1.Application of Anti-tumor Compatibility Structure of Chinese Medicine
Lanpin CHEN ; Feng TAN ; Xiaoman WEI ; Junyi WANG ; Liu LI ; Mianhua WU ; Haibo CHENG ; Dongdong SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):198-208
Malignant tumors are one of the major diseases that endanger human life and health. Chinese medicine has unique advantages in clinical anti-tumor treatment. However, how to translate the anti-tumor effects of Chinese medicine into clinical practice is the core issue that must be addressed in the process of treating malignant tumors with traditional Chinese medicine (TCM). Unlike modern chemical drugs, the compatibility application of Chinese medicine is the key factor that determines whether Chinese medicine can achieve optimal anti-tumor efficacy and realize the goal of "enhancing efficacy and reducing toxicity". The formulation structure based on this compatibility is the basic form for the safe, efficient, and rational clinical use of anti-tumor Chinese medicine, and it mainly includes three categories: herb pairs, tri-herbal combinations, and compound compatibility. Although herb pairs have the characteristics of a simple structure and strong targeting (enhancing efficacy and reducing toxicity), they often have a single effect and cannot fully address the complex pathogenesis of tumors. As a result, herb pairs are rarely used alone in practice. Compared to herb pairs, tri-herbal combinations broaden the application scope of herbs in clinical treatment, but their therapeutic range remains limited. The traditional "sovereign, minister, assistant, and guide" compound prescription, which includes herb pairs and tri-herbal combinations, improves the efficacy of herbs in treating serious diseases, hypochondriasis, chronic diseases, and miscellaneous disorders. However, due to the limitations of its historical background, it has not been integrated with modern clinical practice and modern pharmacological research, which restricts the development of compound compatibility theory. With the emergence of modern medical technology, it has been combined with traditional compatibility theory of Chinese medicine to create an innovative modern compatibility theory. This includes the "aid medicine" theory derived from modern Chinese medicine pharmacology, which compensates for the inability of the "sovereign, minister, assistant, and guide" theory to accurately apply medicine. Additionally, the "state-targeted treatment based on syndrome differentiation" theory, developed from pharmacology and modern medicine, addresses the deficiency in disease cognition in the "sovereign, minister, assistant, and guide" theory. Under the guidance of these compatibility forms and theories, clinical anti-tumor Chinese medicine can exert its maximum anti-tumor efficacy, which is of great significance for the application of Chinese medicine in clinical tumor treatment.
2.Mechanism of Tumor T Cell Exhaustion from Perspective of ''Sanjiao-Yingwei'' Qi Transformation Malfunction
Xinhao TANG ; Bowen CHU ; Yuanyuan QIN ; Yeling LIU ; Xinyan SHU ; Mianhua WU ; Gang YIN ; Jianguo DAI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):176-185
In order to promote the innovative application of Sanjiao theory and Yingwei theory, this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases, integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body, and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi, and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion, which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis, which contributes to T cell exhaustion and is correlated with nutrient deprivation, lipid accumulation, and high lactate levels in the immunosuppressed tumor microenvironment, as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction, Shengming decoction, and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation, and hypoxia inducible factor-1α (HIF-1α) may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.
