1.Expert Consensus on Clinical Application of Pingxuan Capsules
Yuer HU ; Yanming XIE ; Yaming LIN ; Yuanqi ZHAO ; Yihuai ZOU ; Mingquan LI ; Xiaoming SHEN ; Wei PENG ; Changkuan FU ; Yuanyuan LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):201-210
As a patented characteristic medicine of Yi ethnic minority, Pingxuan capsules have the effects of nourishing the liver and kidney, pacifying the liver, and subduing Yang. With the main indications of dizziness, headache, palpitations, tinnitus, insomnia, dreaminess, waist and knee soreness caused by liver-kidney deficiency and liver Yang upward disturbance, Pingxuan capsules are widely used in the treatment of posterior circulation ischemic vertigo, vestibular migraine, benign paroxysmal positional vertigo. However, the current knowledge is limited regarding the efficacy, syndrome differentiation, and safety of this medicine. On the basis of summarizing the experience of clinicians and the existing evidence, this study invites clinical experts of traditional Chinese and Western medicine, pharmaceutical experts, and methodological experts from relevant fields across China to conduct evidence-based evaluation of Pingxuan capsules. The evaluation follows the Specifications for the Development of Clinical Expert Consensus on Chinese Patent Medicines issued by the Standardization Office of the China Association of Chinese Medicine, and reaches 5 recommendations and 16 consensus suggestions. The consensus clarifies the clinical applications, efficacy, dose, course of treatment, combination of medicines, precautions, and contraindications of Pingxuan capsules in the treatment of vertigo and explains the safety of clinical application. This consensus is applicable to clinicians (traditional Chinese medicine, Western medicine, and integrated traditional Chinese and Western medicine) and pharmacists in tertiary hospitals, secondary hospitals, and community-level medical and health institutions across China, providing a reference for the rational use of Pingxuan capsules in the treatment of vertigo. It is hoped that the promotion of this consensus can facilitate the rational use of drugs in clinical practice, reduce the risk of drug use, and give full play to the advantages of Pingxuan capsules in the treatment of vertigo diseases. This consensus has been reviewed and published by the China Association of Chinese Medicine, with the number GS/CACM330-2023.
2.Research progress on the influencing factors of psychological distress in patients with coronary heart disease
Xiaotian DUAN ; Hongshi CAO ; Taiyu BI ; Haiyan WANG ; Songyu WANG ; Quantong ZHAO ; Ran WANG ; Chunjing WU
Sichuan Mental Health 2025;38(1):89-96
Coronary heart disease is a chronic and lifelong disease, which places a dual burden on the physiological and psychological well-being of patients, and can easily lead to psychological distress and affect their prognosis and quality of life. This article provides a systematic review, in which the current status, evaluation tools, influencing factors and intervention methods of psychological distress in patients with coronary heart disease are explored, aiming to provide key information beneficial for identifying and preventing psychological distress, and to improve the overall management and treatment effectiveness of coronary heart disease patients. In this paper, 18 articles were included, and the demographic, physiological, psychological and social factors affecting the psychological distress of patients with coronary heart disease were systematically analyzed, thus to provide a deeper understanding of psychological distress and offering references for formulating targeted intervention strategies.
