1.Stage Treatment of Squamous Cell Carcinoma Based on the Theory of Fire and Heat
Xinyi MA ; Luchang CAO ; Xinmiao WANG ; Guanghui ZHU ; Jie LI
Journal of Traditional Chinese Medicine 2025;66(6):575-580
It is believed that the occurrence and development of squamous cell carcinoma (SCC) is closely associated with inflammatory responses. The theory of fire and heat, advocated by LIU Wansu, provides significant clinical guidance for understanding the pathogenesis and treatment of SCC. Based on this theory, the pathological mechanisms and clinical characteristics of SCC at different stages were analyzed. In the precancerous and early stages, the primary pathogenesis is qi stagnation leading to internal generation of constrained heat; in post-surgery, the condition shifts to qi deficiency with latent yin fire; during the treatment phase, the pathogenesis involves accumulation of pathogenic factors, excess toxins, and severe heat toxicity; in the late stage, the main pathology is yin deficiency with toxic heat, and phlegm-stasis obstruction of the internal organs. Corresponding stage-based treatment strategies are proposed. In the early stage, regulating qi movement to dissipate constrained heat; for post-surgery, tonifying qi and raising yang to dispel latent fire; during treatment stage, clearing heat and detoxifying to eliminate cancerous toxins; and in the late stage, nourishing yin and unblocking the bowels to clear deficiency heat.
2.Strategies for the Syndrome Differentiation and Treatment of Malignant Tumors Based on the Theory of Stagnant Toxin
Luchang CAO ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Guanghui ZHU ; Jie LI
Journal of Traditional Chinese Medicine 2025;66(10):1000-1006
"Stagnation" is an important pathological state in the development and progression of malignant tumors. However, its intrinsic connection with different stages of tumor evolution has not been clearly elucidated in previous studies. Drawing on clinical practice, this paper proposes the theory of stagnant toxin, emphasizing stage-specific pathogenesis and differentiated treatment strategies for tumors based on the varying manifestations of stagnation at each phase. The theory interprets the pathogenesis of stagnant toxin across the stages of tumor development through the five elements "wood, fire, earth, metal, and water" corresponding respectively to wood stagnation in the precancerous stage, metal stagnation in the postoperative phase, fire stagnation during adjuvant therapy, earth stagnation in the progressive stage, and water stagnation in the advanced stage. Each type of stagnation reflects a distinct pathogenic mechanism, such as wood stagnation giving rise to disease, metal stagnation inducing residual symptoms, fire stagnation resulting in ulceration, earth stagnation spreading toxin transmission, and water stagnation leading to critical deterioration. Accordingly, the treatment principles include guiding wood stagnation with counterflow, dispersing metal stagnation to harmonize symptoms, venting fire stagnation to regress ulcers, depleting earth stagnation to block progression, and controlling water stagnation to preserve vitality. This theoretical framework offers a traditional Chinese medicine perspective for understanding and treating malignant tumors based on the concept of stagnant toxin.
