Integrated causal inference modeling uncovers novel causal factors and potential therapeutic targets of Qingjin Yiqi granules for chronic fatigue syndrome

Objective:Chronic fatigue syndrome(CFS)is a prevalent symptom of post-coronavirus disease 2019(COVID-19)and is associated with unclear disease mechanisms.The herbal medicine Qingjin Yiqi granules(QJYQ)constitute a clinically approved formula for treating post-COVID-19;however,its potential as a drug target for treating CFS remains largely unknown.This study aimed to identify novel causal factors for CFS and elucidate the potential targets and pharmacological mechanisms of action of QJYQ in treating CFS.Methods:This prospective cohort analysis included 4,212 adults aged≥65 years who were followed up for 7 years with 435 incident CFS cases.Causal modeling and multivariate logistic regression analysis were performed to identify the potential causal determinants of CFS.A proteome-wide,two-sample Mendelian randomization(MR)analysis was employed to explore the proteins associated with the identified causal factors of CFS,which may serve as potential drug targets.Furthermore,we performed a virtual screening analysis to assess the binding affinity between the bioactive compounds in QJYQ and CFS-associated proteins.Results:Among 4,212 participants(47.5%men)with a median age of 69 years(interquartile range:69–70 years)enrolled in 2004,435 developed CFS by 2011.Causal graph analysis with multivariate logistic regression identified frequent cough(odds ratio:1.74,95%confidence interval[CI]:1.15–2.63)and insomnia(odds ratio:2.59,95%CI:1.77–3.79)as novel causal factors of CFS.Proteome-wide MR analysis revealed that the upregulation of endothelial cell-selective adhesion molecule(ESAM)was causally linked to both chronic cough(odds ratio:1.019,95%CI:1.012–1.026,P=2.75 e^(−05))and insomnia(odds ratio:1.015,95%CI:1.008–1.022,P=4.40 e^(−08))in CFS.The major bioactive compounds of QJYQ,ginsenoside Rb2(docking score:−6.03)and RG4(docking score:−6.15),bound to ESAM with high affinity based on virtual screening.Conclusions:Our integrated analytical framework combining epidemiological,genetic,and in silico data provides a novel strategy for elucidating complex disease mechanisms,such as CFS,and informing models of action of traditional Chinese medicines,such as QJYQ.Further validation in animal models is warranted to confirm the potential pharmacological effects of QJYQ on ESAM and as a treatment for CFS.

Effect of Qingjin Huatan Decoction on transferrin and Iron regulatory protein in COPD rats

Objective:To explore the mechanism of Qingjin Huatan Decoction in regulating iron metabolism by regulating inflammatory factors in the inflammatory environment of chronic obstructive pulmonary disease.Methods:The COPD model was prepared by tracheal drops of lipopolysaccharide(LPS)combined with smoke.40 rats were randomly divided into normal group,COPD group,roxithromycin western medicine group and Qingjin Huatan Decoction traditional Chinese medicine group(n=10).Post-molding drug administration intervention,Qingjin Huatan Decoction Chinese medicine group was given 14.62 g/kg(Qingjin Huatan Decoction),roxithromycin western medicine group was given 0.01575 g/kg(roxithromycin),COPD group and normal group were given normal saline 10 mL/kg,twice a day.The expressions of Hepcidin,IL-1β,IL-10 and TGF-β1 in serum of rats in each group were detected by ELISA.WesternBlot and qRT-PCR were used to detect the expression of TF and IREB2 protein and mRNA in lung tissues of each group.Results:Compared with the normal group,the contents of serum Hepcidin and IL-10 in COPD group were significantly decreased(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly increased(P<0.01,P<0.05).Compared with COPD group,the contents of serum Hepcidin and IL-10 were significantly increased in the two drug groups(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly decreased in the two drug groups(P<0.05).Compared with normal group,TF mRNA and protein expression in COPD group were increased(P<0.01),while IREB2 mRNA and protein expression were decreased(P<0.01).Compared with COPD group,TF mRNA and protein expressions in lung tissues of the two-drug group were decreased(P<0.01,P<0.05),while IREB2 mRNA and protein expressions were increased(P<0.01).Conclusion:Iron metabolism is related to inflammation.Qingjin Huatan Decoction can regulate iron metabolism in inflammatory environment to treat COPD.

