1.Pathogenesis and Syndrome Differentiation of "Gaozhuo" of Oxidative Stress in Diabetic Kidney Disease
Yuman YIN ; Yunfeng YU ; Xiangning HUANG ; Jiawang HUANG ; Gang HU ; Juan HUANG ; Rong YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):226-234
Oxidative stress is a pivotal factor in the onset and progression of diabetic kidney disease (DKD), and it plays an essential role in the prevention and treatment of DKD. The "Gaozhuo" pathogenesis posits that DKD is characterized by the invasion of Gaozhuo and damage to the kidney collaterals, with the underlying cause being the insufficiency of spleen Qi and the internal formation of Gaozhuo, which provides valuable guidance on oxidative stress. The insufficiency of spleen Qi and the internal formation of Gaozhuo represent a dynamic, evolving process. Gaozhuo invades the kidney collaterals, impairs kidney Qi, and progressively leads to the congealing and stagnation of Gaozhuo and blood, ultimately resulting in the failure of both the spleen and kidneys. The damage caused by Gaozhuo to the kidney collaterals and kidney Qi is analogous to the organ and functional damage of the kidneys induced by excessive reactive oxygen species and oxidative stress. Damage to the kidney collaterals means organic injuries to the glomeruli, renal tubules, and renal interstitium, and the depletion of kidney Qi refers to damage to glomerular filtration and renal tubular reabsorption. The congealing and stagnation of Gaozhuo and blood in the kidney collaterals is similar to oxidative stress-induced thickening of the glomerular basement membrane and fibrosis. The interaction between spleen and kidney Qi deficiency and the congealing and stagnation of Gaozhuo and blood creates a vicious cycle that exacerbates the condition, ultimately evolving into the failure of both the spleen and kidneys. The failure of the spleen and kidneys is analogous to renal failure, and its extreme manifestation is end-stage renal disease and uremia. The treatment of oxidative stress in DKD with traditional Chinese medicine (TCM) is based on the principles of strengthening the spleen and tonifying the kidneys, and dispelling turbidity and removing blood stasis. According to the syndrome type, it is recommended to use methods such as strengthening the spleen and tonifying Qi while dispelling dampness and removing turbidity, strengthening the spleen and tonifying the kidneys while dispelling dampness and removing turbidity, strengthening the spleen and tonifying the kidneys while dispelling turbidity and removing blood stasis, or consolidating the spleen and kidneys while clearing away turbidity and blood stasis.
2.Syndrome Differentiation and Treatment Mechanisms of Inflammatory Injury in Diabetic Cardiomypathy from Theory of "Gaozhuo"
Xiaoyue WANG ; Yunfeng YU ; Xiangning HUANG ; Yixin XIANG ; Sihao ZHANG ; Qin XIANG ; Rong YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):235-244
Diabetic cardiomyopathy (DCM) is one of the most common complications of diabetes mellitus and is a major threat to global health. As a key mechanism in the occurrence and progression of DCM, the inflammatory response persists throughout the entire course of the DCM. The Gaozhuo theory suggests that the basic pathogenesis of inflammatory injury in DCM is the Qi deficiency of spleen and kidney and Gaozhuo invasion, and divides the pathological process into three phases: Gaozhuo invasion, turbid heat damage to the channels, and turbid blood stasis and heat junction. Among them, the Qi deficiency of spleen and kidney and the endogenous formation of Gaozhuo represent the process of inflammatory factor formation induced by glucose metabolism disorders. Turbid heat damage to the channels refers to the process of myocardial inflammatory injury mediated by inflammatory factors, and turbid blood stasis and heat junction are the process of myocardial injury developing toward myocardial fibrosis and ventricular remodeling. As the disease continues to progress, it eventually develops into a depletion of the heart Yang, leading to the ultimate regression of heart failure. According to the theory of Gaozhuo, traditional Chinese medicine (TCM) should regulate inflammatory injury in DCM by strengthening the spleen and tonifying the kidney to address the root cause, and resolving dampness and lowering turbidity to treat the symptoms. If the turbidity has been stored for a long time and turns into heat, strengthening the spleen and tonifying the kidney, and clearing heat and resolving turbidity should be the therapy. If the turbidity, stasis, and heat are knotted in the heart and collaterals, strengthening the spleen and tonifying the kidney, and resolving stasis and lowering turbidity should be the therapy. TCM compounds and monomers can regulate the inflammatory response in DCM. TCM compounds can be divided into the categories for benefiting Qi to resolve turbidity, benefiting Qi and clearing heat to resolve turbidity, and benefiting Qi and activating blood to reduce turbidity. The compounds can inhibit upstream signals of inflammation and expression of inflammatory factors, improve the inflammatory damage to myocardium and blood vessels, myocardial fibrosis, and cardiac systole and diastole, and thus slow down the onset and progression of DCM.
