1.Clinical Application and Pharmacological Mechanism of Sishenwan in Treatment of Ulcerative Colitis: A Review
Keqiu YAN ; Xiaoyu ZHANG ; Sifeng JIA ; Yuyu DUAN ; Zixing QIAN ; Yifan CAI ; Junyi SHEN ; Wenjie XIAO ; Xinkun BAO ; Guangjun SUN ; Aizhen LIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):261-270
Ulcerative colitis (UC), a chronic, non-specific inflammatory bowel disease with typical symptoms such as abdominal pain, diarrhea, and bloody stools, demonstrates a high relapse rate and difficulty in curing. Sishenwan, first recorded in Internal Medicine Abstract (Nei Ke Zhai Yao), are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney, and astringing the intestine and stopping diarrhea. In recent years, Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors, including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term, its side effects, high relapse rate, and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan, used alone or in combination with Western medicine or other Chinese medicine compound prescriptions, significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus, pus, and blood in stools, and persistent abdominal pain, reduce Mayo scores and the relapse rate, and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen, isopsoralen, and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level, Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future, a full-chain system covering syndrome differentiation, targeting, and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics, providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.
2.Clinical Application and Pharmacological Mechanism of Sishenwan in Treatment of Ulcerative Colitis: A Review
Keqiu YAN ; Xiaoyu ZHANG ; Sifeng JIA ; Yuyu DUAN ; Zixing QIAN ; Yifan CAI ; Junyi SHEN ; Wenjie XIAO ; Xinkun BAO ; Guangjun SUN ; Aizhen LIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):261-270
Ulcerative colitis (UC), a chronic, non-specific inflammatory bowel disease with typical symptoms such as abdominal pain, diarrhea, and bloody stools, demonstrates a high relapse rate and difficulty in curing. Sishenwan, first recorded in Internal Medicine Abstract (Nei Ke Zhai Yao), are a classic prescription for treating diarrhea caused by deficiency of the spleen and kidney Yang. The core therapeutic principle of Sishenwan is warming and tonifying the spleen and kidney, and astringing the intestine and stopping diarrhea. In recent years, Sishenwan have demonstrated distinct advantages in the clinical treatment of UC. The pathogenesis of UC involves multiple factors, including immune dysregulation and gut microbiota imbalance. Although Western medicine is effective in the short term, its side effects, high relapse rate, and resistance associated with long-term use pose substantial challenges. Sishenwan have shown excellent clinical outcomes in the treatment of UC due to deficiency of the spleen and kidney Yang. Modern clinical studies indicate that Sishenwan, used alone or in combination with Western medicine or other Chinese medicine compound prescriptions, significantly improve the clinical efficacy in treating UC due to deficiency of the spleen and kidney Yang. Sishenwan effectively alleviate core symptoms such as mucus, pus, and blood in stools, and persistent abdominal pain, reduce Mayo scores and the relapse rate, and improve patients' quality of life. Research on the material basis reveals that Sishenwan contain multiple active ingredients such as psoralen, isopsoralen, and evodiamine. Mechanism studies indicate that Sishenwan inhibit the inflammatory cascade reactions by regulating the signal network through multiple targets. Sishenwan regulate cellular immunity and restore intestinal immune homeostasis. At the microecological level, Sishenwan promote the intestinal barrier repair through the "microbiota-metabolism-immunity" axis. The current research still needs to be deepened in aspects such as the mining of specific biomarkers for syndromes and the exploration of the collaborative mechanism of traditional Chinese and Western medicine. In the future, a full-chain system covering syndrome differentiation, targeting, and monitoring needs to be constructed for promoting the paradigm transformation of Sishenwan into precision drugs. This review systematically explains the treatment mechanism of Sishenwan regarding the combination of disease and syndrome and its multi-target regulatory characteristics, providing a theoretical basis and transformation direction for the treatment of UC with integrated traditional Chinese and Western medicine.
