Chief Physician Wang Defen’s Experience in Treating Thyroid Nodules based on Syndrome Differentiation

To summarize the experience of Chief Physician Wang Defen in the treatment of thyroid nodules. According to many years of clinical experience, Chief Physician Wang Defen believes that the occurrence of thyroid nodules is mostly affected by emotional factors. Qi stagnation, liver depression and fire, phlegm and Qi are the pathogenesis of the disease, which is closely related to liver Qi stagnation. Based on the basic treatment principle of Nourishing Yin, clearing heat, soothing liver and strengthening spleen, the prescription chose Danzhi Xiaoyao Powder plus or minus can often achieve good clinical efficacy.

Chinese Herbs Antagonize The Effects of Bisphenol A On Kiss1 Expression Through Epigenetic Regulation In The Promoter Region

Background: Bisphenol A (BPA), an environmental endocrine disruptor, is involved in precocious puberty. Chinese Herbs for Nourishing Yin and Purging Fire (NYPF) have been effective in delaying early onset of puberty. However, the underline mechanism is unknown. As epigenetics plays an important role in advanced puberty caused by extraneous factors. We intend to investigate the epigenetic impact of BPA and NYPF herbs on Kiss1 gene, a vital gene driving puberty onset, in hypothalamic neuron cells.Methods: GT1-7 cells derived from GnRH neurons were used in the study. A series of concentration of BPA and serum containing NYPF herbs were prepared in advance. GT1-7 cells were administrated with BPA or vehicle first, followed by NYPF herbs or normal saline (NS) for 24 hours. Afterward, quantification of Kiss1 expression was performed through Realtime-PCR and Weston-blot methods. In addition, epigenetic modifications at Kiss1 promoter were examined through Bisulphite Sequencing (BSP) and Chromatin immunoprecipitation combined real-time PCR（Chip-qPCR）assays.Results: Compared to control group, GT1-7 cells with BPA 10mg/l administration presented lower methylation status (61.25% Vs. 76.56%) concomitantly with enhanced abundance of mixed-lineage leukemia 1(MLL1) (1.05%±0.15 Vs. 0.27%±0.01) and Tri-Methyl-Histone 3 at lysine 4 (H3K4me3) (0.77%±0.51 Vs. 0.02%±0.04) at Kiss1 promoter, leading to elevated expression of Kiss1. On the contrary, TCM for NYPF promoted increased DNA methylation (83.75% Vs. 72.5%), accompanied with less deposition of MLL1/H3K4me3 (MLL1: 0.14%±0.02 Vs. 0.97%±0.09; H3K4me3: 0.01%±0.00 Vs. 0.57%±0.30) at Kiss1 promoter than BPA 10mg/l group, which resulted in markedly inhibition of Kiss1 expression. Conclusions: BPA may induce elevated expression of Kiss1 through influencing DNA methylation and histone modification at Kiss1 promoter. And NYPF herbs reverse the adverse effects of BPA on Kiss1 gene through epigenetic modification as well.

Treating Diabetes from Cold

Diabetes refers to the disease with the main symptom of “three more and less.” Traditional Chinese medicine (TCM) regards Yin deficiency and dryness heat as the basic pathogenesis, and mostly adopts the method of clearing away heat, nourishing yin and generating fluid. The author thinks that the deficiency of Yuanyang in Zang Fu organs, the lack of stimulation and promotion, the metabolic disorder of body fluid, the loss of moistening of Zang Fu organs, and the onset of diabetes. Body fluid metabolism is closely related to the spleen and kidney. Deficiency of Yang Qi is the root of thirst, stagnation of body fluid and Qi is the pathogenesis, and thirst is the final result.

Combination of the Herbs Radix Rehmanniae and Cornus Officinalis Mitigated Testicular Damage From Diabetes Mellitus by Enhancing Glycolysis via the AGEs/RAGE/HIF-1α Axis

Radix Rehmanniae and Cornus Officinalis (RR-CO) have been widely used as “nourishing Yin and tonifying kidney” herb pairs for the treatment of diabetes mellitus (DM) and its complications in traditional Chinese medicine (TCM). Based on the theory of “kidney governing reproduction” in TCM, the aim of this study was to investigate the therapeutic effects of RR-CO on DM-induced reproduction damage through regulating testicular glycolysis. Moreover, the regulation of AGEs/RAGE/HIF-1α axis on the testicular glycolysis process has also been studied. Spontaneous DM model KK-Ay mice were used to investigate the protective effect of RR, CO, RR-CO on DM-induced reproductive disturbances. RR, CO, RR-CO improved DM-induced renal and testicular morphology damages. Moreover, the impaired spermatogenesis, germ cell apoptosis and motility in testis induced upon DM were also attenuated by RR, CO or RR-CO, accompanied by an increased level of glycolysis metabolomics such as l-lactate, d-Fructose 1,6-bisphosphate, etc. Meanwhile, glucose membrane transporters (GLUT1, GLUT3), monocarboxylate transporter 4 (MCT4) expression, lactate dehydrogenase (LDH) activity, HIF-1α were upregulated by RR, CO and RR-CO treatment compared with the model group, whereas AGE level and RAGE expression were decreased with the drug administration. The RR-CO group was associated with superior protective effects in comparison to RR, CO use only. Aminoguanidine (Ami) and FPS-ZM1, the AGEs and RAGE inhibitors, were used as a tool drug to study the mechanism, showing different degrees of protection against DM-induced reproductive damage. This work preliminarily sheds light on the herb pair RR-CO exhibited favorable effects against DM-induced reproductive disturbances through enhancing testicular glycolysis, which might be mediated by AGEs/RAGE/HIF-1α axis.

