Research on Mechanisms of Chinese Medicines in Prevention and Treatment of Postoperative Adhesion.

Postoperative adhesion (PA) is currently one of the most unpleasant complications following surgical procedures. Researchers have developed several new strategies to alleviate the formation of PA to a great extent, but so far, no single measure or treatment can meet the expectations and requirements of clinical patients needing complete PA prevention. Chinese medicine (CM) has been widely used for thousands of years based on its remarkable efficacy and indispensable advantages CM treatments are gradually being accepted by modern medicine. Therefore, this review summarizes the formating process of PA and the efficacy and action mechanism of CM treatments, including their pharmacological effects, therapeutic mechanisms and advantages in PA prevention. We aim to improve the understanding of clinicians and researchers on CM prevention in the development of PA and promote the in-depth development and industrialization process of related drugs.

GluN2B-BDNF pathway in the cerebrospinal fluid-contacting nucleus mediates nerve injury-induced neuropathic pain in rats.

The present study was aimed to investigate the role of GluN2B-BDNF pathway in the cerebrospinal fluid-contacting nucleus (CSF-CN) in neuropathic pain. Intra-lateral ventricle injection of cholera toxin subunit B conjugated with horseradish peroxidase (CBHRP) was used to label the CSF-CN. Double-labeled immunofluorescent staining and Western blot were used to observe the expression of GluN2B and BDNF in the CSF-CN. Chronic constriction injury of sciatic nerve (CCI) rat model was used to duplicate the neuropathic pain. Pain behavior was scored to determine the analgesic effects of GluN2B antagonist Ro 25-6981 and BDNF neutralizing antibody on CCI rats. GluN2B and BDNF were expressed in the CSF-CN and their expression was up-regulated in CCI rats. Intra-lateral ventricle injection of GluN2B antagonist Ro 25-6981 or BDNF neutralizing antibody notably alleviated thermal hyperalgesia and mechanical allodynia in CCI rats. Moreover, the increased expression of BDNF protein in CCI rats was reversed by intra-lateral ventricle injection of Ro 25-6981. These results suggest that GluN2B and BDNF are expressed in the CSF-CN and alteration of GluN2B-BDNF pathway in the CSF-CN is involved in the modulation of the peripheral neuropathic pain.

[Technical elements and clinical application of umbilical refining of heat-sensitive moxibustion].

Under the guidance of the theory and technique of arrival of qi of heat-sensitive moxibustion, the technical elements of umbilical refining of moxibustion proposed in The Guide to Medicine by LI Yan were analyzed. It is believed that the parameters of moxibustion temperature and time are the key points. The standard of "quantitative moxa" is established to achieve the appropriate moxibustion temperature and moxibustion time. The umbilical refining of heat-sensitive moxibustion is established to reappear the magic effect of LI Yan's umbilical refining of moxibustion. The umbilical refining of heat-sensitive moxibustion is recommended for stomachache, diarrhea, constipation, dysmenorrhea, impotence, etc. with significant curative effect.

[Professor CHEN Ri-xin's academic idea of "pain in joint and disorder in tendon region of meridian" and its clinical application for knee arthralgia].

Professor CHEN Ri-xin's academic idea of "pain in joint and disorder in tendon region of meridian" was explored in this paper. According to the particular characteristics of the occurrence and development of the disease, knee arthralgia is divided into 4 stages, named tendon spasm, tendon blockage, tendon contraction and tendon atrophy. It is proposed that "tendon disorder results in bone disorder", implying the relationship between the disorders of tendon and bone. It is pointed that yang qi insufficiency occurs throughout knee arthralgia. "The tendon disorder should be treated at the first-line procedure for the bone disorder, and the tendon softening benefits the recovery of knee joints". The treatment principle includes "removing obstruction from meridian, eliminating pathogen, warming up yang and softening tendon". In clinical application, the heat-sensitive moxibustion is predominated. The various regimens are developed align with the pathogenesis characteristics of the disease at different stages.

[Professor CHEN Ri-xin's academic thought and clinical application of "no allergy without any deficiency"].

The academic thought of professor CHEN Ri-xin on "no allergy without any deficiency" was explored. Theory and the clinical application were elaborated on allergic diseases treated with heat-sensitive moxibustion. It is believed that the critical pathogenesis of allergic diseases is deficiency, particularly the deficiency of the lung, the spleen and the kidney. The invasion of exogenous factors or the disturbance of the retained pathogens in the body may induce allergy. Regarding the therapeutic method, the warming method is applicable for the deficiency and the heat-sensitization counteracts allergy. The sensitized points are detected in accordance with the two-step location method and they are stimulated with the suspended moxibustion. The feeling of heat-sensitive moxibustion is a sign of activation of endogenous regulatory function in the human body. It is a kind of external therapy for the internal disorders, directly acting on the pathogenesis, strengthening the antipathogenic qi and removing the allergic factors. This therapy is a new endogenous anti-allergic approach.

Identification of candidate biomarkers correlated with pathogenesis of postoperative peritoneal adhesion by using microarray analysis.