3.Effect of Qinghua Yichang Formula (清化益肠方) on NLRP3 Inflammasome in Intestinal Tissue of Mice with Acute Radiation-Induced Intestinal Injury
Yuanyuan QIN ; Lingyan ZHU ; Li LI ; Bowen CHU ; Zequn JIANG ; Mianhua WU
Journal of Traditional Chinese Medicine 2024;65(16):1695-1702
ObjectiveTo explore the effect and possible molecular mechanism of Qinghua Yichang Formula (清化益肠方, QYF) in treating acute radiation-induced intestinal injury mice via NOD-like receptor thermal protein domain associated protein 3 (NLRP3). MethodsSixty C57BL/6J mice were randomly divided into control group, model group, pre-modeling medication group, post-modeling medication group, inhibitor group, and QYF plus inhibitor group, with 10 mice in each group.Except for the control group, the other five groups were irradiated with a single full dose to establish the acute radiation-induced intestinal injury mice model. The pre-modeling medication group and the QYF plus inhibitor group were continuously given 4 g/ml of QYF decoction by gavage before modeling, 0.2 ml each time, once a day for 7 days. The post-modeling medication group, pre-modeling medication group and QYF plus inhibitor group were given 4 g/ml of QYF decoction for 14 days after modeling. The control group, model group and inhibitor group were given 0.2 ml of normal saline once a day for 14 consecutive days. Two hours after irradiation, the inhibitor group and the QYF plus inhibitor group were given an intraperitoneal injection of 0.2 ml of the NLRP3 inhibitor MCC950 (concentration: 10 mg/kg), once every two days. To observe the pathological changes in intestinal tissues, hematoxylin-eosin (HE) staining was used. Western blotting and RT-qPCR were used to detect the protein and mRNA expression levels of NLRP3 in intestinal tissues. Immunohistochemistry was used to detect the expression level of NLRP3, Caspase-1 and GSDMD in intestinal tissues. The proportion of CD4+ and CD8+ T cells in the spleens of mice were detected by flow cytometry. ELISA was used to determine the levels of IFN-γ, IL-18, and IL-1β in mice serum. ResultsHE staining showed no lesions in the intestinal tissue of mice in the control group. The mice in the model group had shortened intestinal villi, thinned mucosal layers, multifocal mucosal necrosis in the lamina propria, and local neutrophil infiltration. The pathological damage of intestinal tissue of mice in each medication group was improved to varied degrees, among which the QYF plus inhibitor group showed most obvious improvement. Compared to those in the control group, the protein and mRNA expression levels of NLRP3 in the intestinal tissue of mice in the model group significantly increased, with higher NLRP3, Caspase-1, and GSDMD protein expression in the intestinal tissue, increased proportion of CD4+ T cells in spleen, decreased proportion of CD8+ T cells, and increased levels of IFN-γ, IL-18 and IL-1β in serum (P<0.05). Compared to those in the model group, the above indicators in the other medication groups were all improved (P<0.05).The NLRP3, Caspase-1, and GSDMD proteins in the pre-modeling medication group were lower than those in the post-modeling medication group (P<0.05); and the NLRP3 mRNA level in the QYF plus inhibitor group was lower than that in the inhibitor group (P<0.05). ConclusionQYF may play a role in preventing and treating acute radiation-induced intestinal injury by inhibiting the expression of NLRP3.
4.Exploration of Integrated Traditional Chinese and Western Medicine Treatment Mode for Malignant Tumors
Junyi WANG ; Liu LI ; Weixing SHEN ; Mianhua WU ; Zhongying ZHOU ; Haibo CHENG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(3):217-222
Malignant tumors are major diseases that seriously threaten human health.Although the integration of traditional Chinese and Western medicine has become an expert consensus on treatment of malignant tumors in China,a mature treatment mode of integrat-ed traditional Chinese and Western medicine has not yet been formed.This paper explores the construction of integrated traditional Chi-nese and Western medicine treatment mode for malignant tumors,namely synergistic therapy,palliative therapy,and preventive thera-py,covering different stages of malignant tumors,in order to give full play to the advantages and characteristics of integrated traditional Chinese and Western medicine treatment in the treatment of malignant tumors.
5.Construction of Detoxication Method of Warming and Nourishing under the Guidance of Compound Pathogenesis Theory of Malignant Tumor
Weichen YUAN ; Hongguang ZHOU ; Yupei ZHUANG ; Hongli ZHOU ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(6):543-549
Based on the compound pathogenesis theory of malignant tumor,this article combines the theories of positive-evil,yin-yang,and central qi theories with the theory of cancer toxin,pointing out that the deficiency of positive and excess of evil are the basis for the onset of tumors.The pathogenesis characteristics of tumors are the loss of both yin and yang,stagnation of qi,and cancer toxin deeply lurking.The paper believes that the loss of both yin and yang often originates from the spleen and kidney,stagnation of qi is first blamed on the spleen and stomach,and cancer toxin deeply lurking often accompanies multiple evil qi.Based on this,the detoxi-cation method of warming and nourishing is proposed to treat malignant tumors.It is the combination or sequential application of the three methods of warming,nourishing,and detoxification,which play the role of warming and nourishing together,harmonizing yin and yang;promoting the circulation of qi,relieving depression,and regulating emotions;eliminating cancer and toxin,and breaking the combined evil.
