Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Methodological Evaluation of Advantages of Traditional Chinese Medicine Treatment of Sjögren's Syndrome / 中国实验方剂学杂志

Screening and evaluating the diseases responding specifically to traditional Chinese medicine （TCM） will help to highlight the advantages of TCM treatment， and the evaluation method should be standardized with consideration to the unique characteristics of the diseases. The incidence of Sjögren's Syndrome （SS） is increasing year by year， while the pathogenesis of this disease remains unclear. Modern therapies for this disease include biological agents and immunosuppressants， which generally have unsatisfactory efficacy. The TCM treatment of SS focuses on the harmony of the physical and mental health. The Rheumatology Branch of the China Association of Chinese Medicine organizes experts in TCM， Western medicine， and evidence-based medicine to form working groups. Delphi method and bibliometric method were used for analysis， and SS was selected as a disease responding specifically to TCM. Furthermore， the evaluation system was established for this disease， and the consensus regarding this disease was reached after seminar discussion. This paper summarized the whole process of the evaluation of the advantages of TCM treatment of SS. First， because TCM atomization is widely used in clinical practice and enriches TCM administration methods， this therapy is included after other non-drug therapies were taken as characteristic therapies. Second， the evaluation indicators of therapeutic effect should be determined with consideration to international acceptance and the current research status. Third， the expression method should be accurate， standardized， and objective， highlight the natural advantages of TCM， and avoid arbitrary extension. This paper provides a reference for clinicians to explore other diseases responding specifically to TCM.

Exploring biological connotation of blood stasis syndrome of rheumatoid arthritis and establishment of improved animal models based on syndrome-symptom mapping / 药学学报

Blood stasis syndrome is one of the core clinical syndrome of rheumatoid arthritis (RA), but the biological connotation of this syndrome is not clear, and there is a lack of disease improved animal models that match the characteristics of this disease and syndrome. The aim of this study was to screen the candidate biomarker gene set of blood stasis syndrome of RA, reveal the biological connotation of this syndrome, and explore and evaluate the preparation method of the improved animal model based on the characteristics of "disease-syndrome-symptom". The study was approved by the ethics committee of Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine (No. 2019-073-KY-01) and the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine (No. TYLL2021[K]018), and the study subjects gave their informed consent. Animal welfare and experimental procedures followed the regulations of the Experimental Animal Ethics Committee of the Chinese Academy of Traditional Chinese Medicine (No. IBTCMCACMS21-2207-01). The whole blood samples were collected clinically from RA patients with blood stasis syndrome (3 cases) or other syndromes (7 types, 3 cases/type), and healthy volunteers (4 cases), and then transcriptome sequencing, KEGG, gene set enrichment analysis (GSEA) and weighted correlation network analysis (WGCNA) analysis were performed. 126 pivotal genes were screened, and their functional annotation results were significantly enriched in "immune-inflammation" related pathways and lipid metabolism regulation (sphingolipids, ether lipid metabolism and steroid biosynthesis). Syndrome-symptom mapping of hub gene set to the TCM primary and secondary symptoms, Western phenotypic symptoms and pathological links showed that joint tingling, abnormal joint morphology, petechiae and abnormal blood circulation are representative of blood stasis syndrome of RA. The results of the improved animal model showed that the rats in the collagen-induced arthritis + adrenaline hydrochloride (CIA+Adr) 3 model group had increased blood rheology, coagulation, platelet function and endothelial function abnormalities compared with the CIA-alone model group, suggesting that the rats with blood stasis syndrome of RA may be in a state of "blood stasis". The results of the study can help to advance the objective study of the evidence of blood stasis syndrome in RA, and provide new ideas for the establishment of an animal model that reflects the clinical characteristics of the disease and syndrome.

