Objective: To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula (HTQS formula), for the health management and treatment of non-alcoholic fatty liver disease (NAFLD). Methods: A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula. In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology. The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot. Finally, 16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids (SCFAs) and bile acids to determine the impact of the HTQS formula on gut microbiota. Results: The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol (TC), triglycerides, blood glucose, and insulin resistance (IR) without causing liver or kidney injury. We detected 28 components using UPLC‒MS/MS and identified 439 shared targets between NAFLD and the HTQS formula. Primarily, we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis. We validated that the HTQS formula inhibited liver steatosis and inflammation by increasing the phosphorylation levels of PI3K, AKT, P27, GSK3β in the PI3K/Akt signaling pathway. 16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group, which was positively correlated with IR and taurodeoxycholic acid. In addition, Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids, which could be essential to the therapeutic effect of the HTQS formula against NAFLD. Conclusions The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury. Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.

The current interdisciplinary research on traditional Chinese medicine （TCM） often comes from the simple combination of TCM application needs and mature engineering technology. Actually， higher goal of cross-disciplinary research should be the win-win development of TCM and interdisciplinary majors. In detail， to enhance the innovative development of original thinking mode of TCM， meanwhile， to stimulate the innovation of interdisciplinary majors with medical tasks. Previously， we successfully performed the research on the objective representation of pre-disease and disease state of dyslipidemia in population with phlegm-dampness constitution. Taking this project as an example， this paper discusses the methodology on scientific issue positioning， key medical tasks selection， interdisciplinary theory， and technology exploration， to expounds the research design and ideas which could be generalized in other cross-disciplinary research of TCM.

Objective:To explore the clinical characteristics and prognoses of severe autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A).Methods:A retrospective analysis was performed. The clinical data of 12 patients with severe GFAP-A admitted to Department of Neurology, Guangdong 999 Brain Hospital from January 2018 to June 2023 were collected, including demography, clinical manifestations, MRI features, laboratory examination results (such as antibodies), treatments and prognoses.Results:Among the 12 patients, 9 were male and 3 were female, with an average onset age of (46.58±17.53) years. Primary symptoms included headache, limb weakness, limb numbness, mental disorder, epileptic seizure, and urinary and defecation disorder; 9 patients had fever before onset. With aggravated severe GFAP-A, 12 patients had impaired consciousness, 12 had respiratory failure, 6 had unstable blood pressure and heart rate, and 2 had status epilepticus. Cranial MRI indicated abnormal lesions in all 12 patients, including 10 with brainstem involvement (7 had involved medulla oblongata); 10 showed soft meningeal enhancement. In 8 patients received MRI of the whole spinal cord, 7 had abnormal spinal cord lesions; point-like enhancement of the whole spinal meninges was observed in 6 of the 7 patients. All 12 patients had positive cerebrospinal fluid GFAP-IgG, and 3 patients also had positive serum GFAP-IgG. All patients accepted glucocorticoids and immunoglobulin immunotherapy, and 1 patient was supplemented with mycophenolate mofetil; 8 patients had good prognosis, and 4 patients died. Pulmonary infection, hyponatremia, hypoproteinemia, and deep vein thrombosis were the common complications.Conclusion:Patients with severe GFAP-A mainly manifest as meningoencephalitis and meningoencephalomyelitis, and are likely involved medulla oblongata, enjoying rapid clinical progression; even with early immunotherapy, high mortality rate is still noted.

Objective To predict the target of Atractylodes-Panxia-Poria in the treatment of pancreatic cancer, and to explore its potential molecular mechanism by using network pharmacology and molecular docking. Methods Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), PharmMapper, OMIM, GeneCards, STRING, DAVID and Cytoscape software were used to construct a series of network diagrams. The core targets and conduct GO analysis and KEGG pathway enrichment analyses of the target genes were selected. Finally, molecular docking verification of key active ingredients and potential targets were conducted by AutoDock software. Results A total of 35 active ingredients, 190 related targets, 1566 targets of pancreatic cancer and 76 intersection targets were screened for the treatment of pancreatic cancer with Atractylodes-Panxia-Poria. These intersection targets were mainly involved in several biological processes, including positive regulation of gene expression, cytokine-mediated signaling pathway and regulation of apoptotic process, etc, which were also related to pathways in cancer, hepatitis B, colorectal cancer, chemical carcinogenesis-receptor activation, pancreatic cancer, and MAPK signaling pathway, etc. Molecular docking results showed that the main active components of Atractylodes-Panxia-Poria had certain affinity with the potential targets of pancreatic cancer. Conclusion Atractylodes-Panxia-Poria mainly exerts a therapeutic effect on pancreatic cancer through multi-component, multi-target and multi-pathway, which provides a certain theoretical basis for the clinical application of Atractylodes -Panxia-Poria in the treatment of pancreatic cancer.

