TCM Treatment of Podocyte Injury in IgA Nephropathy Based on Multiple TCM Theories： A Review / 中国实验方剂学杂志

IgA nephropathy is the most common primary glomerular disease in China. Its clinical manifestations are mainly proteinuria， hematuria， hypertension， edema， hyperuricemia， etc. Most patients have hidden onset. 30%-40% of patients develop into end stage renal disease 10-20 years after diagnosis and rely on dialysis or kidney transplantation to maintain their lives， which is extremely harmful. Proteinuria is a common clinical manifestation of this disease， and most patients have small-to-moderate amounts of proteinuria， while 10%-24% of patients have large amounts of proteinuria. Proteinuria is the main risk factor affecting the progression of renal function in IgA nephropathy. Podocytes are the terminal part of the glomerular filtration barrier， and various factors can affect the fusion and detachment of podocyte processes that occur after podocyte injury. They are common histological lesions in IgA nephropathy and are key factors leading to proteinuria and the continuous progression of the disease. At present， Western medicine lacks targeted treatment for podocyte injury， with limited intervention methods. Drugs such as glucocorticoids are often used for treatment， and there are many adverse reactions. Based on the physiological function of podocytes， pathological and physiological changes after injury， and histological morphology of this disease， it is believed that it is closely related to traditional Chinese medicine's "Xuanfu Theory" "Kidney Collateral Syndrome" "Collateral Disease Theory"， and "Dry Blood Theory". More and more studies have shown that traditional Chinese medicine， which has the characteristics of multiple links， pathways， and targets， has a significant therapeutic effect on podocyte injury in IgA nephropathy. It can protect podocytes and reduce proteinuria and has good application and research prospects. This article systematically summarizes the mechanism and morphological changes of podocyte injury in IgA nephropathy， the understanding of podocyte injury in traditional Chinese medicine theory， and the research progress in traditional Chinese medicine treatment of podocyte injury in IgA nephropathy， so as to provide a reference for further research and application of traditional Chinese medicine intervention in podocyte injury in IgA nephropathy.

Review and prospect of traditional Chinese medicine in treatment of hypertension / 中国中药杂志

Hypertension, a primary cause of cardiovascular and cerebrovascular events, has become a major global public health problem and caused a heavy burden of health economics on the society. In "the 20 Most Important and Most Preventable Health Problems" released by the Chinese Academy of Engineering, hypertension was ranked the second. Due to the disease complexity, many hypertension patients need to take antihypertensive drugs for life. Although significant progress has been achieved in blood pressure lowering by western medicines, the problems including adverse reactions, poor compliance due to long-term medication, and ineffective mitigation in clinical symptoms related to hypertension remain to be addressed. In the last decade, the research on traditional Chinese medicine(TCM) treatment of hypertension has received much attention and achieved remarkable progress. The TCM treatment of hypertension is the most active area of research with integrated Chinese and western medicine in China. In addition to lowering blood pressure smoothly, TCM can alleviate clinical symptoms, reverse risk factors, improve the quality of life, and protect target organs from the damage caused by hypertension. This article systematically reviews the research progress of TCM in treating hypertension in the last decade from the following four aspects: consensus on guideline, clinical trial, experimental study, and systematic review/Meta-analysis. It summarized the evidence of TCM in reducing blood pressure and clarified the mechanism of TCM in reducing blood pressure, aiming to provide a reference for the TCM diagnosis and treatment of hypertension and the development of new drugs.

Treatment of Retinitis Pigmentosa with Traditional Chinese and Western Medicine： A Review / 中国实验方剂学杂志

Retinitis pigmentosa （RP） is a group of progressive and blinding hereditary fundus diseases characterized by damaged retinal photoreceptor cells and retinal pigment epithelium. With the clinical manifestations of night blindness and progressive visual field defect， RP has a high possibility of developing into blindness， which seriously affects the quality of life of the patients. The recent years have witnessed increasing studies about the pathogenesis and treatment of RP. By reviewing the relevant articles， we conclude that the pathogenesis of RP is mainly related to genes， and retinal blood perfusion， oxidative stress injury， and inflammatory cascade all affect the progression of this disease. The traditional Chinese medicine （TCM） therapies for RP mainly include TCM compound prescriptions， Chinese medicine extract， acupuncture combined with medicine， and comprehensive TCM treatment. The Western medicine therapies include gene therapy， stem cell therapy， optogenetic therapy， retinal prosthesis， drugs， treatment of complications and other therapies. The intervention mechanisms of traditional Chinese and Western medicine often involve gene modification， alternative therapy， improvement of retinal blood perfusion， antioxidant damage， and nutritional support. By summarizing the specific methods and effects of traditional Chinese and Western medicine in treating RP， we hope to provide a reference for the management and treatment of RP.

