Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan最新文献

Objective: To research the subtyping and treatment of depression by leveraging studying on extensive Traditional Chinese Medicine (TCM) experiences through artificial intelligence (AI).

Methods: We retrieved depression-related literature published from inception to April 2023 from databases. From these sources, we extracted symptoms, signs, and prescriptions associated with depression. By utilizing the tree number system in the medical subject headings (MeSH), we established a hierarchical relationship matrix for symptoms/signs, as well as depression sample fingerprints. Using an unsupervised clustering algorithm, we constructed a machine learning model for classifying depression patients. Furthermore, we conducted an analysis of medication rules for each depression cluster.

Results: We created a My Structured Query Language (MySQL) database containing datasets of depression-symptoms/signs and depression-herbs, through mining 3522 published clinical literatures on TCM diagnosis and treatment for depression. We established hierarchical relationships among symptoms/signs of depression patients. Our unsupervised clustering analysis revealed that depression patients could be classified into 9 subtypes, with each subtype corresponding to a specific treatment prescription. Notably, one of the depression subtypes was consistently treated by Qi-tonifying formulas and herbs. This finding was further supported by data from Qi-deficiency patients, as there was a high similarity in the top symptoms/signs shared between this subtype and Qi-deficiency diagnosed by TCM.

Conclusions: This study identified the subtypes and TCM treatment of depression by using machine learning and text mining.

Objective: To evaluate the efficacy of Yiqi Chupi powder (, YQCPP) in reducing cancer-related fatigue (CRF) among patients with colorectal cancer (CRC) undergoing chemotherapy.

Methods: This was a prospective, randomized controlled trial. Eligible patients were randomly assigned to either the experimental group, receiving a 12-week regimen of YQCPP and capecitabine plus oxaliplatin (XELOX) chemotherapy, or the control group, receiving a 12-week XELOX chemotherapy alone. Outcome measures were collected at baseline and subsequently at weeks 3, 6, 9, and 12 of the treatment period. The primary outcome was the Piper Fatigue Scale (PFS) score. The secondary outcomes were the Traditional Chinese Medicine syndrome and Karnofsky Performance Status (KPS) scores.

Results: Of 84 patients initially enrolled, 78 (92.9%) were evaluable. The experimental group exhibited significantly lower PFS scores (P <0.05) compared to the control group across all four subscales and total scores at 6, 9, and 12 weeks (P < 0.05). Additionally, the experimental group achieved a significantly higher effective rate (84.0% vs 7.89%, P < 0.05). The number of patients in the experimental group with improved or stable KPS scores increased significantly over the course of the treatment period in comparison to the control group (P <0.05) at 6, 9, and 12 weeks. There was a significant improvement in overall quality of life at weeks 9 and 12 in the experimental group.

Conclusion: YQCPP may decrease the CRF and improve quality of life in patients with CRC undergoing chemotherapy.

Objective: To evaluate the safety and efficacy of Hewei Jiangni recipe (, HWJNR) for treating nonerosive gastroesophageal reflux (NERD) with cold-heat complex syndrome and to clarify its mechanism based on correlation analyses of intestinal flora and metabolites.

Methods: Seventy-two patients with NERD and the Traditional Chinese Medicine (TCM) syndrome of intermingled heat and cold were randomly assigned to either the TCM group or the Western Medicine group, each receiving 8 weeks of treatment. The primary outcome was the score of the gastroesophageal reflux disease questionnaire (GERD-Q). Additionally, 10 healthy individuals were recruited. Mechanistic outcomes included correlation analyses of intestinal flora and metabolites in healthy individuals and NERD participants before and after treatment.

Results: After 8 weeks, the effectiveness rate was 90% in the TCM group and 86.67% in the Western Medicine group (P >0.05). Compared with omeprazole, the TCM group significantly improved quality of life and alleviated symptoms such as loss of appetite, fatigue, bowel sounds, and coldness in the hands and feet (P < 0.05). Dysregulation of intestinal flora and metabolic pathways in NERD patients was restored to balance after TCM treatment, which appeared related to the TCM regulation of "cold and heat disorders."