A Multicenter Cross-sectional Survey on the Clinical Characteristics of Patients of Ankylosing Spondylitis with Kidney Deficiency and Stasis Obstruction Syndrome and Damp-heat Stasis Obstruction Syndrome / 中医杂志

ObjectiveTo compare the differences in clinical characteristics between kidney deficiency and stasis obstruction syndrome and damp-heat stasis obstruction syndrome in patients with ankylosing spondylitis （AS）， thereby providing reference for clinical differentiation and treatment. MethodsThe clinical data of 2339 patients with AS were collected， including 1075 cases of kidney deficiency and stasis obstruction syndrome and 1264 cases of damp-heat stasis obstruction syndrome. The basic information including age， gender， course of disease， history of ophthalmia， family history and human leukocyte antigen B27 （HLA-B27） positive history， Bath ankylosing spondylitis disease activity index （BASDAI） score， Bath ankylosing spondylitis functional index （BASFI） score， Bath ankylosing spondylitis measurement index （BASMI） score， Depression Anxiety Stress Scale 21 （DASS-21） score， single symptom score in terms of spinal pain， peripheral joint pain， tendon tenderness， morning stiffness degree and morning stiffness time， patient-reported outcomes including patient global assessment （PGA） score， chronic disease therapy function-fatigue scale （FACIT-F） score and night pain visual analog scale （VAS） score， laboratory indicators including serum C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR）， and CT grading of sacroiliitis were measured and compared between groups. ResultsPatients with kidney deficiency and stasis obstruction syndrome were older and had a longer course of disease （P＜0.01）. The BASDAI， BASFI and BASMI scores of the patients with kidney deficiency and stasis obstruction syndrome were 3.84±1.79， 2.78±2.00 and 3.42±2.36， respectively， while those in patients with damp-heat stasis obstruction syndrome were 4.30±1.99， 3.43±2.12， and 2.92±1.76. The BASDAI score， BASFI score， PGA score， FACIT-F score， spinal pain score， peripheral arthralgia score， tendon tenderness score， morning stiffness degree score， depression score， anxiety score， and stress score in patients with damp-heat stasis obstruction syndrome were all higher than those with kidney deficiency and stasis obstruction syndrome， with longer duration of morning stiffness and higher CRP （P＜0.05 or P＜0.01）. BASMI score and night pain VAS score were more higher in patients with kidney deficiency and stasis obstruction syndrome （P＜0.01）. There was no significant difference in the ESR level and CT grading of the sacroiliac joint between the two groups （P＞0.05）. ConclusionAS patients with kidney deficiency and stasis obstruction syndrome have poorer spinal mobility， while those with damp-heat stasis obstruction syndrome have higher disease activity， poorer physical function， and are more prone to adverse psychological reactions.

Biological connotation of four traditional Chinese medicine syndromes of rheumatoid arthritis based on "disease-syndrome-symptom" association network / 中国中药杂志

The present study explored the biological connotation of traditional Chinese medicine(TCM) syndromes of rheumatoid arthritis(RA) from the "disease-syndrome-symptom" association network. RA patients with four TCM syndromes(dampness-heat obstruction, phlegm-stasis obstruction, Qi-blood deficiency, and liver and kidney deficiency), three for each type, were assigned as the RA TCM syndrome group, and three healthy volunteers as the normal control group. The differential gene sets of four syndromes were screened out through transcriptome expression profiling and bioinformatics mining. The relevant gene sets of syndrome-related clinical symptoms were collected from TCMIP v2.0(http://www.tcmip.cn/). The "disease-syndrome-symptom" association networks of four RA syndromes were established by using the intersection genes of syndrome-related differential genes and symptom-related genes, and the key network target genes of each syndrome were screened out and the corresponding biological functions were mined through topological feature calculation and enrichment analysis. The genes associated with clinical symptoms such as vasculitis, joint pain, and fever in the damp-heat obstruction syndrome ranked the top, and the key network target genes of this syndrome were most significantly enriched in the pathways related to material and energy metabolism and thermal reaction biological processes. The clinical symptom-related genes of the phlegm-stasis obstruction syndrome were most significantly enriched in the pathways related to "immunity-inflammation", nervous system regulation, and sensory response. The clinical symptoms such as hypoglycemia, hypotension, weight loss, palpitation, and arrhythmia in Qi-blood deficiency syndrome were predominant, and its key network target genes were most significantly enriched in the pathways related to the nervous system and "immunity-inflammation" response. The abnormal symptoms in the liver and kidney in the liver and kidney deficiency syndrome were commonly seen, and its key network target genes were most significantly enriched in the "immunity-inflammation" regulatory pathways, and liver and kidney development and metabolic response. In conclusion, the differences and connections of the biological basis between different TCM syndromes of RA are in line with the theoretical interpretation of TCM on the etiology and pathogenesis of RA. This study summarized the objective essence of syndromes to a certain extent from the "disease-syndrome-symptom" association network and is expected to provide a theoretical basis for the discovery of serum biomarkers of RA syndromes.