Based on qi-depression constitution， we systematically sorted out and summarized the manifestations of specific symptoms and prescriptions of qi-depression constitution. It is believed that a series of syndromes can be developed due to the imbalance in patients with qi-depression constitution. The four most common syndromes inclinic were summarized as liver depression， deficient depression， phlegm-heat depression， and stagnation. “Liver depression” resulted from liver failing to free flow of qi， then qi stagnated， so Xiaoyao Powder （逍遥散） was recommended as treatment for liver qi depression， spleen deficiency and blood insufficiency； Danzhi Xiaoyao Powder （丹栀逍遥散） for liver depression and spleen deficiency， depression transforming into fire； Bentun Decoction （奔豚汤） for liver depression transforming into fire， upward rushing of qi counterflow. “Deficient depression” resulted from long-term mental disorder and will consume qi and blood potentially to qi and blood deficiency， so Ganmai Dazao Decoction （甘麦大枣汤） was recommended as treatment for deficiency of both heart and spleen， and heart and spleen failing to tonify； Baihe Dihuang Decocotion （百合地黄汤） for heart and lung with yin deficiency， spirit and soul failing to guard. “Phlegm-heat depression” resulted from disturbance of qi movement， affecting the transportation of essence， blood and body fluids， gathering dampness and forming phlegm into heat. Banxia Houpo Decoction （半夏厚朴汤） was recommended as treatment for liver depression and failing to transportation， phlegm coagulation and qi stagnation； Chaihu （or Chaiqin） Wendan Decoction （柴胡（芩）温胆汤） for liver depression and phlegm-heat harassing internally， and disharmony of gallbladder and stomach； self-made Shugan Jieyu Decoction （舒肝解郁汤） for liver-qi stagnation and phlegm-fire harassing internally. “Stagnation” resulted from stagnation of Qi and blood， accumulation of turbid phlegm， and forming stasis over time， so Yueju Pill （越鞠丸） was recommended as treatment for liver depression and failing to transportation， phlegm-fire with damp diet and blood depression； self-made Rupi Sanjie Decoction （乳癖散结汤） for liver depression， stagnation of Qi and blood.

Objective:To analyze the medication characteristics and prescription law of Ye Tianshi and Wu Jutong in the treatment of spleen and stomach diseases based on data mining method; To provide reference for clinical treatment of spleen and stomach diseases.Methods:Records related to spleen and stomach diseases in the Lin Zheng Zhi Nan Yi An and Wu Ju Tong Yi An were collected. SPSS Statistics 26.0, SPSS Modeler 18.0 and other software were used to conduct statistical analysis on the frequency, properties and efficacy of Chinese materia medica. The association analysis and clustering analysis were carried out on high-frequency drugs. Results:A total of 423 medical records, 231 kinds of Chinese materia medica (2 752 times) were included in the Lin Zheng Zhi Nan Yi An. A total of 83 medical records, 115 kinds of Chinese materia medica (753 times) were included in Wu Ju Tong Yi An. The Chinese materia medica used by Ye Tianshi and Wu Jutong to treat spleen and stomach diseases was mainly warm, mild and cold, with pungent, sweet and bitter as the main tastes; they mainly belonged to the spleen, lung and stomach meridians, and their main functions included clearing heat, diverting water and dampness, regulating qi, resolving phlegm, relieving cough, and tonifying deficiency. 6 second-order association rule combinations and 5 effective clusters were obtained for Ye Tianshi's treatment of spleen and stomach diseases, and 15 second-order association rule combinations and 6 effective clusters for Wu Jutong's treatment. Conclusions:Ye Tianshi and Wu Jutong's medication attributes in the treatment of spleen and stomach diseases are basically similar. They often use the method of bitter catharsis to regulate the qi movement of spleen and stomach, and the products of sweet and mild infiltration are used to eliminate dampness and heat. Compared with Ye Tianshi, Wu Jutong used few tonic, heat-clearing, phlegm-resolving, cough-relieving and asthma-relieving drugs, and more diuretics and qi-regulating drugs.