3.Effect of gallic acid in increasing the chemosensitivity of hepatocellular carcinoma HepG2 cells to sorafenib
Baikun LIU ; Zhiru WANG ; Wenjing ZHAO
Journal of Clinical Hepatology 2025;41(2):292-299
ObjectiveTo investigate the chemosensitization effect of gallic acid (GA) combined with sorafenib (Sora) on hepatocellular carcinoma HepG2 cells and related mechanisms. MethodsHepG2 cells were randomly divided into control group, GA group, Sora group, and GA+Sora group. CCK8 assay was used to measure cell viability; CompuSyn software was used to analyze combination index (CI); colony formation assay was used to evaluate the colony formation ability of cells; flow cytometry was used to measure cell apoptosis; wound healing assay and Transwell chamber assay were used to observe the migration and invasion abilities of cells; Western Blot was used to measure the expression matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), and apoptosis-related proteins. HepG2 cells were subcutaneously inoculated into the lower right back of mice, and 6 days later, the mice were divided into control group, GA group, Sora group, and GA+Sora group. Tumor size and body weight were measured once a week, and drug intervention was performed for 21 days. Then the nude mice were sacrificed, and tumor weight was measured. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsThe mean IC50 values of GA and Sora for the treatment of HepG2 cells for 48 hours were 123.47±5.16 μmol/L and 9.87±0.98 μmol/L, respectively, and when Sora was combined with 70 μmol/L GA (IC30), IC50 decreased to 2.06±0.35 μmol/L; the CI value was<1 for Sora at different concentrations combined with 70 μmol/L GA. The number of cell colonies was 234.0±20.4, 147.0±12.1, 129.3±13.3, and 73.0±7.6, respectively, in the four groups, and the GA+Sora group had a significantly lower number of cell colonies than the control group, the GA group, and the Sora group (all P<0.05). After 48 hours of treatment, the cell apoptosis rate was 1.98%±0.29%, 15.17%± 1.56%, 18.65%±1.48%, and 34.60%±5.36%, respectively, in the four groups, and the GA+Sora group had a significantly higher cell apoptosis rate than the control group, the GA group, and the Sora group (all P<0.05). After 24 hours of treatment, the cell migration rate was 55.59%±5.08%, 29.34%±4.36%, 21.80%±5.16%, and 6.47%±2.75%, respectively, in the four groups, and the GA+Sora group had a significantly lower cell migration rate than the control group, the GA group, and the Sora group (all P<0.05). After 48 hours of treatment, the number of transmembrane cells was 223.7±13.0, 168.3±10.9, 155.3±29.1, and 62.7±19.7, respectively, in the four groups, and the GA+Sora group had a significantly lower number of transmembrane cells than the control group, the GA group, and the Sora group (all P<0.05). Compared with the control group, the GA group, the Sora group, and the GA+Sora group had significant reductions in the protein expression levels of MMP-2, MMP-9, and Bcl-2 (all P<0.05) and significant increases in the protein expression levels of Bax and cleaved caspase-3 (all P<0.05). Compared with the control group, the GA, Sora, and GA+Sora groups had significant reductions in tumor volume and weight (all P<0.05), and compared with the Sora group, the GA+Sora group had significant reductions in tumor volume and weight in nude mice (both P<0.05). ConclusionGA can increase the sensitivity of HepG2 cells to Sora chemotherapy, possibly by promoting cell apoptosis and inhibiting cell migration and invasion after combination with Sora.
4.Effect and mechanism of gallic acid on the proliferation, migration, invasion, and apoptosis of human hepatocellular carcinoma HepG2 cells
Zhiru WANG ; Wenjing ZHAO ; Xi CHEN
Journal of Clinical Hepatology 2025;41(3):493-498
ObjectiveTo investigate the effect of gallic acid (GA) on the proliferation, migration, invasion, and apoptosis of human hepatocellular carcinoma HepG2 cells and its mechanism. MethodsHepG2 cells were treated with different concentrations of GA (0, 5, 10, 20, 30, 40, and 50 μg/mL) for 24 and 48 hours, and CCK8 assay was used to measure cell viability and calculate IC50. The experiment was divided into control group (HepG2 cells), 5 μg/mL GA group, 10 μg/mL GA group, and 20 μg/mL GA group. Plate colony formation assay was used to evaluate the effect of GA on cell proliferation; wound healing assay and Transwell chamber assay were used to observe the effect of GA on cell migration and invasion; flow cytometry was used to observe the effect of GA on cell apoptosis; Western blot was used to measure the expression of matrix metallopeptidase-2 (MMP-2), matrix metallopeptidase-9 (MMP-9), and apoptosis-related proteins. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsThe mean IC50 value of GA on HepG2 cells was 38.02±2.58 μg/mL at 24 hours and 18.36±1.54 μg/mL at 48 hours. The number of cell colonies was 239.00±29.45 in the control group, 210.00±19.00 in the 5 μg/mL GA group, 144.33±16.03 in the 10 μg/mL GA group, and 57.00±9.55 in the 20 μg/mL GA group, suggesting that compared with the control group, each GA group had a significant reduction in cell colony formation ability (all P<0.05). After 24 hours of treatment, the cell migration rate was 42.62%± 7.82% in the control group, 35.34%±6.42% in the 5 μg/mL GA group, 21.85%±4.42% in the 10 μg/mL GA group, and 12.57%± 3.54% in the 20 μg/mL GA group, respectively, in these four groups, and the number of transmembrane cells in these four groups was 230.30±15.30, 182.12±12.60, 137.20±7.50, and 124.40±6.80, respectively, suggesting that compared with the control group, each GA group had significant reductions in migration rate and the number of transmembrane cells (all P<0.05). After 48 hours of treatment, the cell apoptotic rate was 0.67%±0.08% in the control group, 13.27%±1.07% in the 5 μg/mL GA group, 20.94%± 2.45% in the 10 μg/mL GA group, and 40.74%±2.63% in the 20 μg/mL GA group, and compared with the control group, each GA group had a significant increase in cell apoptosis rate (all P<0.05). Compared with the control group, each GA group had significant reductions in the protein expression levels of MMP-2 and MMP-9 (all P<0.05) and significant increases in the protein expression levels of Bax and cleaved caspase-3 (all P<0.05). ConclusionGA can inhibit the proliferation, migration, and invasion of HepG2 cells and promote the apoptosis of HepG2 cells, possibly by regulating MMP-2, MMP-9, and the apoptosis-related proteins Bax/Bcl-2.