On Chengzhai Poetic Style and Shu Culture

Yang Wanli,a renowned poet of the Southern Song Dynasty(1127-1279 AD),has left an indelible mark on the history of Chinese literature with his unique artistic style.He pioneered the Chengzhai Poetic Style,a unique approach characterized by simplicity,naturalness,freshness,and liveliness in poetic creation.This style marked a turning point in the development of Song poetry and exerted a profound influence on the subsequent trends of Song poetry.As such,he was hailed as a“Leader in Poetry”by his contemporaries.The Chengzhai Poetic Style was gradually formed during Yang’s creation course,under the influence of several important factors,including the Bashu culture and its aesthetic taste represented by Zhang Jun and Zhang Shi,the Zen philosophy that emphasizes liveliness prevailing in the Shu area,and the view that the“Chinese Yi-ology has its roots in the Shu area.”Meanwhile,in the Collected Works of Chengzhai(Chengzhai Ji),there are many poems and essays about the Bashu area,which have provided valuable feedback to the Bashu literature and enriched its content.

Continuity and Change in Dao Yin:Comparing and Contrasting the Therapeutic Exercises in Yin Shu(The Book of Pulling,c.2nd Century BCE)and Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases,610 CE)

The manuscript Yin Shu(The Book of Pulling),excavated from Zhangjiashan Han Tomb No.247,is the earliest surviving text on therapeutic exercise known as Dao Yin(lit.guiding and pulling).Discovered in 1983,this Dao Yin text,together with the drawings of 44 figures performing“guiding and pulling”exercises found in the Mawangdui Han Tomb in 1974,are of great significance to the study of the early history of Dao Yin.Prior to these discoveries,researchers into Dao Yin relied mainly on material found in the Dao Zang(the Daoist Canon),compiled in 1145.This led to their conclusion that Dao Yin was essentially Daoist.The development of Dao Yin reached its zenith during the Sui Dynasty(581–618 CE),when it became one of the three medical departments at the imperial medical education institution.As part of the medical reform of the second Sui Emperor,Yang Di,Dao Yin became the treatment of choice,and the employment of a large number of Dao Yin specialists to the Sui court transformed the state medical service.The compilation of Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases)under Yang Di’s decree,incorporated an abundance of resources on Dao Yin,enabling physicians to potentially“prescribe”Dao Yin to their patients.Situating both Yin Shu and Zhu Bing Yuan Hou Lun in their social and historical contexts,this article analyses their editorial treatments,examines their different objectives,styles,and readerships,and compares the various exercises described in the two texts.It emphasizes the fact that over a period of nearly a thousand years,from the late Warring States(475–221 BCE)to the Sui and Tang periods,Dao Yin was an important medical practice,culminating in its institutionalization by the Sui government.

On the Rice Farming in the Shu Area During the Can Cong Period

The Bashu area was one of the most civilized agricultural areas in ancient China.Since the late Eastern Han Dynasty,it has been reputed as the“Land of Abundance”due to its abundant resources.Archaeological data show that the Shu area cultivated millet as early as the prehistoric period.The legend goes that Can Cong was the first ruler of the Shu area during the pre-Qin period,indicating that agricultural production at that time had made great progress compared with the prehistoric period.During this period,the agricultural pattern of the Shu area experienced profound changes,from dryland millet farming originating from the Western Sichuan Plateau to rice farming that is more suitable for Sichuan Basin,especially for the Chengdu Plain,where there are abundant rainfalls and high temperatures.Since then,rice farming has become a long-established farming tradition in the Shu area.The agricultural production tools and grain crop seeds unearthed from the Baodun site,where the archaeological remains of Can Cong Culture were discovered,show the prosperity of early agriculture in the Shu area.During the Baodun Culture period,the accelerated economic and social development in the Shu area promoted complicated and hierarchical changes in the social organization structure of settlements,which gradually evolved into early states.

三星堆古蜀文化遗址博物馆大型螺旋坡道结构设计与分析

三星堆古蜀文化遗址博物馆中庭的螺旋坡道采用钢箱梁结构体系,最大半径28.7m,水平投影长度118.5m。介绍了大型螺旋坡道结构体系选型和边界条件的对比过程,采用通用计算软件MIDAS Gen建立多尺度整体模型考虑螺旋坡道和主体结构的相互作用,通过静力分析和反应谱分析考察螺旋坡道在不同荷载作用下的承载能力和变形,并采用有限元软件ANSYS建立分析模型进行连续倒塌分析。结果表明,螺旋坡道采用钢箱梁结构具有较好的整体刚度,静力荷载和地震作用下坡道的应力和变形均满足规范要求,并具有较好的抗连续倒塌能力。

