1.Zuogui Wan Improve Ovarian Inflammatory Microenvironment and Stemness of Ovarian Germline Stem Cells in Ovarian Aging via cGAS/STING Signaling Pathway
Yunling ZHENG ; Xinyi PAN ; Zuang LI ; Yixuan WANG ; Junyi AN ; Yuxin ZOU ; Mengting XIAO ; Zheng CHEN ; Ling ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):1-10
ObjectiveTo investigate the mechanism of Zuogui Wan (ZGW) in improving ovarian inflammatory microenvironment and stemness of ovarian germline stem cells (OSCs) for treating ovarian aging via the cyclic guanosine monophosphate/adenosine monophosphate synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway. MethodsForty C57BL/6 female mice were randomly divided into a blank group, a model group, a low-dose ZGW group (2.7 g·kg-1), a high-dose ZGW group (5.4 g·kg-1), and an estradiol valerate group (0.15 mg·kg-1), with 8 mice in each group. Except the blank group, all other groups received a single intraperitoneal injection of cyclophosphamide at 120 mg·kg-1 to establish an ovarian aging mouse model. After successful modeling, each group was continuously administered for 4 weeks, once daily. The physiological status of the mice was observed, and the ovarian index was calculated. The estrus cycle of the mice was monitored. Hematoxylin-eosin (HE) staining was used to observe pathological changes in ovarian tissue. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum sex hormone levels. Serum inflammatory factors interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and mouse interleukin-6 (IL-6) levels were detected using kits. Western blot was used to detect the protein expression of ovarian cGAS, STING, p-STING, TANK-binding kinase 1 (TBK1), p-TBK1, interferon-induced transmembrane protein 3 (Fragilis), and Vasa homolog protein (MVH). Quantitative real-time polymerase chain reaction (Real-time PCR) was used to detect the mRNA expression of inflammatory factors in ovarian tissue. Immunofluorescence double labeling was performed to locate OSCs in ovarian tissues, and fluorescence intensities of OSCs markers MVH and octamer binding transcription factor 4 (Oct4) were calculated. ResultsCompared with the blank group, the model group showed reduced body weight, ovarian wet weight, and ovarian index (P<0.01) and a disordered estrus cycle (P<0.01). In addition, the levels of serum follicle-stimulating hormone (FSH), TNF-α, IL-6, and IL-1β were increased (P<0.01), while anti-Müllerian hormone (AMH) and estradiol (E2) levels were decreased (P<0.01). The protein expression of cGAS, p-STING/STING, and p-TBK1/TBK1 in ovarian tissue was increased (P<0.05, P<0.01), while that of OSCs stemness factors MVH and Fragilis was reduced (P<0.01). Immunofluorescence indicated a reduction in MVH and Oct4 expression in OSCs (P<0.01). The mRNA expression of inflammatory factors TNF-α, IL-6, and IL-1β in ovarian tissue was increased (P<0.05, P<0.01). Compared with the model group, the treatment groups exhibited improved body weight, ovarian wet weight, and ovarian index (P<0.05) and a reduced rate of estrus cycle disorder (P<0.05, P<0.01). The levels of serum FSH, TNF-α, IL-6, and IL-1β were decreased (P<0.05, P<0.01), while AMH and E2 levels were increased (P<0.01). The protein expression levels of cGAS, p-STING/STING, and p-TBK1/TBK1 in ovarian tissue were decreased (P<0.05), while the protein expression of MVH and Fragilis was increased (P<0.05), and the fluorescence intensities of MVH and Oct4 were increased (P<0.05, P<0.01). The mRNA expression of inflammatory factors in ovarian tissue was decreased (P<0.05). ConclusionZGW alleviate ovarian inflammatory response, regulate ovarian microenvironment homeostasis, and maintain stemness of OSCs in ovarian aging mice probably by modulating the cGAS-STING signaling pathway, thereby improving ovarian function and delaying ovarian aging.
