[From "different patterns in the same disease" to "analogous patterns in the same disease"].

The relationship between disease in Western medicine (WM) and pattern in Chinese medicine (CM) is a key scientific issue in integrative medicine (IM). The theory of "different patterns in the same disease" has greatly promoted the development of IM and the modernization of CM. However, this concept is frequently misinterpreted in the clinical practice. The individual difference was overemphasized, while common changes among patients suffering from the same disease were neglected. As a result, the identification and treatment of common changes based patterns were weakened. The theory of "analogous patterns in the same disease" combines the concept of "different patterns in the same disease" and "microcosmic identification of patterns", which reveals the core mechanism of CM from the pathogenesis, and identifies the major pattern by analyses of manifestations and pathologic changes. And under the guidance of the theory of "formula corresponding to pattern", the major formula can be set for the major pattern. For those differences among individuals suffering from the same disease, they can be identified as different analogous patterns (subtypes) within a same major pattern, and can be treated with analogous formulae deriving from modified major formula. The theory of "analogous patterns in the same disease" clarifies the intrinsic relationship between the disease and pattern, perfects and develops the theory of "different patterns in the same disease", and it is an important innovation in thinking ways and research methods of IM.

[Effect of compound bushen recipe on chronic fatigue syndrome in C. elegans: an experimental study].

OBJECTIVE: To evaluate the effect of compound bushen recipe (CBR) in improving the survival state of stress and the overall life span in C. elegans by simulating chronic fatigue syndrome (CFS) under various stress states. METHODS: The tolerance and the average survival time of adult larvae against heat stress (35 degrees C), oxidative stress (250 microg/mL juglone), and in vivo Abeta protein toxicity (Abeta(1-42) transgenic mutant CL4176) under the intervention of the high (500 mg/L), middle (250 mg/L), and low (100 mg/L) dose CBR were observed. The effect of CBR on the average live time (at 25 degrees C), movement distance in 20 seconds, the frequency of pharyngeal pump in 30 seconds, and the reproductive capability were assessed. RESULTS: Compared with the control group, the survival time of heat stressed C. elegans could be significantly increased in each CBR group (P < 0.01). The survival time of heat stressed C. elegans could be elongated, the protein toxicity be attenuated, and the live time prolonged in the high and middle dose CBR groups (P < 0.01, P < 0.05).The movement distance and the frequency of pharyngeal pump could also be increased in the high dose CBR group (P < 0.01). There was no statistical difference in the reproductive capability among all groups (P > 0.05). CONCLUSIONS: CBR could significantly enhance the stress capacity of C. elegans against internal and external environment, and prolong their lifespan. It did not interfere their normal production, and also could improve the quality of life, thus laying a foundation for further mechanism studies and pharmacological researches on CBR in preventing and treating CFS.

[Analysis of the osteogenetic effects exerted on mesenchymal stem cell strain C3H10T1/2 by icariin via MAPK signaling pathway in vitro].

OBJECTIVE: To investigate the effects of icariin, an effective extract from traditional Chinese medicine Epimedium pubescens with the function of tonifying kidney, in promoting osteogenesis of mesenchymal stem cell line C3H10T1/2, and to explore the underlying mechanism. METHODS: After culture with icariin (0, 10(-7), 10(-6), 10(-5), and 10(-4) mol/L) and osteogenic supplement for 26 d in vitro, osteogenic differentiation of C3H10T1/2 cells was detected by alkaline phosphatase (ALP) assay. The RNA was extracted from cells cultured with 10(-5) mol/L icariin for 2, 8, 24 and 48 hours, and mRNA expressions of p38, p42 and p44 were measured using real-time reverse transcription-polymerase chain reaction (PCR) method. Three main proteins of MAPK signaling pathway (p38, and extracellular signal-regulated protein kinase (ERK), also named p42/44) and c-Jun N-terminal kinase (JNK) and their phospho-products were examined using Western blotting after icariin treatments of 10, 30, 60 and 120 min. RESULTS: Icariin at a dose of 10(-5) mol/L, when combined with the osteogenic supplement, had the best ability to promote osteogenic differentiation on C3H10T1/2 cells. Based on real-time PCR, the authors found that after two-hour ICA treatment, the gene expression of p38 revealed a significant decline compared with the control group (P<0.01). The levels of p42 and p44 mRNAs were decreased greatly after two-hour ICA treatment, while increased after 48-hour ICA treatment (P<0.05, P<0.01). There was no significant difference at other time points (P>0.05). Phospho-p42 was decreased after 10-minute icariin treatment, while phospho-p38 expression displayed an increase after 10- and 30-minute of treatment with icariin. There was no notable difference in phospho-JNK expression at these four time points. CONCLUSION: Icariin promotes differentiation of the mesenchymal stem cells C3H10T1/2 into osteoblasts, and its effect is related to the restraining of ERK expression and activation of p38 expression in the MAPK signaling pathway.

