1.Application Analysis of Alzheimer's Disease Animal Models Based on Data Mining
Zhichen WANG ; Senlin CHEN ; Yulong ZOU ; Gengzhao CHEN ; Qianhong ZHU ; Saie HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):244-252
ObjectiveThis paper aims to systematically summarize the construction methods and characteristics of Alzheimer's disease (AD) animal models, providing a reference for improving AD animal models. MethodsLiterature related to AD animal models published between January 2022 and April 2025 was retrieved from China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang Data, and VIP Database. Information such as experimental animal species, month of age, sex, modeling methods, and period, as well as evaluation indicators, was collated, extracted, and imported into Microsoft Excel 2024 to establish the database. In addition, various modeling methods and detection means were summarized and compared. ResultsA total of 400 articles were included. Among the AD animal models, amyloid precursor protein/presenilin-1 (APP/PS1) mice were used most frequently, with a predominance of male animals. Typically, 3-4-month-old rats or 5-6-month-old mice were selected. The main modeling methods included natural aging, accelerated aging, surgical intervention, drug induction, and transgenic technology. The modeling period was mainly concentrated in a single day or 6-8 weeks. Detection indicators of the models focused on physiological, behavioral, pathological-morphological, and biochemical phenotypes. ConclusionThe construction methods of AD animal models are relatively mature, with multifactorial interventions effectively simulating human pathology, though certain limitations remain. By systematically reviewing and analyzing recent experimental literature of AD animal models, this study aims to provide theoretical support and a reference for further improving the construction of the AD animal model.
2.Chaixian Huashen decoction alleviates lipopolysaccharide induced acute lung injury by inhibiting TLR4/NF-κB pathway
Guixin SU ; Yulong HUANG ; Changwei LI ; Yu YANG ; Yang ZHANG ; Rui XUE ; Shuo LI ; Youzhi ZHANG
Chinese Journal of Pharmacology and Toxicology 2025;39(9):651-661
OBJECTIVE To investigate the mechanism through which Chaixian Huashen decoction(CXHSD)ameliorates lipopolysaccharide(LPS)-induced acute lung injury(ALI)in mice.METHODS Component analysis:the components of CXHSD extract were analyzed via ultra-high performance liquid chromatography-high resolution mass spectrometry(UPLC-Q-Exactive HFX).Network pharma-cology analysis was conducted to predict the potential active components and underlying therapeutic targets of CXHSD for ALI treatment.① Animal experiment:mice were randomly divided into the normal control group,model(LPS)group,model+dexamethasone(DEX)4 mg·kg-1 group,model+CXHSD 10 g·kg-1 group,and model+CXHSD 20 g·kg-1 group.Except for the normal control group,ALI was induced in all the mice by intratracheal instillation of LPS.Model+CXHSD groups received daily intra-gastric administration of corresponding treatments for 7 consecutive days.The model+DEX group was administered saline intragastrically for the initial 5 d,followed by DEX for the next 2 d.ALI was induced by intratracheal instillation of LPS 5 mg·kg-1 1 h after the 6th administration of CXHSD/DEX.24 h after modeling,the severity of pulmonary edema was assessed using the wet to dry weight(W/D)ratio,and hematoxylin-eosin(HE)staining was used to evaluate histopathological damage.The levels of myeloperoxidase(MPO),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1β in lung tissue homogenates and serum were measured by enzyme-linked immunosorbent assay(ELISA).The total protein concentration in bronchoalveolar lavage fluid(BALF)was measured by bicinchoninic acid(BCA)assay.Immunohistochemistry and Western blotting were used to assess the expression levels of toll-like receptor 4(TLR4),myeloid differentiation primary response 88(MyD88),zonula occludens-1(ZO-1)and occludin,as well as the phosphorylation level of nuclear factor-kappa B p65(NF-κB p65).② Cell experiment:RAW264.7 cells were divided into the cell control group,LPS 1 mg·L-1 group,LPS 1 mg·L-1+DEX 1 mg·L-1 group,and LPS 1 mg·L-1+CXHSD 50,100 and 200 mg·L-1 groups.After 24 h of culture,the nitric oxide(NO)content was measured with the nitrate reductase method,the levels of TNF-α,IL-1 β and IL-6 in the cell supernatants of each group were detected by ELISA.RESULTS Network pharmacology analysis indicated that CXHSD might alleviate ALI through the NF-κB pathway.