1.Yishen Huashi Granules Protect Kidneys of db/db Mice via p38 MAPK Signaling Pathway
Kaidong ZHOU ; Sitong WANG ; Ge JIN ; Yanmo CAI ; Xin ZHOU ; Yunhua LIU ; Xinxue ZHANG ; Min ZHANG ; Zongjiang ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):58-68
ObjectiveTo explore the mechanism of Yishen Huashi granules in alleviating renal tubular epithelial cell injury and relieving diabetic kidney disease by regulating the mitogen-activated protein kinase (MAPK) signaling pathway. MethodsThe db/db mice of 12 weeks old were randomly assigned into model , dapagliflozin (1.6 mg·kg-1), and Yishen Huashi granules (4.7 g·kg-1), and db/m mice were used as the control group. The general conditions of mice were observed, and fasting blood glucose and 24-h urinary protein and albumin-to-creatinine ratio (ACR) were measured at weeks 0 and 12 of administration. After 12 weeks of treatment, the levels of serum creatinine (SCr), blood urea (UREA), triglycerides (TG), total cholesterol (TC), and low density lipoprotein (LDL) were measured. The pathological changes in the renal tissue were observed by hematoxylin-eosin (HE) staining, Periodic acid-Schiff (PAS) staining, Mallory staining, and transmission electron microscopy. Real-time PCR was employed to determine the mRNA levels of monocyte chemotactic protein-1 (MCP-1) and CC chemokine receptor-2 (CCR2) in the renal tissue of mice. The immunohistochemical assay was employed to examine the expression of p38, phospho-p38 (p-p38), MCP-1, and CCR2 in the renal tissue of mice. Western blotting was employed to measure the protein levels of p-p38, p38, MCP-1, and CCR2 in the renal tissue of mice.HK-2 cells cultured in vitro were grouped as follows: negative control, high glucose(30 mmol·L-1), Yishen Huashi granule-containing serum, and SB203580. After 48 h of cell culture in each group, RNA were extracted and the levels of MCP-1, and CCR2 mRNA were determined by Real-time PCR,proteins were extracted and the levels of p38, p-p38, MCP-1, and CCR2 were determined by Western blot. ResultsThe in vivo experiments showed that before treatment, other groups had higher body weight, blood glucose level, 24 h urinary protein, and ACR than the control group (P<0.05,P<0.01). After 12 weeks of treatment, compared with the model group, the Yishen Huashi granules group showed improved general conditions, a decreasing trend in body weight, lowered levels of blood glucose, 24-h urinary protein, and ACR (P<0.01), reduced SCr and UREA (P<0.01), and declined levels of TC, TG, and LDL (P<0.05,P<0.01). Compared with the model group, the Yishen Huashi granules group showed alleviated damage and interstitial fibrosis in the renal tissue as well as reductions in glomerular foot process fusion and basement membrane thickening. Moreover, the Yishen Huashi granules group showed down-regulated mRNA levels of MCP-1 and CCR2 (P<0.01), reduced positive expression of p-p38, MCP-1, and CCR2 (P<0.01), and down-regulated protein levels of p-p38/p38, MCP-1, and CCR2 (P<0.05) in the renal tissue. The cell experiment showed that compared with the high glucose group, the Yishen Huashi granule-containing serum group showcased down-regulated mRNA levels of MCP-1 and CCR2 (P<0.01) and down-regulated protein levels of p-p38/p38, MCP-1, and CCR2(P<0.05,P<0.01). ConclusionYishen Huashi granules can regulate glucose-lipid metabolism, reduce 24 h urinary protein and ACR, improve the renal function, alleviate the renal tubule injury caused by high glucose, and protect renal tubule epithelial cells in db/db mice by reducing MCP-1/CCR2 activation via the p38 MAPK signaling pathway.