Prescription rules of Qingzhu Fu, Ziming Chen, and Qian Wu for threatened miscarriage based on traditional Chinese medicine inheritance auxiliary platform

Background: To explore the prescription rules of famous ancient physicians in the treatment of threatened miscarriage. Methods: Traditional Chinese Medicine (TCM) prescriptions for threatened miscarriage were screened out of Fu Ren Da Quan Liang Fang by Ziming Chen, Yi Zong Jin Jian by Qian Wu, and Fu Qing Zhu Nv Ke by Qingzhu Fu. Data were standardized and analyzed through the TCM inheritance auxiliary platform. Results: A total of 29 prescriptions for threatened miscarriage were screened. Dang Gui, E Jiao, Gan Cao, Chuan Xiong, Bai Shao were the top five frequently prescribed Chinese herbs. The common herb–herb combinations used by Ziming Chen contained E Jiao, Dang Gui, Chuan Xiong, Ai Ye, Cong Bai, and Sang Ji Sheng. Ren Shen, Gan Cao, and Bai Zhu were the common herbal groups used by Qingzhu Fu. Huang Qi, Shu Di Huang, Bai Shao, Dang Gui, and Gan Cao were one of Qian Wu’s core prescriptions, with Dang Gui and Chuan Xiong being the others. According to the analysis of four Qi, five flavors, and meridian tropism of the prescriptions, herbs with the warm nature, or with the sweet, pungent, bitter flavors topped the list of application. The top six meridian tropisms of high-frequency herbs were: liver, spleen, lung, kidney, heart, and stomach meridian. Conclusion: Based on the principle of restoring the balance within the organs and enriching Qi and blood, clinical treatment of threatened miscarriage involves invigorating the Chong and Ren channels, nourishing Yin, dispelling cold and wind, generating and activating blood, regulating and harmonizing Qi.

Dahuang Zhechong Pills Suppress Silicosis Fibrosis Progression via p38 MAPK/TGF-β1/Smad Pathway In Vitro

Background. Dahuang Zhechong pills (DHZCP) is a classic Chinese medicinal prescription in “Treatise on Cold Pathogenic and Miscellaneous Diseases (Shanghan Zabing Lun),” and it has the function of tonifying blood, nourishing Yin, and removing blood stasis. Previous studies have shown that DHZCP could alleviate SiO2 induced pulmonary fibrosis in mice. This study aims to further explore the preventive and therapeutic effects of DHZCP against silicosis fibrosis and the underlying mechanisms in vitro. Methods. We used the experimental model of SiO2-induced MH-S cells to evaluate the therapeutic potential of DHZCP. MH-S cells induced by SiO2 were intervened with the drug-containing serum of DHZCP, and the effects of drug-containing serum of DHZCP on the MH-S cells were detected by CCK8, ELISA, flow cytometry, western blot, and immunofluorescence. Results. DHZCP improved cell viability by reducing apoptosis. It also decreased the levels of TNF-α, IL-1β, IL-6 in the supernatant of MH-S cells induced by SiO2, inhibited the expression of p38 MAPK, blocked the activation of NF-κB, and controlled the upstream inflammatory response by multiple targeting. Concomitantly, we observed upregulation of Smad7 and a marked decline in TGF-β1, α-SMA, Smad2, Smad3 expression in MH-S cells treated with DHZCP. Conclusion. To sum up, we conclude that DHZCP protects against SiO2-induced silicosis by reducing the persistent irritation of inflammation, regulating the p38 MAPK/TGF-β1/Smad pathway.

Discussion on the Treatment of Ear Vertigo Based on the Theory of "All Winds and Dizziness Belong to the Liver"

The theory of "all winds and dizziness belong to the liver" provides a basis for later physicians to study the etiologic and pathogenesis of vertigo diseases. This theory of pathogenesis suggests that vertigo diseases are most closely related to the liver, so the mechanism can be simply understood as liver and spleen damage. Water dampness is unfavourable for transportation and transformation as dampness gathers phlegm, and liver ‘wind’ carries phlegm to the ear orifice, causing dizziness; or the ear orifice can be attacked due to the deficiency of yin and hyperactivity of yang in liver and kidney, resulting in sudden dizziness. Based on the pathogenesis theory of liver and spleen damage, the treatment principles should be based on strengthening the spleen and dispelling dampness, eliminating phlegm and extinguishing ‘wind’. For ‘yang-type’ hyperactive liver, nourishing yin and suppressing yang, and the clearing of yang in the ears should always be the standard.

The Clinical Experience of Prof. Zhang Xiaofeng in the Treatment of Small Follicular, Ovulatory Infertility with Traditional Chinese Medicine

With the popularization of clinical ultrasound technology, small follicular ovulation infertility is gradually being recognized in clinical practice. Low follicle ovulation refers to the phenomenon that the average value of the three diameter lines of the dominant follicle is less than 14mm-18mm under continuous ultrasound monitoring. The dominant follicle ovulates before it develops to maturity, which is a kind of ovulation disorder and one of the leading causes of unexplained infertility, accounting for 25%-30% of the total number of patients with infertility. At present, Western medicine mostly uses ovulation, stimulating drugs to treat this disease. Still, due to the clinical result of "high ovulation but low pregnancy", there are certain obstacles in treatment. The purpose of this article is to discuss Zhang Xiaofeng's understanding of TCM of this disease. The tutor believes that the location of the disease is in the kidney, and the mechanism of the disease is kidney yin deficiency and blood heat. The treatment principle is sequential therapy, nourishing yin and clearing heat, taking into account the protection of the spleen and stomach, and the therapeutic effect is perfect.