5.Inner Ear Delivery of Polyamino Acid Nanohydrogels Loaded with Dexamethasone
Pingping AI ; Lidong ZHAO ; Zhaohui TANG ; Chaoliang HE ; Xuesi CHEN ; Shiming YANG ; Nan WU
Medical Journal of Peking Union Medical College Hospital 2025;16(2):370-378
To develop a novel polyamino acid-based nanohydrogel drug delivery system for dexamethasone to enhance its delivery efficiency to the inner ear. A fluorescein-labeled polyglutamic acid-based polyamino acid dexamethasone nanohydrogel was synthesized, and its gelation time was measured. The hydrogel was surgically injected into the round window niche of guinea pigs to determine its degradation time in the middle ear cavity in vivo. The safety, pharmacokinetics, and distribution patterns of dexamethasone in the inner ear were evaluated. The hydrogel exhibited a gelation time of 80 seconds in a 37℃ water bath. In vivo, the hydrogel was almost completely degraded within 7 days in the middle ear cavity of guinea pigs. Transient hearing loss was observed one day after administration, but hearing gradually returned to normal over time. No significant cytotoxicity, vestibular stimulation signs, or pathological abnormalities in spiral ganglion cells were observed. Histopathological examination revealed no significant inflammatory reactions. Pharmacokinetic analysis demonstrated sustained drug release and prolonged dexamethasone activity. Immunofluorescence staining confirmed the distribution of dexamethasone in both the cochlea and vestibular organs. The polyamino acid nanohydrogel exhibits excellent injectability and biodegradability, representing a safe and effective drug delivery system for the inner ear.
6.Correlation Between Quality of Life and Traditional Chinese Medicine Syndromes in Patients with Myasthenia Gravis
Yibin ZHANG ; Qi LU ; Baitong WANG ; Yixun QI ; Hanying XU ; Peng XU ; Meijin SONG ; Peixi ZHAO ; Zhiguo LYU ; Jian WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):275-281
ObjectiveThis study aimed to explore the correlation between the quality of life (QOL) and different traditional Chinese medicine (TCM) syndromes in patients with myasthenia gravis (MG), identifying potential influencing factors to provide new insights for clinical interventions and improving the QOL of patients with MG. MethodsA questionnaire survey was conducted on 93 adults with MG who visited the Department of Neurology at the Affiliated Hospital of Changchun University of Chinese Medicine from March 2023 to January 2024. Statistical analysis was performed on the clinical data collected using SPSS 24.0 software. ResultsAmong the 93 patients with MG, the average score for myasthenia gravis quality of life-15 (MGQOL-15) was 17.65±6.27, and that for the 36-item short form health survey (SF-36) was (106.13±11.83) scores. The QOL was rated as good for 16 patients and moderate for 77 patients. There were no statistically significant differences in the scores of MGQOL-15, SF-36, and their individual scales by gender or education level. Age showed statistically significant differences in MGQOL-15 and the role physical (RP) scale (P<0.05), and occupational type showed significant differences in the vitality (VT) scale (P<0.01). The Myasthenia Gravis Foundation of America (MGFA) classification had statistical significance on the total SF-36 score (P<0.01), VT scale (P<0.01), role emotional (RE) scale (P<0.05), social functioning (SF) scale (P<0.05), and physical functioning (PF) scale (P<0.01). Among patients with different TCM syndromes, there were significant differences in MGQOL-15 scores (F=4.919, P<0.01). Moreover, significant differences were observed in SF-36 scores (P<0.01), VT scale (P<0.01), RE scale (P<0.05), mental health (MH) scale (P<0.01), and SF scale (P<0.05). ConclusionFactors affecting the QOL of patients with MG include age, occupational type, and clinical classification of MG. Specifically, a greater impact on the QOL of older patients is observed, while physical laborers have a poorer QOL compared to non-physical laborers. Patients classified as MGFA type Ⅱ and higher have a poorer QOL. Additionally, there is a potential correlation between the QOL and TCM syndromes, with patients presenting with spleen and kidney Qi deficiency having a lower QOL than those with spleen and stomach Qi deficiency or Qi and Yin deficiency, which is particularly evident in the VT, RE, MH, and SF scales.
