusion: The chromatic alteration and saccharide composition of P. kingianum showed significant correlation with processing duration. Both total color difference (Eab*) and reducing sugar content stabilized after four processing cycles (12 hours), suggesting that four cycles of steaming and sun-drying may represent the optimal processing duration.
3.Study on the Medication Law of Wang Zhongyi in Treating Tic Disorder Based on Data Mining
Hongwei FAN ; Min LI ; Xiaojin QIU ; Xiaoqin LYU ; Ying CHANG ; Zhongyi WANG
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(7):55-61
Objective To study the medication law of Professor Wang Zhongyi in the treatment of tic disorder(TD)based on data mining technology.Methods From January 1,2022 to December 31,2023,the cases treated for TD in Professor Wang Zhongyi's outpatient clinic,which participated in the real-world study were collected.A comprehensive database has been established,screening information related to effective case diagnosis and treatment.Utilizing Excel 2021,R 4.4.2,Origin 2024 and Cytoscape 3.9.1,this study conducted medication frequency analysis,property-flavor-meridian tropism analysis,efficacy analysis,association rule analysis,clustering analysis and co-occurrence network analysis to summarize medication law.Results Totally 640 effective prescriptions were included,involving 208 kinds of Chinese materia medica.The properties were mainly warm,cold,and neutral.The flavors were mainly pungent,bitter and sweet.The meridians were mainly liver meridians.The therapeutic categories were primarily composed of liver-calming and endogenous wind-stopping drugs,along with exterior-resolving prescriptions.Correlation analysis obtained 17 strongly correlated rules.Clustering analysis obtained 5 types of medicinal combinations.The therapeutic categories were primarily composed of liver-calming and endogenous wind-stopping drugs,along with exterior-resolving prescriptions.Conclusion According to the comprehensive statistical analysis,Uncariae Ramulus cum Uncis,Gastrodiae Rhizoma,Haliotidos Concha,Paeoniae Radix alba,Bupleuri Radix,Puerariae Lobatue Radix and Scorpio are the core drugs used by Professor Wang Zhongyi to treat TD.Professor Wang Zhongyi believes that the core pathogenesis of TD is the internal movement of liver wind,and the treatment mainly focuses on calming the liver,calming the wind and stopping spasms,while also nourishing the heart,calming the mind,harmonizing blood and relieving qi.Based on different clinical symptoms of TD,modifications and adjustments are made to the core prescription to treat children with TD.
4.Analysis Method of Empagliflozin and Related Substances in Empagliflozin Bulk Drug and Tablets
Yanlin HE ; Ying XIA ; Chaoyu HUANG ; Hongyu FAN ; Jialiang ZHU ; Rui LI ; Geng LI ; Fei YAN
Herald of Medicine 2025;44(1):24-31
Objective To establish a high-performance liquid chromatography method to detect empagliflozin and related substances in empagliflozin bulk drug and tablets,and to provide technical support for quality control and unified monitoring of empagliflozin bulk drug and its tablets.Methods A liquid chromatography development system with the full factorial design of experiments and the Box-Behnken model was used to screen and optimize the chromatographic parameters.Related substances were detected in empagliflozin API and empagliflozin tablets from different companies with the optimized chromatographic parameters.Results The optimized chromatographic parameters were obtained:Shim-pack GIST C18-AQ column(250 mm×4.6 mm,5 μm)was used,column temperature was 15 ℃,gradient elution with water-acetonitrile as mobile phase was as below,flow rate was 1.2 mL·min-1,detection wavelength was set at 224 nm.The specificity of the method is good,with recoveries ranging from 94.8%to 101.7%,and RSD ranging from 0.5%to 3.1%.The known single impurity in APIs and tablets is less than 0.05%,any other unknown single impurity is less than 0.06%,and the total amount of impurities are less than 0.3%.The related substances of supervised sampling are under good control.Conclusion The method is reliable and robust for determining related substances of empagliflozin and its tablets.
5.Study on pricing of initiative hospice and palliative care services by service unit
Tian-shu CHU ; Yi-fan XU ; Li-mei JING ; Xue-ying LI ; Xiao-yu ZHANG ; Jun-mei DENG
Chinese Journal of Health Policy 2025;18(2):47-52
Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.