Research strategies for endophytes in medicinal plants based on high-throughput sequencing and traditional culture and isolation methods / 中国中药杂志

The research on endophytes of medicinal plants mainly relies on the traditional culture and isolation methods. Because of their functions such as promoting host growth, improving stress resistance, promoting the accumulation of medicinal active ingredients or directly producing medicinal active ingredients, the endophytes of medicinal plants have gradually attracted wide attention. However, it was found that the strains isolated by traditional methods were not the true dominant endophytes of medicinal plants by comparing the results of traditional culture isolation with high-throughput sequencing. The blind and random nature of traditional methods leads to the lack of standards in terms of medium selection, culture time and interaction between species. On the contrary, high-throughput sequencing technology is an emerging molecular biology technology developed in recent decades. Due to its high resolution level and indepen-dent culture, it can be used for thorough analysis of the community structure and diversity of environmental microorganisms. Therefore, we proposed the strategy of using high-throughput sequencing technology to guide the traditional culture and isolation of endophytes from medicinal plants. Firstly, the endophytic structure and diversity of medicinal plants were completely clear by high-throughput sequencing technology, and the dominant endophytes of the host were unequivocal. Then according to the characteristics of each dominant endophytes design or query suitable medium for its growth to culture and isolation. Finally, the function of the isolates was studied. This method can prevent researchers from missing out on the important functional strains of the host, expand the research scope of endophytes of medicinal plants, and facilitate the in-depth excavation and utilization of endophytes of medicinal plants.

Study on drug-target binding kinetics profiles of flavonoids in Chrysanthemum morifolium and xanthine oxidase / 中国中药杂志

Based on the target occupancy mathematical model, the binding kinetic process of potential active ingredients of lowering uric acid in Chrysanthemum morifolium with xanthine oxidase(XOD) was evaluated. The potential active ingredients of lowering uric acid in Ch. morifolium were screened by UPLC-Q-Exactivems MS technology, reference substance identification and in vitro enzymatic kinetics experiments. The binding kinetic parameters of xanthine oxidase and potential inhibitor in Ch. morifolium were determined by surface plasma resonance(SPR). The verified mathematical model of the XOD target occupancy evaluated the kinetic binding process of inhibitors and xanthine oxidase in vivo. According to UPLC-Q-Exactive MS and reference substance identification, 39 potential uric acid-lowering active ingredients in Ch. morifolium extracts were identified and the inhibitory activities of 23 compounds were determined. Three potential xanthine oxidase inhibitors were screened, namely genistein, luteolin, and apigenin. whose IC_(50 )were 1.23, 1.47 and 1.59 μmol·L~(-1), respectively. And the binding rate constants(K_(on)) were 1.26×10~6, 5.23×10~5 and 6.36×10~5 mol·L~(-1)·s~(-1), respectively. The dissociation rate constants(K_(off)) were 10.93×10~(-2), 1.59×10~(-2), and 5.3×10~(-2 )s~(-1), respectively. After evaluation by different administration methods, the three selected compounds can perform rapid and sustained inhibition of xanthine oxidase in vivo under combined administration. This study comprehensively evaluated the target occupancy process of three effective components in different ways of administration in vivo by UPLC-MS, concentration-response method, SPR technology and xanthine oxidase target occupancy model, which would provide a new research idea and method for screening active ingredients in traditional Chinese medicine.