① Com-pared with the normal control group,the W/D ratio was elevated,pathological injuries aggravated(such as alveolar wall thickening,inflammatory infiltration,and alveolar congestion),histopathological damage pronounced,MPO activity increased,and total protein concentrations in BALF raised in the model group,in which levels of TNF-α,IL-6 and IL-1 β in both lung tissue and serum became higher.Concur-rently,LPS increased the expressions of p-NF-κB p65,TLR4 and MyD88,but reduced the expressions of ZO-1 and occludin.Compared with the model group,model+CXHSD groups had their pulmonary edema and lung pathological injury ameliorated as evidenced by alleviated alveolar wall thickening,inflammatory infiltration and alveolar congestion.The levels of MPO,TNF-α,IL-1 β and IL-6 in both lung tissue and serum,and the total protein concentrations in BALF were significantly decreased in the model+CXHSD groups.Additionally,the expressions of TLR4,MyD88,and p-NF-κB p65 were significantly downregulated,while those of ZO-1 and occludin were prominently upregulated.② Compared with the cell control,the levels of TNF-α,IL-1 β,IL-6 and NO in the supernatant of RAW264.7 cells were signifi-cantly increased in the LPS group.Compared with the LPS group,in the supernatant of RAW264.7 cells treated with LPS+CXHSD at 100 mg·L-1,there was no significant difference in TNF-α levels.However,in the other groups treated with LPS+CXHSD,the levels of TNF-α,IL-1 β,IL-6,and the content of NO were significantly reduced.CONCLUSION CXHSD can alleviate LPS-induced ALI by inhibiting the TLR4/NF-κB pathway,attenuating inflammation,and preserving pulmonary barrier integrity.
3.Mechanisms of the soluble guanylate cyclase stimulator sGC003 for improving high altitude pulmonary edema in mice
Yulong HUANG ; Shuo LI ; Yingxian SHI ; Guixin SU ; Jinshui ZHANG ; Zhibing ZHENG ; Yun DENG ; Youzhi ZHANG
Chinese Journal of Pharmacology and Toxicology 2025;39(10):761-769
OBJECTIVE To investigate the role and mechanisms of the soluble guanylate cyclase(sGC)stimulator sGC003 in improving high altitude pulmonary edema(HAPE)in mice.METHODS Mice were randomly assigned to a normal control group,model group,model+dexamethasone 4 mg·kg-1 group(before modeling,intragastric administration of saline was performed once daily for 6 d,followed by intragastric administration of dexamethasone 4 mg·kg-1 on days 7 and 8),model+riociguat 10 mg·kg-1 group(before modeling,intragastric administration once a day for 7 d),and model+sGC003 5 and 10 mg·kg-1 groups(before modeling,intragastric administration once a day for 7 d).All groups except the normal control group received intratracheal instillation of lipopolysaccharide at a dose of 4 mg·kg-11 h after drug administration on day 7,followed by placement in a hypoxic environment to establish the HAPE model.After 24 h of modeling,the expiratory time,end-inspiratory pause,enhanced pause,and breathing frequency were measured,Lung tissue morphology was examined using HE staining,and lung tissue edema was assessed by determining the wet to dry weight ratio(W/D).The level of interleukin-1β(IL-1β)was determined using immunofluorescence staining.The phosphorylation level of vasodilator-stimulated phosphoprotein(VASP)in lung tissue was analyzed by Western blotting.Additionally,levels of sGC,hypoxia inducible factor-1α(HIF-1α),cyclic guanosine monophosphate(cGMP),IL-6,and IL-1βin serum were quantified using ELISA.RESULTS Compared with the normal control group,the model group had obvious pulmonary edema,and the lung W/D,IL-1β levels,expiratory time,end-inspiratory pause,enhanced pause,as well as serum levels of IL-1β,HIF-1α and IL-6 were significantly increased.Concurrently,the frequency of breathing and serum levels of sGC and cGMP were significantly decreased.Compared with model group,the expiratory time,end-inspiratory pause,enhanced pause,lung W/D and IL-1β levels,and serum levels of IL-1β,HIF-1α and IL-6 were significantly decreased in the model+sGC003 10 mg·kg-1 group;while the frequency of breathing,serum sGC and cGMP levels,phosphorylation level of VASP in lung tissues were significantly increased.CONCLUSION sGC003 can improve lung function,suppress pulmonary inflammation,and mitigate pulmonary edema in HAPE mice by activating the sGC/cGMP pathway.