6.Study on the Medication Law of Wang Zhongyi in Treating Tic Disorder Based on Data Mining
Hongwei FAN ; Min LI ; Xiaojin QIU ; Xiaoqin LYU ; Ying CHANG ; Zhongyi WANG
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(7):55-61
Objective To study the medication law of Professor Wang Zhongyi in the treatment of tic disorder(TD)based on data mining technology.Methods From January 1,2022 to December 31,2023,the cases treated for TD in Professor Wang Zhongyi's outpatient clinic,which participated in the real-world study were collected.A comprehensive database has been established,screening information related to effective case diagnosis and treatment.Utilizing Excel 2021,R 4.4.2,Origin 2024 and Cytoscape 3.9.1,this study conducted medication frequency analysis,property-flavor-meridian tropism analysis,efficacy analysis,association rule analysis,clustering analysis and co-occurrence network analysis to summarize medication law.Results Totally 640 effective prescriptions were included,involving 208 kinds of Chinese materia medica.The properties were mainly warm,cold,and neutral.The flavors were mainly pungent,bitter and sweet.The meridians were mainly liver meridians.The therapeutic categories were primarily composed of liver-calming and endogenous wind-stopping drugs,along with exterior-resolving prescriptions.Correlation analysis obtained 17 strongly correlated rules.Clustering analysis obtained 5 types of medicinal combinations.The therapeutic categories were primarily composed of liver-calming and endogenous wind-stopping drugs,along with exterior-resolving prescriptions.Conclusion According to the comprehensive statistical analysis,Uncariae Ramulus cum Uncis,Gastrodiae Rhizoma,Haliotidos Concha,Paeoniae Radix alba,Bupleuri Radix,Puerariae Lobatue Radix and Scorpio are the core drugs used by Professor Wang Zhongyi to treat TD.Professor Wang Zhongyi believes that the core pathogenesis of TD is the internal movement of liver wind,and the treatment mainly focuses on calming the liver,calming the wind and stopping spasms,while also nourishing the heart,calming the mind,harmonizing blood and relieving qi.Based on different clinical symptoms of TD,modifications and adjustments are made to the core prescription to treat children with TD.
7.Study on pricing of initiative hospice and palliative care services by service unit
Tian-shu CHU ; Yi-fan XU ; Li-mei JING ; Xue-ying LI ; Xiao-yu ZHANG ; Jun-mei DENG
Chinese Journal of Health Policy 2025;18(2):47-52
Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.
8.Effect of donepezil combined with hypoxia on CYP3A4 and its safety-evaluation
Xiao-xia HAN ; Yue-xin LI ; Wei TENG ; Fang WANG ; Hai-ying HONG ; Ze-shuai YI ; Ying SONG ; Yu-yan ZHOU ; Bao-xin LI ; Pan FAN
Chinese Pharmacological Bulletin 2025;41(12):2354-2361
Aim To investigate the regulatory mecha-nisms of donepezil on the expression and enzymatic ac-tivity of cytochrome P450 3A4(CYP3A4),elucidate the synergistic impact of hypoxia on CYP3A4 function,and reveal its potential association with drug-induced cardiotoxicity,particularly QT interval prolongation.Methods Western blot,co-immunoprecipitation,and gene knockdown techniques were employed to evaluate the effects of donepezil and hypoxia on CYP3A4 pro-tein expression.CYP3A4 enzymatic activity was as-sessed using an in vitro incubation system with rat liver microsomes combined with high-performance liquid chromatography(HPLC),and the half-maximal inhib-itory concentration(IC50)was determined.Results Donepezil(10 μmol·L-1)and hypoxia reduced CYP3A4 protein expression to 31.75%and 45.90%of the control levels,respectively.Both interventions activated the gp78-mediated ubiquitin-proteasome path-way,significantly increasing CYP3A4 ubiquitination levels by 2.1-fold compared to the control group,thereby promoting proteasomal degradation.Donepezil inhibited CYP3A4 enzyme activity with an IC50 of 83.4μmol·L-1,and hypoxia synergistically enhanced this inhibitory effect,reducing the IC50 to 20.79 μmol·L-1.Conclusion Donepezil downregulates CYP3A4 function through dual mechanisms involving ubiquitin-mediated proteasomal degradation and direct enzymatic inhibition.Hypoxia potentiates this effect,leading to impaired metabolism of CYP3A4 substrate drugs,ele-vated plasma drug concentrations(1.6-2.3-fold in-crease compared to normal metabolic conditions),and an increased risk of QT interval prolongation and other forms of cardiotoxicity.