3.Effects of blue light on the development of the dioptric system in guinea pigs
Xiao WANG ; Changlin LUAN ; Yifan SUN ; Shiqiao YANG ; Kailei WANG ; Rui HAO ; Wei ZHANG
Recent Advances in Ophthalmology 2024;44(1):18-23
Objective To investigate the effect of blue light on the dioptric development of the eyes of lens-induced myopia(LIM)guinea pigs.Methods Three-week-old trichromatic guinea pigs were randomly divided into three groups:control group,white light LIM(WL)group,and blue light LIM(BL)group(420 nm LED light,with an illuminance of 700 lx);guinea pigs in the latter two groups wore-10.00 D lenses in their right eyes to induce myopia.All guinea pigs under-went a 12 h light/12 h dark treatment cycle.Before and 2,4 weeks after the intervention,the diopter,axial length,retinal thickness and choroidal thickness were measured in all groups.After 4 weeks of intervention,the corneal fluorescent stai-ning and retinal Hematoxylin and Eosin(HE)staining were conducted.Results Compared with the control group,from week 0 to week 2 of the intervention(changes in weeks 0-2),the eyes in the WL group drifted(-2.22±1.28)D towards myopia,the axial length lengthened by(0.40±0.05)mm,and the retinal and choroidal thicknesses reduced by(-7.42± 7.04)μm and(-6.29±4.66)μm,respectively;compared with the WL group,in the BL group,the eyes drifted toward hyperopia by(0.48±1.16)D,the axial length increased by(0.20±0.10)mm,and retinal and choroidal thicknesses in-creased by(1.36±7.46)μm and(8.05±8.08)μm,respectively(all P<0.05).From week 2 to week 4(changes in weeks 2-4),compared with the control group,the diopter in the WL and BL groups progressed towards myopia,with changes of(-4.64±0.50)D and(-2.11±2.02)D,respectively(both P<0.05);the axial length lengthened,and reti-nal and choroidal thicknesses reduced in the WL group,with changes of(0.44±0.06)mm,(-7.35±5.87)μm and(-4.84±2.61)μm,while the choroidal thickness and the retinal thickness decreased in the BL group,with changes of(-0.33±5.95)μm and(-4.78±4.96)μm,respectively.Observations of corneal fluorescence staining and retinal HE staining indicated that prolonged blue light exposure could lead to damage to corneal and retinal cells.Conclusion Blue light may influence the development of myopia through choroid-related mechanisms,but its inhibitory effect is not positive-ly correlated with time.Prolonged exposure to blue light can damage the cornea and retina,thereby reducing the inhibitory effect.
4.Bone morphogenetic protein 7 attenuates renal fibrosis in diabetic kid-ney disease rats by down-regulating Ajuba
Zhaowei FENG ; Yunli DAI ; Dan LIANG ; Zhiyang LI ; Yifan WANG ; Houxing LÜ ; Jiajia CHEN ; Shengjie CHEN ; Bing GUO ; Ying XIAO
Chinese Journal of Pathophysiology 2024;40(1):110-117
AIM:Bone morphogenetic protein 7(BMP7)reduces the expression of Yes-related protein 1(YAP1)by down-regulating Ajuba level and decreasing extracellular matrix(ECM)deposition.This study aimed to inves-tigate the influence of these factors on modifying the degree of renal fibrosis in rats with diabetic nephropathy.METH-ODS:Eighteen Sprague-Dawley(SD)rats were randomly divided into three groups:the normal control(NC)group,the diabetes mellitus(DM)group,and the DM group treated with BMP7 overexpressing adeno-associated virus(DM+rAAV-BMP7).Each group consisted of six rats.Diabetic kidney disease(DKD)was established in the DM and DM+rAAV-BMP7 groups by injecting 55 mg/kg streptozotocin(STZ)via the tail vein.NRK-52E cells were divided into three groups:the normal glucose(NG)group,the high glucose(HG)group,and the high glucose group treated with recombinant hu-man BMP7(HG+rhBMP7)group.Pathological changes in renal tissues were observed using hematoxylin and eosin(HE)and Sirius red staining.Immunohistochemical staining was performed to examine the expression sites of Ajuba and YAP1 in the renal cortex.Western blot analysis was conducted to determine the expression levels of BMP7,Ajuba,YAP1,colla-gen type Ⅲ(Col-Ⅲ),and fibronectin(FN)in the rat renal cortex and NRK-52E cells.RT-qPCR was used to measure the mRNA levels of Ajuba and YAP1 in the rat renal cortex.RESULTS:Biochemical indices revealed significantly ele-vated levels of blood glucose,serum creatinine,triglycerides,total cholesterol,and 24-hour urinary protein in the DM group compared to the NC group(P<0.05).In the DM+rAAV-BMP7 group,the levels of serum creatinine,24-hour uri-nary protein,triglycerides,and total cholesterol were lower than those in the DM group(P<0.05).Pathological staining demonstrated that the renal interstitium of the DM group exhibited inflammatory cell infiltration,fibrous tissue,collagen fi-ber deposition,disordered renal tubule arrangement,atrophy,and vacuolar degeneration,which were ameliorated in the DM+rAAV-BMP7 group.Immunohistochemistry revealed that Ajuba and YAP1 were mainly expressed in the cytoplasm and nucleus,with high expression in the cytoplasm of the DM group,which was significantly decreased in the DM+rAAV-BMP7 group.Western blot results indicated that the protein levels of FN,Col-Ⅲ,Ajuba,and YAP1 were up-regulated in the DM and the HG groups(P<0.05),but significantly down-regulated in the DM+rAAV-BMP7 group(P<0.05).RT-qP-CR results demonstrated that the mRNA levels of Ajuba and YAP1 were higher in the DM group and significantly lower in the DM+rAAV-BMP7 group(P<0.05).CONCLUSION:The overexpression of BMP7 can ameliorate renal fibrosis in rats with DKD.This effect is likely mediated by the down-regulation of Ajuba,reduction of YAP1 expression,and subse-quent inhibition of ECM deposition.