[A logical framework derived from philosophy of language for analysis of the terms of traditional Chinese medicine and an example for analysis of "kidney essence"].

The true meanings of the terms of traditional Chinese medicine (TCM) need to be analyzed on a logical basis. It is not suitable to use a new term to interpret an old term of TCM, or arbitrarily specify the special term of TCM corresponding to some substances of modern medicine. In philosophy of language, language has a logical structure, which reflects the structure of the world, that is to say, language is the picture of the world in a logical sense. Using this idea, the authors collected the ancient literature on "kidney essence", and extracted each necessary condition for "kidney essence". All necessary conditions formed a sufficient condition to define the term "kidney essence". It is expected that this example can show the effectiveness of philosophy of language in analysis of the terms of TCM.

[Icariin and its pharmaceutical efficacy: research progress of molecular mechanism].

Icariin is one of the key active components of Epimedium species, which is most widely applied to supplement the kidney in traditional Chinese medicine. Scientific research has found that icariin possesses extensive therapeutic effects such as protecting neurons from injury, promoting growth of neuronal synapse, improving sexual dysfunction and bone morphogenesis, as well as anti-inflammation, anti-tumor and anti-depression functions. Considering that molecular mechanism is the fundamental basis for pharmaceutical efficacy of icariin, in this article, the authors retrospectively retrieved 122 scientific papers recorded in the PubMed database with "icariin" in the title from January 1, 1995 to January 5, 2011. It was found that icariin has been closely highlighted in the intervention of p38 mitogen-activated protein kinases and phosphatidylinositol 3-kinase/Akt signal pathways, inhibition of phosphodiesterase 5, and regulation of nuclear receptors. Besides, the authors also discussed the main orientation for molecular mechanism of icariin in future research.

[Immunoregulatory mechanisms of an optimal Chinese herbal monomer compound in mice with allergic rhinitis].

OBJECTIVE: To study the immunoregulatory effect of an optimal Chinese herbal monomer compound, which consists of three monomers, namely, icariin, baicalin and Astragalus saponin I, in a mouse model of allergic rhinitis. METHODS: A mouse model of allergic rhinitis was established by intraperitoneal injection of ovalbumin and aluminum hydroxide gel suspension. The splenic lymphocytes of the mice were separated, cultured in 96-well plates and divided into three groups: control group, concanavalin A group and compound group. Splenic lymphocyte proliferation was detected by cell counting kit-8 method at different time points. Cell cycle distribution was observed by flow cytometry (FCM) also at different time points. The changes of intracellular calcium concentration of splenic lymphocytes were measured by fluorescence microplate reader after the cells were incubated with fluorescence probe Fluo-3/AM. RESULTS: The Chinese herbal monomer compound could inhibit cell proliferation induced by concanavalin A (P<0.01). And the inhibition presented a time-effect relationship. With extending of the action time, the inhibition rate gradually increased and reached peak at the 48th hour. FCM test revealed the fact that concanavalin A could promote cells to enter into the mitosis by reducing the percentage of cells in G0/G1 phases while increasing the percentage of cells in S and G(2)/M phases. Compared with the concanavalin A, the compound could increase the percentage of cells in G(0)/G(1) phases and at the same time reduce the percentage of cells in S and G(2)/M phases at different time points, with the effect most significant at the 24th hour (P<0.05 or P<0.01). The results of the test taken by the fluorescence microplate reader revealed that the fluorescence value of the concanavalin A group increased with time in the previous 24 h while the compound could reduce this trend obviously, thus reduce the intracellular calcium concentration (P<0.01). CONCLUSION: The Chinese herbal monomer compound can inhibit the proliferation of cultured splenic lymphocytes of mice with allergic rhinitis. The effects of the compound of lowering intracellular calcium concentration and arresting cell cycle at G(0)/G(1) phases from entering into S and G(2)/M phases are responsible for its antiproliferation activity.

