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To develop a traditional Chinese medicine (TCM) diagnostic scale for type 2 diabetes mellitus with turbid-toxin accumulation syndrome and to validate the performance of the scale. A candidate pool was established through literature review and expert consultation, and a clinical case information collection form was developed accordingly. Patients with type 2 diabetes mellitus admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from July 2021 to January 2022 were investigated, and 312 valid clinical case information collection forms were obtained, which were randomly divided into 235 cases in the study group and 77 cases in the validation group. Four statistical methods, namely, differentiation analysis, Cronbach's coefficient, correlation coefficient, and stepwise regression, were used to screen out the candidate items, and Logistic regression analysis and factor analysis were used to assign weights to the items, and the final diagnostic model was determined by the receiver operating characteristic (ROC) curve, and the diagnostic thresholds were calculated for the Yoden index. The final TCM diagnostic scale for type 2 diabetes mellitus was composed of 8 items: turbid dirt coating (with a weight value of 23, the same below), sticky stools (16), fullness in the epigastrium and abdomen (12), dark complexion (12), irritability (11), brown spots on the skin (11), heaviness of head (10), and chest stuffiness (5), and the degree score was 0, 0.5, 1.0, and 1.5 points corresponding to no, mild, moderate and severe symptoms, respectively. The total score was the sum of the degree score multiplied by the weighted value of each item, and when the total score reached 33 points, it is diagnosed as the turbid-toxin accumulation syndrome. The established scale was tested and evaluated in the study group and the validation group, and the results showed that the sensitivity of the study group and the validation group was 89.38% and 89.47%, with the specificity of 95.90% and 89.74%, the Yoden index of 0.85 and 0.79, the positive predictive value of 95.28% and 89.47%, the negative predictive value of 90.70% and 89.74%, the diagnostic advantage ratios of 198.18 and 72.67, and the Kappa values of 0.86 and 0.79, which indicated that the TCM diagnostic scale for turbid-toxin accumulation syndrome of type 2 diabetes mellitus showed good diagnostic ability.
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Oligoasthenozoospermia is the main cause of male infertility, with complex and diverse causes. Currently, there are still some unclear causes of oligoasthenozoospermia in clinical practice, known as idiopathic oligoasthenozoospermia. With the development of high-throughput sequencing technology, it has been found that intestinal microbiota disorder may be an important promoting factor for the onset of oligoasthenozoospermia. Traditional Chinese medicine believes that "deficiency of kidney essence" is the core pathogenesis of oligoasthenozoospermia. In clinical practice, the method of tonifying the kidney and strengthening the essence has a significant therapeutic effect on oligoasthenozoospermia, but its mechanism of action has not been fully elucidated. Based on the basic theories of traditional Chinese medicine and molecular biology research, it has been found that there is a similarity between "kidney essence" and intestinal microbiota. During the onset of oligoasthenozoospermia, the disorder of intestinal microbiota has similarities with the pathogenesis of "deficiency of kidney essence" in traditional Chinese medicine. Moreover, traditional Chinese medicine for tonifying the kidney and strengthening the essence can regulate the disorder of intestinal microbiota, which may be one of the effective mechanisms for the treatment of oligoasthenozoospermia with the Bushen Yijing method. Based on this, this article explored the mechanism of Bushen Yijing method of traditional Chinese medicine in treating oligoasthenozoospermia from the perspective of intestinal microbiota, so as to provide new ideas for the treatment of oligoasthenozoospermia with traditional Chinese medicine.