BACKGROUND: Postoperative peritoneal adhesion (PPA), characterized by abdominal pain, female infertility, and even bowel obstruction after surgery, has always been a major concern. The occurrence and formation of adhesion are from complex biological processes. However, the molecular mechanisms underlying the basis of microarray data profile, followed by peritoneal adhesion formation, are largely unknown. AIM: To reveal the underlying pathogenesis of PPA at the molecular level. METHODS: The gene expression profile was retrieved from the Gene Expression Omnibus database for our analysis. We identified a panel of key genes and related pathways involved in adhesion formation using bioinformatics analysis methods. We performed quantitative PCR and western blotting in vivo to validate the results preliminarily. RESULTS: In total, 446 expressed genes were altered in peritoneal adhesion. We found that several hub genes (e.g., tumor necrosis factor, interleukin 1 beta, interleukin 6, C-X-C motif chemokine ligand 1, C-X-C motif chemokine ligand 2) were marked as significant biomarkers. Functional analysis suggested that these genes were enriched in the Toll-like receptor signaling pathway. According to the Kyoto Encyclopedia of Genes and Genomes pathway and published studies, TLR4, myeloid differentiation primary response protein 88 (MyD88), and nuclear factor kappa B (NF-κB) played essential roles in Toll-like signaling transduction. Here, we obtained a regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion involved in the pathogenesis of postoperative adhesion. The results of the microarray analysis were verified by the animal experiments. These findings may extend our understanding of the molecular mechanisms of PPA. CONCLUSION: The regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion may play key roles in the pathogenesis of PPA. Future studies are required to validate our findings.

[Application of professor CHEN Ri-xin's academic thought "yang is often insufficient, but yin is often surplus" in heat-sensitive moxibustion for tumor rehabilitation].

Professor CHEN Ri-xin has explored the causes of the characteristics of TCM syndromes in modern disease spectrum and pointed out that the TCM syndromes are generally characterized by "yang is often insufficient, but yin is often surplus". Based on the clinical experience and the understanding of TCM classics and ancient literature on tumor, professor CHEN has proposed that TCM syndromes of patients with advanced tumor are also generally characterized by "yang is often insufficient, but yin is often surplus". The heat-sensitive moxibustion has the functions of warming and nourishing yang-qi, eliminating dampness, warming meridians and dispersing cold, activating blood circulation and clearing collaterals, therefore tumor patients with deficiency syndrome (yang-deficiency, qi-deficiency), cold syndrome, dampness syndrome, phlegm syndrome and blood-stasis syndrome belonging to the indications of heat-sensitive moxibustion. The heat-sensitive moxibustion has unique advantages in treating spleen-stomach dysfunction after chemotherapy and radiotherapy, bone marrow suppression after chemotherapy and radiotherapy, cancerous deficiency, cancerous pain, pleural effusion, ascites, constipation, which has important clinical value in improving the quality of life and prolonging the life time for patients with advanced tumors.

HuoXueTongFu Formula Alleviates Intraperitoneal Adhesion by Regulating Macrophage Polarization and the SOCS/JAK2/STAT/PPAR-γ Signalling Pathway.

Intraperitoneal adhesion is a common complication after abdominal surgery, which seriously affects the quality of life of patients. HuoXueTongFu Formula (HXTF) plays an important role in the prevention and treatment of intraperitoneal adhesions. However, the molecular-related mechanisms are still not fully known. In this study, the model of Intrapetitoneal adhesion was established by cecum abrasion and treated with HXTF for one week. RAW264.7 cells were given LPS, IFN-γ, IL-4, HXTF-medicated serum, and PPAR-γ agonist/antagonist, respectively. Histopathology, flow cytometry, ELISA, real-time PCR, and Western blotting were used to further detect the related protein, M1/M2 polarization tendency, and PPAR-γ nuclear translocation. The deposition of collagen fibres reduced in the local area of rats after the operation with HXTF treatment. Similar to IL-4, HXTF induced a tendency for macrophages to polarize toward M2 and promoted peroxisome proliferator-activated receptor-gamma (PPAR-γ) nuclear translocation. Furthermore, the use of HXTF and PPAR-γ agonists downregulated macrophage M1 polarization-related factors IL-1, IL-6, and TNF-alpha and upregulated M2 polarization-related factors IL-4, IL-10, and TGF-beta 1. Meanwhile, the use of HXTF and PPAR-γ agonists downregulated the SOCS3/JAK2/STAT1 pathway and activated the SOCS1/STAT6/PPAR-γ pathway. These results show that HXTF may reduce intraperitoneal adhesion by inducing macrophage M2 polarization and regulating the SOCS/JAK2/STAT/PPAR-γ pathway.

[On the deqi in moxibustion].

The original connotation of deqi in Neijing (Internal Classic) was explored to provide the reference for the clinical application of moxibustion. The relevant items of the original definition of deqi in Internal Classic were traced aligning with the achievements in the clinical researches on the heat-sensitive phenomena and its rule, and thus, the characteristics of deqi in moxibustion and its inducing approaches were analyzed. A new viewpoint of the connotation of deqi in Internal Classic was put forward. It is believed that deqi is not only a somatic response to acupuncture, but also a kind of comfortable mental-physical reaction related to curative effect. On this basis, it was discussed that moxibustion on heat-sensitive acupoints could induce deqi which conforms to the original definition described in Internal Classic. Additionally, the method of moxibustion for stimulating deqi, the screening of the items on deqi in moxibustion as well as the preliminary evaluation were introduced in the paper. It is suggested that the deqi in moxibustion is the comprehensive responses of the mental-physical-curative effect.