3.Discussion on Theory of "Gaozhuo" and Syndrome Differentiation and Treatment for Microcirculatory Disorders in Diabetic Retinopathy
Kai WU ; Yunfeng YU ; Xiangning HUANG ; Qianhong LIU ; Fangfang LI ; Rong YU ; Xiaolei YAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):245-252
Retinal microcirculatory disorder is a key factor in the occurrence and development of diabetic retinopathy (DR), and also an important link in the prevention and treatment of DR. The theory of "Gaozhuo" holds that the microcirculatory disorder in DR is based on the deficiency of spleen Qi and is characterized by the obstruction caused by "Gaozhuo" and blood stasis. The deficiency of spleen Qi is an essential precondition for the endogenous formation and accumulation of Gaozhuo, while Gaozhuo invasion is the direct cause of microcirculatory disorders in DR. The deficiency of spleen Qi and the endogenous formation of Gaozhuo mean the process in which glucose metabolism dysfunction induces an excessive production of inflammatory factors and lipid metabolites. The obstruction caused by "Gaozhuo" and blood stasis is the direct pathogenesis of microcirculatory disorders in DR, encompassing two stages: Gaozhuo obstruction and turbidity and stasis stagnation. Gaozhuo obstruction and turbidity and stasis stagnation represent the process in which inflammatory factors and lipid metabolites damage the retinal microcirculation and induce thrombosis, thus mediating microcirculatory disorders. Turbidity and stasis stagnation and blood extravasation outside the vessels reveal the progression to microvascular rupture and hemorrhage resulting from the microcirculatory disorders. According to the pathogenesis evolution of the theory of "Gaozhuo", microcirculatory disorders in DR can be divided into deficiency of spleen Qi with Gaozhuo obstruction, deficiency of spleen Qi with turbidity and stasis stagnation, and turbidity and stasis stagnation with blood extravasation outside the vessels. Clinically, treatment principles should focus on strengthening the spleen and benefiting Qi, resolving turbidity, and dispersing stasis. Different syndrome patterns should be addressed with tailored therapies, such as enhancing the spleen and benefiting Qi while regulating Qi and reducing turbidity, strengthening the spleen and benefiting Qi while resolving turbidity and dispelling stasis, and strengthening the spleen and resolving turbidity while removing stasis and stopping bleeding. Representative prescriptions include modified Wendantang, modified Buyang Huanwutang, modified Danggui Buxuetang, Zhuixue Mingmu decoction, Tangmuqing, Shengqing Jiangzhuo Tongluo Mingmu prescription, Danhong Huayu decoction, and Yiqi Yangyin Huoxue Lishui formula.