5.Changes of quantitative CT indexes in chronic obstructive pulmonary disease patients and correlations with pulmonary function indicators
Xiaona YANG ; Ting GAO ; Jiaxin ZHOU ; Xiao SUN ; Huairong ZHANG ; Yifan WANG ; Li ZHU
Chinese Journal of Medical Imaging Technology 2024;40(1):62-67
Objective To observe changes of CT quantitative indexes in patients with untreated chronic obstructive pulmonary disease(COPD)and relationships with pulmonary function indicators.Methods Totally 99 patients with untreated COPD were retrospectively enrolled.According to the degrees of airflow obstruction,the patients were divided into group A(GOLD grade 1 with mild obstruction,n=36),group B(GOLD 2 with moderate obstruction,n=37)and group C(GOLD 3 or 4 with obvious obstruction,n=26).The results of chest CT and pulmonary function tests conducted at the first diagnosis and the follow-up,as well as their correlations were analyzed.CT quantitative indicators included the whole lung volume,low-attenuation areas less than-950 percentage(LAA%),total number of vessels per 1 cm2 of lung surface area(Ntotal/LSA),total number of vessels with area less than 5 mm2 per 1 cm2 of lung surface area(N<5mm2/LSA),the square root of the wall area of a hypothetical airway with a 10 mm internal perimeter(Pi10),the entire volume,wall thickness and wall area percentage(WA%)of airway wall,etc.,while results of pulmonary function tests included the forced expiratory volume in one second(FEV1)after administration of a bronchodilator,forced vital capacity(FVC),the ratio FEV1/FVC and FEV1 expressed as percent predicted(FEV1%).Results Compared with those at the first diagnosis,the follow-up results of FVC,FEV1,FEV1/FVC,Ntotal/LSA and N<5mm2/LSA were lower,whereas LAA%,Pi10 and entire volume of airway were all higher in each group(all P<0.05).Compared with those in group A,group B and C had decreased LAA%and increased Pi10,and the magnitude increased with the severity of airflow obstruction(all P<0.05).LAA%,Pi1o and entire volume of airway wall were negatively correlated with pulmonary function indicators(all P<0.05),while Ntotal/LSA and N<5 mm2/LSA were positively correlated with pulmonary function indicators(all P<0.05).Conclusion CT quantitative parameters,including LAA%,Ntotal/LSA,N<5mm2/LSA,Pi10 and entire volume of airway wall were related to pulmonary function,which might reflect the longitudinal changes of airways and blood vessels in COPD patients.
6.Exploring the Disease Mechanism and Treatment of Ischemic Stroke Based on Ascending and Descending of Qi Movement from the Perspective of Xiang Thinking
Liuding WANG ; Xiao LIANG ; Yifan CHEN ; Yue LIU ; Hongxi LIU ; Di ZHAO ; Yunfan ZHANG ; Yunmeng CHEN ; Xueru ZHANG ; Yunling ZHANG
Journal of Traditional Chinese Medicine 2024;65(14):1443-1448
Xiang thinking is the key way of thinking to construct the life model of human body in traditional Chinese medicine (TCM), and the theory of ascending and descending of qi movement is an important manifestation of xiang thinking in the theory of TCM. Based on the theory of qi movement, this paper interpreted the mechanism of ischemic stroke through the perspective of xiang thinking "earth weakness - wood constraint - fire hyperactivity", as "earth weakness in the central and dampness accumulated to phlegm" "wood constraint and stirring wind led to blood stasis" and "fire hyperactivity and fire toxin showed flaming upward" due to disorder of qi movement. Combined with the "xiang of medicinal properties and therapy methods" to discuss the treatment and prescriptions of ischaemic stroke, applying wind medicinals to elevate ji-earth (己土) and yi-wood (乙木), so that phlegm and stasis can be eliminated, and cold medicinals to descend jia-wood (甲木) and wu-earth (戊土) so that fire toxin can be cleared, with a view to restore ascending and descending of qi movement for ischaemic stroke.