Treatment of Aural Vertigo Ménière's Disease with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Ménière's disease （MD） is an inner ear disease characterized by vertigo， tinnitus， hearing loss， and ear stuffiness. Modern therapies such as drugs， surgery， and vestibular function rehabilitation have limited effects in relieving the symptoms and reducing the recurrence. Traditional Chinese medicine （TCM） can alleviate the symptoms of MD with simple operation and mild adverse reactions while emphasizing psychological adjustment. The TCM treatment of MD is individualized depending on different stages and pathogenic factors. The internal treatment mainly targets phlegm， dampness， water， wind， fire， deficiency， and blood stasis. External interventions include acupuncture and moxibustion. This paper reviewed the published articles about the treatment of MD with TCM. In recent five years， the published studies were mainly clinical trials and experience discussion （or case reports）， and few reports of fundamental research were published. In these studies， the Western medicine diagnosis of MD mostly refers to the Diagnostic Basis and Efficacy Evaluation of Ménière's Disease （Guiyang， 2006） and the Guidelines for Diagnosis and Treatment of Ménière's Disease （2017）， while the TCM diagnosis mostly refers to the Criteria of Diagnosis and Therapeutic Effect of Diseases and Syndromes in Traditional Chinese Medicine issued by the National Administration of TCM in 1994. The efficacy was mostly evaluated based on clinical efficacy， scales， syndrome scores， pure tone audiometry， etc.， while caboratory indexes were rarely used. The available clinical studies about the treatment of MD with TCM generally have low quality of evidence and single intervention means. In the future， the research on the treatment of MD with TCM can be improved by standardizing the research program， improving the quality of evidence， exploring more intervention methods， and strengthening basic research.

Early Efficacy Predictors of Bushen Shengxue Prescription Combined with Western Medicine in Treatment of Aplastic Anemia / 中国实验方剂学杂志

ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia， and provide prognosis indicators for the treatment of aplastic anemia （AA） with kidney-tonifying therapy in traditional Chinese medicine （TCM） combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment， the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age， sex， disease severity （including severe aplastic anemia and non-severe aplastic anemia）， course of disease， degree of bone marrow nucleated cell proliferation， baseline hemogram levels ［including white blood cell count （WBC）， absolute neutrophil count （ANC）， hemoglobin （HGB）， platelets （PLT）， and reticulocytes （RET）］， T lymphocytes subsets， and the expression levels of T-box transcription factor （T-bet） and GATA-binding protein-3 （GATA-3） were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of ［20， 40） and ［60， 80） were higher in the 4-month effective group （P<0.05）. The sex， disease severity， course of disease， and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB， WBC， ANC， and PLT than the 4-month ineffective group （P<0.05）， and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time， while other indicators did not affect the onset time. The receiver operating characteristic （ROC） curve was established to analyze the value of PLT level before treatment for predicting the onset time， and the area under the curve was 0.691. With the critical value of 40.5×109/L， the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893， respectively. The two groups of patients were graded according to age ｛（14， 20）， ［20， 40）， ［40， 60）， and ［60， 80）｝ and PLT level before treatment （PLT<40×109/L， PLT≥40×109/L）. The proportion of the patients with PLT≥40×109/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group （P<0.05）. The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment （P<0.05）. The levels of Th1 cells， Th2 cells， CD4+ T cells， and CD8+ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment （P<0.05）， while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of ［20， 40） or ［40， 60）， with higher levels of HGB， WBC， ANC， and PLT （especially those with PLT≥40×109/L）， lower level of total T lymphocytes， or higher T-bet expression level before treatment.