[Effects of active ingredients in three kidney-tonifying Chinese herbal drugs on gene expression profile of bone marrow stromal cells from a rat model of corticosterone-induced osteoporosis].

OBJECTIVE: To observe the effects of icariin, psoralen and oleanolic acid, the three active ingredients of Yinyanghuo (Herba Epimedii Brevicornus), Buguzhi (Fructus Psoraleae) and Nuzhenzi (Fructus Ligustri Lucidi), respectively, on gene expression profile of bone marrow stromal cells (BMSCs) from rats with corticosterone-induced osteoporosis. METHODS: Fifty Sprague-Dawley rats were randomly divided into normal control group, untreated group, icariin group, psoralen group and oleanolic acid group (the last three groups are called treatment groups). Rats in untreated group and treatment groups were subcutaneously injected with corticosterone once a day for 14 d while rats in normal control group were injected isodose of olive oil. Rats in the treatment groups were intragastrically administered with icarrin, or psoralen, or oleanolic acid at 20 mg/(kg·d), respectively, 5 d prior to modeling for 19 d. The body weight of rats was recorded on the 1st, 4th, 7th, 11th, and 14th day after modeling, respectively. All rats were sacrificed and the fourth lumbar vertebrae were harvested for micro-CT scanning to evaluate bone mass. BMSCs were obtained ex vivo by the methods of bone marrow adherent culture. The mRNAs of BMSCs were detected by using gene chip technique on the 7th day of culture. RESULTS: There was no significant difference in body weight of rats between untreated group and treatment groups. Micro-CT showed no significant difference in lumbar vertebral morphometry between the untreated and the normal control, or the untreated and treatment groups. In microarray, icariin, psoralen and oleanolic acid changed expressions of 11, 12 and 15 genes compared to the normal level, respectively. These three active ingredients all acted on 5 genes involving osteoblast differentiation, cell cycle regulation, cell metabolism and Notch signal pathway. CONCLUSION: Traditional Chinese herbal drugs with the effect of tonifying the kidney may promote BMSCs to differentiate into osteoblasts by regulating BMSCs cycles and cell metabolism, and show therapeutic effect on osteoporosis. However, the exact mechanisms need to be further studied.

[Optimal combination of baicalin, icariin and Astragalus saponin I from a Chinese herbal compound Biminne].

OBJECTIVE: To study the optimal combined ratio of baicalin, icariin and Astragalus saponin I from a Chinese herbal compound Biminne. METHODS: Firstly, a mouse model of allergic rhinitis was established by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel suspension, and the effective dose range of baicalin, icariin and Astragalus saponin I was detected by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide inner salt method. Secondly, 10 groups of combinations of baicalin, icariin and Astragalus saponin I assembled by U(10)(10(8)) form were employed to determine the optimal combination by means of analyzing of the inhibitory effect on the splenocyte proliferation. Finally, the effects of each effective ingredient and the optimal combination were compared by observing the splenocyte proliferation, the contents of interleukin-4 (IL-4), IL-5, interferon-gamma (IFN-gamma) in supernatant of the splenocyte cultures and the ratio of IL-4 to IFN-gamma in order to verify the result. RESULTS: Baicalin or icariin at concentrations ranging from 2 to 10 micromol/L, and Astragalus saponin I from 1 to 10 micromol/L effectively suppressed the splenocyte proliferation. When the proportion of baicalin, icariin and Astragalus saponin I was 1:2.14:2.65, the inhibitory effect was most remarkable. Further research confirmed the rationality of the optimal combination. CONCLUSION: An optimal combination of the major effective ingredients from Chinese herbal compound Biminne most effectively suppresses the proliferation of splenocytes from sensitized mice and regulates the cytokine secreting.