Conclusion: HWJNR was clinically as effective as omeprazole and demonstrated advantages in improving quality of life.

Objective: To investigate the effect of central amino acid metabolic profiles on acupuncture analgesia.

Methods: BALB/c mice were injected with Complete Freund's Adjuvant (CFA) and acupuncture was applied at Zusanli (ST36) for 7 d after modeling. Paw withdrawal thermal latency (PWTL) and paw withdrawal mechanical threshold (PWMT) were tested during the experiment. The level of prostaglandin E2 (PGE2) was measured by enzyme-linked immunosorbent assay (ELISA). Using liquid chromatography-mass spectrometry (LC-MS/MS) based on the multiple reaction monitoring (MRM)-targeted metabolomic approach, neurotransmitter in the brain and spinal cord as well as were detected, further tryptophan metabolites in spinal cord were detected, and the data was analyzed using multiquant software.

Results: Acupuncture significantly improved the PWTL and PWMT on the modeling side of CFA mice, and simultaneously, decreased the PGE2 level. Based on targeted neurotransmitter analysis, acupuncture increased the expression of phenylethylamine and decreased N-acetyl serotonin in the brain, while significantly up-regulated serotonin, and down-regulated the levels of homovanillic acid, 5-hydroxy-L-tryptophan and 3,4-Dihydroxyphenylethylene Glyco in the spinal cord. Further investigation targeted tryptophan metabolism found that acupuncture considerably decreased the content of tryptophan and L-kynurenine, but increased serotonin.

Conclusions: This study aims to assess changes in central neurotransmitters of CFA mice treated with acupuncture, revealing that abnormalities in central neurotransmitter metabolism may be a potential biochemical basis for pain. More importantly, our preliminary study suggests the potential role of tryptophan and its metabolites in acupuncture analgesia, which may provide new insight and direction for the pain management interface of neurometabolism.

Objective: To determine direct targeting of localized adiposity through Morus alba Linne bark injection based on pharmacology network analysis.

Methods: Male C57BL/6J mice were fed a high-fat diet (HFD) to induce obesity. After 6 weeks on HFD, the water extract of Morus alba L.bark (MAB, 2 mg/mL) was locally injected into one inguinal fat pad, while saline was injected into the other side, 3 times/week for 6 weeks (n = 6/group). The water extract of MAB was freeze-dried and then diluted in saline before use.

Results: HFD-fed mice treated with local MAB topical injection showed reduced adipocyte weight and size in inguinal fat pads by dual-energy X-ray absorptiometry. No toxicity changes seen in liver, spleen, kidney tissue, or alanine aminotransferase / aspartate aminotransferase levels in serum by MAB injection. Protein levels of phosphorylated insulin receptor substrate-1 and glucose transporter type 4, and mRNA expression of adiponectin, were increased in inguinal adipose tissue injected with MAB locally. Locally MAB injection led to a decrease in glucose-6-phosphatase and phosphoenolpyruvate carboxykinase, linked to gluconeogenesis, while forkhead box protein O1, which regulates these factors, was increased. Moreover, there was an increase in adenosine 5'-monophosphate-activated protein kinase, related to lipogenesis, as well as elevated levels of hormone-sensitive lipase and fatty acid synthase, both associated with lipolysis. These results support the 'insulin signaling pathway' and 'regulation of lipolysis in adipocytes' identified in the Kyoto Encyclopedia of Genes and Genomes pathway through network analysis.

Conclusion: This study suggests that MAB topical injection exhibits localized fat reduction by inhibiting insulin resistance, gluconeogenesis and lipogenesis mediator, while activating lipolysis enzymes within targeted adipose site.

Objective: To explore the mechanism of action of Tiaogeng decoction (, TG) in alleviating oxidative stress damage in the hippocampus of a mouse model of cognitive impairment.