Background: Metabolic diseases pose considerable burden on the healthcare system worldwide, indi-cating the significance of prevention and treatment. In constitution theory of traditional Chinese med-icine, phlegm-dampness constitution (PDC) is the common basis of metabolic diseases. In clinical practice, Huatan Qushi (HTQS) decoction targeting on PDC can effectively improve metabolic indicators. However, its underlying biochemical mechanism still remains unclear.Methods: Eight PDC participants received HTQS decoction for three months. Their blood was collected at baseline and 1 and 3 months after intervention started. Related biomedical indicators were detected. High-throughput sequencing and RT-qPCR were used for validation. Due to the missing data, repeated measures with missing values in mixed models were used. Results: After 3-month treatment, HDL-C level increased (P<.001) and FBG, FINS, and HbA1c all showed decreasing trend at different time points (all P < .05). After miRNA high-throughput sequencing, compared with the baseline, differential miRNAs at 1 and 3 months were screened, and target gene prediction and KEGG pathway enrichment analysis were performed. The results displayed that metabolic disease-related pathways mainly included pathways in cancer, PI3K-Akt signaling pathway, etc. Further, RT-qPCR showed that hsa-miR-1237-3p differed statistically (P =.008). Then we validated the target genes of hsa-miR-1237-3p in the"Pathways in Cancer"pathway including SDF1, AC, CRK, and HGF, also known as upstream target genes of PI3K/AKT pathway. The results showed that two indicators of CRK and HGF were in statistical significance (P=.045 and P=.036, respectively). Conclusion: PDC serves as a common basis for various metabolic diseases. Through adjusting PDC, HTQS decoction can improve biomedical indicators including blood glucose, HbA1c, insulin, and HDL-C. The target pathway is"Pathways in cancer". Specifically, HTQS decoction acts on targets of CRK and HGF by regulating hsa-miR-1237-3p, and probably exerts effects on their downstream PI3K/AKT pathway.

Objective: To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers. Methods: Seventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese med-icine clinician. Of the participants, we included healthy participants with normal weight (NW, n =23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group. Results: After comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups. Conclusion: Participants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.

Background: The constitution theory of traditional Chinese medicine(TCM)states that body constitution and disease are associated; therefore,the identification of body constitution can provide reference for disease prevention and treatment.A series of clinical studies evaluating the association between TCM constitution and metabolic syndrome(MetS)have been conducted in recent years.The aim of this systematic review is to summarize and evaluate the clinical evidence of the relationship between constitution and MetS.Methods: The PubMed,Embase,China National Knowledge Infrastructure(CNKI),Chongqing VIP,and Wanfang Data electronic databases were searched from April 2009 to July 2020.The search terms included"metabolic syndrome,""constitution,"and"Chinese medicine."Observational studies evalu-ating the relationship between body constitution of TCM and MetS were included.The primary outcome included the distribution of constitutional types in the MetS population,and odds ratio(OR)or relative risk(RR)between constitution and MetS.Effect size was expressed as proportion or OR with 95％con-fidence interval(CI).Methodological quality of included studies was evaluated by the Newcastle—Ottawa Scale(NOS)or the American Agency for Healthcare Research and Quality(AHRQ)criteria.Results: Three case—control and 26 cross-sectional studies involving 30435 cases were included.Phlegm-dampness,qi-deficiency,and damp-heat were the main constitution types in patients with MetS,accounting for 29％(22％—39％),18％(13％—24％),and 12％(9％—17％)of the population,respectively;the risk of MetS in people with phlegm-dampness and qi-deficiency constitution was 1.74 [1.27,2.38] and 1.29 [1.01,1.65] times higher than that in those with other constitutions.There were sex-and age-related differences in the distribution of TCM constitution in patients with MetS.Conclusion: Phlegm-dampness and qi-deficiency were associated with the occurrence of MetS.Well-designed cohort and case—control studies are needed to provide evidence for the use of TCM to pre-vent and treat MetS.

Objective To analyze the characteristics of the operating room occupational exposure and its reason of the occurrence; to formulate the occupational exposure prevention and control interventions of operating room and have a evaluation the interventions.Methods Based on data from occupational exposure report of the hospital medical staff occupational exposure monitoring system from January 1,2009 to December 31, 2015, occupational exposure was summarized that happened six years in Operating Room, and analyze the characteristics of the operating room occupational exposure, as well as the causes, factors of occupational exposure, the effect of prevention and control interventions of occupational exposure.Results It was a comparison between occupational exposures occurred in the operating room and the total occupational exposure in the hospital that gender has differences(χ2=26.90,P<0.01). Males constitute ratio in the operating room is higher than that of hospital, but exposure type comparison showed that there was no significant difference between the operating room and the hospital(χ2=0.42,P>0.05). The mainly occupational exposure was sharps' injuries. Comparison showed that doctors proportions was significantly higher in operating room than hospital (χ2=46.81,P<0.01). In the operating room, the ratio of occupational exposure in nurses was higher than in doctors, and the same trend presented in the hospital as well. After interventions, the ratio decreased from the occupational exposure during 2009 and 2011 (before intervention) compared with the occupational exposure happening in 2012 to 2014 in operating room (after intervention) (χ2=11.02,P<0.01). After intervention, the exposure constituent rate in the time of 2012 to 2014 decreased as well comparing the rate during 2009 and 2011 (χ2=11.68,P<0.01).Conclusions Operating room is one of the main places of occupational exposure. In operating room, mainly occupational exposure was sharps' injuries and blood, body fluid exposure. The proportion of doctors is higher than nurses who occurs occupational exposure. To formulate intervention measures against operating room occupational exposure features, and supervise in real-time can reduce incidence of surgery-related personnel occupational exposure.