4.Expert consensus on clinical treatment of acute radiation syndrome from external irradiation
Li LIANG ; Long YUAN ; Changlin YU ; Qingjie LIU ; Yulong LIU ; Wenfeng YANG ; Jin WANG ; Weixu HUANG ; Ying LIU ; Cuiping LEI ; Huifang CHEN ; Ximing FU ; Baoshan CAO ; Mopei WANG ; Zhaohui ZHANG ; Yu XIAO ; Yamei CHEN ; Quanfu SUN
Chinese Journal of Radiological Medicine and Protection 2025;45(9):827-839
China emerges as a major country in nuclear energy development and the application of nuclear and radiologic technology. The diagnosis and treatment of acute radiation syndrom (ARS) caused by external irradiation represent a core function in the country′s medical rescue of nuclear and radiological emergencies. Clinically, ARS manifests hematopoietic, gastrointestinal, cutaneous, and central nervous system syndromes, with specific clinical manifestations, signs, severity, and prognosis strongly correlated with radiation dose. China has established a number of national and provincial centers for treating radiation-induced damage. Nevertheless, most medical staff have limited experience in ARS treatment. This consensus presents a summary of recent experience in treating ARS of China. In combination with recommendations from international organizations such as the World Health Organization (WHO), this consensus proposes key evidence of critical clinical issues of ARS, covering all links in the rescue of external irradiation-induced ARS. Initially, clinical diagnosis, syndromes, and severe degrees should be determined based on clinical symptoms and dose estimates. It is necessary to normalize clinical treatment measures for hematopoietic recovery, gastrointestinal injury treatment, infection control, symptomatic treatment, and multi-organ function preservation. To this end, this consensus offers cautions. This consensus provides principles of treatment with traditional Chinese medicine, psychological intervention, and follow-up. Additionally, it highlights multidisciplinary collaboration. It is recommended that this consensus be applied in relevant treatment centers.
5.Anti-fatigue effect of chicory polysaccharide on mice exposed to simulated hypobaric hypoxia and mechanisms
Yingxian SHI ; Shuo LI ; Yulong HUANG ; Xin CHENG ; Dingduo SHAN ; Youzhi ZHANG ; Henglin WANG
Chinese Journal of Pharmacology and Toxicology 2025;39(10):742-750
OBJECTIVE To investigate the anti-fatigue effect of chicory polysaccharide(CP)on mice exposed to simulated hypobaric hypoxia.METHODS Male C57BL/6J mice were randomly divided into the control group,model group,model+CP 150,300 and 600 mg·kg-1 groups.The control and model groups were given normal saline,while the CP groups were given drugs of different doses.After a 14 d pre-administration period,all the mice except the control group were exposed to a simulated alti-tude of 7 000 m in a hypobaric and hypoxic animal experimental chamber.After 7 d,a treadmill fatigue test was conducted to assess exercise endurance.The body weight and organ indexes were evaluated.The pathological changes in organs and tissues were observed via HE staining.The levels of fatigue-related and oxidative stress-related indicators were measured.The expression levels of phosphorylated AMP-activated protein kinase(p-AMPK),peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α),and cytochrome c oxidase Ⅳ(COXⅣ)were determined using Western blotting anal-ysis.RESULTS Compared with model group,exercise endurance was significantly enhanced,body weight and organ indexes improved,and pathological damage to the lung,liver and skeletal muscle mitigated in the model+CP 600 mg·kg-1 group.Compared with model group,the model+CP 600 mg·kg-1 group had the contents of serum lactate and blood urea nitrogen reduced,but the contents of glycogen and the activity of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in the liver and skeletal muscle were increased.The malondialdehyde content was lowered,but the expressions of p-AMPK,PGC-1α,and COXⅣ in skeletal muscle were significantly increased.CONCLUSION CP can alleviate altitude-induced fatigue by reducing the metabolite accumulation,increasing glycogen storage,and lowering oxidative stress levels.The underlying mechanism may involve the activation of the AMPK/PGC-1αsignaling pathway.