2.Clinical Efficacy of Shugan Huazhuo Zhenyang Prescription in Treatment of Chronic Prostatitis Combined with Erectile Dysfunction
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):135-142
ObjectiveTo explore the clinical efficacy of Shugan Huazhuo Zhenyang prescription in treating patients with chronic prostatitis (CP) complicated by erectile dysfunction (ED). MethodsThis study is a randomized controlled trial, which enrolled 90 CP patients with ED from Professor ZHAO Zongjiang's outpatient clinic. The patients were randomly divided into a treatment group and a control group in a 1∶1 ratio, with 45 patients in each group. The treatment group received the Shugan Huazhuo Zhenyang prescription, while the control group received Sildenafil citrate tablets. Both treatments lasted for 4 weeks. Baseline data, including age, body mass index (BMI), and disease duration, were collected before and after treatment. Clinical efficacy, chronic prostatitis symptom score (CPSI), international erectile function questionnaire (IIEF-5), erection hardness score (EHS), traditional Chinese medicine (TCM) syndrome score, and routine changes in prostate fluid were compared and analyzed between the two groups to evaluate the effectiveness and safety of the treatments for CP combined with ED. ResultsThere were no statistically significant differences in general information between the two groups. After treatment, the treatment group showed a significant decrease in the CPSI score and an increase in the IIEF-5 score (P<0.05). The differences in EHS ratings and TCM syndrome scores were statistically significant (P<0.05). Compared to the control group, there were significant differences in CPSI scores and TCM syndrome scores (P<0.05). Although the clinical efficacy and IIEF-5 score in the treatment group improved after treatment, the differences were not statistically significant. After treatment, the white blood cells, red blood cells, and pus cells in the prostate fluid of the treatment group decreased compared to the control group, while lecithin bodies increased. The differences between the two groups were statistically significant (P<0.01). No significant abnormalities were found in the safety evaluations. ConclusionShugan Huazhuo Zhenyang prescription can improve symptoms such as pain, discomfort, abnormal urination, moist scrotum, weak erection, premature ejaculation, and erectile dysfunction. It is an effective treatment for CP complicated by ED.
3.Effect of Shenkang Injection on Podocyte Apoptosis and GRP78/CHOP Signaling Pathway in db/db Mice with Diabetic Kidney Disease Based on Endoplasmic Reticulum Stress
Yanmo CAI ; Sitong WANG ; Xin ZHOU ; Ge JIN ; Kaidong ZHOU ; Yunhua LIU ; Fengfeng ZHANG ; Xinxue ZHANG ; Zongjiang ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):81-90
ObjectiveTo investigate the mechanism of Shenkang injection in delaying diabetic kidney disease by regulating endoplasmic reticulum stress and attenuating podocyte apoptosis through the Glucose regulated protein 78 ( GRP78 ) / transcription factor C / EBP homologous protein ( CHOP ) signaling pathway (GRP78/CHOP) signaling pathway. MethodsFor the animal experiment, 10 12-week-old db/m mice were selected as a normal group, and 30 12-week-old db/db mice were randomly divided into a model group, a Shenkang injection group (15.6 mL·kg-1), and a dapagliflozin group (1.6 mg·kg-1). To observe the general condition of mice, fasting blood glucose, urinary albumin/urine creatinine (ACR), and 24 h urine protein quantification were detected in each group before drug administration. After 12 weeks of drug treatment, mice were tested for fasting blood glucose, total cholesterol (TC), triglyceride (TG), low-density cholesterol (LDL), ACR, 24 h urine protein quantification, blood creatinine (SCr), and blood urea (UREA). Hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and transmission electron microscopy were used to observe the pathologic morphology in renal tissue. Immunohistochemistry was used to detect the expressions of nephroprotective marker protein (Nephrin), glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) in renal tissue. Western blot was used to detect the expressions of GRP78, CHOP, Bcl-2, Bax, and Nephrin proteins, and Real-time polymerase chain reaction (Real-time PCR) was employed to detect the expressions of Nephrin, GRP78, CHOP, Bcl-2, and Bax mRNAs in renal tissue. ResultsBefore drug administration, compared with those in the normal group, the body mass of db/db mice was significantly increased, and blood glucose, 24 h urine protein quantification, and ACR were