1.Role of Macrophage Activation and Polarization in Diabetes Mellitus and Its Related Complications and Traditional Chinese Medicine Intervention
Zhichao CHEN ; Qiaoni LIN ; Liya SUN ; Jinxi WANG ; Zishan FU ; Yufeng YANG ; Yan SHI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):311-320
The occurrence of diabetes mellitus (DM) is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver,fat,skeletal muscle,islets, and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response,improving insulin resistance,and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing,heat-clearing, and detoxicating medicinal,which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore,by summarizing the mechanisms between macrophage activation,polarization, and insulin resistance in various tissues,this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio,providing references for the future treatment of DM and its related complications with traditional Chinese medicine.
6.Professor TONG Xiaolin's Experience in Treating Prediabetes with Overweight and Obesity Using the Method of Relieving Depression and Reducing Turbidity
Sicheng WANG ; Yangyang LIU ; Yan YAN ; Zishan JIN ; Boxun ZHANG ; Qingwei LI ; Xiaoxuan XU ; Linhua ZHAO ;
Journal of Traditional Chinese Medicine 2025;66(14):1424-1427
To summarise the clinical experience of Professor TONG Xiaolin in treating prediabetes combined with overweight or obesity using the method of relieving depression and reducing turbidity. It is believed that prediabetes belongs to the category of "spleen-heat syndrome" in traditional Chinese medicine, and its core pathogenesis is center fullness with internal heat, while obesity is the initiating factor for exacerbating center fullness and internal heat, therefore, it is of great significance to reduce the risk of diabetes by interrupting the transformation between overweight, obesity and glucose metabolism abnormality. It is proposed that the main pathogenesis of prediabetes combined with overweight or obesity is qi depression and turbidity obstruction in middle jiao, with qi depression as the root and turbidity obstruction as the cause, forming a treatment idea with the method of relieving depression and reducing turbidity as the core. In clinic, Dahuang Huanglian Xiexin Decoction (大黄黄连泻心汤) is used as the basic prescription, with a primary focus on directing the turbid downward, supplemented by regulating qi, which embodies the concept of "promoting movement through descent, then figuring out the root of spleen-heat syndrome. Furthermore, the treatment is flexibly modified based on the patient's deficiency-excess syndrome to ensure individualized therapy.
8.Mechanism of Xibining Ⅱ Combined with ADSC-Exos in Improving Knee Osteoarthritis by Regulating Mitochondrial Autophagy
Junfeng KANG ; Lishi JIE ; Houyu FU ; Taiyang LIAO ; Lei SHI ; Zishan SU ; Likai YU ; Yibao WEI ; Deren LIU ; Di TIAN ; Jun MAO ; Peimin WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(11):111-119
ObjectiveTo observe the effects of Xibining (XBN) and adipose stem cell exosome (ADSC-Exos) in the cases of separate or joint application on cartilage degeneration and mitochondrial autophagy and explore its mechanism of action to improve knee osteoarthritis (KOA). MethodSD rats were divided into a sham operation group (sham group), a model group, an ADSC-Exos group (Exos group), an XBN group, and an ADSC-Exos+XBN group (Exos+XBN group). KOA model was established by using anterior cruciate ligament transection (ACLT). The pain sensitivity status of rats was evaluated, and the degeneration degree of the knee joint and cartilage tissue was detected by Micro-CT and pathological staining. The expression of p62 and LC3B was observed by immunofluorescence, and the serum levels of TNF-α, IL-1β, IL-6, and IL-15 in rats were detected by ELISA. The Western blot was used to detect the protein expression levels of MMP-3, MMP-13, ADAMTS5, ColⅡ, TIMP, ACAN, PINK1, Parkin, p62, and LC3A/B. ResultCompared with the sham group, rats in the model group showed decreased cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds, varying degrees of abrasion and loss of cartilage tissue, degeneration of cartilage tissue, elevated serum IL-1β, IL-6, IL-15, and TNF-α levels (P<0.01), and increased protein expression of MMP-3, MMP-13, and ADAMTS5 in cartilage tissue. In addition, the protein expression of ColⅡ, TIMP1, and ACAN was decreased (P<0.01). Compared with the model group, rats in each treatment group showed higher cold-stimulated foot-shrinkage thresholds and mechanical pain sensitivity thresholds, reduced cartilage tissue degeneration, lower serum levels of IL-1β, IL-6, IL-15, and TNF-α (P<0.05,P<0.01), decreased protein expression of MMP-3, MMP-13, and ADAMTS5, and higher protein expression of Cold, TIMP1, and ACAN in cartilage tissue (P<0.05,P<0.01). Moreover, the changes were the most obvious in the Exos+XBN group. ConclusionBoth ADSCs-Exos and XBN can increase the level of mitochondrial autophagy in chondrocytes and delay cartilage tissue degeneration by promoting the expression of the PINK1/Parkin signaling pathway, and the combination of the two can enhance the therapeutic effect.
9.Reliability and validity of assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Peri-operative Period
Boyang YU ; Yanyan YANG ; Ao MA ; Tao LI ; Xiaoxie LIU ; Zhengyang LI ; Yajing DUAN ; Jiaqi LIU ; Yuxiao XIE ; Cui WANG ; Zhen HUANG ; Lining ZHANG ; Xinyi LIU ; Zishan JIA ; Mouwang ZHOU
Chinese Journal of Rehabilitation Theory and Practice 2024;30(9):1053-1059
Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period(ICSAKOPP). Methods From May,2022 to April,2023,320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital,China-Japan Friendship Hospital,Peking University First Hospital and Chinese PLA General Hospital.Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty,three days(±one day)after arthroplasty,three weeks(±one week)after arthroplasty,and three months(±one month)after ar-throplasty.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were recorded at the same time.Five professionals were asked to score all the items of Brief ICSAKOPP,and the content validity index(CVI)was caculated. Results A total of 64 cases were dropped down.CVI of all the items of the Brief ICSAKOPP were above 0.8,with a av-erage CVI of the scale of 0.938.The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813.There was a moderate correlation(r=0.681,P<0.001)between the overall Brief ICSAKOPP and WOMAC scores,as well as body functional dimension score(r=0.668,P<0.001)and activities and participation dimension score(r=0.657,P<0.001). Conclusion Brief ICSAKOPP is good in content validity,internal consistency reliability and criterion validity.
10.Application and Considerations of Cohort Study in Effectiveness Evaluation of Traditional Chinese Medicine in the Prevention and Treatment of Diabetes
Sicheng WANG ; Jiaxing TIAN ; Ying ZHANG ; Boxun ZHANG ; Anzhu WANG ; Xing HANG ; Zishan JIN ; Linhua ZHAO
Journal of Traditional Chinese Medicine 2024;65(14):1438-1442
Through the systematic analysis of the current research results on the effectiveness of traditional Chinese medicine(TCM) in the prevention and treatment of diabetes and its promotion dilemma, it is believed that cohort study, as an observational research method, is particularly suitable for evaluating complex and individualized interventions such as traditional Chinese medicine in the prevention and treatment of diabetes. Considering the design features and relevant practices of prospective cohort studies, it is specifically proposed to carry out prospective cohort studies using a modern TCM diagnostic and treatment system for diabetes, centered on "state-targeted differentiation and treatment", and framed by "classification-staging-syndrome differentiation". Focused on personalized prevention and treatment, long-term multidimensional assessment of therapeutic effectiveness and syndrome changes, this paper gives in-depth exploration of the advantages and value of applying prospective cohort studies in the effectiveness evaluation of TCM in prevention and treatment of diabetes, aiming to provide insights for clinical researches on TCM for diabetes.

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