Animal model analysis of diabetic lower extremity arterial disease based on clinical symptoms of traditional Chinese and Western medicine / 中国中药杂志

The evaluation standard of LEAD animal model was established according to the understanding of the etiology and pathogenesis of diabetic lower extremity vascular disease based on Chinese and Western medicine. The consistency between the existing LEAD animal model and the clinical characteristics of traditional Chinese and Western medicine was analyzed and evaluated. The advantages and disadvantages of the existing model were compared,the application scope of different models was considered,and the possible improvement methods of the existing model were proposed,so as to provide impetus for the improvement of LEAD animal model.We should reflect more characteristics of traditional Chinese medicine syndromes in the process of model improvement and development,making the LEAD animal model to get closer to clinical features of traditional Chinese and Western medicine.

Advances in biomimetic modification of materials for oromaxillofacial bone regeneration and dental implant / 华西口腔医学杂志

Oromaxillofacial hard tissue defects is still a difficult problem in clinical treatment. Regeneration of oromaxillofacial hard tissue based on tissue engineering technology has a good clinical application prospect. The functional modification of scaffolds is one of key factors that influence the outcome of tissue regeneration. The biomimetic design of biomaterials through simulating the natural structure and composition of oromaxillofacial hard tissue has gradually become a research hotspot due to its advantages of simplicity and efficiency. In this article, the biomimetic modification of biomaterials for oromaxillofacial hard tissue regeneration is reviewed, expecting to provide a new idea for the treatment of oromaxillofacial hard tissue defect.

Simulation Analysis of Occupancy Rates of Baicalein， Quercetin and Galangin on Target Sites of Xanthine Oxidase / 中国实验方剂学杂志

Objective:To simulate the occupancy rates of baicalein， quercetin and galangin on the target sites of xanthine oxidase <italic>in vivo</italic>. Method:In this experiment， the half inhibitory concentration （IC₅₀） of febuxostat， baicalein， quercetin and galangin against xanthine oxidase were determined by <italic>in vitro</italic> enzymatic reaction. Binding free energy was predicted by molecular docking technology and their association rate constant （k_on） and dissociation rate constant （k_off） were determined by surface plasmon resonance technology. Based on measured binding kinetic parameters （k_on and k_off） and extracted pharmacokinetic data， the target occupancy model <italic>in vivo</italic> was established. Result:The IC₅₀values of febuxostat， baicalein， quercetin and galangin were 0.002 7， 1.63， 0.38， 1.59 µmol·L^-1， respectively. The IC₅₀ of febuxostat was very close to that reported in the literature. The predicted curve of target occupancy rate <italic>in vivo</italic> of febuxostat was consistent with its duration of clinical efficacy. When single intragastric administration of long-circulating liposomes of quercetin with dose of 100 mg·kg^-1 in rats， the time of target occupancy rate >70% <italic>in vivo</italic> lasted for about 3.9 h. When rats were orally administered baicalein and galangin with dose of 200 mg·kg^-1， the time of target occupancy rate >50% <italic>in vivo </italic>lasted for about 10 h and 1.7 h， respectively. Conclusion:The prediction model of xanthine oxidase target occupancy constructed by drug target binding kinetics and <italic>in vivo</italic> pharmacokinetic curves can effectively evaluate the <italic>in vivo</italic> inhibitory activity of compounds against the target.

Research progress and prospect of endophytes from medicinal plant Atractylodes lancea / 中国中药杂志

The endophytes of medicinal plants play an important role in promoting the quality formation of the host. Therefore, this paper made a review of endophytes of medicinal plant Atractylodes lancea. According to previous studies, A. lancea boasts endophytes, such as fungi, bacteria, and actinomycetes, among which the beneficial microorganisms help the growth and development of A. lancea. There is a close interaction between the volatile oil of A. lancea and endophytes. Different endophytes vary in regulating the composition and content of the volatile oil of A. lancea, which might contribute to the quality formation of A. lancea. However, the information of the endophytic flora of A. lancea obtained by traditional culture and isolation is not enough to reflect the real situation of the endophytes of A. lancea. Little is known about the endophytes of A. lancea from different chemical types and different habitats, which is not conducive to the study of the ecological relationship between A. lancea and endophytes and limits the development and utilization of the endophytes. Therefore, at the end of this paper, the authors put forward suggestions for future research on endophytes in A. lancea, including:(1)mining the core endophyte resources of A. lancea by combining high-throughput sequencing with traditional culture and isolation;(2)exploring the relationship between the diversity of endophytes and chemical types of A. lancea;(3)strengthening the application of endophytes in A. lancea cultivation, in order to facilitate the cultivation efficiency and quality of A. lancea.