significantly elevated in the Shenkang injection group and Dapagliflozin group (P<0.01). After 12 weeks of administration, compared with those in the model group, the general state of mice in the Shenkang injection group was significantly improved, and the body mass was decreased. The blood glucose was significantly reduced (P<0.01), and blood lipids TC, TG, and LDL were significantly decreased (P<0.05, P<0.01). The 24 h urine protein quantification and ACR were significantly decreased (P<0.05), and SCr and UREA were significantly reduced (P<0.01). Compared with those of the model group, the pathologic results of the Shenkang injection group showed that proliferation of mesangial cells, reduction of inflammatory cell infiltration, and alleviation of renal tubular vacuolization and podocyte damage were observed in renal tissue of mice. Electron microscopy showed that fusion of the pedicle protruding and thickening of the basement membrane were reduced. Immunohistochemistry results showed that the expressions of GRP78, CHOP, and Bax proteins were significantly reduced (P<0.01), and the expressions of Nephrin and Bcl-2 proteins were significantly increased (P<0.01) in renal tissue of the Shenkang injection group. Western blot results showed that the expressions of Nephrin and Bcl-2 in the Shenkang injection group were significantly increased (P<0.05, P<0.01), and the expressions of GRP78, CHOP, and Bax proteins were significantly decreased (P<0.05, P<0.01). Real-time PCR results showed that the expressions of GRP78, CHOP, and Bax mRNAs were down regulated in the Shenkang injection group (P<0.01), and the expressions of Nephrin and Bcl-2 mRNAs were up regulated (P<0.01). ConclusionShenkang injection inhibits endoplasmic reticulum stress response and podocyte apoptosis by regulating the GRP78/CHOP signaling pathway, which in turn ensures the integrity of glomerular filtration barrier, reduces the occurrence of proteinuria, improves renal function, and thus delays the progression of diabetic kidney disease.
4.Effect of Shenkang Injection on Podocyte Apoptosis and GRP78/CHOP Signaling Pathway in db/db Mice with Diabetic Kidney Disease Based on Endoplasmic Reticulum Stress
Yanmo CAI ; Sitong WANG ; Xin ZHOU ; Ge JIN ; Kaidong ZHOU ; Yunhua LIU ; Fengfeng ZHANG ; Xinxue ZHANG ; Zongjiang ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):81-90
ObjectiveTo investigate the mechanism of Shenkang injection in delaying diabetic kidney disease by regulating endoplasmic reticulum stress and attenuating podocyte apoptosis through the Glucose regulated protein 78 ( GRP78 ) / transcription factor C / EBP homologous protein ( CHOP ) signaling pathway (GRP78/CHOP) signaling pathway. MethodsFor the animal experiment, 10 12-week-old db/m mice were selected as a normal group, and 30 12-week-old db/db mice were randomly divided into a model group, a Shenkang injection group (15.6 mL·kg-1), and a dapagliflozin group (1.6 mg·kg-1). To observe the general condition of mice, fasting blood glucose, urinary albumin/urine creatinine (ACR), and 24 h urine protein quantification were detected in each group before drug administration. After 12 weeks of drug treatment, mice were tested for fasting blood glucose, total cholesterol (TC), triglyceride (TG), low-density cholesterol (LDL), ACR, 24 h urine protein quantification, blood creatinine (SCr), and blood urea (UREA). Hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and transmission electron microscopy were used to observe the pathologic morphology in renal tissue. Immunohistochemistry was used to detect the expressions of nephroprotective marker protein (Nephrin), glucose-regulated protein 78 (GRP78), CCAAT/enhancer-binding protein homologous protein (CHOP), B-cell lymphoma-2 (Bcl-2), and Bcl-2-associated X protein (Bax) in renal tissue. Western blot was used to detect the expressions of GRP78, CHOP, Bcl-2, Bax, and Nephrin proteins, and Real-time polymerase chain reaction (Real-time PCR) was employed to detect the expressions of Nephrin, GRP78, CHOP, Bcl-2, and Bax mRNAs in renal tissue. ResultsBefore drug administration, compared with those in the normal group, the body mass of db/db mice was significantly increased, and blood glucose, 24 h urine protein quantification, and ACR were significantly elevated in the Shenkang injection group and Dapagliflozin group (P<0.01). After 12 weeks of administration, compared with those in the model group, the general state of mice in the Shenkang injection group was significantly improved, and the body mass was decreased. The blood glucose was significantly reduced (P<0.01), and blood lipids TC, TG, and LDL were significantly decreased (P<0.05, P<0.01). The 24 h urine protein quantification and ACR were significantly decreased (P<0.05), and SCr and UREA were significantly reduced (P<0.01). Compared with those of the model group, the pathologic results of the Shenkang injection group showed that proliferation of mesangial cells, reduction of inflammatory cell infiltration, and alleviation of renal tubular vacuolization and podocyte damage were observed in renal tissue of mice. Electron microscopy showed that fusion of the pedicle protruding and thickening of the basement membrane were reduced. Immunohistochemistry results showed that the expressions of GRP78, CHOP, and Bax proteins were significantly reduced (P<0.01), and the expressions of Nephrin and Bcl-2 proteins were significantly increased (P<0.01) in renal tissue of the Shenkang injection group. Western blot results showed that the expressions of Nephrin and Bcl-2 in the Shenkang injection group were significantly increased (P<0.05, P<0.01), and the expressions of GRP78, CHOP, and Bax proteins were significantly decreased (P<0.05, P<0.01). Real-time PCR results showed that the expressions of GRP78, CHOP, and Bax mRNAs were down regulated in the Shenkang injection group (P<0.01), and the expressions of Nephrin and Bcl-2 mRNAs were up regulated (P<0.01). ConclusionShenkang injection inhibits endoplasmic reticulum stress response and podocyte apoptosis by regulating the GRP78/CHOP signaling pathway, which in turn ensures the integrity of glomerular filtration barrier, reduces the occurrence of proteinuria, improves renal function, and thus delays the progression of diabetic kidney disease.
5.Quantitative Analysis of Syndromes in 558 Cases of Kidney Yang Deficiency Syndrome Based on Factor Analysis
Shuyue WANG ; Zongjiang ZHAO ; Xinxue ZHANG ; Zuzhen YAN ; Yan ZHANG ; Zhimei ZHANG ; Tingting JIAO ; Qi WU ; Yunhua LIU ; Sitong WANG ; Xinjiang ZHANG ; Kaidong ZHOU
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(7):2304-2312
Objective Through factor analysis of the quantified syndrome information of 558 cases of kidney yang deficiency syndrome,the constructing feature of kidney yang deficiency syndrome was revealed,which provides clinical data support for the objectification,standardization and normalization of kidney Yang deficiency syndrome.Methods Firstly,the frequency analysis of symptoms,tongue and pulse signs of 558 patients with kidney Yang deficiency syndrome was carried out,and then the main syndrome information of the patients with kidney Yang deficiency syndrome was quantified.Finally,the common factors and their representative variables of kidney Yang deficiency syndrome were screened out through factor analysis,and the constructing feature of kidney Yang deficiency syndrome was analyzed combined with TCM syndrome knowledge.Results Eight common factors with eigenvalues greater than 1 were extracted by principal component analysis,and the cumulative contribution rate was 60.483%.After the factor rotation,the representative variables with the absolute value of load coefficient greater than 0.45 in each common factor were selected.The representative variables of F1 are afraid of cold and fond of warmth(0.947)and intolerance to cold(0.932).The representative variables of F2 are waist pain(0.754),waist and knee weakness(0.720)and cold in waist and knees(0.466).The representative variables of F3 are depression(0.749),insomnia(0.711)and diarrhoea(0.470).The representative variables of F4 are thin fur(0.819)and white fur(0.768).The representative variable of F5 are tinnitus and deafness(0.687),frequent nocturnal urination(0.591)and decreased libido(0.587).The representative variables of F6 are pulse sinking(0.766)and pulse weakness(0.736).The representative variables of F7 is thready pulse(0.942).The representative variable of F8 is pale tongue(0.961).External syndrome of disease location involved in these common factors are waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.The disease nature involved in these common factors is deficiency and cold.Conclusion The basic constituent units of kidney Yang deficiency syndrome include disease location syndrome elements and disease nature syndrome elements.The disease location is kidney,and the abnormal changes of kidney location are mainly external symptoms of waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.Its disease nature is deficiency and cold.Yang deficiency leads to external cold.Yang Qi deficiency can not warm the body surface resulting in the appearance of external cold syndrome.