6.Current status and advances in the diagnosis and treatment of inflammatory breast cancer
Wenjing ZENG ; Juan HUANG ; Shouman WANG ; Yangyi LI ; Weizhi XIA ; Yulong ZHANG ; Jun WU ; Taohong SHEN ; Fangli ZHOU ; Ayong CAO
Chinese Journal of General Surgery 2025;34(5):1044-1055
Inflammatory breast cancer(IBC)is a rare but highly aggressive subtype of breast cancer characterized by rapid clinical progression and poor prognosis.Although it accounts for only 2%-4%of all breast cancer cases,it is responsible for 8%-10%of breast cancer-related mortality.The etiology of IBC is multifactorial,involving genetic,hormonal,environmental,and socioeconomic factors.Pathologically,IBC is marked by the presence of dermal lymphatic tumor emboli,and molecular subtypes are predominantly HER2-positive and triple-negative,indicating high tumor invasiveness.Diagnosis relies on characteristic clinical manifestations and histopathological confirmation,while imaging techniques such as MRI and PET/CT play important roles in evaluating disease extent and metastasis.Given that IBC is often diagnosed at a locally advanced or metastatic stage,there is currently no specific treatment protocol.Instead,management generally follows the treatment paradigm of non-IBC,emphasizing systemic therapy within a multidisciplinary framework.HER2-positive IBC benefits from chemotherapy combined with dual-targeted anti-HER2 therapy;triple-negative IBC may respond to immune checkpoint inhibitors;and CDK4/6 inhibitors show potential efficacy in hormone receptor-positive subtypes.Despite advancements,the prognosis remains poor,with a high risk of early recurrence and distant metastasis.Prognostic factors include lymph node involvement,molecular subtype,and response to neoadjuvant therapy.As research into the tumor microenvironment and molecular mechanisms deepens,targeted and individualized therapies hold promise for improving outcomes.This review summarizes the epidemiology,pathology,diagnostic criteria,treatment strategies,and prognostic factors of IBC,aiming to inform clinical practice and future research.
7.Chaixian Huashen decoction alleviates lipopolysaccharide induced acute lung injury by inhibiting TLR4/NF-κB pathway
Guixin SU ; Yulong HUANG ; Changwei LI ; Yu YANG ; Yang ZHANG ; Rui XUE ; Shuo LI ; Youzhi ZHANG
Chinese Journal of Pharmacology and Toxicology 2025;39(9):651-661
OBJECTIVE To investigate the mechanism through which Chaixian Huashen decoction(CXHSD)ameliorates lipopolysaccharide(LPS)-induced acute lung injury(ALI)in mice.METHODS Component analysis:the components of CXHSD extract were analyzed via ultra-high performance liquid chromatography-high resolution mass spectrometry(UPLC-Q-Exactive HFX).Network pharma-cology analysis was conducted to predict the potential active components and underlying therapeutic targets of CXHSD for ALI treatment.① Animal experiment:mice were randomly divided into the normal control group,model(LPS)group,model+dexamethasone(DEX)4 mg·kg-1 group,model+CXHSD 10 g·kg-1 group,and model+CXHSD 20 g·kg-1 group.Except for the normal control group,ALI was induced in all the mice by intratracheal instillation of LPS.Model+CXHSD groups received daily intra-gastric administration of corresponding treatments for 7 consecutive days.The model+DEX group was administered saline intragastrically for the initial 5 d,followed by DEX for the next 2 d.ALI was induced by intratracheal instillation of LPS 5 mg·kg-1 1 h after the 6th administration of CXHSD/DEX.24 h after modeling,the severity of pulmonary edema was assessed using the wet to dry weight(W/D)ratio,and hematoxylin-eosin(HE)staining was used to evaluate histopathological damage.The levels of myeloperoxidase(MPO),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1β in lung tissue homogenates and serum were measured by enzyme-linked immunosorbent assay(ELISA).The total protein concentration in bronchoalveolar lavage fluid(BALF)was measured by bicinchoninic acid(BCA)assay.Immunohistochemistry and Western blotting were used to assess the expression levels of toll-like receptor 4(TLR4),myeloid differentiation primary response 88(MyD88),zonula occludens-1(ZO-1)and occludin,as well as the phosphorylation level of nuclear factor-kappa B p65(NF-κB p65).② Cell experiment:RAW264.7 cells were divided into the cell control group,LPS 1 mg·L-1 group,LPS 1 mg·L-1+DEX 1 mg·L-1 group,and LPS 1 mg·L-1+CXHSD 50,100 and 200 mg·L-1 groups.After 24 h of culture,the nitric oxide(NO)content was measured with the nitrate reductase method,the levels of TNF-α,IL-1 β and IL-6 in the cell supernatants of each group were detected by ELISA.RESULTS Network pharmacology analysis indicated that CXHSD might alleviate ALI through the NF-κB pathway.