Clinical Efficacy of Chinese Medicine Combined with Indirect Moxibustion Plaster on COVID-19 Patients During Recovery Period Based on COVID-19 Diagnosis and Treatment Protocol（Tenth Edition） / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Chinese medicine combined with indirect moxibustion plaster on corona virus disease 2019 （COVID-19） patients during recovery period. MethodNinety patients of COVID-19 during the recovery period were randomly divided into a Chinese medicine group， an indirect moxibustion plaster group， and a combination group，with 30 cases in each group. According to the 10th edition of COVID-19 Diagnosis and Treatment Protocol，patients in the Chinese medicine group received oral Chinese medicine based on syndrome differentiation，one dose per day， twice a day. Patients in the indirect moxibustion plaster group were treated with indirect moxibustion plaster at Zusanli （ST 36）， Pishu （BL 20）， Dazhui （GV 14）， Feishu （BL 13）， Kongzui （LU 6）， and Tiantu （CV 22），once a day，40 min each time. Patients in the combination group were treated with Chinese medicine combined with indirect moxibustion plaster. Treatment lasted two weeks. Before and after treatment，the traditional Chinese medicine （TCM） symptom score，pulmonary computed tomography （CT） score，St. George's Respiratory Questionnaire （SGRQ） score，blood routine indexes ［white blood cell count （WBC），neutrophil count （NEUT），and lymphocyte count （LYM）］， and inflammatory indexes ［C-reactive protein （CRP），serum ferritin， and interleukin-6 （IL-6）］ were observed in the three groups. The clinical efficacy was evaluated. ResultAfter treatment，the scores of TCM symptoms，pulmonary CT， and SGRQ，CRP，IL-6，and ferritin in the three groups decreased（P<0.05），while WBC and LYM increased（P<0.05）， but there was no significant difference in NEUT. The above indexes in the combination group were better than those in the other two groups（P<0.05）. After treatment， the cured and markedly effective rate was 76.7% （23/30） in the combination group， 50.0% （15/30） in the Chinese medicine group， and 46.7% （14/30） in the indirect moxibustion plaster group. The cured and markedly effective rate of the combination group was significantly higher than that of the Chinese medicine group （χ2=4.593， P<0.05） and the indirect moxibustion plaster group （χ2=5.711， P<0.05）. The total effective rate was 96.7 % （29/30） in the combination group， 93.3% （28/30） in the Chinese medicine group， and 86.7% （26/30） in the indirect moxibustion plaster group. The total effective rate of the combination group was higher than that of the Chinese medicine group and the indirect moxibustion plaster group， but the differences were not statistically significant. ConclusionChinese medicine combined with indirect moxibustion plaster can effectively improve the clinical symptoms，promote pulmonary inflammation，blood routine indexes， and inflammatory indexes， and improve the quality of life of COVID-19 patients during the recovery period，which is more advantageous than Chinese medicine alone or indirect moxibustion plaster.

Research progress on pathogenesis and treatment of drug-resistant epilepsy / 药学学报

Epilepsy is a chronic nervous system disease, which affects more than 70 million people all over the world. Although more than 30 kinds of antiepileptic drugs (AEDs) have been on the market, about one third of the patients with epilepsy fail to respond to medical treatment, who become drug-resistant epilepsy patients. Identifying the mechanism and developing effective treatment methods for drug-resistant epilepsy have become a hot area in the field of epilepsy research. This review discussed resent advance on the pathogenesis of drug-resistant epilepsy from the transporter hypothesis, neural network hypothesis and target hypothesis, and we also summarized the existing potential treatment methods and research progress of drug-resistant epilepsy, such as surgical resection, deep brain stimulation, ketogenic diet, precise treatment, and traditional Chinese medicine treatment. Our review may provide useful clues for the mechanisms research and clinical treatments of drug-resistant epilepsy.

Advances in comprehensive multidisciplinary treatment for burning mouth syndrome / 口腔疾病防治

@#Burning mouth syndrome (BMS) is a chronic oral and facial pain disorder characterized by burning pain in the oral mucosa, with multiple pathogenic factors including psychosocial, neuropathological, endocrine, and immune factors. There is still a lack of effective treatment options that have been demonstrated to work. With the development of research on the pathogenesis and treatment of BMS, multidisciplinary comprehensive treatment has gradually been introduced and become a new trend of diagnosis and treatment. Before multidisciplinary treatment, it is necessary to go through a full and comprehensive diagnosis and analysis, select the best comprehensive treatment plan, take the diagnosis and treatment of stomatology as the basis and premise, and apply other multidisciplinary combined treatment, including the treatment of concurrent diseases, psychological interventions, correction of bad habits, etc. A combination of laser therapy and psychological intervention is a more effective treatment method among the current treatment methods, with high comfort and good acceptance by patients. If necessary, mecobalamin tablets, clonazepam α-lipoic acid and other drugs can be used to nourish nerves and provide symptomatic treatment. The comprehensive multidisciplinary treatment of BMS is expected to become a new trend and provide a new strategy for improving the therapeutic effect.