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PURPOSE: To evaluate the safety and efficacy of a novel hyperthermic intravesical chemotherapy (HIVEC) device in combination with gemcitabine. MATERIALS AND METHODS: A pilot clinical trial was performed on patients with high-risk non-muscle invasive bladder cancer (NMIBC), who received HIVEC via the novel device (BR-PRG). Treatment regimen included eight weekly instillations of intravesical GEM (3 g in 150 mL normal saline [NS]) at a temperature of 45 °C for 60 min. Assessment of adverse events (AEs) was the primary objective of the trial. Disease recurrence and the thermal stability of GEM were also analyzed. RESULTS: A total of 116 HIVEC treatments were delivered. Fifteen and eighteen patients were included in the effectiveness and safety analysis, respectively. Median follow-up was 12 months; five patients experienced a disease recurrence. One-year cumulative incidence of recurrence was 23.8% in EORTC intermediate risk group and 37.5% in high-risk group. Ten patients experienced at least one AE, with the most common being acute urinary tract infection, followed by urinary tract pain, and hematuria. Two patients experienced acute cystitis (grade 3 AE) and instillations were postponed until full recovery. Other AEs were minor, and no systemic toxicity was observed. The contents of GEM in solution of 0.9% NS or NS mixed with artificial urine were stable at 25 °C, 37 °C, 43 °C, 45 °C, 47 °C and 50 °C for 2 h. CONCLUSION: GEM can be an ideal drug for use in HIVEC due to its good thermal stability. BR-PRG, combined with GEM was safe and effective in administering HIVEC.
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Hipertermia Induzida , Neoplasias da Bexiga Urinária , Humanos , Gencitabina , Hipertermia Induzida/efeitos adversos , Incidência , Invasividade Neoplásica , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Projetos PilotoRESUMO
Objective:To evaluate the role of autophagy in electroacupuncture (EA)-induced improvement in sepsis-associated encephalopathy (SAE) in mice.Methods:A total of 135 healthy adult male mice, aged 8-12 weeks, weighing 22-25 g, were used in this study. Ten mice were randomly selected to prepare caecal slurry after anesthesia. The remaining 125 mice were divided into 5 groups ( n=25 each) using a random number table method: sham operation group (group Sham), SAE group, SAE+ EA group (group EA), SEA+ EA+ autophagy agonist rapamycin group (group SAE+ EA+ R), and SAE+ EA+ autophagy inhibitor 3-methyladenine group (group SAE+ EA+ MA). SAE was induced by intraperitoneal injection of cecal slurry 200 μl. Bilateral Zusanli (ST36) acupoints were stimulated at 2, 24, 48 and 72 h after surgery in group SAE+ EA, group SAE+ EA+ R and group SAE+ EA+ MA. Autophagy agonist rapamycin 10 mg/kg and autophagy inhibitor 3-methyladenine 15 mg/kg were intraperitoneally injected at 30 min before EA in SAE+ EA+ R group and SAE+ EA+ MA group, respectively. The survival of mice was recorded at 7 days after developing the model. Ten mice were selected from each group at 8-12 days after developing the model, and the learning and memory ability was assessed by Morris water maze test. Five mice from each group were sacrificed after anesthesia, brains were removed, and hippocampal tissues were obtained for determination of contents of interleukin-1beta (IL-1β), IL-18 and tumor necrosis factor-α (TNF-α) (by enzyme-linked immunosorbent assay) and expression of p62, autophagy-related protein 16 like protein 1 (ATG16L1), and nucleotide like receptor protein 3 (NLRP3) (by Western blot). Results:Compared with Sham group, the survival rate at 7 days after developing the model was significantly decreased in the other 4 groups ( P<0.01). There was no significant difference in the survival rate at 7 days after developing the model among SAE group, SAE+ EA group, SAE+ EA+ R group and SAE+ EA+ MA group ( P>0.05). Compared with Sham group, the activity time at the target quadrant was significantly shortened, the escape latency was prolonged, the number of crossing the original platform was reduced, the contents of TNF-α, IL-1β and IL-18 were increased, the expression of ATG16L1 was down-regulated, and the expression of p62 and NLRP3 was up-regulated in SAE group ( P<0.05). Compared with SAE group, the escape latency was significantly shortened, the activity time at the target quadrant was prolonged, the number of crossing the original platform was increased, the contents of TNF-α, IL-1β and IL-18 were decreased, the expression of ATG16L1 was up-regulated, and the expression of p62 and NLRP3 was down-regulated in SAE+ EA group ( P<0.05). Compared with SAE+ EA group, no significant change was found in the parameters of Morris water maze test ( P>0.05), the contents of TNF-α, IL-1β and IL-18 were significantly decreased, the expression of ATG16L1 was up-regulated, and the expression of NLRP3 and P62 was down-regulated in SAE+ EA+ R group, and the expression of ATG16L1 was significantly down-regulated, and the expression of p62 and NLRP3 was up-regulated in SAE+ EA+ MA group ( P<0.05). Conclusions:The mechanism by which EA improves SAE is related to promotion of autophagy in hippocampal neurons, inhibition of NLRP3 inflammasome activation, and alleviation of neuroinflammatory responses in mice.