6.Summary of the Academic Thought of TCM Master Zhou Zhongying on Integrating the Ancient and Modern to Create a New System of Pathogenesis Theory
Fang YE ; Mianhua WU ; Xueping ZHOU ; Haibo CHENG ; Liu LI ; Zhe FENG ; Lu JIN ; Yao ZHU ; Lizhong GUO ; Zhiqiang ZHAO ; Zhiying WANG ; Miaowen JIN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(10):1071-1079
This paper summarizes the exploration process and academic significance of the academic thought of Zhou Zhongying,a master of traditional Chinese medicine,who took the creation of a new system of TCM pathogenesis theory as the core,and interprets its theoretical connotation.As a pioneer in the construction of higher education textbooks for traditional Chinese medicine,Professor Zhou Zhongying created the outline of TCM internal medicine viscera differentiation,persisted in carrying out innovative research on patho-genesis theory,achieved fruitful academic results,and enriched and developed the academic system of TCM theory.In the clinical di-agnosis and treatment of exogenous febrile diseases and acute and difficult internal injuries,he systematically created new pathogenesis theories such as stasis-heat theory and cancer toxicity theory.Based on this,the legislation of medication can improve the clinical effi-cacy,and it is realized that identifying the pathogenesis is the key link in syndrome differentiation and treatment.In his later years,Professor Zhou Zhongying,guided by the holistic view,proposed the"thirteen pathogenesis"and constructed a new system of TCM pathogenesis differentiation,highlighting the guiding value of complex pathogenesis and the causal chain of pathogenesis elements to complex clinical diseases and syndromes,forming a theory with the idea of"examining syndromes and seeking pathogenesis,activating syndrome differentiation"as its soul.This theory breaks through the rigid thinking of syndrome differentiation and treatment based on a single pathogenesis or fixed syndrome type,reconstructs the theoretical framework of TCM with the idea of holistic view,and is a major academic innovation in modern TCM.
7.Discussion on the Idea of Differentiation and Treatment of Precancerous Lesions of Gastric Cancer Based on Cancer Toxin Theory
Bingyin YU ; Wenting LI ; Mianhua WU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(10):1109-1113
Precancerous lesions of gastric cancer are a category of chronic diseases of the stomach with a clear risk of becoming cancerous.Early intervention of precancerous lesions of gastric cancer is an essential way of secondary prevention of gastric cancer.Based on the functional characteristics of the spleen and stomach and the theory of cancer toxin,Professor Wu Mianhua be-lieves that emotional distress is the triggering cause of precancerous lesions of gastric cancer;weakness of the spleen and stomach is the basic pathogenesis;phlegm and stagnation is the key pathogenesis;and accumulation of cancer toxin is the pathological feature.Syn-drome differentiation should focus on identifying the location,pathological factors,and the nature of the disease;treatment should pri-oritize soothing the liver and gallbladder and be based on regulating and harmonizing the spleen and stomach,with resolving phlegm and blood stasis as the core and anti-cancer and detoxification throughout the entire process;attention should be paid to the transformation of the pathogenesis;prescriptions and medications should be based on the main principles of regulating qi without damaging yin,nour-ishing yin without hindering the spleen,removing blood stasis without damaging the healthy qi,and replenishing without aiding evil,so as to give full play to the advantages and characteristics of traditional Chinese medicine and provide ideas and references for the clinical diagnosis and treatment of gastric precancerous lesions.
