The development of traditional Chinese medicine (TCM) diagnosis and treatment has undergone multiple paradigms, evolving from sporadic experiential practices to systematic approaches in syndrome differentiation and treatment and further integration of disease and syndrome frameworks. TCM is a vital component of the medical system, valued alongside Western medicine. Treatment based on syndrome differentiation embodies both personalized treatment and holistic approaches; however, the inconsistency and lack of stability in syndrome differentiation limit clinical efficacy. The existing integration of diseases and syndromes primarily relies on patchwork and embedded systems, where the full advantages of synergy between Chinese and Western medicine are not fully realized. Recently, driven by the development of diagnosis and treatment concepts and advances in analytical technology, Western medicine has been rapidly transforming from a traditional biological model to a precision medicine model. TCM faces a similar need to progress beyond traditional syndrome differentiation and disease-syndrome integration toward a more precise diagnosis and treatment paradigm. Unlike the micro-level precision trend of Western medicine, precision diagnosis and treatment in TCM is primarily reflected in data-driven applications that incorporate information at various levels, including precise syndrome differentiation, medication, disease management, and efficacy evaluation. The current priority is to accelerate the development of TCM precision diagnosis and treatment technology platforms and advance discipline construction in this area.

This study searched the clinical researches on traditional Chinese medicine （TCM） for cardiovascular diseases registered in Chinese Clinical Trial Registry and the US Clinical Trial Registry， the cardiovascular disease-related studies funded by the National Natural Science Foundation of China， as well as those published in China National Knowledge Infrastructure （CNKI）， Wanfang database， VIP.com， China Biology Medicine disc （CBMdisc）， Embase， Medline， Cochrane Library， and other databases published cardiovascular disease-related studies from 1 January 2021 to 30 June 2023. In order to analyse and evaluate the research progress of TCM treatment for coronary heart disease， hypertension， heart failure， and arrhythmia， this study aimed at recent research hotspots and research direction. It is found that the research on TCM for cardiovascular diseases was gradually deepening and the high-quality evidence continued to emerge. It is believed that studies related to the prevention and treatment of common cardiovascular diseases by TCM reflected the multi-angle integration of modern technology and pattern differentiation and treatment， closer integration of clinical and basic research， and further optimisation of pattern identification and interventions. On this basis， the research programme and implementation process should be further standardized， and the translation of research results should be emphasized to promote the standardized application and promotion of TCM diagnosis and treatment of cardiovascular diseases.

OBJECTIVE To optimize the formulation for sustained-release particles of matrine(MAT) and paeonol(PAE) and to primarily evaluate their quality. METHODS The sustained-release particles were fabricated by the extrusion-spheronization method. Single factor analysis was conducted on the main sustained-release materials and their dosage, auxiliary sustained-release materials, and the total amount and proportion of mixed sustained-release materials, using the cumulative release rates of MAT and PAE in vitro as evaluation indicators. By combining central composition design-response surface methodology, the formulation of sustained-release materials was optimized, and the effects of the total amount and mass ratio of ethyl cellulose(EC) and chitosan(CS) on the cumulative release rate and release synchronization of MAT and PAE were investigated. The formulation characteristics, in vitro release, and preliminary stability tests of MAT-PAE-SRPs were evaluated, and the release process kinetic equation was fitted. RESULTS The optimized formulation contained 23.5% EC and 17.1% CS as sustained-release materials. The yield, repose angle, bulk density and friability of final particles were 97.23%, 38.1°, 0.74 g·mL−1 and 0.74%, respectively. The particles showed sustained release pattern in various media and released faster in acidic media with its release percentage >90% at 12 h. The release profile of MAT was fitted best with first order equation, and that of paeonol with Higuchi equation. The formation of SRPs improved the stability of both drugs. CONCLUSION The sustained-release effect of MAT-PAE-SRPs prepared by sustained-release materials EC and CS is significant, and the cumulative release rate and release synchronization of MAT and PAE are good, which can provide reference for the research of dual loaded sustained-release formulations.

As the smallest combination unit of Chinese medicinals， herbal pairs serve as the bridge between medicinals and formulas， whose combination theory reflects the basic characteristics of Chinese medicinals combination and the core essence of prescription composition. Simultaneously， as a key combination of medicinals in clinical treatment of diseases， syndromes， and symptoms， herbal pairs are the main form of clinical medication in traditional Chinese medicine （TCM） as well as the characteristic advantage of treating diseases. This article summarized that “mutual complement of medicinals of same or antagonism flavor and nature” theory is the theoretical origin， and efficacy-enhancement and toxicity-attenuation is the core purpose of the combination of herbal pairs. The property theory of Chinese medicinals and the thought of differentiation and treatment are the main basis of the combination of herbal pairs， and pertinence and flexibility are the key points in clinical application. All mentioned above are expected to provide theoretical guidance for the clinical use and modern research of herbal pairs.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

Objective To evaluate the diagnostic value of magnetic resonance spectroscopy analysis in patients with prostate specific antigen (PSA) abnormal prostate disease. Methods The patients who had abnormal PSA from January 2017 to December 2018 in Weifang People′s Hospital were selected. Patients with prostate puncture indications were as research target. A total of 137 patients including 44 patients with prostate cancer and 93 patients with benign prostatic hyperplasia were diagnosed by puncture. All patients underwent magnetic resonance scan and enhancement and spectroscopy before surgery. The comparative value of magnetic resonance scan + enhancement, magnetic resonance spectroscopy and joint examination was obtained. Results Sensitivity of magnetic resonance imaging and enhancement was 77.3% (34/44), specificity was 86.0% (80/93), and accuracy was 83.2% (114/137). Sensitivity of magnetic resonance spectroscopy was 52.3% (23/44), specificity was 77.4% (72/93), and accuracy was 69.3% (95/137). The sensitivity of the combined application was 90.9% (40/44), specificity was 91.4% (85/93), and accuracy was 91.2% (125/137). Conclusions The application of magnetic resonance spectroscopy can increase the sensitivity, specificity and accuracy of magnetic resonance plain scan and intensive examination for diagnosis of prostate cancer.