Mechanism of intermittent and persistent noise exposure-induced anxiety and depression-like behavior in rats / 中国职业医学

OBJECTIVE: To investigate the effects and mechanisms of intermittent and persistent noise exposure-induced anxiety and depression-like behavior in rats. METHODS: The specific pathogen free male SD rats were randomly divided into control group, four times/day intermittent noise exposure group, two times/day intermittent noise exposure group and persistent noise exposure group, with 15 rats in each group. The rats in the control group were housed in natural environment(background noise ≤50 dB), and the rats in other three exposure groups were exposed to noise with intensity of(95±2) dB of 20 to 20 000 Hz noise for four hours per day for 14 days; rats in the four times/day intermittent noise exposure group entered a five-hour quiet period every one hours of noise exposure, four times/day; rats in the two times/day intermittent noise exposure group entered a 10-hour quiet period every two hours of noise exposure, two times/day; rats in the persistent noise exposure group entered a 20-hour quiet period every four hours of noise exposure. After exposure, anxiety like behavior was evaluated by open field test and elevated cross maze test. The depression like behavior was evaluated by sugar preference test and forced swimming test. The pathological changes of neurons in the hippocampus were observed by hematoxylin-eosin(HE) staining, and the ultrastructural changes of hippocampal tissues were observed by transmission electron microscope. Chemiluminescence and colorimetry were used to detect the levels of reactive oxygen species(ROS), malondialdehyde, glutathione(GSH) and the activity of superoxide dismutase(SOD). RESULTS: In the behavioral experiment, the percentage of exercise time in the central area decreased in the three noise exposure groups(all P<0.01). The exercise distance in the central area and sugar preference index decreased in the persistent noise exposure group(both P<0.01). The percentage of open arm exercise time and open arm exercise distance decreased in the two times/day intermittent noise exposure group and persistent noise exposure group compared with the control group(all P<0.01). The open arm distance of rats in the persistent noise exposure group were lower than those in the four times/day intermittent noise exposure group(P<0.05), while the immobility time was longer than in control group and the four times/day intermittent noise exposure group(both P<0.05). The HE staining showed that the neuronal spacing in CA1 area of the hippocampus of rats was significantly widened, and the pyramidal cells showed degeneration and necrosis in the persistent noise exposure group. There was no obvious necrosis found in the neurons of the other three groups. The ultrastructure of neurons showed that most mitochondria of cells in the hippocampus of rats in the two times/day intermittent noise exposure group were swollen. In the persistent noise exposure group, some neurons of the hippocampus of rats were necrotic, the cell membrane was discontinuous, the mitochondria were swollen, and the cristae were broken, dissolved or even disappeared. The mitochondrial structure of the hippocampus of rats in the other two groups was normal. The activity of SOD in the hippocampus of rats decreased in the four times/day intermittent noise exposure group(P<0.05), and the activity of SOD and the level of GSH in the hippocampus of rats decreased in the two times/day intermittent noise exposure group(both P<0.05), compared with the control group. The level of ROS and malondialdehyde in the hippocampus of rats in the persistent noise exposure group increased(all P<0.05), while the SOD activity and GSH level decreased(all P<0.05), compared with the other three groups. CONCLUSION: Intermittent noise exposure causes less anxiety and depression-like changes in rats than persistent noise exposure. Noise may cause anxiety and depression in rats through oxidative stress pathways.