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In recent years,with the change in lifestyle and social environment and the increase in pressure in both life and work,male fertility has decreased significantly in China,and the incidence of male infertility has increased year by year,which has brought great challenges to andrologists. Traditional Chinese medicine (TCM) has a definite curative effect in the treatment of male infertility and is widely applied in clinical practice. In order to clarify the role of TCM in different types and each stage of male infertility,the China Association of Chinese Medicine (CACM) invited outstanding young andrologists in the clinic of TCM and western medicine to discuss topics such as idiopathic oligospermia and teratospermia,abnormal semen liquefaction,varicocele,immune infertility,improving success ratio of assisted reproductive technology,and ameliorating depression or anxiety. They conducted in-depth discussions on the advantages,characteristics,disadvantages,diseases responding specifically,and advantageous aspects of TCM treatment. The causes of male infertility and related links of treatment were summarized. Due to the unclear etiology and complex pathogenesis of male infertility,western medicine cannot achieve a good curative effect,while TCM,taking the holistic view as the core,specializes in improving functional diseases and can correspond to multiple targets and factors,with comprehensive treatments such as internal treatment and external treatment. This study summarized the advantageous diseases and advantageous stages of TCM treatment alone and integrated TCM and western medicine treatment and put forward suggestions for the treatment of the diseases by TCM and western medicine in order to promote the therapeutic effects and advantages of TCM among andrologists,increase mutual learning and communication between TCM and western physicians,provide patients with excellent and personalized treatment plans in clinical practice,and improve the curative effect of male infertility and fertility of males in China.
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Experimental research on male infertility is critical to the study of the pathogenesis of male infertility and the evaluation of drug therapy. This paper reviewed animal experiments on male infertility in recent years. The experimental models of male infertility mainly include oligoasthenozoospermia (OA),teratozoospermia,azoospermia, and varicocele animal models. The OA animal models are mostly induced by glycosides of Tripterygium wilfordii (GTW), adenine,hydrocortisone, and radiation,which are mainly chemical means. The animal models of azoospermia were usually constructed by intraperitoneal injection of bissulfonyl alkylating agent busulfan and immersion of scrotum in 43 ℃ water. There are few studies on animal models of teratozoospermia,and the induction methods by GTW and methyl methanesulfonate(MMS) are common. The animal models of varicocele-caused infertility are usually induced by operation. The ligation of the middle division of the left renal vein between the lateral inferior vena cava and the medial spermatic vein has a significant influence on testicular morphology and epididymal sperm quality. Animal experimental studies have shown that classic prescriptions for tonifying the kidney and promoting spermatogenesis represented by Wuzi Yanzongwan and clinical empirical prescriptions by modern research have played a significant role in the treatment of male infertility. The mechanism of tonifying the kidney in the treatment of male infertility mainly focuses on inhibiting spermatogenic cell apoptosis. The kidney-tonifying method can regulate the apoptosis of spermatogenic cells,which provides a new treatment idea and a reliable scientific basis for traditional Chinese medicine in the field of male reproduction.