Methods: Amyloid precursor protein/presenilin-1 (APP/PS1) transgenic female mice were randomly divided into model, estradiol valerate, low-, medium-, and high-dose TG groups, female C57 mice were used as the control group (n = 12/group). After 12 weeks of treatment, the behavior of mice was tested with the Morris water maze, and brain tissue samples were collected, and changes in hippocampal neurons were observed using electron microscopy. The deposition of beta-amyloid protein (Aβ) amyloid plaques in the hippocampus was determined by light microscopy. Aβ1-42 protein levels were detected through immunofluorescence. Oxidative stress indicators in the hippocampus were detected by enzyme linked immunosorbent assay. The expressions of nuclear factor-erythroid 2-related factor 2 (Nrf2), c-Jun N-terminal kinase (JNK), phospho-JNK (p-JNK), B-cell lymphoma-2 (Bcl-2), caspase-9, and cleaved caspase-9 were detected by Western blot. Hippocampal cell apoptosis was detected using the terminal deoxynucleotidyl transferase-mediated nick end Labeling.

Results: TG improved the cognitive function of APP/PS1 mice, as judged by improvements in several indices from the Morris water maze test. TG increased Nrf2, superoxide dismutase, and heme oxygenase-1 protein expression and reduced malondialdelyde and reactive oxygen species expression. TG also inhibited the expression of JNK proteins, upregulated the expression of Bcl-2, and downregulated the expression of caspase-9, reducing cell apoptosis. TG decreased the percentage of the hippocampal cornu ammonis 1 area positive for Aβ1-42, reducing mitochondrial damage caused by oxidative stress and Aβ protein deposition.

Conclusions: TG may improve memory ability while reducing oxidative stress and apoptosis. It also reduces Aβ protein deposition in the hippocampus, protecting the central nervous system and improving memory function. TG may reduce the risk of AD.

Objective: To investigate the efficacy and mechanism of Traditional Chinese Medicine Yishui Shengxue pills (, YSSX) in mouse models of immunosuppression induced by three chemotherapy drugs.

Methods: We determined an optimal intervention dose of YSSX to investigate efficacy. Changes in immune cell subpopulations were detected by flow cytometry, while immunofluorescence, immunohistochemistry, and other molecular biology methods, were used to verify pathway targets. We used PX-478, an inhibitor of hypoxia-inducible factor-1α (HIF-1α), to validate the mechanism of action.

Results: Analysis showed that YSSX enhanced the immunity of mouse models of immunosuppression. At the cellular level, YSSX reduced the numbers of myeloid-derived suppressor cells (MDSCs) and enhanced CD8+ T cell infiltration. At the molecular level, YSSX reduced the expression levels of hypoxia-inducible factor-1α (HIF-1α), inducible nitric oxide synthase (iNOS), general control nonderepressible 2 (GCN2), and eukaryotic initiation factor 2α (eIF2α) in mouse MDSCs, thereby reducing the transcription of HIF-1α, GCN2, and eIF2α mRNA. Collectively, these changes led to the increased secretion of interferon-γ and interleukin 12, concomitant with a reduction in tumor necrosis factor-α level.

Conclusions: YSSX improved MDSC-mediated immunosuppression in a mouse model after chemotherapy by inhibiting the HIF-1α/iNOS-GCN2/eIF2α signaling axis.

Objective: To explore the clinical observation of white eye distribution characteristics of hyperlipidemic patients based on artificial intelligence digital eye diagnosis technology.

Methods: One hundred and fifty subjects were examined in the outpatient and inpatient departments of Guang'anmen Hospital of the China Academy of Traditional Chinese Medicine from 01 February 2022 to 01 February 2023, including 80 cases in the hyperlipidemic patient (HLP) group and 70 cases in the normal lipid level patient (NC) group. The two groups were collected and extracted by the artificial intelligence visual diagnostic instrument and analyzed by the MyEyeD-10 white eye shadowless imaging health intelligence analysis system. Finally, SPSS 26.0 (Version X; IBM Corp., Armonk, NY, USA) was used for statistical processing.