6.Evolution Patterns of 256 Cases of Chronic Kidney Disease with Kidney Yang Deficiency Syndrome Based on Data Mining
Xinjiang ZHANG ; Xinxue ZHANG ; Zuzhen YAN ; Yunhua LIU ; Shuyue WANG ; Sitong WANG ; Kaidong ZHOU ; Zongjiang ZHAO ; Yan ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(11):141-150
ObjectiveTo analyze the characteristics of kidney Yang deficiency syndrome in different stages and time evolution of chronic kidney disease (CKD) to explore the evolution patterns of kidney Yang deficiency syndrome in CKD. MethodThe evidence information of 256 patients with CKD was collected from October 2020 to September 2022 according to relevant standards, and the "Kidney Yang Deficiency Syndrome Evaluation Scale for Chronic Kidney Disease" was developed. With SPSS Statistics 20.0, SPSS Modeler 18.0, Gephi 0.9.2, and R 4.2.1, the syndrome information of CKD patients at various stages and the syndrome changes after one year were statistically analyzed using complex network analysis, association rule analysis, probability transition matrix analysis, and chi-square test, and the kidney Yang deficiency syndrome of patients at various stages was comprehensively evaluated. ResultIn the CKD population, the proportion of females with kidney Yang deficiency syndrome was higher than that of males (P<0.01), and the proportion of people over 65 years old was higher than in people under 65 years old. The proportion of people with kidney Yang deficiency syndrome increased with the progression of kidney disease, and the proportion of Ⅳ-Ⅴ CKD patients with kidney Yang deficiency syndrome was higher than that of Ⅰ-Ⅱ CKD patients (P<0.01). From Ⅰ CKD to Ⅴ CKD, the frequency of dull tongue continued to increase, and the frequency of enlarged tongue and tooth-marked tongue continued to increase after Ⅲ CKD. The frequency of thick coating and greasy coating ranked in the top 3 of frequency distribution in Ⅴ CKD. After Ⅲ CKD, the top 3 tongue characteristics were weak pulse, deep pulse, and thready pulse, all of which were characteristics of kidney Yang deficiency syndrome. Complex network analysis of the tongue and pulse showed that the core tongue and pulse characteristics of patients with end-stage CKD were tooth-marked tongue with white coating and deep and thready pulse. The results of symptom frequency analysis and complex network analysis showed that aversion to cold and preference for warmth, weakness of the knees, and cold extremities were the top 3 symptoms in Ⅰ-Ⅲ CKD patients with kidney Yang deficiency syndrome, and in Ⅳ-Ⅴ CKD, the manifestations of the syndrome of Yang deficiency and water diffusion, such as drowsiness and fatigue, edema, and frequent urination at night became characteristic symptoms. The scores of edema, pale complexion, soreness and weakness of the waist and knees, loose stools, and mental depression symptoms, as well as the total score of kidney Yang deficiency syndrome gradually increased with disease progression, with statistical differences between different stages of CKD (P<0.05, P<0.01). The frequency analysis of disease-related syndrome elements showed that the frequencies of Yang deficiency syndrome, phlegm-dampness syndrome, blood stasis syndrome, and turbidity-toxin syndrome gradually increased with disease progression, and there were statistically significant differences in the distribution between different stages of CKD (P<0.05, P<0.01). The results of complex network analysis showed that Yang deficiency syndrome was the core syndrome element throughout all stages of CKD and was the main syndrome element type of CKD, while phlegm-dampness syndrome, blood stasis syndrome, and turbidity-toxin syndrome were gradually revealed in the middle and late stages of CKD. In the CKD population with kidney-Yang deficiency syndrome, the distribution of phlegm-dampness syndrome, blood stasis syndrome, and turbidity-toxin syndrome as concurrent syndromes in different CKD stages had statistically significant differences (P<0.05, P<0.01). The association rule analysis showed that as the disease progressed, associations between the concurrent syndromes, such as phlegm-dampness syndrome, blood stasis syndrome, turbidity-toxin syndrome, and fluid retention syndrome, and kidney-Yang deficiency syndrome were gradually enhanced. The comparison of the changes in CKD with kidney Yang deficiency syndrome within one year showed that the disease location was centered on the kidney and transmitted between the spleen, stomach, heart, and liver. There is a 23.81% probability of kidney-Yang deficiency syndrome transforming into Qi deficiency syndromes (Qi deficiency in the spleen and kidney, Qi deficiency in the liver, and Qi deficiency in the heart), 23.79% into Yin deficiency syndromes (Yin deficiency in the liver and kidney, Qi and Yin deficiency, and Yin deficiency in the liver and stomach), and 9.52% into dampness syndromes (phlegm-dampness internal obstruction and wind-dampness obstruction). In contrast, 20% of spleen and kidney Qi deficiency syndrome transformed into kidney Yang deficiency syndrome, and 33.33% of Qi deficiency and blood stasis syndrome transformed into kidney Yang deficiency syndrome. ConclusionAs Ⅰ CKD progresses to Ⅴ CKD, the severity of kidney Yang deficiency syndrome gradually increases, and the syndrome characteristics of kidney Yang deficiency become pronounced. Furthermore, the pathogenic factors, such as phlegm-dampness, blood stasis, and turbidity-toxin, gradually increase. With the change of time, kidney Yang deficiency syndrome in CKD tends to evolve into syndromes related to Qi deficiency, Yin deficiency, and dampness. The discovery of these rules provides a theoretical basis and reference guidance for the treatment of CKD based on syndrome differentiation.
7.Clinical effects of free perforator propeller myocutaneous flap from buttock in repairing complex wounds in the buttock with deep dead cavity
Liming CHEN ; Gang WANG ; Hong LIU ; Ruomei ZHAO ; Xiaohui LIU ; Guangtong CAO ; Zongjiang YAO ; Zhiyong LI ; Yi LIU
Chinese Journal of Burns 2023;39(8):753-757
Objective:To investigate the feasibility and clinical effects of using free perforator propeller myocutaneous flap from buttock in repairing complex wounds in the buttock with deep dead cavity.Methods:A retrospective observational study was conducted. From June 2020 to June 2022, 9 patients with complex wounds in the buttock with deep dead cavity who met the inclusion criteria were admitted to Lanzhou University Second Hospital, including 6 males and 3 females, aged 26 to 62 years, with original wound area ranging from 4.0 cm×3.0 cm to 8.0 cm×7.0 cm and dead cavity depth of 7 to 11 cm. All the wounds were repaired with free perforator propeller myocutaneous flap from buttock, with flap area of 6.0 cm×2.5 cm to 13.0 cm×7.0 cm and muscle flap length of 6 to 11 cm. All the wounds in the donor area were closed and sutured directly. Postoperative myocutaneous flap survival, complications, as well as donor and recipient wound healing were observed, and the shape of donor and recipient areas were followed up.Results:Congestion occurred under the myocutaneous flap of one patient due to poor drainage on post surgery day 2, which was healed after 15 days of drainage and dressing change. The myocutaneous flaps of other patients survived successfully after surgery. The wounds in the donor and recipient areas were all well healed. During the follow-up of 3 to 10 months, the donor and recipient areas were full in shape, with little difference from the healthy side, and were able to bear pressure.Conclusions:The free perforator propeller myocutaneous flap from buttock can repair the deep dead cavity and surface wounds at the same time. The use of this myocutaneous flap in repairing complex wounds in the buttock with deep dead cavity results in minimal damage to the donor area, allows pressure-bearing of the donor and recipient areas after surgery, and ensures a full buttock shape.