4.Syndrome Differentiation and Treatment Mechanisms of Hepatic Stellate Cell Activation in Type 2 Diabetes Mellitus Combined with Non-alcoholic Fatty Liver Disease Based on Theory of "Gaozhuo"
Yixin XIANG ; Yunfeng YU ; Xiaoyue WANG ; Xiangning HUANG ; Qin XIANG ; Rong YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):253-260
Non-alcoholic fatty liver disease (NAFLD) is one of the most common complications of type 2 diabetes mellitus (T2DM), and hepatic stellate cell (HSC) activation is the key link in the progression of NAFLD to liver fibrosis. According to the theory of "Gaozhuo", spleen deficiency and Qi stagnation, along with Gaozhuo invasion, are the causes of NAFLD progression to liver fibrosis, which reveals the pathogenesis essence of HSC activation in traditional Chinese medicine (TCM). Among them, spleen deficiency and Qi stagnation are the root causes of the endogenous formation of Gaozhuo. Spleen deficiency indicates the insulin sensitivity decrease and glucose metabolism disorders, and Qi stagnation means the dysregulation of hepatic glucose and lipid metabolism, which creates the preconditions for HSC activation. Gaozhuo invasion is the direct cause of HSC activation, including three stages: Internal retention of Gaozhuo, turbidity and stasis stagnation, and toxic stasis and consolidation. Internal retention of Gaozhuo refers to the abnormal metabolism and deposition of hepatic lipids, as well as the microcirculatory disorders. Turbidity and stasis stagnation is the process by which lipotoxicity stimulates the transformation of HSC into myofibroblast (MFB), and toxic stasis and consolidation represent the secretion of a large amount of extracellular matrix (ECM) by MFB to promote the fibrosis. According to the theory of Gaozhuo and the activation process of HSC, syndromes for T2DM combined with NAFLD can be classified into spleen deficiency and Qi stagnation with internal retention of Gaozhuo, spleen Qi deficiency with turbidity and stasis stagnation, and spleen Qi deficiency with toxic stasis and consolidation. Clinically, the treatment principle is to strengthen the spleen and promote Qi, resolve turbidity, and eliminate blood stasis. Both TCM compounds and monomers can effectively inhibit the HSC activation. TCM compounds can be classified into categories for regulating spleen and harmonizing liver, resolving turbidity and removing stasis, and detoxifying and removing stasis. They mainly work by improving lipid metabolism, reducing lipid accumulation in the liver, alleviating inflammatory and oxidative stress responses, inhibiting the activation and proliferation of HSC, and reducing ECM deposition, thereby delaying the progression of liver fibrosis.
5.Challenges and aspirations in the development of transfusion medicine and discipline construction in China
Chinese Journal of Blood Transfusion 2026;39(1):1-7
This paper systematically expounds the core challenges and development vision facing transfusion medicine and discipline construction in China under the strategic goals of achieving "Chinese modernization" and "Healthy China". This article puts forward for the first time the "blood transfusion view" of Chinese blood transfusion practitioners and elaborates on key challenges in the field, including the disciplinary system, talent pool, service balance, technical bottlenecks and standardization in emerging fields. To address the challenges, it is urgently necessary to establish the disciplinary status of transfusion medicine, improve talent cultivation, enhance the integration of scientific research and technology, optimize transfusion assessment, promote autologous blood transfusion, advance the localization of evidence-based medicine, and expand the management functions of biological therapy. The ultimate goal is to build a modern blood transfusion system led by science and technology and with Chinese characteristics to safeguard people's health.
6.Epidemiological characteristics and disease burden of liver cancer in Guangdong Province
Ying ZHANG ; Yixuan CHEN ; Rong CAO ; Yue GAO ; Yutong HAN ; Ye WANG ; Ruilin MENG ; Xueyan ZHENG ; Yu LIAO ; Zhuanping ZENG
Journal of Public Health and Preventive Medicine 2026;37(1):68-72
Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000,respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.
7.Bibliometric visualization analysis of research literature of Angelica sinensis at home and abroad from 2012 to 2022 based on CiteSpace
Feifei LIU ; Liping CHEN ; Yan ZHONG ; Rong WANG ; Wenbin LI
Journal of Pharmaceutical Practice and Service 2026;44(2):88-95
Objective Based on the visualization graph analysis of the research hotspots of Angelica sinensis, predict the future research trends, and provide references for the next step of Angelica sinensis research. Methods Chinese and English literatures on Angelica sinensis collected from CNKI, WanFang, VIP and Web of Science from 2012 to 2022 were retrieved. CiteSpace 6.1.R6 software was used to perform visualization econometrics analysis on the number of publications, authors, institutions, journals, keywords and other topics. Results