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ObjectiveTo construct the physical activity intervention effect category and framework for college students with mental and behavioral health and functioning problems based on International Classification of Functioning, Disability, and Health (ICF). MethodsThe typical mental and behavioral health and functioning condition of college students were systematically analyzed using ICF. Relevant literatures about the health and functioning outcomes of college students participating in physical activity were retrieved from the databases of PubMed, Web of Science, EBSCO, and CNKI, from the establishment to August 20th, 2022, and reviewed systematically. ResultsTen English literatures were included, involving ten randomized controlled trials with 848 participants aged 15 to 34 years from seven countries, mainly from the journals of rehabilitation science, sports rehabilitation, rehabilitation psychology and health psychology, and were mainly published after 2016. The typical mental and behavioral health and functioning problems of college students mainly focused on stress, anxiety, depression, sleep disorders, learning fatigue, mobile phone addiction, alcohol drinking disorder, sedentary behavior and physical inactivity. Physical activity interventions included Biodanza, Hatha Yoga, Tai Chi, basketball, Baduanjin, cycling, swimming, roller skating, baseball, skill training, stretching exercise, resistance training, and aerobic exercise, etc. The frequency of interventions was mainly a long-term (four to 14 weeks, one to three times per week) program of high-, moderate-, or low-intensity physical activity. The health outcomes included improving cognitive function, relieving stress, anxiety, depression and learning fatigue, reducing negative automatic thinking, enhancing mindfulness, reducing loneliness and deficiency, improving sleep quality, improving upper limb muscle endurance; promoting the development of exercise habits, increasing physical activity participation, improving activity performance and academic performance, reducing sedentary behavior, drinking behavior and problematic mobile phone use; increasing social interaction, improving health perception and psychosocial function, enriching and improving recreation and campus life, and improving the quality of interpersonal relationships, quality of life and well-being. ConclusionA conceptual framework of physical activity participation of college students with mental and behavioral health and functioning problems is constructed using ICF. The typical mental and behavioral health and functioning problems of college students are mainly classified as mental health and functioning problems, behavioral health and functioning problems. The intervention types of physical activity are divided into physical fitness category, skill category, sports category and combination category. Health outcomes can be reflected in three dimensions: physical and mental health, activity and behavioral health, and overall functioning and quality of life.
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Chronic heart failure(CHF) has become a worldwide public health problem due to its high morbidity and mortality, which seriously endangers people's lifespan and quality of life. In recent years, the treatment strategy of CHF has shifted its emphasis on short-term improvement and transformation of hemodynamics to long-term repair as well as improvement of the biological properties of heart failure. At present, with the continuous deepening of medical research, it has been found that histone acetylation is closely related to the occurrence and development of CHF. Traditional Chinese medicine, via regulating histone acetylation, delays ventricular remodeling, improves energy metabolism, inhibits fibrosis and cardiomyocyte hypertrophy, and intervenes in the development process of heart failure, thus reducing the mortality and the readmission rate and ultimately improving long-term prognosis. Therefore, this study reviewed the mechanism of histone acetylation in the treatment of heart failure as well as its prevention and treatment with traditional Chinese medicine, to provide reference for clinical treatment of CHF.
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Humanos , Medicina Tradicional Chinesa , Histonas/uso terapêutico , Acetilação , Qualidade de Vida , Insuficiência Cardíaca/prevenção & controleRESUMO
Platycodon grandiflorum (Jacq.) A. DC. is a famous medicinal plant commonly used in East Asia. Triterpene saponins isolated from P. grandiflorum are the main biologically active compounds, among which polygalacin D (PGD) has been reported to be an anti-tumor agent. However, its anti-tumor mechanism against hepatocellular carcinoma is unknown. This study aimed to explore the inhibitory effect of PGD in hepatocellular carcinoma cells and related mechanisms of action. We found that PGD exerted significant inhibitory effect on hepatocellular carcinoma cells through apoptosis and autophagy. Analysis of the expression of apoptosis-related proteins and autophagy-related proteins revealed that this phenomenon was attributed to the mitochondrial apoptosis and mitophagy pathways. Subsequently, using specific inhibitors, we found that apoptosis and autophagy had mutually reinforcing effects. In addition, further analysis of autophagy showed that PGD induced mitophagy by increasing BCL2 interacting protein 3 like (BNIP3L) levels.In vivo experiments demonstrated that PGD significantly inhibited tumor growth and increased the levels of apoptosis and autophagy in tumors. Overall, our findings showed that PGD induced cell death of hepatocellular carcinoma cells primarily through mitochondrial apoptosis and mitophagy pathways. Therefore, PGD can be used as an apoptosis and autophagy agonist in the research and development of antitumor agents.