2.Experience in Treating Ischemic Stroke with Triple-Medicinal Combinations
Xueru ZHANG ; Wei SHEN ; Xiao LIANG ; Xiansu CHI ; Yunfan ZHANG ; Liuding WANG ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2025;66(4):407-410
This paper summarized the clinical experience in treating ischemic stroke with jiao (角) medicine (triple-medicinal combinations). Clinically, the combination of Roucongrong (Cistanche deserticola)-Shanyurou (Cornus officinalis)-Guijia (Testudinis Carapax et Plastrum) is used to nourish the kidneys and liver for disease mechanism of liver-kidney depletion, and foundation deficiency due to insufficient essence and blood; the combination of Xixiancao (Sigesbeckia orientalis)-Tianma (Gastrodia elata)-Gouteng (Uncaria rhynchophylla) is used to extinguish wind and eliminate dampness for treating numbness and swelling of limbs caused by ischemic stroke; the combination of Shichangpu (Acorus Tatarinowii)-Yuanzhi (Polygala tenuifolia)-Yujin (Curcumae Radix) is used to improve intelligence, refresh the brain, and clear the mind for treating cognitive impairment, memory loss, or speech difficulties caused by ischemic stroke; the combination of Banxia (Pinellia ternata)-Baizhu (Atractylodes macrocephala)- Tianma (Gastrodiae rhizoma) is used to dissolve phlegm and extinguish wind, unblock meridians and relieve dizziness for treating dizziness or headache caused by ischemic stroke; the combination of Danggui (Angelica sinensis radix)- Chuanxiong (Ligusticum chuanxiong)-Guijianyu (Euonymus alatus) is used to nourish and activate blood circulation, remove blood stasis and unblock meridians for treating weak limbs and activiry difficulty caused by ischemic stroke; the combination of Chaihu (Bupleurum chinense)-Zhiziz (Gardenia jasminoides)-Guanye Jinsitao (Hypericum perforatum) is used to soothe the liver and resolve constraint, cool the blood and calm the mind for treating emotional complications.
3.Exploring the differentiation and treatment of apoplexy based on"treating the elderly by focusing on the fu":a perspective from"six fu viscera-xuanfu-collaterals"
Di ZHAO ; Xiao LIANG ; Jingjing WEI ; Lina MIAO ; Yunfan ZHANG ; Hongxi LIU ; Yue LIU ; Liuding WANG ; Qi ZHANG ; Yunling ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):690-695
The incidence of apoplexy remains persistently high among the older population.Based on the traditional Chinese medicine principle of"treating the elderly by focusing on the fu",this paper explores the holistic connotation of"fu".It proposes that the onset of apoplexy in the elderly is characterized by obstruction,stagnation,depression,and sluggishness,which should be treated from six fu viscera,xuanfu,and collaterals.The interconnected hierarchical network of these three systems,serving as macro-and micro-channels for qi and fluid metabolism,plays a central role in both disease development and treatment.The failure of the six fu viscera to descend and the upward invasion of turbid yin are identified as prerequisites for apoplexy onset,whereas yang qi stagnation and xuanfu blockage act as key pathogenic drivers,and the core mechanisms involve phlegm-stasis-toxin accumulation,and dysfunction of the collaterals and fu.In the treatment,acute phase requires unblocking fu viscera and restoring xuanfu patency;chronic phase focuses on dredging collaterals and opening xuanfu;and recovery phase emphasizes tonifying combined with regulating xuanfu.The understanding of"treating the elderly by focusing on the fu"emphasizes that the pathogenesis of the disease should be changed to individual conditions;"six fu viscera-xuanfu-collaterals"exhibits a pathological mechanism characterized by the transmission and reception of pathogenic factors,as well as progressive mutual involvement;in clinical practice,treatment should meticulously assess the severity and nuances of the condition,prioritizing method that emphasizes unobstructed flow;additionally,therapy should be essential to protect stomach qi and integrate therapeutic attacks within a framework of supplementation.These principles offer valuable reference for the differentiation and treatment of apoplexy.
