1.Traditional Chinese Medicine Treats Sepsis by Regulating PI3K/Akt Pathway: A Review
Zhu LIU ; Jiawei WANG ; Jing YAN ; Jinchan PENG ; Mingyao XU ; Liqun LI ; Sheng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):314-322
Sepsis is a systemic inflammatory response syndrome caused by the invasion of pathogenic microorganisms such as bacteria. In addition to the manifestations of systemic inflammatory response syndrome and primary infection lesions, critical cases often have manifestations of organ hypoperfusion. The morbidity and mortality of sepsis have remained high in recent years, which seriously affect the quality of life of the patients. The pathogenesis of sepsis is complicated, in which uncontrollable inflammation is a key mechanism. The phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway plays a key role in mediating inflammation in sepsis. The available therapies of sepsis mainly include resuscitation, anti-infection, vasoactive drugs, intensive insulin therapy, and organ support, which show limited effects of reducing the mortality. Therefore, finding new therapeutic drugs is a key problem to be solved in the clinical treatment of sepsis. In recent years, studies have shown that traditional Chinese medicine (TCM) can regulate the PI3K/Akt pathway via multiple pathways, multiple effects, and multiple targets to inhibit inflammation and curb the occurrence and development of sepsis, which has gradually become a hot spot in the prevention and treatment of sepsis. Moreover, studies have suggested that TCM has unique advantages in the treatment of sepsis. TCM can regulate the PI3K/Akt signaling pathway to inhibit inflammation, reduce oxidative stress, and control apoptosis in the prevention and treatment of sepsis. Despite the research progress, a systematic review remains to be performed regarding the TCM treatment of sepsis by regulating the PI3K/Akt signaling pathway. After reviewing relevant papers published in recent years, this study systematically summarizes the relationship between PI3K/Akt pathway and sepsis and the role of TCM in the treatment of sepsis, aiming to provide new ideas for the potential treatment of sepsis and the development of new drugs.
2.Research progress on the mechanism of traditional Chinese medicine intervening in esophageal cancer by microRNA regulation
Zhiwen SHEN ; Liqun LI ; Mingyao XU ; Xin LIU ; Jing HUANG ; Xiaoning ZHANG ; Jiaqi YIN ; Sheng XIE
China Pharmacy 2024;35(8):1016-1022
Esophageal cancer (EC) is a common malignant tumor of the digestive system with an extremely poor prognosis. MicroRNA (miRNA) is an important regulator in tumor occurrence and development, and can participate in malignant biological behaviors such as tumor cell proliferation, invasion, metastasis and apoptosis. Traditional Chinese medicine has the characteristics of accurate curative effects, wide range of effects, and few side effects. The review uses miRNA as the entry point to systematically elaborate on the mechanism of traditional Chinese medicine-mediated miRNA intervening in EC. The results showed that active ingredients of traditional Chinese medicine (including curcumin, Tussilago farfara polysaccharides, Atractylodes macrocephala polysaccharides and ophiopogonin B) and Dougen guanshitong oral liquid could up-regulate the expressions of miRNAs such as miRNA-532-3p (miR-532-3p), miR-551b-3p, miR-99a, miR-34a, miR-199a-3p and miR-377; and the active ingredients/parts of traditional Chinese medicine (including chrysin and Actinidia arguta extract), and Chinese herbal formulas (including Chaihu shugan san combined with Xuanfu daizhe decoction and Modified jupi zhuru decoction) could down-regulate the expressions of miRNAs such as miR-199a-3p, miR-451 and miR-21, which could regulate the expressions of signaling pathways (phosphoinositide 3-kinase/protein kinase B, etc.) or their downstream protein(zinc-finger and homeobox protein 1, etc.) or enzymes(thymidine kinase-1, etc.), inhibit the proliferation, invasion and metastasis of EC cells and induce apoptosis, thereby ultimately achieving the purpose of preventing the disease from aggravating.
3.Role of NF-κB Signaling Pathway in "Reflux Esophagitis-esophageal Cancer" and Traditional Chinese Medicine Intervention:A Review
Mingyao XU ; Liqun LI ; Xin LIU ; Zhiwen SHEN ; Xiaoning ZHANG ; Jing HUANG ; Jiaqi YIN ; Zhu LIU ; Sheng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):221-233
Reflux esophagitis is an inflammatory disease of esophageal mucosa damage caused by the reflux of gastric contents into the esophagus. Its incidence is on the rise, and it has become an important precancerous disease of esophageal cancer. Studies have shown that the continuous inflammatory response stimulates the esophageal mucosa, causing abnormal proliferation of esophageal epithelial cells and damage to esophageal mucosal tissue, which eventually leads to the occurrence of heterogeneous hyperplasia and even carcinogenesis. The nuclear transcription factor-kappa B (NF-κB) signaling pathway is one of the most classical inflammatory and cancer signaling pathways. It has been found that abnormal activation of the NF-κB signaling pathway is crucial to the development and prognosis of reflux esophagitis and esophageal cancer. It is widely involved in the proliferation, autophagy, apoptosis, and inflammatory response of esophageal epithelial cells and tumor cells, accelerating the transformation of reflux esophagitis to esophageal cancer and making it a potential target for the treatment of reflux esophagitis and esophageal cancer. Currently, there is no specific treatment for reflux esophagitis and esophageal cancer, and large side effects often appear. Therefore, finding a promising and safe drug remains a top priority. In recent years, traditional Chinese medicine scholars have conducted a lot of research on NF-κB signaling pathway, and the results indicate that NF-κB signaling pathway is an important potential target for traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer, but there is a lack of comprehensive and systematic elaboration. Therefore, this paper summarized the relevant studies in recent years, analyzed the relationship among NF-κB signaling pathway, reflux esophagitis, esophageal cancer, and transformation from inflammation to cancer, and reviewed the research literature on the regulation of the NF-κB signaling pathway in traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer, so as to provide new ideas for the prevention and treatment of reflux esophagitis and esophageal cancer.