3.Postoperative Stage-based Functional Protection Strategies for Lung Cancer Based on Theory of "Lungs Governing Qi"
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Wei HOU ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):86-93
Lung cancer (LC) is a significant global public health issue, with both its incidence and mortality rates ranking among the highest worldwide. The age-standardized incidence and mortality rates are increasing annually, posing a serious threat to the life and health of LC patients. Radical surgical resection is the primary treatment for malignant lung tumors. However, postoperative multidimensional functional impairments, including respiratory, mucosal, and psychological functions, are common. These impairments not only reduce patients' quality of life and affect their treatment tolerance and duration, but also negatively correlate with prognosis, facilitating disease recurrence and metastasis. At present, postoperative functional dysfunction after LC surgery remains a key clinical challenge that urgently needs to be addressed. There is a lack of standardized and regulated postoperative rehabilitation treatment management and traditional Chinese medicine (TCM) differentiation and treatment strategies for LC. Focusing on the core underlying pathogenesis of "Qi sinking" after LC surgery, and guided by the classical TCM theory of "lungs governing Qi", this study, based on the core concept of the "five perspectives on treatment" theory, innovatively proposes the respiratory dysfunction as the core pathogenesis of "Qi sinking in the chest" during the rapid rehabilitation phase, mucosal dysfunction as the core pathogenesis of "Yin deficiency and Qi sinking" during the postoperative adjuvant treatment phase, and the psychological dysfunction as the core pathogenesis of "Qi sinking with emotional constraint" during the consolidation phase. Accordingly, stage-specific dynamic functional protection strategies are constructed. In the rapid rehabilitation phase, the strategy emphasizes tonifying Qi and uplifting sinking Qi, with differentiation and treatment based on the principle of ''descending before ascending''. In the adjuvant treatment phase, the approach focuses on nourishing Yin and uplifting Qi, with prescription combinations that integrate unblocking and tonification. In the consolidation phase, the strategy aims to resolve constraint and uplift Qi, with clinical treatment emphasizing a combination of dynamic and static methods. At each stage of functional rehabilitation, clinical differentiation and treatment should support healthy Qi and eliminate pathogenic factors simultaneously. This study is the first to propose the concept of postoperative functional protection in TCM, offering a new approach for TCM differentiation and treatment in the full-cycle, stage-based, and dynamic protection of postoperative function in LC patients. It is expected to contribute to the construction and development of an integrated TCM-Western medicine comprehensive program for cancer prevention and treatment in China.
4.A Hierarchical Strategy for Differentiation and Treatment of Recurrent Aphthous Oral Ulcers Related to Targeted Therapy for Lung Cancer Based on Yin Deficiency and Qi Collapse
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Ming LIN ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):116-125
Tumor treatment-related adverse reactions are a major focus of clinical concern, among which recurrent aphthous oral ulcers (RAU) associated with targeted therapy for lung cancer (LC) are among the most painful and distressing for patients. Currently, modern medical interventions show limited efficacy, and there is an urgent need for more effective treatment strategies. This study differentiates RAU associated with targeted therapy for LC from chemotherapy-related and ordinary oral ulcers, elucidates the pathophysiological basis of such ulcers, and traces the theoretical origin of "Yin deficiency and Qi collapse". Based on the new system of "five perspectives on diagnosis and treatment" for tumor prevention and treatment, with a focus on the core and symptom perspectives and rooted in the traditional concept of "lung dominating Qi", we innovatively propose the concept of "medicine-induced ulcer" and are the first to introduce the theory of "Yin deficiency and Qi collapse" into the syndrome differentiation and treatment of RAU associated with targeted therapy for LC (i.e., medicine-induced ulcer). We propose that "Yin deficiency and Qi collapse" is the core pathogenesis of medicine-induced ulcers, in which the collapse of formless Qi is the key to their onset, while the deficiency and stasis of tangible Yin and blood constitute the root of recurrence. A hierarchical strategy for syndrome differentiation and treatment is established: first treating the collapse of formless Qi, then replenishing tangible deficiencies, and concurrently preventing recurrence. We emphasize that treatment should address both root and manifestation, with appropriate prioritization. In the acute phase, while relieving symptoms and promoting ulcer healing by nourishing Qi, uplifting collapse, and generating body fluids, attention should also be paid to nourishing spleen Yin, facilitating the circulation of nutritive Qi, and alleviating stasis to target the root pathogenesis and reduce recurrence. A verified case is presented to support this approach. This study enriches the theoretical framework and clinical methods of traditional Chinese medicine (TCM) in the treatment of RAU associated with targeted therapy for LC, promotes symptom management of treatment-related adverse reactions through integrated TCM and Western medicine, and provides theoretical support for the construction and development of a comprehensive differentiation and treatment system for lung cancer prevention, treatment, and rehabilitation.