7.Compatibility Mechanism of Mineral Medicine Os Draconis in Bupleuri Radix-containing Tri-herbal Medicines Based on Supramolecular Systems
Zi XING ; Junling HOU ; Yifan ZHAO ; Liman XIAO ; Mengjia WEI ; Mengyuan YANG ; Lu YUN ; Yuanfei NIU ; Zhijie ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):191-198
ObjectiveBy starting with the combination of Os Draconis, Bupleuri Radix, and Ostreae Concha, the role of mineral medicine Os Draconis in the combination of the Bupleuri Radix-containing tri-herbal medicines was preliminarily explored from the perspective of supramolecular system formation. Method① The appearance and Tyndall phenomenon of single decoction of Os Draconis, Bupleuri Radix, and Ostreae Concha, as well as co-decoction of Bupleuri Radix-Os Draconis, Bupleuri Radix-Os Draconis-Ostreae Concha, and Bupleuri Radix-Ostreae Concha were observed, and the average particle size, dispersion coefficient, and Zeta potential of suspension particles in each decoction were determined. The micromorphology of supramolecular structures was observed by scanning electron microscope (SEM). ② The pH of different compatibility systems, liquid viscosity coefficient, liquid surface tension, freeze-dried powder yield rate, and other physical properties were determined, and the interaction of different compatibility systems was detected by infrared absorption spectroscopy (FTIR) and UV-visible spectrophotometry (UV-Vis). ③ The composition and content difference of different compatible systems were determined by high-performance liquid chromatography (HPLC) and ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry (UPLC-Q-TOF-MS). ResultCompared with the single decoction, the co-decoction had more obvious turbidity and Tyndall phenomenon. The particles in the co-decoction suspension were smaller and more evenly distributed, and the Zeta potential was reduced, indicating a more stable system. Under SEM, Bupleuri Radix was irregularly lamellar, and Bupleuri Radix-Os Draconis and Bupleuri Radix-Os Draconis-Ostreae Concha were mainly spherical nanoparticles. Bupleuri Radix-Ostreae Concha was irregularly lamellar, with a small number of spherical nanoparticles. The pH of the single decoction of Bupleuri Radix and co-decoction increased, and the viscosity coefficient increased. The liquid surface tension decreased. The freeze-dried powder yield rate of the Bupleuri Radix-Os Draconis co-decoction was the highest, followed by Bupleuri Radix-Ostreae Concha decoction and Bupleuri Radix-Os Draconis-Ostreae Concha decoction, and the yield rate of Bupleuri Radix single decoction was the lowest. The main change of FTIR was the stretching vibration of -OH, and the co-decoction moved to the low-frequency direction obviously. UV-Vis showed that the maximum absorption occurred at 295.8 nm for all groups, and the absorption intensity was different (Bupleuri Radix-Os Draconis>Bupleuri Radix-Os Draconis-Ostreae Concha>Bupleuri Radix-Ostreae Concha>Bupleuri Radix). The components of Bupleuri Radix were used as the indexes, and the content of methanol extract determined by HPLC was higher than that of water extract, and the components of Bupleuri Radix single decoction were mainly saikosaponin a (SSa) and saikosaponin c (SSc), which were slightly higher after co-decoction compatibility. UPLC-Q-TOF-MS could identify 37 compounds in both single decoction and co-decoction. ConclusionThe combination of Bupleuri Radix, Os Draconis, and Ostreae Concha can form a smaller, more uniform, and stable nano-sized supramolecular system, which is conducive to the dissolution of the main components of Bupleuri Radix, and the Os Draconis contributes the most in this process.
8.Research progress on the application of botulinum toxin type A in the treatment of myogenous temporoman-dibular disorders
Yifan CHEN ; Liangchen TANG ; Min'er CHEN ; Xiao ZHANG ; Kuangyun TANG ; Zhiyong LI
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(6):470-477
Myogenous temporomandibular disorder(M-TMD)is one of the main subtypes of temporomandibular dis-order(TMD)and typically manifests as masticatory myofascial pain;the incidence of TMD has been increasing annually in recent years.Botulinum toxin type A(BTX-A)is a potent neurotoxin produced by Clostridium botulinum.BTX-A in-hibits the release of acetylcholine from the presynaptic membrane,thereby blocking neuromuscular junction signaling.The noncosmetic application of BTX-A in the oral and maxillofacial regions is a prominent research topic.In recent years,an increasing number of studies have focused on the application of BTX-A in the treatment of M-TMD.The re-sults of a literature review revealed that an appropriate dose(10-50 U unilaterally)of BTX-A administered in a single in-jection into the masticatory muscles can effectively treat myalgia over a period of 3-6 months.Common adverse effects,such as masticatory weakness and facial paralysis,are transient and can be avoided by standardized injection tech-niques.However,there is a lack of standardized guidelines for injection techniques in clinical practice.
