Background Plateau environment may pose a serious impact on the physiological and psychological stress of people stationed on a plateau, especially for those engaged in military training and occupational activities. There is an urgent need to find drugs to prevent and treat injuries caused by high-altitude environment. Objective To analyze the current status, hotspots, and future trends of domestic and international research in the field of prevention and treatment of high-altitude disease (HAD) by traditional Chinese medicine (TCM), and provide references for scientific research. Methods Web of Science Core Collection (WOSCC) and China National Knowledge Infrastructure (CNKI) were searched for literature on TCM and HAD published from inception to 2022. Excel, CiteSpace, VOSviewer, and RStudio softwares were used to conduct visual analysis on the number of publications, types of publications, journals, authors, research institutions, and keywords. Results A total of 501 publications were evaluated in the present study, including 443 Chinese publications and 58 English publications. The annual number of publications showed a rising trend. MA Huiping was the leading author in number of publications in Chinese (37 publications), and ZHANG Yi and MENG Xianli were the leading authors in the number of publications in English (both 8 publications), respectively. The institutions with the most publications in Chinese were The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army and Lanzhou General Hospital of Lanzhou Military Region (both 32 publications), and the institution with the most publications in English was Chengdu University of Traditional Chinese Medicine (8 publications), respectively. The Chinese and English journals with the largest number of publications were the Journal of High Altitude Medicine (39 publications) and the Journal of Ethnopharmacology (10 publications), respectively. The most highly cited Chinese and English literature included Effects of rhodiola on the free radical metabolism and serum creatine kinase after exercise at plateau (61 citations) and Anti-hypoxic activity at simulated high altitude was isolated in petroleum ether extract of Saussurea involucrate (68 citations) , respectively. The most frequent keywords in the Chinese and English literature were high altitude polycythemia and oxidative stress, respectively. The keyword time zone and emergence maps showed that the research hotspots in this field shifted from prevention and treatment of HAD to animal experiments, and then to mechanisms of action, in which oxidative stress, hypoxic injury, inflammation, and apoptosis were the main focuses. Conclusion The research of TCM against HAD is identified from early clinical observation to associations between clinical outcome variation and pharmacological mechanisms, and further to applying multi-omics techniques to explore the physical basis of TCM efficacy and mechanisms of action with focuses like TCM formula and single herb active ingredients, so as to elaborate potential scientific connotation of TCM against HAD.

OBJECTIVES: To explore the effects of hypoxic and hypobaric conditions on blood gas and erythrocyte-related indicators in rats. METHODS: SD male rats were exposed to low-pressure hypoxic conditions simulating an altitude of 6500 m in a small or a large experimental cabin. Abdominal aortic blood samples were collected and blood gas indicators, red blood cells (RBCs) count, and hemoglobin (Hb) content were measured. The effects of exposure to different hypoxia times, different hypoxia modes, normal oxygen recovery after hypoxia, and re-hypoxia after hypoxia preconditioning on blood gas indicators, RBCs count and Hb content were investigated. RESULTS: The effect of blood gas indicators was correlated with the length of exposure time of hypoxia and the reoxygenation after leaving the cabin. Hypoxia caused acid-base imbalance and its severity was associated with the duration of hypoxia; hypoxia also led to an increase in RBCs count and Hb content, and the increase was also related to the time exposed to hypoxia. The effects of reoxygenation on acid-base imbalance in rats caged in a small animal cabin were more severe that those in a large experimental cabin. Acetazolamide alleviated the effects of reoxygenation after leaving the cabin. Different hypoxia modes and administration of acetazolamide had little effect on RBCs count and Hb content. Normal oxygen recovery can alleviate the reoxygenation and acid-base imbalance of hypoxic rats after leaving the cabin and improve the increase in red blood cell and hemoglobin content caused by hypoxia. The improvement of hypoxia preconditioning on post hypoxia reoxygenation is not significant, but it can alleviate the acid-base imbalance caused by hypoxia in rats and to some extent improve the increase in red blood cell and hemoglobin content caused by hypoxia. CONCLUSIONS Due to excessive ventilation and elevated RBCs count and Hb content after hypoxia reoxygenation, oxygen partial pressure and other oxygenation indicators in hypoxic rats are prone to become abnormal, while blood gas acid-base balance indicators are relatively stable, which are more suitable for evaluating the degree of hypoxia injury and related pharmacological effects in rats.
Rats ; Animals ; Male ; Acetazolamide ; Hypoxia ; Oxygen ; Erythrocytes ; Hemoglobins ; Acid-Base Imbalance