5. Progress and prospect of inhaled biological agents in asthma
Guanghui LI ; Jing HUANG ; Min ZHU ; Yakun WAN ; Zhihong CHEN ; Rui ZHAO
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):406-414
More than 300 million people worldwide suffer from asthma, and the incidence is increasing year by year. As one of the most common chronic diseases, asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity. With the in-depth study of physiological and pathological mechanisms, therapeutic small molecule and hormone drugs have been introduced to control and treat most patients, but about 5% - 10% of patients still suffer from various subtypes of difficult to control and treat asthma, that is, severe asthma. In the past decade, with the rapid development of bio-pharmaceutical research, protein and antibody have become the key drugs for the treatment of severe asthma with high efficacy, high specificity and high safety. However, biological drugs are usually administered by injection, they cannot be noninvasive and directly delivered into the lung to quickly absorb and take effect. Therefore, there is an urgent need for the introduction of inhaled biologics with quick effectiveness, convenience, economy and safety in clinical. The review summarizes the existing small molecule, hormone and biological therapy drugs, and summarizes the development of inhalable biological agents of asthma, and analyzes the future prospects of the inhalable biological drugs, which is designed to deepen the perception of the direction of the inhalable biological drugs research, and update the information of the field, in order to provide reference for the development of more inhalable biologics.
6.Study on the correlation between the active components of Salviea Miltiorrhizae Radix et Rhizoma screened by high-throughput sequencing and the regulation of lncRNA-mRNA in human lung adenocarcinoma A549 cells
Qi ZHENG ; Yan HE ; Chao XUE ; Guanghui ZHU ; Xueqian WANG ; Wei HOU
International Journal of Traditional Chinese Medicine 2024;46(4):479-484
Objective:Study on the correlation between the active components of Salviea Miltiorrhizae Radix et Rhizoma screened by high-throughput sequencing and the regulation of lncRNA-mRNA in human lung adenocarcinoma A549 cells.Methods:A549 cells were cultured, and the IC 50 dose of cryptotanshinone and tanshinone ⅡA was confirmed according to the cell proliferation experiment. A549 cells were randomly divided into blank control group, cryptotanshinone group, and tanshinone IIA group using a random number table method. After 24 hours of intervention, the cell cycle was detected by flow cytometry. High-throughput sequencing technique was used to detect the expressions of lncRNA and mRNA in A549 cells in intervention group and non-intervention group. By analyzing the expression profiles of differential genes related to cryptotanshinone and tanshinone ⅡA, the obtained differential genes were analyzed by GO and KEGG. Results:The cell cycle results showed that the proportion of G0/G1 phase cells in cryptotanshinone and Tanshinone ⅡA was increased ( P<0.01), the proportion of S phase cells was decreased ( P<0.01), and the proportion of G2/M phase cells in cryptotanshinone was decreased ( P<0.01). The results of high-throughput screening showed that cryptotanshinone could up-regulate 4 698 lncRNA, down-regulate 1 557 lncRNA, up-regulate 4 810 mRNA and down-regulate 5 644 mRNA. Tanshinone ⅡA could up-regulate 1 348 lncRNA, down-regulate 1 299 lncRNA, up-regulate 4646 mRNA and down-regulate 4 741 mRNA. The function and pathway enrichment analysis of differential lncRNA and mRNA showed that the differentially expressed genes of cryptotanshinone and tanshinone ⅡA were mainly related to cell cycle, autophagy, AMPK signaling pathway, FoxO signaling pathway and EGFR signaling pathway. GAS5 may be one of the targets for the inhibitory effects of cryptotanshinone and tanshinone ⅡA. Conclusion:Cryptotanshinone and tanshinone ⅡA have certain inhibitory effects on A549 cells, and there are differentially expressed genes of lncRNA-mRNA, which are closely related to cell cycle and signal pathway.