8.Clinical Study on Prevention and Treatment of Acute Radiation-Induced Oral Mucositis in Patients with Head and Neck Tumor Using Yangyin Jiedu Decoction
Wanxia WANG ; Dahai YU ; Mianhua WU ; Yijun WANG ; Xinyu BIAN ; Jie LIU ; Teng HUANG ; Lejun CHEN ; Hong LU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(11):1250-1255
OBJECTIVE To observe the clinical efficacy of Yangyin Jiedu Decoction in the prevention and treatment of acute ra-diation-induced oral mucositis(RTOM).METHODS A total of 80 inpatients who were diagnosed with head and neck tumors by pathological examination and received radiotherapy in the Department of Radiotherapy,Affiliated Hospital of Nanjing University of Chi-nese Medicine from November 2021 to September 2023 were selected and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given mouthwash treatment from the onset of RTOM symptoms until the symp-toms disappeared;the observation group was given Yangyin Jiedu Decoction from the first day of radiotherapy on the basis of the treat-ment of the control group until the end of radiotherapy.During the treatment,the onset time,duration and incidence of grade Ⅱ-ⅣRTOM in the two groups were observed;the pain numerical rating scale(NRS)score,Karnofsky performance status(KPS)score,body mass index(BMI)changes were evaluated;and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor α(TNF-α)]were detected.RESULTS After radiotherapy,RTOM ap-peared in both groups to varying degrees.The incidence of grade Ⅱ-Ⅳ RTOM,the onset time,duration and NRS score of RTOM in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After radiotherapy,the levels of se-rum CRP,IL-6,IL-1β and TNF-α in the observation group were lower than those in the control group(P<0.05,P<0.01).After radiotherapy and 1 month of follow-up,the KPS score and BMI in the observation group were higher than those in the control group(P<0.05,P<0.01).CONCLUSION Yangyin Jiedu Decoction can decrease the incidence and severity of RTOM in patients with head and neck tumors,shorten its duration,improve the quality of life of patients,downregulate the level of inflammatory cytokines,and has a preventive effect on RTOM caused by radiotherapy in patients with head and neck tumors.
9.Role of Cytokines and Related Signaling Pathways in Intervention of Chinese Medicine in Radiation-induced Lung Injury: A Review
Jiayi SHAO ; Mianhua WU ; Yanxia MA ; Zequn JIANG ; Hongyi XU ; Muhan LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(22):244-253
Radiation-induced lung injury (RILI), one of the common complications caused by radiotherapy, encompasses two phases: an early phase known as radiation pneumonitis (RP) and a late phase called radiation fibrosis (RF), threatening the life and life quality of patients, with poor prognosis. Accumulating evidence has shown that the occurrence of RILI is related to a variety of cytokines and signaling pathways. This paper summarized the research on the effects of Chinese medicine on RILI from the perspective of cytokines and signaling pathways. Cytokines include transforming growth factor-β1 (TGF-β1), interleukins (ILs), tumor necrosis factor-α (TNF-α), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and high mobility group box-1 (HMGB1). Related signaling pathways are phosphatidylinositol-3-kinase/protein kinase B(PI3K/Akt) signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, Wnt/β-catenin signaling pathway, Notch1/Jagged1 signaling pathway, and nuclear factor-E2-related factor2/antioxidant response element (Nrf2/ARE) signaling pathway. Cytokines may interfere with RILI progression by initiating various downstream signaling pathways, such as TGF-β1/Smads signaling pathway, TGF-β1/VEGF signaling pathway, TNF-α/nuclear factor-κB (NF-κB) signaling pathway, and HMGB1/Toll-like receptor 4 (TLR4) signaling pathway. In recent years, many scholars have attempted to delay RILI progression by down-regulating the expression of cytokines, antagonizing the effect of cytokines or regulating signaling pathways. It has been verified that many Chinese medicines, Chinese medicine monomers, and compound Chinese medicine prescriptions can inhibit the release of some cytokines or regulate some signaling pathways to reduce the incidence/severity of RILI, with satisfactory therapeutic effects, which have attracted the interest of scholars.
10. Follow-up of community injecting drug user cohort, 2014-2017
Wei LUO ; Junpeng KONG ; Lu YANG ; Mianhua SU ; Keming ROU ; Zunyou WU
Chinese Journal of Epidemiology 2019;40(7):791-794
Objective:
To explore the methods of establishing and maintaining community injecting drug user (IDU) cohort.
Methods:
From June 2014 to June 2017, a community survey was conducted on basis of local needle and syringe exchange site to recruit 200 HIV sero-negative IDU for a prospective cohort study in Longyang district of Baoshan city, Yunan province. Follow-up was carried out every six month to investigate high risk drug use behavior and sexual behavior, and blood samples were collected from them for the tests of HIV and HCV serum antibodies. The cohort would be opened every 12 months to replenish the cohort to 200 subjects.
Results:
The follow up was conducted for 3 years in 229 IDUs. Cohort follow-up rate was 93.0

Result Analysis
Print
Save
E-mail