4.Construction and Testing of Health LifeStyle Evidence (HLSE)
Chen TIAN ; Yong WANG ; Yilong YAN ; Yafei LIU ; Yao LU ; Mingyao SUN ; Jianing LIU ; Yan MA ; Jinling NING ; Ziying YE ; Qianji CHENG ; Ying LI ; Jiajie HUANG ; Shuihua YANG ; Yiyun WANG ; Bo TONG ; Jiale LU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1413-1421
Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (
5.Method for Developing Patient Decision Aid in China
Yao LU ; Qian ZHANG ; Qianji CHENG ; Jianing LIU ; Mingyao SUN ; Jinling NING ; Jiajie HUANG ; Simeng REN ; Wenzheng ZHANG ; Yajie LIU ; Xiyuan DENG ; Jinhui TIAN ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1422-1431
To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids. Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted. A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points. The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.
6.Multi-evidence Integration Methodology for Traditional Chinese Medicine: the MERGE Framework
Honghao LAI ; Zhe WANG ; Ying LI ; Wenjing TANG ; Beibei WANG ; Peidong SUN ; Mingyao SUN ; Jiajie HUANG ; Zhipan XIAO ; Ying LI ; Chen ZHAO ; Hongcai SHANG ; Kehu YANG ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(1):172-182
In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.
7.Methods for Developing Rapid and Living Evidence-based Guidelines
Chen TIAN ; Qiuyu YANG ; Mingyao SUN ; Jie LIU ; Jinhui TIAN ; Yaolong CHEN ; Kehu YANG ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(1):183-191
The aims of developing rapid and living guidelines is to keep the recommendations in the guideline up-to-date. Compared with the conventional guideline, the rapid and living guideline can make better use of the existing evidence and apply and transform the evidence in a timely manner. This paper introduces the advantages and usage of rapid and living guidelines, the development process and existing challenges, and offers some insights, in order to provide reference for domestic organizations and scholars engaged in guideline development.
8.Construction and Testing of Health LifeStyle Evidence (HLSE)
Chen TIAN ; Yong WANG ; Yilong YAN ; Yafei LIU ; Yao LU ; Mingyao SUN ; Jianing LIU ; Yan MA ; Jinling NING ; Ziying YE ; Qianji CHENG ; Ying LI ; Jiajie HUANG ; Shuihua YANG ; Yiyun WANG ; Bo TONG ; Jiale LU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1413-1421
Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (
9.Method for Developing Patient Decision Aid in China
Yao LU ; Qian ZHANG ; Qianji CHENG ; Jianing LIU ; Mingyao SUN ; Jinling NING ; Jiajie HUANG ; Simeng REN ; Wenzheng ZHANG ; Yajie LIU ; Xiyuan DENG ; Jinhui TIAN ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1422-1431
To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids. Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted. A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points. The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.
10.Traditional Chinese Medicine Intervention in Colorectal Cancer Based on NF-κB Signaling Pathway: A Review
Mingyao XU ; Liqun LI ; Xin LIU ; Zhiwen SHEN ; Xiaoning ZHANG ; Jing HUANG ; Jiaqi YIN ; Zhu LIU ; Sheng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(19):243-256
Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths worldwide, with increasing incidence and mortality rates. The disease often develops covertly and lacks specific symptoms in its early stages, leading to late-stage diagnoses in most patients. It has become a prominent research topic in the field of digestive system tumors. The exact mechanisms underlying CRC are not yet clear and involve factors such as genetics, gene mutations, inflammatory responses, and aberrant activation of tumor-related signaling pathways. Nuclear factor-kappa B (NF-κB) is a crucial transcription factor that participates in various biological processes, including inflammatory responses, immune responses, cell proliferation, and apoptosis. Research suggests that NF-κB, serving as a molecular link between inflammation and cancer, is highly expressed in CRC. It promotes the occurrence and development of CRC by regulating the activity of target genes such as cell pro-inflammatory factors, chemokines, angiogenic factors, metastasis factors, and anti-apoptotic proteins. Currently, common treatments for CRC include surgery, radiation therapy, and chemotherapy drugs like 5-fluorouracil. However, these treatments have limitations such as significant adverse reactions, high metastasis rates, and the development of drug resistance. Therefore, the search for effective, low-adverse-reaction drugs to replace or supplement current treatments is essential. In recent years, traditional Chinese medicine (TCM) has shown some effectiveness in preventing and treating CRC. TCM has been found to inhibit the growth of CRC cells by modulating the NF-κB signaling pathway, playing a positive role in the occurrence and progression of CRC. Based on the asthenia in origin and sthenia in superficiality and deficiency-excess in complexity in CRC, this article summarized and analyzed the mechanisms and effects of TCM interventions targeting the NF-κB signaling pathway in CRC, and reviewed advances of 10 Chinese medicinal compound formulas and 37 Chinese medicinal monomer components of different types, including flavonoids, phenols, alkaloids, glycosides, and terpenoids with the effects of dispelling pathogenic factors, reinforcing healthy qi, and removing toxins in the prevention and treatment of CRC by targeting the NF-κB pathway. It is found that Chinese medicine can inhibit CRC cell proliferation, invasion, metastasis, angiogenesis, and inflammation by modulating the NF-κB signaling pathway, induce cell apoptosis, restore drug and radiation sensitivity, and counteract CRC. This article is expected to provide insights and references for the in-depth exploration and treatment of CRC mechanisms.

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