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Humanos , Mitofagia , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/patologia , Linhagem Celular , Autofagia , Apoptose , Proteínas de Membrana , Proteínas Proto-Oncogênicas/genética , Proteínas Supressoras de Tumor/farmacologiaRESUMO
The deep cerebellar nuclei (DCN) integrate various inputs to the cerebellum and form the final cerebellar outputs critical for associative sensorimotor learning. However, the functional relevance of distinct neuronal subpopulations within the DCN remains poorly understood. Here, we examined a subpopulation of mouse DCN neurons whose axons specifically project to the ventromedial (Vm) thalamus (DCNVm neurons), and found that these neurons represent a specific subset of DCN units whose activity varies with trace eyeblink conditioning (tEBC), a classical associative sensorimotor learning task. Upon conditioning, the activity of DCNVm neurons signaled the performance of conditioned eyeblink responses (CRs). Optogenetic activation and inhibition of the DCNVm neurons in well-trained mice amplified and diminished the CRs, respectively. Chemogenetic manipulation of the DCNVm neurons had no effects on non-associative motor coordination. Furthermore, optogenetic activation of the DCNVm neurons caused rapid elevated firing activity in the cingulate cortex, a brain area critical for bridging the time gap between sensory stimuli and motor execution during tEBC. Together, our data highlights DCNVm neurons' function and delineates their kinematic parameters that modulate the strength of associative sensorimotor responses.
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Animais , Camundongos , Piscadela , Núcleos Cerebelares/fisiologia , Cerebelo , Neurônios/fisiologia , TálamoRESUMO
Cognitive impairment seriously affects the quality of life of patients. Clinically, it is common in cerebral ischemia, sepsis and postoperative. Its etiology includes abnormal expression of regulatory molecules in the brain, ischemic injury of brain tissue and abnormal expression of genes and proteins in brain tissues. However, there is no effective treatment at present. Electroacupuncture has a certain effect on cognitive impairment. Its mechanism mainly includes inhibiting oxidative stress response, enhancing synaptic plasticity, inhibiting neuroinflammation, regulating glial cell activity, regulating excitatory amino acids, and improving glucose metabolism.
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Parkinson's disease (PD) is a neurodegenerative disease that seriously endangers the health of the middle-aged and elderly people. The main clinical manifestations include motor symptoms such as bradykinesia, static tremor, and myotonia and non-motor symptoms like constipation, mental disorders, sleep disorders, and autonomic nervous dysfunction. Its etiology and pathogenesis have not been fully understood, and the clinical efficacy is not satisfactory. By searching the relevant literature in China and abroad in recent years, this paper summarized the etiology, pathogenesis, and treatment of PD in both traditional Chinese medicine (TCM) and western medicine as well as the integrated TCM and Western medicine treatment. In general, liver and kidney deficiency is recognized by domestic experts in related fields as the main pathogenesis of PD. The abnormal aggregation of α-synuclein, oxidative stress, mitochondrial dysfunction, ubiquitin-proteasome system dysfunction, neuroinflammation, autophagy, microbiota-gut-brain axis regulation, and excitatory neurotoxicity are closely related to the pathogenesis of this disease. At present, treatment based on syndrome differentiation, empirical formulae from famous doctors, single Chinese herbs, and acupuncture and moxibustion are mainly adopted for the tackling of PD in TCM. Western medicine is still dominated by drug replacement therapy, supplemented by such surgical treatments as traditional immunotherapy, neurotrophic factors, and deep brain stimulation (DBS), rehabilitation and exercise therapy, and scientific nursing. Gene therapy has become a new technical means for the treatment of this disease in recent years. In addition, the combined therapy of TCM and Western medicine has received increasing importance. This paper reviewed the pathogenesis and treatment of PD in TCM and Western medicine, so as to provide reference for its clinical diagnosis and treatment.