Core position of secondary metabolism of medicinal plants in ecological planting of Chinese materia medica and its utilization / 中国中药杂志

This paper summarized the effects of ecological planting on secondary metabolism firstly and pointed out that ecological planting can increase the content of secondary metabolites in plants, especially the content of defensive secondary metabolites. The possible mechanism was analyzed subsequently. Then, we reviewed the induction and utilization of secondary metabolism in the ecological planting of Chinese materia medica from the perspectives of biological control of pests and diseases, promotion of beneficial microorganism accumulation, optimization of mixed planting, regulation of no-tillage and straw cover. In this article, we pointed out that paying close attention to secondary metabolism is the most important feature of ecological planting of Chinese materia medica. Ecological planting can promote the accumulation of secondary metabolites of Chinese materia medica which means can improve the quality of Chinese materia medica, beneficial to the prevention and control of diseases, insects and weeds. Furthermore, lacking of systemic researches,the extensive verifications and systematic in-depth researches on the ecological planting of Chinese materia medica should be carry out urgently.

Influence and mechanism of stress combination on medicinal plants secondary metabolism / 中国中药杂志

Numerous studies showed that the growth of medicinal plants in their native areas was simultaneously affected by abiotic stress combinations. Compared with single stress, plants have unique responses to a combination of different abiotic stresses and cannot be inferred directly from plants' responses to each individual stress. The effect of combined stresses on plants usually has three types of synergistic antagonism or independence. The secondary metabolism in the process of medicinal plant stress combination response also played a vital role, and environmental stresses can spur the accumulation of secondary metabolites, but under the stress combination, plants induce specific gene expression of key enzymes on secondary metabolic pathways, in turn, the accumulation of secondary metabolites against stress is formed. When plants are subjected to stress combination, the interaction of multiple signaling pathways makes it highly complex for plants to respond to stress combination. This paper summarized the effects of stress combination on physiological and secondary metabolism of medicinal plants, and discussed the related physiological, biochemical and molecular mechanisms. It provides theoretical basis for improving the adaptability of medicinal plants to adversity, improving the quality of Chinese medicinal materials, and further optimizing the cultivation of medicinal plants.

Research progress in effects of interspecific interaction on medicinal plants in intercropping system / 中国中药杂志

Intercropping farming system is one of the essence of traditional agriculture in China and one of the most common and basic patterns of modern ecological planting. Intercropping system uses the principle of species diversity to create reasonable interspecific interaction conditions with obvious productivity advantages. In this paper, the interspecies interaction is divided into aboveground and underground parts from the space view, and its influence and mechanism on the yield and secondary metabolites of medicinal plants are elaborated.The interspecific interaction in the aboveground part mainly introduces the distribution and utilization of space resources among plants. The interspecific interaction in the underground part mainly introduces the soil rhizosphere effect and related mediating factors, root exudates, soil microorganisms, root space structure and soil environmental factors. On the basis of understanding the mechanism of interspecific interaction, this paper further discusses the application of intercropping in traditional Chinese medicine ecological agriculture, taking the effective control of diseases and insect pests, the increase of medicinal material yield and the improvement of medicinal material quality as the benefit index, so as to seek better advantages of intercropping and provide ideas for the utilization of intercropping production mode in traditional Chinese medicine ecological agriculture.

Effect of Modified Yiweitang on Fatigue Symptom of Primary Sjörgren′s Syndrome / 中国实验方剂学杂志

Objective:To observe the effect of modified Yiweitang on fatigue symptom and immunological indicators in primary Sjörgren′s Syndrome (pSS). Method:By random, control, single-blind method, 116 cases of patients with pSS were divided into treatment group and control group, with 58 cases in each group. The treatment group was given modified Yiweitang, a dose a day, twice a day， and the control group was given hydroxychloroquine sulfate (HCQ) 200 mg/time, twice a day. The treatment lasted for six months. Visual analogue scale (VAS) of fatigue symptoms, total traditional Chinese medicine (TCM) syndrome score, TCM fatigue score, rheumatoid factor (RF) and serum immunoglobulin G (IgG) were used to compare two groups before and after treatment. Result:After treatment, the treatment group had a better efficacy on TCM syndromes than control group (Z=3.712, P<0.05). After treatment, the treatment group were superior to control group in improvement of TCM fatigue score and VAS score of fatigue symptom (P<0.05). After 6 months of treatment, IgG level in treatment group decreased significantly compared with before treatment, with statistical differences (P<0.05), but no difference between treatment group and control group. After treatment, RF in two groups showed no significant decrease compared with before treatment. The incidence of adverse reactions in the treatment group and the control group were 1.75%（1/57） and 25.49%（13/51）, respectively. Conclusion:Compared with HCQ, modified Yiweitang can significantly alleviate fatigue and overall symptoms of patients of pSS, both of which can reduce serum IgG, and the efficacy of modified Yiweitang is more obvious than hydroxychloroquine sulfate. Both drugs had no significant effect on RF level of pSS patients. After long-term administration, modified Yiweitang is safer than hydroxychloroquine sulfate in the treatment of pSS.