① Com-pared with the normal control group,the W/D ratio was elevated,pathological injuries aggravated(such as alveolar wall thickening,inflammatory infiltration,and alveolar congestion),histopathological damage pronounced,MPO activity increased,and total protein concentrations in BALF raised in the model group,in which levels of TNF-α,IL-6 and IL-1 β in both lung tissue and serum became higher.Concur-rently,LPS increased the expressions of p-NF-κB p65,TLR4 and MyD88,but reduced the expressions of ZO-1 and occludin.Compared with the model group,model+CXHSD groups had their pulmonary edema and lung pathological injury ameliorated as evidenced by alleviated alveolar wall thickening,inflammatory infiltration and alveolar congestion.The levels of MPO,TNF-α,IL-1 β and IL-6 in both lung tissue and serum,and the total protein concentrations in BALF were significantly decreased in the model+CXHSD groups.Additionally,the expressions of TLR4,MyD88,and p-NF-κB p65 were significantly downregulated,while those of ZO-1 and occludin were prominently upregulated.② Compared with the cell control,the levels of TNF-α,IL-1 β,IL-6 and NO in the supernatant of RAW264.7 cells were signifi-cantly increased in the LPS group.Compared with the LPS group,in the supernatant of RAW264.7 cells treated with LPS+CXHSD at 100 mg·L-1,there was no significant difference in TNF-α levels.However,in the other groups treated with LPS+CXHSD,the levels of TNF-α,IL-1 β,IL-6,and the content of NO were significantly reduced.CONCLUSION CXHSD can alleviate LPS-induced ALI by inhibiting the TLR4/NF-κB pathway,attenuating inflammation,and preserving pulmonary barrier integrity.
8.Clinical Efficacy of Gandouling Decoction Combined with Neuromuscular Electrical Stimulation on Dysphagia in Wilson Disease with Combined Phlegm and Stasis
Zhihong RAO ; Wenming YANG ; Yue YANG ; Xiang LI ; Peng HUANG ; Yulong YANG ; Ke DIAO ; Shuzhen FANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):155-162
ObjectiveTo observe the clinical efficacy of Gandouling decoction combined with neuromuscular electrical stimulation (NMES) in the treatment of dysphagia in Wilson disease (WD) with combined phlegm and stasis. MethodsA total of 80 WD patients with dysphagia due to combined phlegm and stasis treated in the Department of Encephalopathy, the First Affiliated Hospital of Anhui University of Chinese Medicine were randomized into a control group and an observation group, with 40 patients in each group. In addition, 40 healthy volunteers were recruited as the normal group. The control group was treated with basic copper drainage combined with NMES. The observation group was treated with Gandouling Decoction on the basis of the therapy in the control group. Each course of treatment lasted for 8 days, and the patients were treated for a total of 4 courses. All subjects underwent video fluoroscopic swallowing study (VFSS) before and after treatment. During the examination, contrast agents with 4 different characters were used for the swallowing action, and the passing time was recorded. The TCM syndrome score, water swallow test score, standard swallowing assessment (SSA) score, and 24-h urinary copper level before and after treatment were analyzed. ResultsWhen performing VFSS, the passing time of contrast agents of different characters in the oral stage was longer in the WD group than in the normal group (P<0.01), while it had no significant difference in the pharyngeal stage. After treatment, the passing time in the oral stage shortened in the control and observation groups (P<0.01), and the observation group outperformed the control group (P<0.01). After treatment, both the control and observation groups showed declines in TCM syndrome score and SSA score (P<0.01) and an increase in water swallow test score (P<0.01), and the changes were more obvious in the observation group than in the control group (P<0.01). In addition, the treatment in the control and observation groups elevated the 24-h urinary copper level (P<0.01), and the elevation in the observation group was more obvious than that in the control group (P<0.01). Neither group showed obvious adverse reaction. ConclusionGandouling decoction combined with NMES can significantly ameliorate dysphagia in WD patients with the syndrome of combined phlegm and stasis regarding the TCM syndrome score, water swallow test score, and SSA score, demonstrating definite clinical efficacy and high safety.