[Activating effect and mechanism of epimedium on endogenous stem cells].

Stem cells are the cells with capacities of self-renovation, multiplication and differentiation. By activating endogenous stem cells to promote regeneration response has provided a new thinking for the treatment of degenerative diseases. The authors found that epimedium flavonoids (EF) can promote the proliferation and migration of adrenocortical stem cells in corticosterone-treated rats (as a model of Shen-yang deficiency); and through gene-chip test it was showed that EF could significantly up-regulate the growth hormone (GH), growth hormone releasing hormone (GHRH) and other growth factors such as insulin-like growth factor binding protein (IGFBP) and nerve growth factor (NGF) in the model rats. In natural aging rats (as model for Shen deficiency), EF could make the gene expression of multiple tissues youthening, and up-regulate the lowered expressions of GH, GHRH, IGFBP and NGF, etc. Further study on the in vitro isolated and cultivated neuro-stem cells proved that EF and its components have direct promoting actions on stem cell proliferation. All the above-mentioned outcomes indicated that the actions of EF and its extracts on stem cells are possibly the cytological basis for their effects on counteracting the suppression of glucocorticoids on hypothalamus-pituitary-adrenal (HPA) axis and retarding aging; also illustrated that TCM could treat diseases by a way of activating endogenous stem cells through mobilizing and elevating hormones and cytokines levels, and bringing the reserved potential of organism into full play.

[Transition of studying on Shen deficiency syndrome and aging from holistic concept to systematic biologic viewpoint].

Holistic concept is a characteristic contribution of Chinese medicine to medical science. Based on holistic concept, we investigated the correlation of Shenyang deficiency syndrome with the hypothalamus-pituitary-target gland axis; and revealed by gene chip technique the molecular network regulatory rule of intervention with Chinese drugs on hypothalamus-pituitary-adrenal-thymus axis in aged rats as a model for Shen deficiency syndrome; also the two major gene regulation pathways, namely, the neuro-endocrine-immune pathway and the neuro-endocrine-bone metabolic pathway, in hypothalamus, pituitary, adrenal, lymphocytes, kidney, liver, bone of aged rats, so as to advance the holistic research on Chinese medicine syndromes. Recently, based on the dynamic, intervention and multi-layer integration requirement of systematic biology, the common rule of aging was found at three different levels, the whole genomic transcription level, the metabolic level and the single ageing signaling pathway level. Meanwhile, it was demonstrated that the temporal and spatial association of genes will be weakened gradually along with aging. And Epimedium Flavonoids (EF), an extracts from Epimedium have been proved to be capable of effectively reversing both of these systemic changes. Thus, the transition of study from holistic concept to systematic biologic viewpoint could surely promote the progression of Chinese medicine to modern life science.

Effects of Chinese herbal formula Biminne in regulating endocrine-immune function in mice with airway allergy.

OBJECTIVE: To investigate the effects of Biminne, a traditional Chinese herbal formula, in regulating the endocrine-immune function in mice with airway allergy. METHODS: Forty BALB/c mice were randomly divided into four groups: control group, untreated group, Biminne group, and dexamethasone (Dex) group. The murine model of airway allergy was established by intraperitoneal injection sensitization and intranasal challenge with ovalbumin (OVA). On day 28, the mice were sacrificed and the sera were collected. The lung tissue of mice was removed for haematoxylin-eosin staining and the pathological changes were observed. The spleen cells of mice were isolated and the ratio of Th2/Th1 was determined by flow cytometry. The isolated spleen cells were also cultured in 24-well plates in the presence of concanavalin A and the supernatants were collected after 72-hour culture. Levels of interleukin-4 (IL-4), IL-5 and interferon-gamma (IFN-gamma) in the supernatants and the corticosterone level in sera were analyzed by enzyme-linked immunosorbent assay. RESULTS: Biminne significantly relieved the inflammatory reaction in the lung tissue of airway allergic mice. Compared with the control group, the Th2 cells in the untreated group increased, while the IFN-gamma level decreased and the ratio of Th2/Th1 increased significantly, showing a Th2 response priority. Biminne treatment could down-regulate the Th2 cells and their cytokines IL-4 and IL-5, and up-regulate the Th1 cells and their cytokine IFN-gamma. So the ratio of Th2/Th1 decreased significantly, shifting to the control level. In addition, Biminne also inhibited the reduction of the serum corticosterone of sensitized mice. CONCLUSION: The Chinese herbal formula Biminne can reverse the functional disorder of the endocrine-immune system, which may explain its therapeutic effects on airway allergic disease.