Objective:The development of traditional Chinese medicine(TCM)in the plateau area is relatively backward.There is a lack of system to analyze the effects of the special environment of plateau low pressure and hypoxia on human meridians qi and blood,as well as the etiology and pathogenesis of plateau hypoxic diseases.To analyze the composition rules of anti-hypoxia TCM formulation with data mining methods. Methods:The experimental literatures related to high altitude hypoxia were searched in China National Knowledge Infrastructure(CNKI),Wanfang Med Online,VIP,China Biology Medicine disc and other databases,a standardized prescription database was established after screening and standardization of prescription data in the literature.The composition rules of these prescription including drug frequency,drug attributes,drug efficacy,drug combination,and core prescription were analyzed and displayed with visual charts. Results:A total of 135 TCM prescriptions were included,and 229 flavored drugs were included.Among these prescriptions,the TCM with high frequency of use were Astragalus,Danshen,Ginseng,and Angelica,etc.Four natures of the TCM were mostly warm and calm.Five flavours of the TCM were mostly sweet,bitter,and pungent.And channel tropism of the TCM mostly entered the heart,lung,and liver meridians.The frequency combination of TCM was Astragalus-Danshen and Astragalus-Angelica.The core medicines of these prescriptions were Astragalus,Danshen,Angelica,Rhodiola,Goji,and Ginseng.TCM could alleviate symptoms such as chest tightness,chest pain,coughing and wheezing,coughing,vomiting,fatigue,and loss of appetite caused by hypoxia at high altitude. Conclusion:Through data mining,it is concluded that the prevention or treatment of plateau hypoxic diseases mostly utilized products can nourish blood,replenish qi and dispel stasis,and help yang and dispel qi,most of them are compatible with qi tonic drugs and blood circulation and stasis dissolving drugs,and pay attention to the combination of virtual and real,yin and yang.

The plateau is a special environment with low pressure,low oxygen,low temperature,and high ultraviolet radiation.The exercise performance of people on the plateau is generally reduced,which seriously affects the life and health of people living in the plateau and entering the plateau.In recent years,the prevention and treatment of injury caused by high altitude hypoxia has attracted wide attention.It has shown that the higher the altitude with the longer the duration of exercise,the faster the stationing,the greater the impact on people's sports performance.Rapid entry into the plateau and long-term stay in the plateau have an impact on people's explosive power,endurance and fine operation.Advances in medical technology enable various prevention methods to be used to acclimate to high altitude environments.However,in vitro intervention methods are costly,easy to rebound and possess limited effects.Therefore,drug prevention and treatment is obviously a more economical choice.Chemical drugs increase the efficiency of high altitude exercise by improving the ischemic and hypoxic symptoms of the heart and brain,increasing lung ventilation and arterial oxygenation capacity,and accelerating the elimination of adverse product accumulation after exercise.Single Chinese medicine,Chinese patent medicine,and compound preparations can improve exercise performance by promoting body metabolism,improving muscle endurance,enhancing immunity,and other mechanisms.Traditional Chinese medicine has unique advantage and application prospect in improving plateau sports performance damage.

OBJECTIVE To summarize the strategies and potential drugs that can improve the oxygen affinity of red blood cells in the hypobaric and hypoxic environment in the current research. METHODS The retrieved literatures were screened, extracted and summarized by referring to the literature on the relationship between hypobaric hypoxic environment and erythrocyte oxygen affinity in CNKI database, Web of Science database and Pubmed database. RESULTS Under the hypobaric and hypoxic environment, the body’s oxygen uptake capacity and oxygen utilization efficiency decreased, resulting in the body being in a state of hypoxia. Improving the oxygen affinity of red blood cells could help the body adapt to and get used to the hypobaric and hypoxic environment, and many improvement methods had been applied in other diseases. CONCLUSION Improving the oxygen utilization rate of red blood cells by increasing the oxygen affinity of erythrocytes under hypobaric and hypoxia environment is the starting point and focus of the current research on preventing the damage of high altitude hypobaric and hypoxic environment to the human body.

Objective To analyze the drug-drug interaction (DDI) between intravenous voriconazole (VRZ) and intravenous cyclosporine (CsA) in patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and provide an individualized and accurate clinical drug delivery. Methods In a self-contrast study, Allo-HSCT patients from January 2019 to December 2019 were enrolled according to the inclusion and exclusion criteria. These patients were treated with CsA and VRZ successively and the blood concentration of CsA and VRZ before and after 5-7 days of VRZ administration were determined with LC-MS/MS. The correlation between the concentration of VRZ and concentration/dose (C/D) ratio of CsA was analyzed with SPSS20.0. Results A total of 15 patients with ALLo-HSCT were enrolled. Wilcoxon sign rank sum test was used to compare the change of median C/D of CsA before and after VRZ administration, which had shown significant difference (P<0.001). Spearman correlation analysis was conducted on the increase of C/D ratio between VRZ and CsA, which had no significant correlation between them (ρ=−0.273, P=0.32). Conclusions There was obvious drug-drug interaction (DDI) between CsA and VRZ. VRZ increased CsA blood concentration significantly, but there was no significant correlation between VRZ blood concentration and the degree of concentration increase, which might be related to individual difference.