7.Connotation and Application of the Theory of "Gout is Not Bi (痹) Syndrome"
Huifang GUAN ; Linhua ZHAO ; Jiaxing TIAN
Journal of Traditional Chinese Medicine 2025;66(10):987-991
Gout in modern medicine is often attributed to "Li Jie Disease (历节病)", "Bai Hu Wind" (白虎风), and "Bi (痹) Syndrome" categories in traditional Chinese medicine, mainly because its joint pain often presents as wandering attacks, and the clinical symptoms are similar to those caused by wind. However, the essence of gout is actually dietary disorders caused by internal injuries, so it should not be classified as Bi (痹) syndrome due to wind, cold, dampness. Focusing on the theory of "gout is not Bi syndrome" proposed by TONG Xiaolin, combining ancient and modern medical literature and modern clinical research, this article analyzes the underlying etiology of gout, which originates from dietary irregularities and accumulation of turbid toxins, as well as the disease mechanism of "toxicity hurts joints and accumulation of toxins impairs the kidneys", in order to clarify the essential difference between gout and impediment syndrome. Using the theory of "state-targeted diagnosis and treatment", gout is classified into two categories: dampness-heat and deficiency-cold, and the treatment strategy of lowering the turbid toxin, facilitating the joints, and preserving the kidneys was proposed in order to guide the clinical practice.
8.Professor TONG Xiaolin's Experience in Treating Prediabetes with Overweight and Obesity Using the Method of Relieving Depression and Reducing Turbidity
Sicheng WANG ; Yangyang LIU ; Yan YAN ; Zishan JIN ; Boxun ZHANG ; Qingwei LI ; Xiaoxuan XU ; Linhua ZHAO ;
Journal of Traditional Chinese Medicine 2025;66(14):1424-1427
To summarise the clinical experience of Professor TONG Xiaolin in treating prediabetes combined with overweight or obesity using the method of relieving depression and reducing turbidity. It is believed that prediabetes belongs to the category of "spleen-heat syndrome" in traditional Chinese medicine, and its core pathogenesis is center fullness with internal heat, while obesity is the initiating factor for exacerbating center fullness and internal heat, therefore, it is of great significance to reduce the risk of diabetes by interrupting the transformation between overweight, obesity and glucose metabolism abnormality. It is proposed that the main pathogenesis of prediabetes combined with overweight or obesity is qi depression and turbidity obstruction in middle jiao, with qi depression as the root and turbidity obstruction as the cause, forming a treatment idea with the method of relieving depression and reducing turbidity as the core. In clinic, Dahuang Huanglian Xiexin Decoction (大黄黄连泻心汤) is used as the basic prescription, with a primary focus on directing the turbid downward, supplemented by regulating qi, which embodies the concept of "promoting movement through descent, then figuring out the root of spleen-heat syndrome. Furthermore, the treatment is flexibly modified based on the patient's deficiency-excess syndrome to ensure individualized therapy.