9.Correlation between serum PARP1,sTNFR1 and ventricular arrhythmias in patients with chronic heart failure
Ling XIAO ; Yuanyuan SHI ; Yifan MA ; Yingying LIU
International Journal of Laboratory Medicine 2024;45(22):2779-2783
Objective To investigate the correlation between serum polyadenyldiphosphate ribose polymer-ase(PARP)1,soluble tumor necrosis factor receptor 1(sTNFR1),and ventricular arrhythmias(VA)in pa-tients with chronic heart failure(CHF).Methods A total of 117 CHF patients who visited the hospital from August 2021 to February 2023 were selected as the research objects,and were regarded as the CHF group.Ac-cording to whether VA occurred during hospitalization,they were separated into a VA group of 25 cases and a non VA group of 92 cases.A total of 120 healthy individuals who underwent physical examinations were re-garded as the healthy group.Enzyme linked immunosorbent assay was applied to determine the expression levels of serum PARP1 and sTNFR1 in the research objects.Spearman method was applied for correlation a-nalysis.Logistic regression was applied to analyze the factors affecting the occurrence of VA in CHF patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum PARP1 and sTNFR1 levels in evaluating the occurrence of VA in CHF patients.Results The serum PARP1 and sT-NFR1 levels in the CHF group were higher than those in the control group(P<0.05).The serum PARP1 and sTNFR1 levels in the VA group were obviously higher than those in the non VA group(P<0.05).The cardiac troponin 1(cTnⅠ)in the VA group was higher than that in the non VA group,and the proportion of heart function grade Ⅰ,left ventricular ejection fraction,and hemoglobin(Hb)were lower than those in the non VA group(P<0.05).The levels of serum PARP1 and sTNFR1 were positively correlated with cTnⅠ and cardiac function grading,but negatively correlated with Hb and left ventricular ejection fraction(P<0.05).Logistic regression analysis showed that PARP1 and sTNFR1 were risk factors for VA in CHF patients(P<0.05).ROC curve shows that the area under the curve(AUC)of the combined prediction of serum PARP1 and sTNFR1 for the occurrence of VA in CHF patients was 0.909,which was higher than those of single pre-dictions(ZPARP1-combination=2.023,P=0.043,ZsTNFR1-combination=2.077,P=0.038),and the sensitivity and the spe-cificity were 92.00%and 72.83%,respectively.Conclusion Serum PARP1 and sTNFR1 expression is up-reg-ulated in CHF patients,and their high expression is closely related to the occurrence of VA in CHF patients.The combination of the two has high predictive value for VA.
10.The status and its influencing factors of tissue silence of nurses in 3 Grade A general hospitals
Ni XIAO ; Xuan ZHAO ; Jiajia MA ; Yifan QI ; Minna WANG ; Xin XING ; Yongxing WU ; Litao GUO
Modern Clinical Nursing 2024;23(7):17-23
Objective To investigate the status quo and its influencing factors of nurses'organizational silence in 3 Grade A general hospitals.Methods Convenient sampling method was used to investigate clinical nurses in 3 Grade A general hospitals in Xi'an from April to August 2023 by general data questionnaire,nurses'organizational silence questionnaire and hospital magnetic factor scale.Multiple linear regression was used to analyze the influencing factors of organizational silence.Results A total of 855 nurses completed the study.The total silence score of nurses was(56.33±8.55);The total score of hospital magnetic level was(107.63±12.85).There was a negative correlation between nurse tissue silence and hospital magnetic level(r=-0.318,P<0.01).Hospital magnetic level,age,job title and working time were the influential factors of nurses'organizational silence(all P<0.001),which together explained 62.60%of the variation.Conclusions The silence of nurses'tissue and the level of hospital magnetism are in the low-medium level.Nurses are younger in age,lower in professional title,shorter in nursing age and lower in hospital magnetism level,the higher the tissue age level is,the nursing managers can reduce the tissue silence of nurses by improving the hospital magnetism level.


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