9.Correlation between Kayser-Fleischer ring grading and cognitive function in Wilson’s disease
Wei HE ; Yulong YANG ; Wenming YANG ; Yue YANG ; Chen HU ; Hui LI ; Peng HUANG
Journal of Clinical Hepatology 2025;41(6):1150-1155
ObjectiveTo investigate the correlation with cognitive function based on a new Kayser-Fleischer ring (K-F ring) grading method in Wilson’s disease (WD). MethodsA total of 136 WD patients who were hospitalized in Encephalopathy Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, from April 2022 to October 2023 were enrolled. All subjects underwent slit lamp examination, and the grade of K-F ring was determined according to the shape and extent of copper deposition in the cornea, whether it formed a ring or not, and whether there was a sunflower-like cloudy change in the lens. The patients were instructed to complete UWDRS, MoCA, and MMSE scale assessments, and these indicators were compared between patients with different K-F ring grades. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test (homogeneity of variance) or the Dunnett’s T3 test (heterogeneity of variance) was used for further multiple comparisons; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups; the chi-square test was used for comparison of categorical data between groups. The Spearman correlation analysis was used to investigate the correlation of K-F ring grade with UWDRS, MoCA, and MMSE scores. ResultsAmong the 136 patients with WD, there were 40 patients with grade 4 K-F ring, accounting for the highest proportion of 29.4%, and 14 patients with grade 0 K-F ring, accounting for the lowest proportion of 10.3%, and there were 22 patients with grade 1 K-F ring (16.2%), 19 with grade 2 K-F ring (14%), 25 with grade 3 K-F ring (18.4%), and 16 with grade 5 K-F ring (11.7%). According to the different grades of K-F ring, there was a significant increase in UWDRS score (F=22.61, P<0.001) and significant reductions in MoCA and MMSE scores (F=16.40 and 13.80, both P<0.001). The Spearman correlation analysis showed that K-F ring grade was positively correlated with UWDRS score (r=0.67, P<0.01) and was negatively correlated with MoCA and MMSE scores in WD patients (r=-0.59 and -0.57, both P<0.01). ConclusionThe new K-F ring grading method can determine disease severity in WD patients to a certain degree and partially reflect cognitive function and activities of daily living in such patients.
10.Exploring the Diagnosis and Treatment of Vascular Cognitive Impairment Based on the Relationship Between "Kidney Governing Water" and the Glymphatic System
Senlin CHEN ; Yu CHEN ; Yulong ZOU ; Zhichen WANG ; Gengzhao CHEN ; Qianhong ZHU ; Saie HUANG
Journal of Traditional Chinese Medicine 2025;66(11):1114-1118
Starting from the intrinsic relationship between the glymphatic system and the core pathogenesis of vascular cognitive impairment (VCI), including internal dampness, phlegm turbidity, and blood stasis, this paper explores clinical approaches to the diagnosis and treatment of VCI. Dysfunction of the kidney's role in governing water leads to the accumulation of dampness, phlegm turbidity, and blood stasis, which are key pathological mechanisms underlying the onset and progression of VCI. The glymphatic system participates in the circulation of cerebrospinal fluid within the central nervous system, and its impairment can result in reduced clearance of soluble metabolic waste products in the brain, a crucial factor contributing to VCI. It is proposed that the "kidney governing water" function is related to the glymphatic system, and that the cerebral collaterals correspond structurally to the glymphatic pathways. Clinically, therapies aimed at tonifying the kidney, resolving phlegm, activating blood circulation, and unblocking collaterals, such as modified Kaixin Powder (开心散), which eliminates dampness and turbidity, transforms phlegm, restores consciousness, enhances cognition, and strengthens the brain, are commonly employed. These treatments may improve VCI prognosis by regulating glymphatic system function, providing a theoretical basis for the prevention and treatment of VCI with traditional Chinese medicine.

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