4.Reconsideraton of Stroke with Syndrome of Combined Blood Stasis and Toxin from the Perspective of Xiang Thinking
Yunfan ZHANG ; Di ZHAO ; Lina MIAO ; Hongxi LIU ; Jingjing WEI ; Xiao LIANG ; Liuding WANG ; Xueru ZHANG ; Yunmeng CHEN ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2025;66(13):1305-1310
Xiang thinking is a cognitive approach that reflects the relationships between phenomena and their underlying principles by analyzing their external manifestations through methods such as analogy, reasoning, deduction, and symbolism. This article applied xiang thinking to analyze the etiology and pathogenesis of "wind, fire, phlegm, and blood stasis" in stroke, thereby exploring its impact on the principles of syndrome differentiation and treatment of this condition. Meanwhile, the article traced the construction process of xiang thinking, and interpreted the concept of "toxin pathogen" in traditional Chinese medicine from four perspectives, state, attribute, origin, and law. Furthermore, the relationship between the process of constructing xiang thinking and the origin of etiology, identification methods, pathogenesis evolution, and treatment strategies for stroke with syndrome of combined blood stasis and toxin was explored, so as to provide insights into research on the etiology and pathogenesis of stroke, as well as clinical diagnosis and treatment approaches.
5.Exploring the differentiation and treatment of apoplexy based on"treating the elderly by focusing on the fu":a perspective from"six fu viscera-xuanfu-collaterals"
Di ZHAO ; Xiao LIANG ; Jingjing WEI ; Lina MIAO ; Yunfan ZHANG ; Hongxi LIU ; Yue LIU ; Liuding WANG ; Qi ZHANG ; Yunling ZHANG
Journal of Beijing University of Traditional Chinese Medicine 2025;48(5):690-695
The incidence of apoplexy remains persistently high among the older population.Based on the traditional Chinese medicine principle of"treating the elderly by focusing on the fu",this paper explores the holistic connotation of"fu".It proposes that the onset of apoplexy in the elderly is characterized by obstruction,stagnation,depression,and sluggishness,which should be treated from six fu viscera,xuanfu,and collaterals.The interconnected hierarchical network of these three systems,serving as macro-and micro-channels for qi and fluid metabolism,plays a central role in both disease development and treatment.The failure of the six fu viscera to descend and the upward invasion of turbid yin are identified as prerequisites for apoplexy onset,whereas yang qi stagnation and xuanfu blockage act as key pathogenic drivers,and the core mechanisms involve phlegm-stasis-toxin accumulation,and dysfunction of the collaterals and fu.In the treatment,acute phase requires unblocking fu viscera and restoring xuanfu patency;chronic phase focuses on dredging collaterals and opening xuanfu;and recovery phase emphasizes tonifying combined with regulating xuanfu.The understanding of"treating the elderly by focusing on the fu"emphasizes that the pathogenesis of the disease should be changed to individual conditions;"six fu viscera-xuanfu-collaterals"exhibits a pathological mechanism characterized by the transmission and reception of pathogenic factors,as well as progressive mutual involvement;in clinical practice,treatment should meticulously assess the severity and nuances of the condition,prioritizing method that emphasizes unobstructed flow;additionally,therapy should be essential to protect stomach qi and integrate therapeutic attacks within a framework of supplementation.These principles offer valuable reference for the differentiation and treatment of apoplexy.