Traditional Chinese and Western Medicine in Treatment of Postmenopausal Osteoporosis： A Review / 中国实验方剂学杂志

Postmenopausal osteoporosis （PMOP） is a systemic disease characterized by increased bone fragility caused by insufficient estrogen secretion in women after menopause，resulting in decreased bone mass and damage to the microstructure of bone tissues. The main clinical manifestations are low back pain，osteoporotic fractures，spinal deformities，and multiple organ dysfunction. PMOP directly leads to high morbidity， high mortality， and a decline in the quality of life. In addition to miss diagnosis， it is often not treated in time. In recent years， significant progress has been made in the research on factors related to the pathogenesis of PMOP. Based on the previous findings in recent years，this article described three major pathogenesis of PMOP， including intestinal flora imbalance，oxidative stress，and abnormal differentiation of bone marrow mesenchymal stem cells （BMMSCs）， and analyzed the current status of PMOP treatment， such as syndrome differentiation and treatment，acupuncture and moxibustion，exercise therapy， and external treatment in traditional Chinese medicine （TCM）， and basic measures，drug intervention，and physical therapy in western medicine. Among them，drug intervention in western medicine treatment is generally divided into bone resorption inhibitors，bone formation promoters，and other mechanism drugs according to the mechanism of action. This article summarized the specific methods and effects or mechanisms of TCM and western medicine in the clinical treatment of PMOP，which is expected to provide a reference for formulating reasonable health management models and drug treatments in the future.

Current progress in the treatment of nonarteritic anterior ischemic optic neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Nonarterial anterior ischemic optic neuropathy(NAION)is a group of common optic nerve diseases that seriously endanger visual function. It is resulted from insufficient perfusion of the posterior ciliary artery, which causes acute ischemia, structural and functional disorders of the optic nerve, and ultimately leads to hypopsia and even vision loss. The etiology and pathogenesis of this disease is complex. It is nowadays considered that multiple factors including local anatomy, risk of systemic vascular cause this disease together, which result in no clear, unified and recognized treatment. Early detection, diagnosis and treatment are of great significance in the prognosis of NAION. Possible therapeutic methods include etiological treatment, drug therapy, traditional Chinese medicine(TCM)treatment, combined medication, optic nerve sheath decompression, adjuvant treatments and exosomes. With the continuous development and application of various anti-NAION drugs in recent years, a variety of therapeutic methods have been proposed, especially with the exosomes as the research focus. In order to better treat NAION with improvement of the cure rate and guidance for clinical work, this paper mainly reviews the progress in the treatment of NAION in recent years.

Respiratory infectious diseases and tissue "damage-repair" balance:pathological characteristics, treatment, and characteristics of traditional Chinese medicine / 中国中药杂志

Respiratory infectious diseases are important diseases causing major public safety events, posing a great threat to life, health, and social development. Effective control and scientific treatment of the diseases is the key basis for ensuring the stability and long-term development of the community of a shared future for human health. Although the pathogens of respiratory viral infectious diseases are diverse and the process is complex, the common pathological basis of their pathogenesis is characterized by the "damage-repair" functional imbalance of the immune microenvironment of the lesions, which leads to the subsequent structural and functional destruction of important organs. Therefore, the treatment should focus on antivirus and immunological regulation, strengthen the protection against immune injury, and promote the functional repair of damaged tissues. The above conclusions are the scientific core of host-directed therapies(HDT), which coincides with "human-disease co-treatment and healthy qi and pathogen interaction" in traditional Chinese medicine(TCM) theories. Under the support of TCM and western medicine theories, the complete pathological chain "infection-immunity-injury" of respiratory viral infectious diseases is integrated with dynamic change in "healthy qi-pathogen" in TCM to transform the treatment focus from the diseases to the patients. It is possible to fundamentally correct the "damage-repair" imbalance in the disease state, change the environment for disease development, and bring benefits to patients by strengthening human intervention, maintaining immune homeostasis, enhancing the protection of tissues and organs, and promoting the repair and regeneration of damaged tissues. This study focused on the common and key pathological processes of respiratory infectious diseases, especially the immune damage caused by the viral infection, to seek effective prevention and treatment strategies, review relevant theoretical progress, summarize effective drug candidates, prospect future research and development, and highlight the therapeutic characteristics of TCM.