Shen-Jing as a Chinese Medicine Concept Might Be a Counterpart of Stem Cells in Regenerative Medicine.

As the epitome of the modern regenerative medicine, stem cells were proposed in the basic sense no more than 200 years ago. However, the concept of "stem cells" existed long before the modern medical description. The hypothesis that all things, including our sentient body, were generated from a small origin was shared between Western and Chinese people. The ancient Chinese philosophers considered Jing (also known as essence) as the origin of life. In Chinese medicine (CM), Jing is mainly stored in Kidney (Shen) and the so-called Shen-Jing (Kidney essence). Here, we propose that Shen-Jing is the CM term used to express the meaning of "origin and regeneration". This theoretical discovery has at least two applications. First, the actions underlying causing Shen-Jing deficiency, such as excess sexual intercourse, chronic diseases, and aging, might damage the function of stem cells. Second, a large number of Chinese herbs with Shen-Jing-nourishing efficacy had been proven to affect stem cell proliferation and differentiation. Therefore, if Shen-Jing in CM is equivalent with stem cells in regenerative medicine, higher effective modulators for regulating stem-cell behaviors from Kidney-tonifying herbs would be expected.

[Establishment of a quantitative mathematical model of Shen-deficiency syndrome based on whole-genome transcriptional profiles].

OBJECTIVE: To establish a quantitative mathematical model of Shen-deficiency syndrome of TCM by utilizing whole-genome transcriptional profiles. METHODS: The 4, 10, 18, 24 months old SD rats were used, 24-months aged rats intervened by Epimedium Flavonoids (EF) were adopted in the experiment. Rats' hypothalamus, pituitary, adrenal, lymphocytes, bone, liver, and kidney, and spleen were taken for determining whole-genome mRNA expression with gene chip, and a quantitative nerve network model was established by utilizing the gene expression profile of different aged rats, then the model was used to evaluate the effects of EF on Shen-deficiency syndrome. RESULTS: Totally 199 genes showing age-dependent characteristics were screened out from the 7 kinds of tissue, most of them were neuro-endocrine immune related genes. Evaluation based on the mathematical model showed the age of hypothalamus, pituitary, adrenal, liver, kidney, bone, and spleen in the 24-months rats after EF intervention was 12.64, 10.87, 8.10, 12.70, 11.93, 13.14, and 10.13 months, respectively. CONCLUSION: A quantitative mathematical model can be established based on the gene expression profile, it is suitable for estimating the efficacy of Shen-tonifying drugs. EF can make the gene expression of elder close to the young state, suggesting that EF has action in improving Shen-deficiency syndrome and delaying senescence.

[Effect and mechanism of Epimedium flavanoids for aging retardation from viewpoint of transcriptomics and metabonomics].

OBJECTIVE: To investigate the effect and its mechanism of Epimedium flavanoids (EF) in retarding aging with different systematic viewpoints. METHODS: Hypothalamus, pituitary, adrenal and lymphocytes taken from 4-, 10-, 18-, 24-month old rats and from EF treated 24-month old rats were used to measure whole genome mRNA expression by gene array. Serum samples were used for metabonomic assay with high performance liquid chromatography. Using specific gene chip for NF-kappaB signaling pathway to detect the gene expression of the molecule related to that pathway in lymphocytes. Then, a neural network (NN) model was established upon the data obtained to quantitatively evaluate the degree of aging and the efficacy of drug intervention. RESULTS: Gene expression of 199 genes showedan age-dependent pattern, most of which were reversed by EF, and the output of NN model showed that EF made the transcriptomics of 24-month old rats to 8-13 months. Seventeen metabolites among the 1,885 peaks detected were identified to have significant age-depending changes, and EF intervention reset the level of metabolites to a younger (18-month) level. The integral level of gene expression for NF-kappaB signaling pathway decreased significantly along with the increasing of age, and was significantly elevated by EF, NN model showed it approached to 10.5-month old. CONCLUSION: Phenotype of aging at different levels demonstrates a common age-dependent trend; EF can reverse this age-dependent change at different levels in a synchronous manner.