Objective To investigate the clinical significances of additional chromosome abnormalities and t(15;17) in acute promyelocytic leukemia (APL). Methods A total of 90 newly diagnosed APL patients in the Affiliated Hospital of Qingdao University from January 2007 to June 2014 were analyzed retrospectively. Patients with different chromosome karyotypes were divided into four groups: additional chromosome number abnormalities group (16 cases), additional chromosome structural abnormalities group (14 cases), additional chromosome number and structural abnormalities group (4 cases) and typical chromosome group (56 cases). According to whether the patient contained t(15;17), the patients were divided into group with t (15;17) and group without t (15;17). The short-term efficacy and survival of each group were analyzed and compared. Results The rate of complete remission in additional chromosome number abnormalities group, additional chromosome structural abnormalities group, additional chromosome number and structural abnormalities group and typical t(15;17) chromosome changes group were 56.3％(9/16), 100.0％(14/14), 25.0％(1/4) and 82.1％(46/56), the early mortality rates were 25.0％(4/16), 0 (0/14), 75.0％(3/4) and 8.9％ (5/56) respectively. Among them, the additional number and structural abnormalities group had lower complete remission rate and higher early mortality rate, and compared with other groups, the differences were statistically significant (all P< 0.05). The complete remission rates of the group with t (15;17) and the group without t (15;17) were 80.5％ (66/82) and 50.0％ (4/8), respectively, and the difference was not statistically significant (P= 0.070). Conclusions APL patients with karyotypes with additional number and structural changes have low complete remission rate, high early mortality rate and poor prognosis. Patients with t(15;17)have a high rate of complete remission.

Objective To investigate the immunological characteristics and clinical significance of reactive plasmacytosis in patients with severe fever with throbocytopenia syndrome (SFTS).Methods Bunyavirus-infected patients who were diagnosed with SFTS were collected from March 2015 to October 2015 in Taizhou Hospital.Morphology analysis of bone marrow and peripheral blood (PB) smear, as well as flow cytometry analysis of plasma cell immune phenotype from peripheral blood were conducted.Serum immunoglobulin levels and helper T hymphocytes (Th)1/Th2 cytokine expressions were detected.Mann-Whitney U test was used.Results PB plasma cells from all of the SFTS patients increased in varying degrees, and the phenotype of the plasma cells was CD19+CD38++CD45+CD138+, which indicated normal mature plasma cells.The ratio of PB plasma cells was >0.030 in 10/16 patients, and >0.300 in 2/16 patients.The ratios of PB plasma cells in the patients with severe and critical groups were significantly higher than that in the mild group (0.052 vs 0.016, P<0.05).Monocytoid histiocytes and hemophagocytes were observed in the BM morphology of 9 patients.Three of them were diagnosed as hemophagocytic lymphohistiocytosis (HLH).The ratio of plasma cells was more than 0.030 in the bone marrow of 8 patients.The serum levels of interlewkin (IL)-6, IL-10 and interferon (IFN)-γ in acute phase were significantly elevated with the median level of 49.75 ng/L, 26.98 ng/L (reference value 2.6 to 4.9 ng/L) and 17.57 ng/L, respectively.While the levels of IL-2, IL-4 and twmor necrosis fautor(TNF)-α were not significantly changed.The serum IL-6 and IL-10 levels in the patients with severe and critical groups were both significantly higher than those in the mild group (IL-6: 132.36 vs 22.81 ng/L;IL-10: 75.28 vs 6.33 ng/L, both P<0.05), but the difference of IFN-γ level was not significant (P>0.05).The serum IgG, IgA and IgM levels did not increase in acute stage, with the median of 11.6 g/L, 2.56 g/L and 1.60 g/L (reference value 0.46 to 3.04 g/L), respectively.Conclusion The patients with SFTS show excessive humoral and cellular immunity, and the severity of disease is positively correlated with the ratio of peripheral plasma cells and the levels of cytokines IL-6 and IL-10.

Aim To investigate the induction effect of ginsenoside Rc, Re, Rf and Rg1 on CYP1A1, and further validate the role of aryl hydrocarbon receptor in CYP1A1 expression. Methods Dual luciferase re-porter gene system was performed. Four kinds of gin-senoside were screened for aryl hydrocarbon receptor activation by reporter assays, and TCDD as the positive control. Further with different concentrations of ginsen-oside Rc, Re, Rf and Rg1 treated on LS174T cells, RNA and total protein were extracted to detect the reg-ulating effect of ginsenosides on CYP1 A1 mRNA and protein expression with Real-time PCR and Western blot technology respectively. Results Reporter gene screening showed that the ginsenoside Rc, Re, Rf and Rg1 could activate AhR and had potential effects on the induction of CYP1A1 enzyme. Meanwhile, dose-de-pendent induction of the gene expression were observed in response to ginsenoside Rc, Re, Rf and Rg1 and the levels of CYP1 A1 protein expression were increased by ginsenoside Rc, Re, Rf and Rg1 in varying de-grees. Conclusion Ginsenoside Rc, Re, Rf and Rg1 can up-regulate the gene and protein expression of CYP1 A1 possibly via the AhR-mediated CYP1 A1 path-way.

Fever ; Humans ; Plasma Cells ; pathology ; Thrombocytopenia ; diagnosis ; pathology