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ObjectiveTo predict the mechanism of Sinitang in treating myocardial ischemia-reperfusion injury (MI/RI) based on network pharmacology and verify the prediction results by cellular experiments. MethodThe traditional Chinese medicine system pharmacology database and analysis platform (TCMSP) was employed for retrieval of the main components and potential targets of Sinitang. Online Mendelian Inheritance in Man (OMIM) and GeneCards were employed to obtain the targets of Sinitang in treating MI/RI. STRING was employed to construct the protein-protein interaction (PPI) network, and DAVID to perform gene ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Finally, cellular experiments were carried out to verify the predicted anti-MI/RI mechanism of Sinitang. ResultA total of 105 active ingredients and 234 targets of Sinitang were screened out, among which 116 targets were predicted to be involved in the treatment of MI/RI. The GO annotation gave 587 entries, including 417 biological process entries, 101 cell component entries, and 69 molecular function entries. The KEGG analysis enriched 125 signaling pathways, involving vascular endothelial growth factor (VEGF), phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), forkhead box transcription factor O (FoxO), hypoxia-inducible factor-1 (HIF-1) apoptosis and other signaling pathways. The results of cell viability assay showed that Sinitang increased the survival rate of H9C2 cells damaged by hypoxia/reoxygenation (H/R). Sinitang decreased the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and creatine kinase-MB (CK-MB) in H9C2 cells damaged by H/R. The results of flow cytometry demonstrated that Sinitang decreased the apoptosis rate of H9C2 cells damaged by H/R. Western blot showed that Sinitang down-regulated the expression of Bcl-2 related X protein (Bax) and up-regulated that of B-cell lymphoma-2 (Bcl-2) in H/R-injured H9C2 cells. ConclusionSinitang treats MI/RI in a multi-target and multi-pathway manner, which involves the signaling pathways associated with apoptosis.
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Esophageal carcinoma is one of the malignant tumors with a high mortality rate, accounting for nearly 570,000 cancer deaths worldwide annually, and this number is increasing year by year. In recent years, despite the continuous improvement of treatment programs for esophageal carcinoma, the overall five-year survival rate of esophageal carcinoma is still less than 20% due to the development of drug resistance and the tolerance of patients during the treatment process. Tumor microenvironment (TME) is composed of various cells and related components with tumor cells as the core and featured by hypoxia, acidosis, chronic inflammation and immunosuppression, which plays an important role in the progression of tumors. Studies have found that tumor-associated fibroblasts, tumor-associated macrophages, myeloid-derived suppressor cells and regulatory T cells in TME can promote the proliferation, migration, invasion, and lymph node metastasis of cancer cells by secreting cytokines and activating pro-inflammatory pathways, and promote cancer progression by inducing the drug resistance of cancer cells and evading immunosuppression. Because cancer-associated cells in TME are genetically more stable than cancer cells, have fewer mutations and have lower chance of drug resistance, targeting cancer-associated cells in TME by regulating TME is a new research direction of cancer therapy. Traditional Chinese medicine has the advantages of multi-component and multi-target. It can participate in the regulation of TME through multiple ways, reduce the number of cancer-associated cells in TME, inhibit crosstalk between TME and cancer cells, and restore immune cell function. It is an important source for the regulation of TME and the research and development of drugs targeting cancer-associated cells in TME. In this paper, the role of cancer-associated cells in the TME of esophageal cancer and the current application of traditional Chinese medicine targeting cancer-associated cells in TME are reviewed, so as to provide reference for the research and development of TME targeted drugs for esophageal carcinoma.