Reticulated Meta-analysis of effectiveness of traditional Chinese medicine therapy for traumatic optic neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the clinical efficacy of different interventions of traditional Chinese medicine in the treatment of traumatic optic neuropathy by means of mesh Meta-analysis.<p>METHODS:The Computer searched of Chinese databases(CNKI, VIP, WanFang, SinoMed)and English databases(PubMed, Embase, Cochrane Library). Search time was limited from their inception to March 2020. Randomized controlled clinical trials of traditional Chinese medicine for treatment of traumatic optic neuropathy were subjected to Meta-analysis. Cochrane evaluation tool was used to evaluate the quality of the included studies and Stata 14.2 software was used to conduct network Meta-analysis.<p>RESULTS: Twenty-one RCT studies involving 1 297 patients were included and 7 interventions were involved. Among them, Chinese medicine, Chinese medicine+hormone drugs, acupuncture+Chinese medicine+neurotrophic drugs were better than those with neurotrophic drugs alone. Chinese medicine+hormone drugs, acupuncture+Chinese medicine+neurotrophic drugs, acupuncture+Chinese medicine+hormone drugs were better than that of hormone drugs alone(<i>P</i><0.05), and the intervention measures ranked first in terms of effective treatment rate is acupuncture+Chinese medicine+neurotrophic drugs.<p>CONCLUSION: Chinese medicine has advantages in the treatment of traumatic optic neuropathy. Among them, acupuncture+ Chinese medicine+neurotrophic drugs is most likely to be the best choice.

The SARS-CoV-2 Antibody and Drug Research Based on the Structure of the Spike Protein and the Mechanism of Cell Entry / 中国生物化学与分子生物学报

COVID-19 is a severe acute respiratory syndrome caused by a novel coronavirus, SARS-CoV- 2.COVID-19 is now a pandemic, and is not yet fully under control.As the surface spike protein (S) mediates the recognition between the virus and cell membrane and the process of cell entry, it plays an important role in the course of disease transmission.The study on the S protein not only elucidates the structure and function of virus-related proteins and explains their cellular entry mechanism, but also provides valuable information for the prevention, diagnosis and treatment of COVII)-19.Concentrated on the S protein of SARS-CoV-2, this review covers four aspects: (1 ) The structure of the S protein and its binding with angiotensin converting enzyme II (ACE2) , the specific receptor of SARS-CoV-2, is introduced in detail.Compared with SARS-CoV, the receptor binding domain (RBD) of the SARS-CoV- 2 S protein has a higher affinity with ACE2, while the affinity of the entire S protein is on the contrary.(2) Currently, the cell entry mechanism of SARS-CoV-2 meditated by the S protein is proposed to include endosomal and non-endosomal pathways.With the recognition and binding between the S protein and ACE2 or after cell entry, transmembrane protease serine 2(TMPRSS2) , lysosomal cathepsin or the furin enzyme can cleave S protein at S1/S2 cleavage site, facilitating the fusion between the virus and target membrane.(3) For the progress in SARS-CoV-2 S protein antibodies, a collection of significant antibodies are introduced and compared in the fields of the target, source and type.(4) Mechanisms of therapeutic treatments for SARS-CoV-2 varied.Though the antibody and medicine treatments related to the SARS-CoV-2 S protein are of high specificity and great efficacy, the mechanism, safety, applicability and stability of some agents are still unclear and need further assessment.Therefore, to curb the pandemic, researchers in all fields need more cooperation in the development of SARS-CoV-2 antibodies and medicines to face the great challenge.