6.Mediating role of self-regulatory fatigue between psychological distress and patient activation among old patients receiving PCI
Wenjing ZHANG ; Feifei GUO ; Zhihao WANG ; Hongli GUO ; Yunling XIAO
Chinese Journal of Geriatrics 2024;43(8):1025-1029
Objective:To investigate the mediating role of self-regulatory fatigue between psychological distress and patient activation among elderly patients undergoing PCI, in order to establish a foundation for enhancing patient activation in this population.Methods:A cross-sectional study was conducted on 267 elderly patients hospitalized in the Department of Geriatrics at Qilu Hospital, Shandong University, for PCI treatment of coronary artery disease from March to August 2023.The study utilized the Patient Self-Regulation Fatigue Scale(SRF-S), the Positivity Scale(PAM), and the Kessler Scale of Psychological Distress(K10)to evaluate self-regulation fatigue, positivity, and psychological distress in the patients.Additionally, a structural equation model was developed to investigate the relationships among these variables.Results:The study found that the scores of PAM, SRF-S, and K10 were as follows: (56.49±9.52), (42.74±8.11), and(23.42±4.45)respectively.Patient activation showed a negative correlation with self-regulatory fatigue and psychological distress, while self-regulatory fatigue was positively correlated with psychological distress.Furthermore, self-regulatory fatigue was identified as playing a partial mediating role between psychological distress and patient activation, with a mediating effect of 0.198, which accounted for 53.8% of the total effect.Conclusions:self-regulatory fatigue serving as a mediating factor between psychological distress and patient activation.Clinicians should prioritize addressing self-regulatory fatigue to enhance the efficacy of patient activation interventions.
7.Exploring the Disease Mechanism and Treatment of Ischemic Stroke Based on Ascending and Descending of Qi Movement from the Perspective of Xiang Thinking
Liuding WANG ; Xiao LIANG ; Yifan CHEN ; Yue LIU ; Hongxi LIU ; Di ZHAO ; Yunfan ZHANG ; Yunmeng CHEN ; Xueru ZHANG ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2024;65(14):1443-1448
Xiang thinking is the key way of thinking to construct the life model of human body in traditional Chinese medicine (TCM), and the theory of ascending and descending of qi movement is an important manifestation of xiang thinking in the theory of TCM. Based on the theory of qi movement, this paper interpreted the mechanism of ischemic stroke through the perspective of xiang thinking "earth weakness - wood constraint - fire hyperactivity", as "earth weakness in the central and dampness accumulated to phlegm" "wood constraint and stirring wind led to blood stasis" and "fire hyperactivity and fire toxin showed flaming upward" due to disorder of qi movement. Combined with the "xiang of medicinal properties and therapy methods" to discuss the treatment and prescriptions of ischaemic stroke, applying wind medicinals to elevate ji-earth (己土) and yi-wood (乙木), so that phlegm and stasis can be eliminated, and cold medicinals to descend jia-wood (甲木) and wu-earth (戊土) so that fire toxin can be cleared, with a view to restore ascending and descending of qi movement for ischaemic stroke.
8.Study on Zhang Yunling's Medication Law in Treating Headache Based on Data Mining
Hongxi LIU ; Xiao LIANG ; Jingzi SHI ; Jingjing WEI ; Wei SHEN ; Guojing FU ; Yue LIU ; Liuding WANG ; Yunling ZHANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):59-64
Objective To study the medication law of Professor Zhang Yunling in the treatment of headache based on data mining technology;To provide ideas for the clinical treatment of headache.Methods Professor Zhang Yunling's outpatient TCM prescription data for the treatment of headache from Sep.2017 to Dec.2020 were collected,and the Ancient and Modern Medical Record Cloud Platform 2.3.5 was used to mine the selected TCM prescriptions for herbal medicine frequency statistics,property,taste and meridian tropism statistics,herbal medicine efficacy statistics,correlation analysis,clustering analysis,complex network analysis,etc.Results Through collection and screening,totally 332 prescriptions were included,involving 178 kinds of Chinese materia medica,with a total frequency of 5 380 times.The top 10 kinds of Chinese materia medica were Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Testudinis Carapax et Plastrum,Bambusae Caulis in Taenia,Glycyrrhizae Radix et Rhizoma,Astragali Radix,Amomi Fructus Rotundus,Pinelliae Rhizoma Praeparatum,and Polygalae Radix.They