Mechanisms and Medication Rules of Type 2 Diabetes Mellitus Based on Data Mining and Network Pharmacology / 中国实验方剂学杂志

Objective: To analyze the medication rules of traditional Chinese medicine (TCM) in treating type 2 diabetes mellitus (T2DM),and explore the mechanism of action.Method: The articlesabout TCM treatment for T2DM in CNKI and Wanfang Med Online were retrieved.The data was entered into Excel 2013 to set up a database,and the factor analysis,association rules and cluster analysis were used to analyze core medication combinations by SPSS Statistics 19.0 and SPSS Modeler 14.1.kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was performed using BATMAN-TCM to reveal the mechanism of action.Result: A total of 92 prescriptions were included,the high frequency medicines were Astragali Radix.The major properties of TCM were cold and plain.The major flavors of TCM were sweet and bitter.The major meridian tropism of TCM was livermeridian.These high frequency medicines were deficiency-nourishing herbs,and blood circulation-invigorating and stasis-eliminating herbs.Totally 6 core medication combinations were mined through association rules.Seven common factors were extracted from factor analysis.Clustering analysis was used to get 6 kinds of herbs.KEGG pathway analysis revealed 24 biological pathways and 6 diseases relating to T2DM.Conclusion: The most commonly used Astragali Radix for treating T2DM.In clinical,it can be combined with Poria,Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix for treating T2DM.At the same time,it can be combined with such herbs as deficiency-nourishing herbs,and blood circulation-invigorating and stasis-eliminating herbs.The mechanism of action of high-frequency herbs may be related to the targets of exophosphatase/phosphodiesterase (PDEs),adenosine A1 receptor gene 1(ADORA1),adenosine A2A receptor gene (ADORA2A),neuropetide second receptor (NPY2R),and endothelial carbon monoxide synthase (NOS3) by interfering with PI3K/Akt,starch and sucrose metabolism signaling pathways.

Analysis of Animal Model with Clinical Disease Characteristics of Uterine Dysplasia / 中国实验方剂学杂志

Uterine dysplasia or naive uterus mainly refers to a pathological state in which the uterus volume is significantly smaller than normal after adolescence. It is a common gynecological disease, which is caused by low levels of hormones during development process. The main symptoms are delayed menstruation, scanty menstruation, dysmenorrhea and even amenorrhea, and often manifested as infertility after marriage. The article summarizes existing animal models of uterine dysplasia based on clinical symptom characteristics of uterine dysplasia according to clinical diagnostic standard of traditional Chinese medicine (TCM) and western medicine. According to etiology and pathogenesis of uterine dysplasia and diagnostic criteria of TCM and Western medicine, advantages and disadvantages and coincidence of animal models with characteristics of uterine dysplasia and clinical symptoms of uterine dysplasia were proposed. The corresponding animal model evaluation index system and existing uterine dysplasia animal models were proposed to improve ideas and methods. At present, there are not many methods for establishing uterus dysplasia models. The existing models of uterine dysplasia are pathological models based on western medicine indexes. The existing models reflect clinical situations of uterine dysplasia in some aspects, but there is no evaluation index system of uterine dysplasia model and animal model reflecting cause of TCM. Based on existing single-factor animal models, a composite animal model with clinical conditions and similar typical symptoms of human uterine dysplasia is established, which is more consistent with characteristics of clinical symptoms. At same time, it is focus of future researches to improve evaluation index system of uterine animal models and establish a combination model of dysplasia of uterus with TCM syndromes.