Fever is a sign of infection and inflammatory diseases in the body. Persistent high fever will lead to cell degeneration, causing multiple organ dysfunction, and seriously affecting brain nerve and tissue function. Although the fever process is common and ordinary, its pathological mechanism involves multiple signaling pathways, such as nuclear transcription factor κB signaling pathway, Toll-like receptor 4 signaling pathway. A large number of studies have shown that traditional Chinese medicine compound and its active components can reduce serum inflammatory factors (TNF-α, IL-1β and IL-6) and hypothalamic thermoregulatory mediators (PGE

Objective To investigate the effects and mechanism of verbascoside on hypoxia-induced memory impairment.Methods The eight-arm maze was used to train mice′s spatial memory ability.After successful training, mice were randomly divided into five groups:a normoxic control group (distilled water, 0.1ml/10g), hypoxic model group (distilled water, 0.1ml/10g), the verbascoside low dose group (50 mg/kg), medium dose group (150 mg/kg), and high dose group (300mg/kg) were administered orally once a day for a total of 7days.After administration on the fourth day, except for the normoxic control group was placed in the animal room (1 500m), the remaining four groups were placed in a large-scale hypobaric chamber to simulate the hypoxic environment of the plateau (7 500m, 3days).Eight-armed maze test (4 000m) was used and the plasma and brain tissues were dissected out and measured for reactive oxygen species (ROS) in the brain, malondialdehyde (MDA), reduced glutathione (GSH) and total superoxide dismutase (T-SOD) activity in plasma and brain.Results Compared with the normoxic control group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma of the hypoxia model group were significantly increased, and the GSH and T-SOD enzyme activities in the brain and plasma were notably decreased.Compared with the hypoxic model group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma in the various groups of verbascoside were reduced more or less, the GSH and T-SOD enzyme activities in the brain and plasma slightly were increased.Conclusion Verbascoside could ameliorate the hypoxic memory impairment at high altitude, which might be related to the stabilization of the body′s antioxidant enzyme system balance and

OBJECTIVE:To optimize the extraction technology of Tibetan medicine Pedicularis kansuensis and compare con-tent of verbascoside and isoverbascoside differences in P. kansuensis from various habitats. METHODS:Using verbascoside and iso-verbascoside and dry paste yield as comprehensive evaluation indexes,single factor test and orthogonal test were used to investigate the extraction solvent,solvent dosage,extraction time and times to optimize extraction technology,and the verification test was conducted. Contents of the 2 constituents verbascoside and isoverbascoside in P. kansuensis from Gansu,Qinghai and Sichuan were compared. RESULTS:The optimal extraction technology was as follows as 8-fold 50% ethanol,extraction for 3 times,90 min each time. The verification results showed that the average contents of verbascoside and isoverbascoside were 3.49%(RSD=1.28%,n=3),1.26%(RSD=1.32%,n=3),and average dry paste yields were 37.99%(RSD=1.97%,n=3). The contents of verbascoside and isoverbascoside in P. kansuensis from Qinghai were relatively higher. CONCLUSIONS:Optimized extraction tech-nology is reasonable,stable,feasible;the contents of index constituents in P. kansuensis from different habitats have certain differ-ences. The study can provide scientific evidence for the development and utilization of extraction,and the in-depth study of quality evaluation for medicinal material.

Objective To develop an HPLC method to determine the contents of chrysophanol, emodin, physcion, aloe-emodin, sennoside A, and sennoside B simultaneously in the aerial part of Rheum tanguticum Maxim.ex Balf. Methods The analysis was achieved with an Agilent ZORBAX SB-C18 analytic column (250 mm × 4.6 mm, 5 μm) by gradient elution of methanol-0.1％ phosphoric acid in water gradient elution system (0 min, 70％ B; 5 min, 65％ B;8–16 min, 60％ B; 18–23 min, 55％ B; 25–30 min, 45％ B; 32–39 min, 35％ B; 49–57 min, 24％ B; 65–72 min, 20％ B). The flow rate was 1.0 mL/min; detection wavelength was 254 nm; the column temperature was room temperature; the quantification used external standard method. Results The peak areas and concentrations of chrysophanol, emodin, physcion, aloe-emodin, sennoside A, and sennoside B showed good linear relationship within a certain concentration range (r≥0.9995); the RSD of precision was 0.75％–1.17％; the RSD of repeatability was 0.99％–2.06％; the RSD of stability was 0.97％–1.76％; the average recoveries were 99.7％–100.4％. The results showed that there were differences in content between the root and aerial part of Rheum tanguticum Maxim.ex Balf. Conclusion HPLC method for simultaneous determination of contents of 6 contents of the aerial part of Rheum tanguticum Maxim.ex Balf can be used as the references for quality control.