7.Clinical analysis of re-fracture after bone healing treated with combined surgery for congenital pseudarthrosis of the tibia in children
Xiping LIU ; Kun LIU ; Guanghui ZHU
Chinese Journal of Orthopaedics 2024;44(5):315-321
Objective:To explore the possible risks of re-fracture after bone healing in children with congenital pseudarthrosis of the tibia, who were treated with combined surgery.Methods:56 children (35 males and 21 females, with an average age of 38.0±9.2 months ranging from 18 to 66 months) with re-fracture after bone healing were retrospectively enrolled from January 2007 to August 2016, during which a total of 142 children with CPT underwent combined surgical treatment in the orthopedics department of Hunan Children's Hospital. Complete healing of the tibial pseudarthrosis, trauma after surgery, breakage of fibula, and the distal end of the tibial intramedullary rod located in the tibial medullary cavity or not were hypothesized as 4 risk factors. Univariate logistic regression analysis was conducted to investigate the correlation between these factors and re-fractures after tibial pseudarthrosis healing.Results:The average follow-up was 81.7±10.8 months ranging from 60 to 120 months with at least 5 years after bone healing. For complete or partial healing of the tibial pseudarthrosis after surgery, the number of re-fractures was 48 and 8, respectively; For with or without a history of trauma, the number of re-fractures was 50 and 6, respectively; for with an intact or broken fibula after surgery, the number of re-fractures was 7 and 49, respectively; For entry or no entry of the intramedullary rod into the tibial medullary cavity, the number of re-fractures was 44 and 12, respectively. The results of univariate logistic regression analysis showed that partial healing of the tibial pseudarthrosis after surgery [ OR=0.255, 95% CI (0.107, 0.605), P=0.002], history of trauma [ OR=36.458, 95% CI (13.332, 99.701), P<0.001], incomplete fibula [ OR=0.267, 95% CI (0.108, 0.661), P=0.004], and intramedullary rod insertion into the tibial medullary cavity [ OR=2.640, 95% CI (1.224, 5.695), P=0.013] were associated with re-fracture after bone healing. The number and proportion of cases with recurrent fractures occurring ≤1, 1-3, 3-6, ≥6 years after bone healing were 5 cases, 9% (5/56), 14 cases, 25% (14/56), 22 cases, 39% (22/56), 15 cases, and 27% (15/56), respectively, the difference was statistically significant (χ 2=11.569, P=0.009). With the extension of follow-up time, the number of cases of re-fractures after bone healing increases, mostly occurring more than one year after bone healing. There were 44 cases (47%, 44/94) and 12 cases (25%, 12/48) of re fractures after bone healing in 94 cases of distal intramedullary rods in the tibial medullary cavity and 48 cases of cross ankle joint fixation, respectively. The difference in the incidence of re-fractures was statistically significant (χ 2=6.327, P=0.018). The incidence of intramedullary rod displacement in cases where the distal end of the intramedullary rod is located within the tibial medullary cavity was 100%. Conclusions:Factors of partial healing of the tibial pseudarthrosis, a history of trauma, incomplete status of the fibula after surgery, and intramedullary rod's entry into the tibia were risk factors for re-fracture after bone healing treated with combined surgery for CPT. After the healing of the tibial pseudarthrosis, it is not advisable to push the tibial intramedullary rod into the tibial medullary cavity, which can cause unstable fixation of the tibial intramedullary rod and result in displacement, and even affect the development of the tibial mechanical axis or the occurrence of re-fractures.
8.Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine
Qianhui SUN ; Guanghui ZHU ; Bowen XU ; Ying ZHANG ; Jie LI
Journal of Traditional Chinese Medicine 2024;65(11):1120-1125
As an important concept in Chinese medicine theory, "qi sinking" is the inheritance and extension of the thought core of sinking of qi in whole body. This article explored the concept of sinking of pectoral qi, center qi, and kidney qi in the theory of qi sinking, and believed that sinking of pectoral qi, stagnation and sinking of center qi, deficiency and sinking of kidney qi were the core pathogenesis of postoperative injury in malignant tumours. Anchored to the method of reinforcing healthy qi and lifting the sunken, this article recommended to identify pattern and treat by guiding supplement and lifting the sunken. For lung gold impairment, heart yang depletion, and pectoral qi sinking, the treatment is to warm and supplement heart and lung, lift pectoral qi, and restore the respiratory function by modified Shengxian Decoction (升陷汤) plus Guizhi Decoction (桂枝汤); for spleen depletion and pathways blockage, liver failing to act freely, and center qi stagnation and sinking, the treatment is to warm and supplement center qi, raise yang and lift the sunken, and restore the digestive function by modified Buzhong Yiqi Decoction (补中益气汤); for source exhausted and essence deficiency, liver qi hiding, and kidney qi deficiency to inward invasion, the treatment is to nourish the kidney and astringe the liver, consolidate the original qi and lift qi, improve the pelvic floor dysfunction, and protect the kidney function by modified Liuwei Dihuang Pill (六味地黄丸) plus Shengma Chaihu Decoction (升麻柴胡汤). Modification need base on different disease patterns and stages, and new ideas for postoperative traditional Chinese medicine treatment and rehabilitation of malignant tumours were provided.