Results: Significant differences were noted in the scores of "spot" and "foggy" features between the two groups. Between groups, the "spot" feature score of the white eye morphology in the HLP group (11.07 ± 3.22) was higher than that in the NC group (7.50 ± 4.11) (P <0.01). Moreover, the "foggy" feature score of the eye morphology in the HLP group (8.37 ± 2.25) was higher than that in the NC group (P <0.01), higher than that of the NC group (5.72 ± 1.21) (P <0.05). There were significant differences in the "A" (stomach), "B", "O" (spleen), and "M" (liver) eye-contact region scores between the two groups, and the "B", "O" (spleen) and "M" (liver) eye-contact region scores were significantly different. The scores of the white eye channel region in the HLP group were significantly higher than those in the control group, with the "A", "B", and "O" regions (P <0.01), "M" region (P <0.01), "A", "B", "O", and "M" region (P <0.01). "M" zone (P <0.05). The scores of "dull red" and "yellow" features were significantly different, and the scores of "dull red" and "yellow" colors of the white eye choroid in the HLP group were significantly higher than those in the HLP group. The scores of "dull red" and "yellow" were significantly higher in the HLP group than in the NC group (P <0.01).

Conclusion: The morphological features of the white eye ocular image, the white eye chakra's color, and the bulbar conjunctiva's vascular zoning are closely related to hyperlipidemia. Importantly, these provide a reference for the objectivity and precision of the identification of Chinese medicine by looking at the eyes.

Objective: To investigate the effect of Shisiwei Jianzhong decoction (, SJD) on non-severe aplastic anemia (NSAA).

Methods: Bone marrow mesenchymal stem cells (BMSCs) were isolated from bone marrow samples of 15 NSAA patients and 3 healthy controls. Cells were treated with gradient concentrations of SJD, and a portion was transfected with a vector overexpressing the nuclear factor of activated T cells, cytoplasmic 4 (NFATC4). Cell viability and apoptosis were detected by cell counting kit-8 and flow cytometry, respectively. After adipogenic differentiation induction, lipid droplet formation in BMSCs was examined by Oil Red O staining. The expression of NFATC4, peroxisome proliferator-activated receptor gamma (PPARG), fatty acid-binding protein 4 (FABP4), peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α), and acetylated PGC-1α was measured by quantitative real-time polymerase chain reaction or Western blot.

Results: SJD significantly increased the viability and decreased the apoptosis of NSAA-derived BMSCs. It also dose-dependently inhibited lipid droplet formation and decreased the expression of PPARG and FABP4 in NSAA-derived BMSCs. NFATC4 expression was higher in patients with NSAA than in healthy controls, and SJD downregulated its expression. NFATC4 overexpression reversed the inhibitory effect of SJD on adipogenic differentiation. Additionally, SJD promoted the deacetylation of PGC-1α in NSAA-derived BMSCs, which was also partially eliminated by NFATC4 overexpression.

Conclusions: SJD inhibits adipogenic differentiation of BMSCs through downregulating NFATC4, thereby contributing to the remission of NSAA.

It is well known that Traditional Chinese Medicine (TCM) has two outstanding academic characteristics: the holistic concept comes from Huang Di Nei Jing, and the syndrome differentiation and treatment comes from Shang Han Lun. These two characteristics denote the two major academic systems of TCM: one is the medical system of Huang Di Nei Jing, also named syndrome differentiation and treatment system of Zang-Fu organs and meridians, focuses on theoretical exploration, which highlights functional connection and emphasizes philosophical thinking. The treatment in this system is based on physiological functions by taking Zang-Fu organs as the main body, Qi, blood, essence, and body fluid as the auxiliary body, and the meridians and collaterals as the connection channels. The other is the syndrome differentiation and treatment system of the six meridians, which emphasizes clinical practice. It encompasses the idea that the six meridians govern various diseases, emphasizes the disease sites and divisional treatment, and pays attention to the precision and appropriateness of prescription-syndrome differentiation. These two academic systems, with mutual influences and relations, are both the essence and pearl of TCM, nevertheless, there are obvious differences between the two in clinical application, so they should be distinguished. This paper will elaborate on the connection and difference between them, and how to organically combine the two systems for better application in clinical practice of TCM.