9.Analysis Method of Empagliflozin and Related Substances in Empagliflozin Bulk Drug and Tablets
Yanlin HE ; Ying XIA ; Chaoyu HUANG ; Hongyu FAN ; Jialiang ZHU ; Rui LI ; Geng LI ; Fei YAN
Herald of Medicine 2025;44(1):24-31
Objective To establish a high-performance liquid chromatography method to detect empagliflozin and related substances in empagliflozin bulk drug and tablets,and to provide technical support for quality control and unified monitoring of empagliflozin bulk drug and its tablets.Methods A liquid chromatography development system with the full factorial design of experiments and the Box-Behnken model was used to screen and optimize the chromatographic parameters.Related substances were detected in empagliflozin API and empagliflozin tablets from different companies with the optimized chromatographic parameters.Results The optimized chromatographic parameters were obtained:Shim-pack GIST C18-AQ column(250 mm×4.6 mm,5 μm)was used,column temperature was 15 ℃,gradient elution with water-acetonitrile as mobile phase was as below,flow rate was 1.2 mL·min-1,detection wavelength was set at 224 nm.The specificity of the method is good,with recoveries ranging from 94.8%to 101.7%,and RSD ranging from 0.5%to 3.1%.The known single impurity in APIs and tablets is less than 0.05%,any other unknown single impurity is less than 0.06%,and the total amount of impurities are less than 0.3%.The related substances of supervised sampling are under good control.Conclusion The method is reliable and robust for determining related substances of empagliflozin and its tablets.
10.Feasibility study of using clinical trial individual-level data sample bank as external control to support drug and device development:taking transcatheter aortic valve replacement device as an example
Xiao-ying LIN ; Chi-lie DANZENG ; Duo-er WANG ; Ying-xuan ZHU ; Ye LU ; Fan GAO ; Yuan-xin LI ; Meng-zhu SU ; Zi-long ZHANG ; Min CHEN ; Qi-ze LI ; Ru JIANG ; Yan-yan ZHAO ; Yang WANG
Chinese Journal of Interventional Cardiology 2025;33(8):459-466
Objective To explore the feasibility and corresponding implementation methods of constructing a sample resource bank based on individual-level data of completed clinical trials and using it to construct external controls for drug/device clinical trials.Methods Taking the pre-marketing clinical trial of transcatheter active valve replacement(TAVR)for the treatment of aortic valve stenosis as an example,the individual-level databases of multiple trials were standardized to form a sample bank.The original data of any trial in the sample bank were selected as the experimental group,and the remaining samples were selected as the control group.The potential confounding was handled by using the propensity score matching and stratification methods to clarify the process of constructing external controls based on the sample bank of individual-level data of clinical trials.Results This study included individual-level data of single-group trials of 4 TAVR devices,with a total of 569 subjects(59.2%male).The number of subjects in Trials 1 to 4 was 120,120,163,and 166,respectively.Propensity score matching enabled the matching of 113,117,125,and 147 subjects with comparable or similar characteristics from individual-level data from other trials,respectively,demonstrating a high matching success rate.The PS score distribution plot after stratification showed that the proportions of subjects in the experimental and control groups in strata 1 to 5 in scheme 1 were 4/103,11/103,22/92,32/87,and 51/64,respectively.For all constructed external controlled trials,a certain number of control samples with similar baseline characteristics to the experimental groups were distributed within each propensity score stratum.The results of the simulation test also reflected the potential differences between different devices in the 12-month all-cause mortality rate.Conclusions The sample bank constructed with individual-level data from clinical trials,as a high-quality data source,can serve as a source of external control for single-arm trials in the same field,and as a useful supplement to the external control scenario of real-world evidence to support drug and device development.At the same time,targeted research on research methods and bias control measures in related fields is also needed.

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