Clinical Efficacy of Modified Qilang Prescription in Treatment of Drug-dependent Constipation with Qi and Yin Deficiency and Its Effect on MTL， VIP， 5-HT， and 5-HT4R in Peripheral Blood / 中国实验方剂学杂志

Objective:To investigate the curative efficacy of modified Qilang prescription on drug-dependent constipation with Qi and Yin deficiency and the effects on serum vasoactive intestinal peptide （VIP）， motilin （MTL）， 5-hydroxytryptamine （5-HT）， and 5-hydroxytryptamine 4 receptor （5-HT4R）. Method:A total of 160 patients diagnosed with drug-dependent constipation were randomly divided into a treatment group （<italic>n</italic>=80， Qilang prescription） and a control group （<italic>n</italic>=80， lactulose oral solution）. The treatment lasted for eight weeks. Changes in clinical symptoms， traditional Chinese medicine （TCM） syndrome， and serum VIP， MTL， 5-HT， and 5-HT4R before and after treatment were observed. The clinical efficacies of the two groups were compared. An eight-week follow-up was carried out for the observation of recurrent rate and TCM syndrome. Result:The overall response rate of the treatment group （90.91%） was higher than that （75.00%） of the control group<italic> </italic>（<italic>Z</italic>=-6.514，<italic>P</italic><0.05）. There was no significant difference in serum VIP， MTL， 5-HT， and 5-HT4R between the two groups before treatment. After treatment for eight weeks， both groups showed reduced serum VIP level as compared with those before treatment， and the treatment group was inferior to the control group （<italic>P</italic><0.05）. The serum MTL levels of the two groups were both higher than those before treatment （<italic>P</italic><0.05）， and the treatment group was superior to the control group （<italic>P</italic><0.05）. After treatment， the level of 5-HT in the treatment group was higher than that in the control group （<italic>P</italic><0.05）. The post-treatment 5-HT4R level in the treatment group slightly increased （<italic>P</italic><0.05）， but no significant difference in 5-HT4R levels between the two groups after treatment was observed. During the eight-week follow-up， the recurrence rate in the treatment group was significantly lower than that in the control group at the 2nd and 4th weeks （<italic>P</italic><0.05）. There was no significant difference in the recurrence rate between the treatment group ［57.14% （40/70）］ and the control group ［64.81% （35/54）］ after eight weeks. Conclusion:Modified Qilang prescription was superior to lactulose in the short- and mid-term efficacy on drug-dependent constipation with Qi and Yin deficiency. No significant difference in the long-term efficacy was observed. The underlying therapeutic mechanism might be related to the regulation of serum VIP， MTL， 5-HT， and 5-HT4R levels.

Mechanism of Sleep Deprivation and Cognitive Impairment and Research Progress of Traditional Chinese Medicine Intervention / 中国实验方剂学杂志

Adequate sleep is an important factor to ensure the healthy functioning of the body. A type of chronic sleep diseases characterized by insufficient sleep can be collectively referred to as sleep deprivation （SD）， which is divided into primary and secondary sources in terms of sources. As one of the most frequent types of diseases in recent years， SD has received more and more attention and attention from the whole society. SD can have a wide-ranging and far-reaching impact on cognitive behavior， such as decreased wakefulness， decreased alertness， and inattention， decreased sensory perception， decreased learning and memory capabilities， et al， involving the impact on multiple system functions of the human body， and It is closely related to the occurrence of many diseases， and may cause serious troubles to the normal life of patients and even their relatives and friends. The cognitive impairment caused by SD has been fully verified in clinical tests and various animal behavior experiments， mainly involving pathological damage such as changes in synaptic plasticity， enhanced endoplasmic reticulum stress， circadian rhythm disorders， and energy metabolism imbalance. Western medicine treatments for SD mostly have negative factors such as high side effect and strong addiction. However， Chinese medicine intervention focuses on the overall concept， has long-lasting effectiveness， significant effects， and mild side effects. It has also been widely recognized clinically for improving the complications of sleep disorders. This article reviews the current status and classification of SD research， its pathological mechanisms that lead to cognitive impairment and its molecular-level exploration directions and results. In recent 5 years， the therapeutic effect and experience of traditional Chinese medicine intervention therapy such as compound Chinese medicine， acupuncture and moxibustion as well as auxiliary therapy such as exercise and five sounds， in order to further summarize and clarify the interaction mechanism between SD and cognitive behavior， and provide a theoretical basis for the study of the pathological mechanism of SD disease and future clinical treatment.