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Benign prostatic hyperplasia (BPH) model, as a carrier of BPH, is vital for exploring the pathogenesis of the disease and evaluating the efficacy of corresponding drugs. This paper reviewed the in vivo and in vitro models of BPH, the modeling principles and methods, and evaluation indicators, and analyzed the advantages and disadvantages of different types of models. At present, the BPH model is getting closer to the clinical characteristics of human BPH, providing powerful support for the evaluation of drug efficacy. Furthermore, the model has been developed towards cytology to allow further research on the pathogenesis of BPH. The relevant testing indicators reflect the core pathological changes of BPH from different levels, providing a guarantee for further exploring the pathogenesis of BPH and the development of prevention and control drugs. However, no model can fully simulate the natural development process of human BPH, and each model and evaluation criterion has its unique advantages and limitations. In terms of model evaluation, most BPH models are assessed based on benign prostate enlargement (BPE), and there is still a lack of reliable models to simulate BPH progression and combine with bladder dysfunction. In terms of indicator evaluation, symptom-reflected behavioral indicators are absent in the replication of BPH models in animals. The study of the BPH model in traditional Chinese medicine (TCM) only focuses on the replication and investigation of the "disease" model, rather than the "syndromes" and "signs", which cannot simulate the syndrome differentiation and treatment under the guidance of the TCM theory. In view of the above deficiencies, we should further improve the modeling method based on clinical characteristics, explore the multifactor composite models, especially those of disease-syndrome combination suitable for basic research of TCM, replicate the model closing to disease development, and optimize the evaluation indicators, which is of great theoretical and practical significance to develop drugs for effective prevention and control of BPH.
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Benign prostatic hyperplasia (BPH), a common disease in urology and andrology, is mainly manifested as enlarged prostate glands, bladder outlet obstruction, and lower urinary tract symptoms(LUTS), which seriously affects the quality of life of middle-aged and elderly men. This disease falls into the categories of "retention of urine" and "prostatic hypertrophy" in traditional Chinese medicine (TCM). In recent years,many doctors have put forward their understandings of BPH based on academic classics and their clinical experience. Clinical research on the treatment of BPH with TCM has become increasingly abundant. The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged. The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney. It is basically characterized by deficiency in origin and excess in superficiality. A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients, improving their quality of life, reducing the volume of the prostate, and decreasing postoperative complications. In addition, the external treatment methods of TCM, such as acupuncture therapy, moxibustion, hot water bathing, acupoint application, anal suppository, and enema therapy, are also widely used in clinical practice, demonstrating the diverse ways of TCM in treating BPH. TCM and western medicine complement each other's advantages in the treatment of BPH, thus enhancing the clinical efficacy and reducing the occurrence of long-term complications. This study reviewed the etiology, pathogenesis, and treatment progress of BPH with TCM in recent years, and summarized the current research status. From three aspects of producing high-quality clinical research, standardizing the clinical diagnosis and treatment of TCM, and combining cutting-edge research to explore the mechanism of TCM, it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.
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Rehmanniae Radix is a common medicine of traditional Chinese medicine, which has the function of nourishing Yin and tonifying the kidney, and has a long application history of processing. This medicine was first recorded in Synopsis of Golden Chamber (《金匮要略》), which was mainly produced by steaming and boiling. Its processing materials were diverse. In addition to rice wine, honey, Amomi Fructus, milk, Aquilariae Lignum Resinatum, and Carthami Flos were also recorded in ancient books, but with the evolution of time, the characteristic excipients gradually disappeared. Based on this, starting with different excipients, the author consulted the classics of materia medica and processing specifications in various regions, sorted out the historical evolution of Rehmanniae Radix processing, and explored new methods and new ideas to exert the maximum efficacy on this basis. At the same time, the effects of different processing excipients on the chemical components and pharmacodynamic effects of Rehmanniae Radix were analyzed. After literature review, it was found that Rehmanniae Radix mainly had the effects of clearing heat and cooling blood, nourishing Yin and generating fluid. Its traditional processing excipients generally used rice wine, Carthami Flos and others. After processing with different excipients, there was different effects on the chemical components and pharmacological effects of Rehmanniae Radix. In summary, this paper can provide useful reference for standardized research on different processed products of Rehmanniae Radix.