8.Correlations of Characteristics of Kidney Yang Deficiency Syndrome with Clinical Indicators and Risk Factors of Chronic Kidney Disease
Qi WU ; Xinxue ZHANG ; Tingting JIAO ; Xinjiang ZHANG ; Shuyue WANG ; Yunhua LIU ; Pengfei ZHENG ; Sitong WANG ; Kaidong ZHOU ; Zongjiang ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(19):204-213
ObjectiveTo study the correlations of the characteristics of kidney Yang deficiency syndrome in patients with chronic kidney disease (CKD) with clinical indicators and to explore the risk factors of kidney Yang deficiency in CKD. MethodThe differentiation of traditional Chinese medicine (TCM) syndrome classified the 225 CKD patients who met the inclusion criteria into two groups: one group of kidney Yang deficiency syndrome (99 patients) and one group of non-kidney Yang deficiency syndrome (126 patients). The symptoms, tongue manifestation, pulse manifestation, and accompanied symptoms of the kidney Yang deficiency syndrome group were recorded. The syndrome characteristics were summarized by factor analysis and clustering analysis. The levels of hemoglobin, red blood cell count, urinary protein, urinary glucose, creatinine, urea nitrogen and glomerular filtration rate were compared between the kidney Yang deficiency syndrome group, the non-kidney Yang deficiency syndrome group and the normal control group by ANOVA and non-parametric test. The binary logistic regression model was employed to analyze the correlations of lifestyle, body mass index (BMI) with syndrome. ResultThe high-frequency symptoms of CKD patients with kidney Yang deficiency syndrome were waist pain, fear of cold, favor of warm, lethargy, fear of cold at waist and knees, etc. The patients mainly presented deep pulse, thready pulse, or weak pulse, and the tongue with white coating, greasy coating, or thin coating. A total of 13 common factors were obtained, which can be classified into 5 categories. The patients with kidney Yang deficiency syndrome mainly had symptoms in limbs (especially lower limbs), chest, bladder, fleshy exterior, and stomach, with the main manifestations of deficiency-cold, Qi deficiency, fluid retention, and blood stasis. The clustering analysis classified the patients into 11 categories, which reflected that kidney Yang deficiency syndrome mainly presented the symptoms of Qi deficiency, blood stasis, and fluid retention, with fleshy exterior, limbs, spleen, stomach, ears, mind, and bladder involved. The results of clustering analysis and factor analysis were consistent, both of which indicated that the patients were weak with deficiency-cold, accompanied by fluid retention and blood stasis. Frequency analysis also showed that common symptoms mainly included Qi deficiency, fluid retention, cold-dampness, and blood stasis. Compared with the non-kidney Yang deficiency group, the kidney Yang deficiency group showed a large proportion of patients in stage 3-5 CKD, elevated urea nitrogen (P<0.05), decreased glomerular filtration rate, hemoglobin, and red blood cell count (P<0.05), and increased qualitative grade of urine protein. In addition, the results of regression analysis showed that female, little or no exercise, and diet preference were the risk factors for kidney Yang deficiency syndrome in CKD (P<0.05). ConclusionThe disease location and manifestations have correspondence in the CKD patients with kidney Yang deficiency syndrome. The TCM symptoms are correlated with clinical indicators. Hemoglobin, red blood cell count, glomerular filtration rate, urea nitrogen, and urine protein can reflect the connotation of kidney Yang deficiency syndrome in CKD to a certain extent. Additionally, related risk factors in life can affect the occurrence of kidney Yang deficiency syndrome in CKD.