Mechanism and intervention of mucosal immune regulation based on "lung and large intestine being interior-exteriorly related" theory of traditional Chinese medicine / 浙江大学学报·医学版

The "lung and large intestine being interior-exteriorly related" is one of the classical theories in traditional Chinese medicine, which indicates a close correlation between the lung and large intestine in physiology and pathology, and plays a pivotal role in guiding the treatment of the lung and bowel diseases. Modern medicine has revealed some connections between the lung and large intestine in tissue origin and mucosal immunity, and preliminarily illuminated the material basis and possible regulatory mechanism of the theory. Recently, this theory has been applied to guide the treatment of refractory lung and intestine diseases such as COVID-19 and ulcerative colitis and has obtained reliable efficacy. Existing research results show that the anatomical homogeneity of lung and large intestine promotes the correlation between lung-bowel mucosal immunity, and mucosal immunity and migration and homing of innate lymphocytes are one of the physiological and pathological mechanisms for lung and large intestine to share. Under the guidance of this theory, Chinese medicines with heat-clearing and detoxifying or tonic effects are commonly used in the treatment of the lung and intestinal diseases by regulating lung-bowel mucosal immunity and they can be candidate drugs to treat lung/intestinal diseases simultaneously. However, the existing studies on immune regulation are mainly focused on the expression levels of sIgA and cytokines, as well as the changes in the number of immune cells such as innate lymphocytes and B lymphocytes. While the following aspects need further investigation: the airway/intestinal mucous hypersecretion, the functional changes of pulmonary and intestinal mucosal barrier immune cells, the dynamic process of lung/intestinal mucosal immune interaction, the intervention effect of local pulmonary/intestinal microecology, the correlation and biological basis between the heat-clearing and detoxifying effect and the tonic effect, and its regulation of pulmonary/intestinal mucosal immunity. In this paper, we try to analyze the internal relationship between lung and intestine related diseases from the point of view of the common mucosal immune system of lung and intestine, and summarize the characteristics and rules of traditional Chinese medicine compound and its active ingredients, which have regulatory effect on lung and intestine mucosal immune system, so as to further explain the theoretical connotation of "lung and large intestine being interior-exteriorly related" and provide reference for the research and development of drugs for related diseases.

Treatment of Myocardial Injury from Coronavirus Disease-2019 by Chinese Medicine / 中国实验方剂学杂志

Myocardial injury from coronavirus disease-2019 (COVID-19) is a clinical sign after the novel coronavirus infection, which can be seen in common type and severe type in acute stage, or after recovery of COVID-19. From the mouth and nose, the epidemic and pathogenic factors enter the lung, involving the heart, so that Qi and blood are blocked and developed into myocardial injury. More than 100 patients with COVID-19 and rehabilitation were treated, and we found that some patients infected with novel coronavirus had palpitation, shortness of breath, chest pain, chest oppression, fatigue and other symptoms. Electrocardiogram(ECG) showed myocardial ischemia injury and increased myocardial enzymes, due to the pathological changes of warm pathogen, first invading the lung and reversely spreading to the heart. Myocardial injury due to infection of novel coronavirus, on the one hand, made the patients weak and conditions lingering and hard to heal after COVID-19 was recovered in discharged patients. On the other hand, myocardial injury in severe cases could easily aggravate the disease and even threaten life. According to the different stages of the disease, the severity of the disease, and the patients' physique in the recovery period, different treatment methods were adopted. For the myocardial injury in patients with acute severe COVID-19, Shengmaiyin and Emergency Huiyangtang can be taken， if the poisonous heat disturbs the mind, we can use Angong Niuhuangwan and Zhibaodan as appropriate. For myocardial injury occurred in common type of COVID-19, Zhuye Shigaotang and Shenxiantang can be used. For the pathological changes mainly including myocardial injury after clinical recovery of COVID-19, we can use Shengxiantang, Yangxintang, Chaixiantang and so on. Methods of detoxification, tonifying Qi and Yin, invigorating Qi and ascending Qi collapse, blood circulation and phlegm resolving were used for treatment of myocardial injury from COVID-19, which can not only effectively improve clinical symptoms, but also restore creatine kinase isoenzyme-MB(CPK-MB) and ECG levels to obtain satisfactory results. All of these could reflect that TCM has a notable advantage in the prevention and treatment of this disease.