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ObjectiveTo explore the potential mechanism of Polygonati Rhizoma on the treatment of osteoporosis (OP) based on network pharmacology and molecular docking method and to verify the mechanism by experiments. MethodThe main active ingredients and corresponding targets of Polygonati Rhizoma were screened out from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) 2.3 by conditional searching. The treatment targets were obtained from the genes related to OP and DisGeNET 7.0. The potential target genes of Polygonati Rhizoma for treating OP were obtained by the crossing of the corresponding targets and the treatment targets. Cytoscape 3.7.1 was used to construct the “Polygonati Rhizoma-active ingredient-potential target” network. The protein-protein interaction (PPI) analysis was carried out by STRING 11.0, and the PPI network was constructed. Metascape 3.5 was used to conduct Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of the key targets. The core ingredients and key targets of Polygonati Rhizoma were selected for molecular docking by AutoDock Vina 1.1.2. Finally, the effect of β-sitosterol on osteogenic differentiation of MC3T3-E1 cells in rats was observed. ResultTwelve active ingredients and 32 potential targets of Polygonati Rhizoma for OP treatment were screened out. Six active ingredients including baicalein and β-sitosterol and key targets including protein kinase 1 (Akt1), tumor suppressor p53 (TP53), vascular endothelial growth factorA (VEGFA), proto-oncogene Jun (JUN), matrix metalloproteinase-9 (MMP-9), and proto-oncogene c-Fos (FOS) were obtained by Cytoscape 3.7.1 topological analysis. A total of 995 GO entries and 181 signaling pathways involving the response to reactive oxygen species and regulations of growth were obtained from GO and KEGG enrichment analyses. The results of molecular docking showed that the core active ingredients possessed good binding activities with the respective key targets. The results of cell experiments showed that β-sitosterol promoted the osteogenic differentiation at the concentration of 2.5 μmol·L-1 and 5 μmol·L-1. ConclusionPolygonati Rhizoma had the therapeutic effect on treating OP by regulating inflammation, oxidative stress, apoptosis, and metabolism. The β-sitosterol significantly promoted the osteogenic differentiation of MC3T3-E1 cells.
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OBJECTIVE@#Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25).@*METHODS@#The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured.@*RESULTS@#The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01).@*CONCLUSION@#At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pontos de Acupuntura , Terapia por Acupuntura/métodos , Vértebras Lombares , Imageamento por Ressonância Magnética , AgulhasRESUMO
An ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS) method was established to investigate the pharmacokinetic behaviors of psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, psoralen, isopsoralen, methylnissolin, and neobavaisoflavone in rat plasma after oral administration of Bufei Huoxue Capsules. After SD rats were administered with Bufei Huoxue Capsules suspension by gavage, blood samples were collected from the inner canthus at different time points. After protein precipitation, plasma samples were separated on ACQUITY UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm). The mobile phase consisted of acetonitrile(A) and water(B) containing 0.1% formic acid in gradient elution. The positive and negative ions were measured simultaneously in the multi-reaction monitoring(MRM) mode. The pharmacokinetic parameters were calculated and fitted by DAS 3.2.8. Psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, psoralen, isopsoralen, methylnissolin, and neobavaisoflavone were detected in the rat plasma after drug administration, with AUC_(0-t) of(3 357±1 348),(3 555±1 696),(3.03±0.88),(2.21±0.33),(1 787±522),(2 295±539),(5.69±1.41) and(3.40±0.75) μg·L~(-1)·h, and T_(max) of(1.56±0.62),(1.40±0.70),(0.21±0.05),(0.25±0.12),(0.26±0.11),(0.34±0.29),(0.74±0.59), and 0.25 h. The method is proved specific and repeatable and is suitable for the determination of psoralenoside, isopsoralenoside, calycosin-7-glucoside, ononin, pso-ralen, isopsoralen, methylnissolin, and neobavaisoflavone in the rat plasma, which can be applied to pharmacokinetic study.