9.Formation of Hyperprogression of Immunotherapy from Perspective of "Yang Deficiency and Toxin Knot" and Role of "Five Views on Differentiation and Treatment" Intervention
Xinpu HAN ; Guanghui ZHU ; Qianhui SUN ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):186-191
Immune checkpoint inhibitors (ICIs) have shown good efficacy in tumor treatment and have changed the landscape of tumor treatment. However, some patients treated with ICIs have not only failed to achieve the desired therapeutic effect, but also developed an atypical response pattern of abnormally accelerated tumor growth, namely hyperprogressive disease (HPD). The pathogenesis of HPD is still unclear and it is difficult to diagnose, which poses a challenge for clinical identification and treatment decisions. Exploring the underlying mechanism of HPD is important to improve the effect of immunotherapy. Based on the theory of "Yang deficiency and toxic knot", this paper discussed the mechanism of HPD in immunotherapy from the perspective of "spleen and kidney Yang deficiency and hefty toxic pathogens". It was concluded that the inactivation of p53 oncogene and immunosuppressive microenvironment were the manifestations of the deficiency of healthy qi in the body and declined yang in the spleen and kidney, serving as an important basis for the occurrence of HPD. Adverse reactions caused by ICIs belong to the category of "drug toxicity". The occurrence and development of murine double minute 2 (MDM2)/murine double minute 4 (MDM4) activation, epidermal growth factor receptor (EGFR) mutation, and tumor inflammatory microenvironment are the manifestations of the hyperactivity of pathogenic Qi, conflict of cancer toxicity and drug toxicity, and being hefty by virtue of deficiency, which can promote the abnormal proliferation of tumor cells, and they are the core pathogenic elements of HPD and are closely related to disease prognosis. In terms of treatment, under the guidance of the theory of "five views on differentiation and treatment" (time-space view, core view, symptom view, precision view, and disease-before-onset view), which was summarized according to the clinical practice of this research team, this paper, taking the prevention and treatment of HPD as the entry point, formulated traditional Chinese medicine (TCM) compounds to reinforce healthy Qi and warm Yang and realize the dynamic management of the whole spatiotemporal cycle, and removed toxins and resisted cancer to realize the all-round systemic intervention of the specimen. Additionally, targets were enriched in the macro-clinical manifestations and microscopic pathological changes of HPD to improve the targeting of drug selection and the precision of prevention and treatment, giving full play to the unique therapeutic advantages of TCM, and providing new ideas for the clinical application of TCM in the prevention and treatment of HPD.
10.Progress and prospect of inhaled biological agents in asthma
Guanghui LI ; Jing HUANG ; Min ZHU ; Rui ZHAO ; Yakun WAN ; Zhihong CHEN
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(4):406-414
More than 300 million people world-wide suffer from asthma,and the incidence is in-creasing year by year.As one of the most common chronic diseases,asthma is an immune-mediated inflammatory disease with complex triggering mechanisms and strong heterogeneity.With the in-depth study of physiological and pathological mech-anisms,therapeutic small molecule and hormone drugs have been introduced to control and treat most patients,but about 5%-10%of patients still suffer from various subtypes of difficult to control and treat asthma,that is,severe asthma.In the past decade,with the rapid development of bio-pharmaceutical research,protein and antibody have become the key drugs for the treatment of se-vere asthma with high efficacy,high specificity and high safety.However,biological drugs are usually administered by injection,they cannot be noninva-sive and directly delivered into the lung to quickly absorb and take effect.Therefore,there is an ur-gent need for the introduction of inhaled biologics with quick effectiveness,convenience,economy and safety in clinical.The review summarizes the existing small molecule,hormone and biological therapy drugs,and summarizes the development of inhalable biological agents of asthma,and ana-lyzes the future prospects of the inhalable biologi-cal drugs,which is designed to deepen the percep-tion of the direction of the inhalable biological drugs research,and update the information of the field,in order to provide reference for the develop-ment of more inhalable biologics.

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