清代蜀道文献的特点及其历史文化价值

清代蜀道文献主要由行旅文献、诗歌文献及碑刻文献构成。蜀道行旅文献之多超过前代总合,多糅合日记、诗歌于一体,其中不乏有重要史料的佳作,是清代行旅文学的重要组成部分;蜀道诗歌文献浩繁庞杂,多见于清人别集稿本,作者群体庞大,其中既有名家巨擘,更多为非知名士人,具有写真纪实的风格特点,感叹自然奇险、忧患战乱与民生是其重要主题;碑刻文献主要是清代学者对蜀道沿线汉魏两宋碑石书法的史事考证、碑刻释文及转录。清代蜀道文献在反映蜀道交通历史变迁、蜀道地带生态环境及其社会风貌方面有重要的史料价值,同时也与清代川陕诸多重大历史事件息息相关。大量的清代蜀道诗不仅承载了清代士大夫艰难的人生行迹,也是山地生命体验的典型写照。

职教型非遗产业学院人才培育研究——以四川蜀绣学院为例

非物质文化遗产得以传承与创新,离不开专门人才和产业发展。四川安靖镇蜀绣基地拥有得天独厚的历史资源,在地方政府及头部企业的综合支持下,开创了国内第一所职教型非遗蜀绣产业学院。学院办学机制、教育理念、培育模式、产教融合、发展策略与职业教育融通。通过创新文化创意公共服务平台协同蜀绣衍生设计,形成地方化“产教研”职教模式,服务地方教育与产业发展。积极探索蜀绣教育的课程体系和建设机制,研究蜀绣的产教研与跨界融合模式,对非遗人才培育及产业的发展具有启示作用。

清金化痰汤治疗糖尿病合并下呼吸道感染临床观察

目的分析清金化痰汤加减治疗糖尿病合并下呼吸道感染的可行性。方法拟选取宜丰县人民医院2021年1月—2022年12月收治的糖尿病合并下呼吸道感染患者60例,分为对照组、观察组,各30例。统计分析两组临床症状恢复时间(发热、咳嗽、全身症状、局部症状)、血糖情况、炎症因子水平[白细胞、C反应蛋白(CRP)]、并发症发生情况(消化道反应、皮疹、心动过缓等)、临床疗效。结果治疗后,观察组患者的发热、咳嗽、局部症状、全身症状恢复时间均短于对照组(P<0.05);观察组空腹血糖水平、餐后2 h血糖水平、白细胞计数、CRP水平均低于对照组(P<0.05);观察组并发症总发生率3.33%(1/30)低于对照组的26.67%(8/30)(P<0.05);观察组治疗总有效率96.67%(29/30)高于对照组的73.33%(22/30)(P<0.05)。结论清金化痰汤加减治疗糖尿病合并下呼吸道感染的可行性高。

输刺治疗神经根型颈椎病上肢麻痛的疗效观察及对肌电图F波传导速度的影响

目的观察在CT定位基础上行输刺治疗神经根型颈椎病上肢麻痛的临床疗效及对患者正中神经和尺神经肌电图F波传导速度的影响。方法将98例神经根型颈椎病上肢麻痛患者作为研究对象,用随机数字表法分为对照组和研究组,每组49例。研究组在CT定位基础上采用输刺治疗,对照组采用常规针刺治疗。比较两组患者治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、颈椎病功能障碍指数(neck disability index,NDI)评分和颈椎活动度以及血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-8(interleukin-8,IL-8)和白介素-1β(interleukin-1β,IL-1β)水平的变化。通过肌电图检查,比较两组治疗前后正中神经和尺神经的F波传导速度以及F波出现率的变化。比较两组临床疗效。结果研究组总有效率高于对照组(P<0.05)。治疗后,两组VAS和NDI评分降低(P<0.05),颈椎前屈、后伸、左屈、右屈、左旋、右旋活动度增大(P<0.05),正中神经和尺神经的F波传导速度以及F波出现率提高(P<0.05),血清TNF-α、IL-8和IL-1β水平降低(P<0.05)。治疗后,研究组VAS和NDI评分低于对照组(P<0.05),颈椎前屈、后伸、左屈、右屈、左旋、右旋活动度大于对照组(P<0.05),正中神经和尺神经的F波传导速度以及F波出现率高于对照组(P<0.05),血清TNF-α、IL-8和IL-1β水平低于对照组(P<0.05)。结论在CT定位基础上行输刺治疗神经根型颈椎病上肢麻痛的临床疗效优于常规针刺,可缓解疼痛,改善颈椎活动度,减轻炎症反应,提高肌电图F波出现率和传导速度,有较好的神经修复作用。

六艺:从共同资源到一家垄断——孔子与儒家经典之成立

按章太炎的划分,礼乐射御书数为“小六艺”,为王公贵族子弟在小学阶段的必修技能;被孔子删订的《诗》《书》《礼》《乐》《易》《春秋》则为“大六艺”,属于成人教育的“大学之道”,是官员任职前必须学习的待人接物、处事礼仪与一般道理。孔子晚年集中精力编辑、注解、诠释六艺,因“有德无位”而称“述而不作”,渗透思想价值和道义灵魂,总结三代而又超越三代,寄托《春秋》而行“素王”褒贬赏罚之权柄,最终把作为上古道术的六艺演绎为儒家学派独有而专用的文本载体。