[Study on changes of protein phosphorylation of p65, IkappaBalpha and IkappaBepsilon in lymphocytes of rats in progress of aging and interventional effect of Epimedium flavonoids].

OBJECTIVE: To study the characteristics of protein phosphorylation of p65, IkappaBalpha and IkappaBepsilon in lymphocytes of rats in the progress of aging and the the interventional effect of Epimedium flavonoids (EF). METHOD: We chose the lymphocytes derived from SD rat spleen. We divided the SD rats into five groups i. e. 4 months (4 m), 27 months (27 m), the 27 m EF treated group (27 m + EF), and we also observed the whole interventional effect of PDTC (a NF-kappaB inhibitor) on old rat groups (27 m PDTC, 27 m PDTC + EF ) when IkappaBepsilon, IkappaBalpha were detected. Through the western-blotting analyses, we studied the entire characteristics and distinctions of phosphorylation expression in molecules related to NF-kappaB signal transduction pathway p65, IkappaBepsilon and IkappaBalpha in lymphocytes across the age spectrum of rats in aging. We also observed the whole interventional effect of EF on lymphocytes of old rats. RESULT: With the increasing of age, the mean level of phosphorylation expressions of p65, IkappaBalpha and IkappaBepsilon in rat spleen lymphocytes decreased obviously, When inhibited NF-kappaB by PDTC, there was decreased evidently, while PDTC + EF can active NF-kappaB family and the above molecules were increased to a certain extent. CONCLUSION: The phosphorylation expressions of p65, IkappaBalpha and IkappaBepsilon in rat spleen lymphocytes were not enouphe, EF have a strong effect to upregulated the expression of them during aging.

[Comparison of gene expression profiles between rats of Shen deficiency syndrome and Shen-yang deficiency syndrome differentiated according to therapeutic efficacy of drugs used].

OBJECTIVE: To explore similarity and difference of connotation between Shen deficiency syndrome (SDS) and Shen-yang deficiency syndrome (SYDS) on the molecular level. METHODS: The senescent SD rats and corticosterone-treated rats were adopted for models of SDS and SYDS respectively, their syndrome was differentiated according to the therapeutic efficacy of treatment with epimedium flavonoids (EF). The gene expression profiles of hypothalamas, pituitary, adrenal gland and lymphocytes (HPAT axis) were detected before and after EF treatment using gene chip provided by Affymetrix company. RESULTS: As compared with the young rats, the ageing rats and corticosterone-treated rats showed a significant down-regulation in highly consistent pattern, of various neurotransmitters of HPAT axis firstly, followed with that of growth and sex hormone related genes. EF could reverse the above genes expression in both models, and for SYDS model rats, it could also significantly up-regulate the gene expressions of heat shock protein, cytochrome P450 and thyroid stimulating hormone (TSH). CONCLUSION: Both SDS and SYDS model rats show connotation of Shen deficiency, and the substantial base of Shen-yang deficiency syndrome resides in the process of oxidative phosphorylation of energy metabolism accelerated by thyroid hormone.

[Important action of improving adrenocortical function for certain diseases recovery].

It has been found that the hypofunction status of hypothalamus-pituitary-adrenal (HPA) axis exists in patients with Shen-yang deficiency syndrome of TCM, also presents in most asthma patients. Seasonal attack of asthma can be prevented with Shen-tonifying drugs by improving adrenocortical function. Since patients subject to long-term glucocorticoids display hypofunction condition of HPA axis, Shen-tonifying drugs should be helpful to gluocorticoid withdrawal for getting higher success rate. Basic researches also indicated that the activating of adrenocortical stem cells and promoting regeneration of adrenal cortex is one of the mechanisms underlying improvement of adrenocortical function. Series of research showed that hypofunction of adrenocortex is the general pathological change in some diseases, so, Shen-tonifying drugs act a part in unitarily modulating the adrenocortical function, to get the therapeutic effect of both regulating the whole and improving the local.