Research progress on prevention and treatment of cytokine storm with traditional Chinese medicine / 中草药

Cytokine storm is an excessive immune process when the body is stimulated. The disease progresses rapidly with a high mortality and complicated pathogenesis. In the outbreak of coronavirus disease 2019 (COVID-19), the rapid deterioration of the condition of patient is closely related to the outbreak of cytokine storm in the body. The sixth edition of Diagnosis and Treatment of Novel Coronavirus Pneumonia also provides a traditional Chinese medicine treatment plan. This paper reviewed the pharmacological effects of traditional Chinese medicine in antigen clearance, immune modulation and tissue protection based on the source, process and harm of cytokine storm. Furthermore, traditional Chinese medicine is contributive in prevention and treatment of cytokine storm, which can provide valuable medication guidance for the treatment combining traditional Chinese and Western medicine in clinic.

Analysis of influencing factors of death in patients with COVID-19 / 中草药

Objective: To analyze the influencing factors of death in patients with coronavirus disease 2019 (COVID-19) and provide a reference for clinically reducing the mortality of patients with COVID-19. Methods: Based on the retrospective analysis of the case data of all patients with COVID-19 admitted in our hospital from January 17th to February 25th, 2020, and the sex, age, whether or not to take Chinese medicine preparations during hospitalization, clinical classification, comorbidities, nucleic acid test results, admission time, discharge and other relevant indicators were collected for statistical analysis. Results: During the period of COVID-19, the number of patients of COVID-19 in our hospital gradually increased. At the epidemic peak period, 904 patients with COVID-19 were treated simultaneously. From January 17th to February 25th, 2020, a total of 1 305 patients with COVID-19 were treated in our hospital, including 632 males and 673 females, and the male to female ratio was 1:1.06. The age distribution ranged from 7 to 111 years, with a median of 63 (51, 70) years old. There was no significant difference in the age distribution of patients between different genders (Z = 1.217, P = 0.224). The results of univariate analysis showed that the patient's gender, age, whether to take Chinese medicine preparations during treatment, clinical classification, whether combined with underlying diseases (hypertension, coronary heart disease, diabetes, tumors and uremia) and nucleic acid test results all could affect patients fatality rate. Logistics multivariate regression analysis found that taking traditional Chinese medicine preparations, clinical classification, and whether combined with underlying diseases were independent risk factors for death in patients with COVID-19. Conclusion: The death of patients with COVID-19 is related to various factors. Reducing the occurrence of critical illness, controlling underlying diseases, stabilizing blood pressure and blood sugar, actively improving cardio-cerebral vascular conditions, and stabilizing renal function are main measures to improve the therapeutic effect, and early application of traditional Chinese medicine treatment also plays a very important role in reducing the mortality of patients with COVID-19.

Meta-analysis for Qishen Yiqi Dropping Pills in Treatment of Chronic Heart Failure with Syndrome of Qi Deficiency and Blood Stasis / 中国实验方剂学杂志

Objective: To evaluate the efficacy and safety of Qishen Yiqi dropping pills in the treatment of chronic heart failure. Method: Eight databases were searched at home and abroad, and the randomized controlled trials of Qishen Yiqi dropping pills in the treatment of chronic heart failure were screened. Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network, and the Meta-analysis was performed by RevMan 5.3 software. Result: A total of 606 related literature were retrieved, and 11 studies were eventually included, involving 931 patients. The quality of the included literature was generally low. Meta-analysis results showed that efficacy of Qishen Yiqi dropping pills combined with conventional western medicine was better than conventional western medicine alone in improving B-type natriuretic peptide[weighted mean difference (WMD)=-29.47, 95% confidence interval (CI) (-37.29,-21.64), PPPP=0.005], 6-minute walk test[WMD=50.13, 95%CI (22.32, 77.93), P=0.000 4]. In terms of safety indicators, one study intended to observe safety indicators, but it was not reported in the actual literature, and the remaining studies did not find adverse reactions of Qishen Yiqi dropping pills combined with conventional western medicine. Conclusion: The results of this study support the clinical use of Qishen Yiqi dropping pills combined with conventional western medicine in the treatment of chronic heart failure, but in view of the limitations in the quantity and quality of clinical studies, the positive results are only used as a reminder and reference for clinical diagnosis and treatment. In the future, more high-quality researches are needed to further confirm its efficacy.