were mainly warm,mild and slightly cold in properties,sweet,pungent and bitter in tastes,and liver,lung,spleen meridian in meridian tropism.In the statistics of herbal medicine efficacy,expelling wind and relieving pain,suppressing liver yang,promoting blood circulation and qi,clearing heart and relieving restlessness,clearing heat and detoxifying,softening liver and relieving pain were used more frequently.The combinations in herbal medicines association included"Atractyodis Macrocephalae Rhizoma-Chuanxiaong Rhizoma","Testudinis Carapax et Plastrum-Paeoniae Radix alba","Glycyrrhizae Radix et Rhizoma-Paeoniae Radix alba","Testudinis Carapax et Plastrum-Chuanxiaong Rhizoma","Bambusae Caulis in Taenia-Chuanxiaong Rhizoma".Herbal medicines clustering clustered 32 kinds of high-frequency herbal medicines used more than 60 times into 6 categories.Complex network analysis screened out the core formula for the treatment of headache:Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Pinelliae Rhizoma Praeparatum,Testudinis Carapax et Plastrum,Astragali Radix,Amomi Fructus Rotundus,and Glycyrrhizae Radix et Rhizoma.Conclusion In the treatment of headache,Professor Zhang Yunling holds that the pathogenesis of headache is deficiency in origin and excess in superficiality,deficiency of qi and blood,loss of nourishment of brain collaterals,stagnation of phlegm and dampness,disturbance of wind pathogen,obstruction of brain collaterals,and the location of the disease is related to the five viscera and involves the stomach.Focuses on tonifying deficiency and reducing excess,treats exterior and interior separately,and gives consideration to both the symptoms and the root causes,which often uses drugs to treat headache,such as dispelling wind and relieving pain,promoting blood circulation and relieving pain,relieving spasm and relieving pains,eliminating phlegm and dampness,invigorating qi and spleen,nourishing blood and yin,eliminating dampness and regulating stomach,relieving depression and restlessness,which can provide some reference for the clinical treatment of headache.
9.Diagnosis and Treatment of Traditional Chinese Medicine for Encephalopathy Based on the Theory of “Identificating the Onset of Diseases”
Di ZHAO ; Zhenmin XU ; Xiao LIANG ; Hongxi LIU ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2023;64(22):2295-2299
Brain diseases in traditional Chinese medicine were complex and difficult to diagnosis and treatment, and new diagnostic and therapeutic ideas are urgently needed. The onset of the disease was the result of the struggle between healthy qi and pathogenic qi. Common types of the onset of diseases included sudden onset, slow onset, latent onset, secondary onset, and recurrent onset, reflecting the strength of the healthy qi and pathogenic qi, the pathogenic qi that reduced diseases, the site of onset, and other informatin. “Identificating the onset of diseases” was simple and easy to operate, and helped to clarify the complex development of encephalopathy. When applying it, we should first identify urgency and importance, focus on the characteristics; grasp the tendency of diseases, and know the overall situation of the disease; compare similarities and differences horizontally; and carefully observe and dynamically understand the disease. “Identificating the onset of diseases” has the characteristics of comprehensiveness and prognosis, and can lay the foundation for pattern identification and treatment and “treating disease before its onset”.
10.Clinical Application of Supplementing Essence and Boosting Marrow Method in the Treatment of Encephalopathy Based on the Marrow Sea Theory
Hongxi LIU ; Mengying LU ; Xiao LIANG ; Jingjing WEI ; Yue LIU ; Yunmeng CHEN ; Xiansu CHI ; Guojing FU ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2023;64(18):1877-1884
As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine (TCM), The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years, analyzed the treatment method and effects from eight aspects in terms of stroke, dizziness, insomnia, headache, constraint syndrome, dementia, tremor syndrome, and atrophy syndrome, and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow, the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes, which can effectively improve the symptoms of the disease, delay the progression, increase the daily life ability of the patients, and improve the quality of life. Based on the marrow sea theory, the method of supplementing essence and boosting marrow, rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.

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