9.Effect of cerebral white matter lesion on the symptoms of Parkinson disease
Journal of Apoplexy and Nervous Diseases 2025;42(2):137-142
Parkinson’s disease (PD) is a common neurodegenerative disease with a high incidence rate in the elderly population, and its complex pathogenesis involves α-synuclein misfolding and aggregation, mitochondrial dysfunction, neuroinflammation, and oxidative stress, resulting in different impairments of motor and non-motor symptoms and a bad influence on the quality of life of patients. White matter lesion (WML) is a neurodegenerative disease caused by damage to myelin sheath tissue in the central nervous system of the brain, with the pathogenesis of endothelial damage, hypoperfusion of brain white matter, and impairment of blood-brain barrier. WML causes varying degrees of impairment in postural instability, gait disturbance, and motor retardation in PD patients and exerts a certain degree of negative effects on cognitive function and sleep, anxiety, depression, and autonomic nervous function in PD patients. This article reviews the pathogenesis of PD and WML and the damage or influence of WML on the motor and non-motor symptoms of PD, in order to elaborate on the association between WML and PD.
Parkinson Disease
10.Quality Evaluation of Black Panacis Quinquefolii Radix Based on Neuroprotective Spectrum-effect Relationship
Yuting YANG ; Shuyun LIANG ; Shanshan LI ; Yulong YANG ; Ziqi YANG ; Guangzhi CAI ; Liru ZHAO ; Jiyu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):149-156
ObjectiveTo clarify the neuroprotective effect of black Panacis Quinquefolii Radix(PQR) and explore its active ingredients, with the aim of establishing an activity-oriented quality evaluation method. MethodsTransgenic Tg(HuC∶EGFP) zebrafish was used to establish a neuronal injury model by aluminum chloride immersion. Different doses(10, 20 mg·L-1) of PQR and black PQR ethanol extracts were administered. The neuroprotective effects of PQR and black PQR were compared by analyzing the fluorescent area and intensity of zebrafish neurons. Based on ultra-performance liquid chromatography(UPLC), a fingerprint profile of black PQR was established, followed by principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA). Differential components were screened using the criteria of variable importance in the projection(VIP) value>1 and P<0.05. The neuroprotective activity of 14 batches of black PQR was assessed, and Spearman correlation analysis was used to identify saponins related to neuroprotective activity, which were then validated. Based on the above results, active marker components were determined, and an UPLC method was established for their quantitation with clear content limits. ResultsPharmacological efficacy results showed that both PQR and black PQR at different doses could significantly improved neuronal damage in zebrafish. At a dose of 20 mg·L-1, black PQR demonstrated superior efficacy(P<0.05). The fingerprint similarities of 14 batches of black PQR were>0.94, with 26 common peaks identified. Through comparison with the reference standards, 8 components were confirmed, including peak 1(ginsenoside Rg1), peak 2(ginsenoside Re), peak 5(ginsenoside Rb1), peak 9(ginsenoside Rd), peak 16[ginsenoside 20(S)-Rg3], peak 17[ginsenoside 20(R)-Rg3], peak 18(ginsenoside Rk1), and peak 19(ginsenoside Rg5). The results of PCA and OPLS-DA indicated that there were differences in saponins among black PQR samples from different origins, and 12 differential components were screened. All 14 batches of black PQR exhibited good protective effects on zebrafish neurons, with Shaanxi-produced black PQR showing superior protective effects compared to the other three production regions. Spearman correlation analysis revealed that a total of 11 components, including ginsenosides 20(S)-Rg3, 20(R)-Rg3, Rk1 and Rg5, showed a significant positive correlation with the neuroprotective effect in zebrafish(P<0.05). The activity validation results indicated that ginsenosides 20(S)-Rg3, 20(R)-Rg3, Rk1 and Rg5 were the primary components responsible for the neuroprotective effects of black PQR. Quantitative analysis showed that the content of ginsenoside 20(S)-Rg3 in 14 batches of black PQR ranged from 0.17% to 0.52%, and the repair rate of neuronal damage ranged from 42.77% to 97.83%. ConclusionBased on the fingerprint and neuronal protective activity, the spectrum-effect related quality control model of black PQR was established, with ginsenoside 20(S)-Rg3 as the quality control index, and the neuronal damage repair rate≥60% as the evaluation standard, the minimum limit of ginsenoside 20(S)-Rg3 in black PQR should be≥0.20%.

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