Status of Organism Factors in Occurrence of Toxicity of Traditional Chinese Medicine / 中国实验方剂学杂志

Through analysis of factors affecting toxicity of traditional Chinese medicine (TCM), relationship between toxicity of TCM and physical constitution was explored, which provided a new idea for preventing occurrence of toxicity of TCM. Efforts were made to summarize causes of toxicity of TCM, and analyze relationship between physical constitution and toxicity of TCM. following aspects were taken into account:①main reason for people to use TCM is disease, which is pathological state of human beings. The pathological state may have more demands for corresponding TCM. The TCM rule of "disease-based treatment" is an important manifestation for correlating drugs with syndromes. Then how can normal animals reflect human toxicity under pathological conditions. ②People with pathological conditions, especially with a long disease course, may have abnormal liver and kidney functions. Then how to distinguish cause of toxicity of TCM in liver and kidney dysfunctions.③The long-term disease state can also lead to disorder of intestinal flora of body. Then how is impact of interaction between intestinal flora and TCM reflected in toxicity of TCM.④Although emotional and psychological factors account for a small proportion of toxicity of TCM, it still has an effect.⑤Although humans and animals have a high degree of similarity, there are still species differences (such as croton). Then how is human clinical toxicity consistent with animal research toxicity. The efficacy is related to expectation, while toxicity is related to background. At present, toxicity of TCM is more caused by factors of TCM (such as variety, quality, processing), and factors of TCM application (like compatibility, drug correspondence, dosage, course of treatment), which are external causes of toxicity of TCM. physiological condition, pathological state, emotional and psychological factors, and intestinal flora of body are internal factors. The physical constitution factors are internal factors of toxicity of TCM, and external factors play a role based on internal factors. At the same time, there are essential differences between humans and animals. Animal toxicological experiments are only for clinical reference. By analyzing concepts related to toxicity of TCM and physical constitution factors, modern researches on toxic effects of TCM are also promoted accordingly, and TCM toxicity theory is also improved, which provides a scientific basis for safe and rational application of TCM in clinical practice. Of course, research on animal models under pathological conditions shall be strengthened to promote study of toxicity of TCMs, so as to deepen people's understanding of toxicity of TCMs.

Regularity of prescription and medication of Jiang Quan in treating rheumatoid arthritis / 中国中药杂志

The data mining method was used to analyze and summarize the prescription and medicate regularities of chief physician Jiang Quan in the treatment of rheumatoid arthritis,in order to provide references for the clinical treatment of rheumatoid arthritis. Totally 121 prescriptions of rheumatoid arthritis treated by chief physician Jiang Quan from 2007 to 2017 were collected and input into the Chinese medicine inheritance auxiliary system. The " prescription statistics" function of the software " statistical report" system,and the " prescription analysis" function of the " data analysis" system,the data mining methods such as rule analysis,integration correlation,complex system entropy clustering,and unsupervised entropy hierarchical clustering,were used to analyze the prescription regularity of chief physician Jiang Quan. A total of 121 prescriptions were included,involving 144 herbs,in which 30 herbs had a higher frequency of more than 20 times,20 two-herb combinations had a frequency of more than 59 times; after evolution,14 core combinations and 7 new prescriptions were obtained. Among the prescriptions in the treatment of rheumatoid arthritis,those for clearing heat and dampness,promoting blood circulation and removing blood stasis had a higher frequency,and the core prescriptions were modified " Qingre Huoxue Decoction" and modified " Ermiao Pills". The newly evolved prescriptions not only reflected director Jiang Quan' s method of treating rheumatoid arthritis by clearing away heat and dampness and promoting blood circulation by the,but also included the treatment methods of removing wind and removing dampness,dredging collaterals and removing phlegm,nourishing Yin and clearing heat,nourishing Yin and nourishing kidney,nourishing blood and nourishing Qi. The method can be used to analyze the pathogenetic changes of the mutual knot of phlegm and blood stasis,injury of Qi and blood,long-term implication on liver and kidney. At the same time,it also reflects the treatment principles of treating phlegm and strengthening the evil.