8.Mechanistic study on ITGA6 regulation of abdominal wall endometriosis via the PI3K/AKT signaling pathway
Rong GU ; Hailiang HUANG ; Xinrui WANG ; Hanlu LI ; Kaijiang LIU ; Ying ZHU
Acta Universitatis Medicinalis Anhui 2026;61(1):67-74
ObjectiveTo investigate the differential expression of integrin alpha-6(ITGA6) in abdominal wall endometriosis (AWE) tissues and its molecular mechanisms in regulating AWE. Methods36 AWE lesions were designated as the experimental group, while 36 cases of normal endometrial tissues served as the controls. Differential expression of ITGA6 between the two groups was assessed through immunohistochemical (IHC) staining. Human ITGA6 gene-specific interference sequences were designed, synthesized, and packaged into lentiviral vectors to establish the Ishikawa cell line with ITGA6-knockdown. Similarly, the ITGA6-overexpression cell line was constructed using the coding sequence (CDS) of the gene. Real-time PCR and Western blot were performed to detect changes in epithelial-mesenchymal transition(EMT)-related markers and angiogenesis-related indicators. Cell invasion and migration capabilities were assessed by Cell Scratch and Transwell assays. Furthermore, Western blot was conducted to profile PI3K/AKT pathway dynamics. ResultsEctopic endometrial tissues exhibited a marked increase in the number of ITGA6-positive cells and their expression intensity compared to eutopic endometrium (each P < 0.001). Compared with the NC group, the ITGA6-knockdown group showed significantly reduced expression of N-cadherin, VEGF, and TGF-β1 (all P < 0.01), while E-cadherin expression was markedly increased (P < 0.01). Concomitantly, the invasion and migration capacities of ITGA6-low expression were significantly impaired (P < 0.001 for both), accompanied by a marked reduction in AKT and phosphorylated AKT(p-AKT) levels (P < 0.001). Conversely, overexpressing ITGA6 resulted in opposite effects. ConclusionITGA6 modulates EMT and angiogenesis in Ishikawa cells via the PI3K/AKT signaling pathway, thereby enhancing cell invasion and migration capabilities, which contributes to the pathogenesis of AWE.
9.Correlation analysis of inflammatory markers (NLR/PLR/SII) with the severity of intrauterine adhesions
Ying WANG ; Xuan XU ; Longyu ZHANG ; Rong WU ; Jingjing HU ; Wenjuan YANG ; Xiao WU ; Zhaolian WEI
Acta Universitatis Medicinalis Anhui 2026;61(1):146-150
ObjectiveTo investigate the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and the severity of intrauterine adhesions (IUA). MethodsThe retrospective study included 380 patients who underwent transcervical resection of adhesions (TCRA) from December 2019 to March 2025. Based on the American Fertility Society (AFS) classification, patients were divided into mild (n=61), moderate (n=225), and severe (n=94) groups. NLR, PLR, and SII were calculated from preoperative blood tests. Statistical analyses included Kruskal-Wallis test and ordinal Logistic regression. ResultsNLR, PLR, and SII were significantly higher in the severe IUA group compared to the mild group (P<0.05), with SII showing the strongest predictive ability (OR=1.004, P=0.001). The number of intrauterine procedures was an independent risk factor (OR=1.27/level, P=0.016). The predictive model [Logit(P)=-0.676+0.241×operation times+0.004×SII] effectively identified severe IUA cases. ConclusionInflammatory markers (particularly SII) are correlated with IUA severity and may serve as non-invasive tools for clinical assessment.
10.Research progress on traditional Chinese medicine in the treatment of sepsis by regulating helper T cell differen-tiation
Sihan GUO ; He SU ; Ruifen ZHANG ; Tingting JIA ; Hairong ZHANG ; Jilintai RONG
China Pharmacy 2026;37(4):516-521
epsis is a systemic inflammatory response syndrome triggered by infection, and its high mortality rate is closely associated with immune imbalance, particularly the imbalance in the differentiation of helper T cell (Th) cell subsets [Th1, Th2, Th17, regulatory T cell (Treg) ] . In recent years, traditional Chinese medicine (TCM), with its characteristics of multi-component and multi-target actions, has demonstrated unique advantages in regulating Th cell differentiation and function, as well as correcting immune imbalances in sepsis, offering new perspectives for immunotherapy of sepsis. This review summarizes relevant studies on the regulation of Th cell differentiation for sepsis treatment by TCM monomers and active ingredients (such as Astragalus membranaceus , Scutellaria baicalensis , Coptis chinensis , Rheum palmatum , Ganoderma lucidum , Ginkgo biloba , and Cistanche deserticola ), the alcohol extract of Dai Baijie, and TCM formulas and preparations categorized as blood-activating and stasis-removing, purgative and laxative, warming and tonifying yang, and tonifying qi and nourishing yin. The results indicate that these TCM monomers, active ingredients, extracts, formulas, and preparations can regulate the Th1/Th2 and Th17/Treg balance, target the differentiation balance of Th cell subsets, alleviate inflammatory responses, or improve immune suppression, thereby exerting therapeutic effects on sepsis.


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