9.Tangshenping granule inhibits pyroptosis in a rat model of streptozotocin-induced diabetic nephropathy via the NLRP3/caspase-1/GSDMD pathway
Gao KUN ; Zheng PENGFEI ; Yang TAO ; Zhang XINXUE ; Zhao ZONGJIANG
Journal of Traditional Chinese Medical Sciences 2021;8(4):317-326
Objective:To explore the inhibitory effect of Tangshenping (TSP) on pyroptosis in a streptozotocin-induced diabetic nephropathy (DN) rat model.Methods:DN was established in Sprague-Dawley rats.Rats were randomly divided into DN (model group),irbesartan,and TSP low-,medium-,and high-dose groups,besides the control group.The 24 h albuminuria content,and serum content of TC,TGs,Scr,IL-1β,UREA,LDLs,and IL-18 were assessed.Hematoxylin & eosin and Mallory staining were performed to examine pathological changes in the kidney.The mRNA and protein expression of NLRP3,caspase 1,and GSDMD in the kidney were also examined.Results:The 24 h albuminuria content was obviously lower in the treatment groups compared to the model group (all P <.01).Levels of TC,TGs,Scr,UREA,LDLs,and IL-18 after drug interventions were obviously lower compared to the model group (all P <.05).The serum content of IL-1β in the TSP me-dium-and high-dose groups were much lower compared to the model group (P =.013 and P =.001,respectively).Through immunohistochemistry and western blotting,we observed that the protein ex-pressions of NLRP3,caspase-1,GSDMD,IL-1 β,and IL-18 were lower after drug interventions compared to the model group (all P <.05).Using qPCR,we observed that the mRNA expressions of caspase-1,IL-1β,IL-18,and GSDMD after drug interventions were significantly lower compared to the model group (all P <.05).The mRNA expressions of NLRP3 in the TSP medium-and high-dose groups were both lower compared to the model group (all P <.05).Conclusion:TSP downregulated mRNA and protein expressions of NLRP3,caspase-1,and GSDMD.Our findings demonstrate that the beneficial effects of TSP on renal function are at least partly mediated by the inhibition of micro-inflammation and modulation of the expression of pyroptosis-related factors.
10.Establishment and Explanation of "Consumptive Kidney Disease" Theory
Yonghui MIAO ; Zongjiang ZHAO ; Xinxue ZHANG ; Amin WU
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(6):1031-1037
Diabetic kidney disease (DKD) is a serious long-term complication and major death cause of patients who have suffered from diabetes mellitus (DM),which is a serious threat to the health of human being.Professor Zhao Zongjiang first came up with the of DKD "consumptive kidney disease" scientific theory,and led the scientific research team for DKD research.Our team had achieved some results,which were mainly focused on the animal experiments and cell culture experiment.And the research fields covered pharmacodynamics,oxidative stress levels and signal transduction pathways.Focusing on the reduction of extracellular matrix in the glomerular mesangial area and tubulointerstitial deposition,inhibition of podocyte injury,inhibition of podocyte apoptosis,inhibition and reversal of podocyte transdifferentiation,inhibition of renal tubular epithelial cell transdifferentiation and other scientific issues,this paper systematically explored the biological mechanism of DKD "consumptive kidney disease" scientific theory.This paper explained how "consumptive kidney disease" scientific theory was proposed and summarized related research results of our research team and developed traditional Chinese medicine (TCM) theory by supplying the TCM "consumptive organ disease" theory.

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