吕才《阴阳书·历注》与唐历——具注历源起新说

唐太宗曾命吕才等人编修《阴阳书》,此书“历注”二卷被作为注历书长期使用,可以视作最早的注历书。梳理敦煌吐鲁番出土具注历与日本藏《大唐阴阳书》抄本后发现:一、《大唐阴阳书》抄本即《阴阳书》卷三十二、三十三“历注”部分,与出土唐至宋初具注历历注顺序、类目相同,内容相关;二、今存最早的具注历为唐高宗显庆三年具注历,晚于《阴阳书》,具注历阴阳历注内容应系从后者抄出。因此推断,具注历的产生与《阴阳书》有关,时间不早于太宗贞观十五年。

《诗经·魏风》“硕鼠”释义新考

随着“安大简”的发现与整理,人们对《诗经·魏风》中的“硕鼠”有了新的认识。“硕鼠”在“安大简”简文中书作“石鼠”,这为我们准确理解常见版本中的“硕鼠”提供了更为客观的新视角。《诗经·魏风》中的“硕鼠”“石鼠”实际上即“鼫鼠”“大鼠”“鼯鼠”“雀鼠”“飞生”等,这是一种形体较大,双翼如蝙蝠,毛色多种,既能穴处,又能入“树空中”的大飞鼠。它不仅食人禾苗,而且食粟、豆,史书中亦有“雀鼠耗”之典故。它实际上属于兽类,既不是人们一般所认为的大老鼠,更不是昆虫类中名为“硕鼠”的蝼蛄。学界对《诗经·魏风》中的“硕鼠”诠释上出现的分歧,多由不辨其名同物异所致。

从小病房写出大社会——薛舒非虚构新作《太阳透过玻璃》四人谈

薛舒的非虚构新作《太阳透过玻璃》,是其《远去的人》的续作,描述父亲住进病院直至去世,在叙述对失智失能父亲的照料中,描述病房其他病友的状态,也呈现出护工们的工作与追求,从一个病房写出了整个社会,中国式的情感特色呼之欲出。薛舒写的是临终病院的苦痛人生,她常特意用一些欢快的声音来冲淡文字的痛感,最终汇成一场情感交融的交响乐。非虚构写作与人的潜意识有着紧密的联系,所谓的记忆就是不同的事情进入心灵的顺序。薛舒的非虚构创作已经达到比较高的境界和层次。

论唐枢的经学思想

作为晚明时期甘泉学派的重要学者,唐枢在经学方面有颇多著述,其经学思想的核心理念可概括为“以心解经”。在他看来,六经之实质为吾性“幾神”触感而发的自然作用,六经之来源为圣人对“当世已行之迹”的誊写与记录,六经之功用为对物欲的克除与对性情的燮理。经学为唐枢的心学体系提供了文本依据,心学则为唐氏解经提供了价值取向。唐枢的经学思想对中晚明心学解经思潮起到积极的推动作用,在“心”的领域为明代经学诠释扩展了空间。

俞募配穴针刺治疗肝郁脾虚型抑郁症的临床效果观察

目的:观察俞募配穴针刺治疗肝郁脾虚型抑郁症患者的临床疗效。方法:选取2022年1月至2022年12月福建中医药大学附属第二人民医院收治的肝郁脾虚型抑郁症患者100例作为研究对象,随机分为对照组和观察组,每组50例。对照组给予艾司西酞普兰口服治疗,持续用药1个月;观察组在对照组基础上联合俞募配穴针刺治疗,2 d治疗1次,持续治疗15次。比较2组患者治疗前后主要症状、抑郁程度、生命质量评分、血清5-羟色胺(5-HT)水平、肠道菌群、不良反应、复发率及临床疗效。结果:治疗后,观察组健康调查简表(SF-36)评分、血清5-HT水平、粪便标本乳酸杆菌及双歧杆菌数量高于对照组(均P<0.05),主要症状评分、汉密尔顿抑郁量表(HAMD-24)评分、粪便标本大肠埃希菌及肠球菌数量低于对照组(均P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组治疗后6个月复发率略低于对照组,但差异无统计学意义(P>0.05)。治疗后观察组总有效率高于对照组(P<0.05)。结论:俞募配穴针刺治疗肝郁脾虚型抑郁症患者疗效明确,可有效改善患者症状,减轻抑郁程度,提高生命质量,调节血清5-HT水平及改善肠道菌群分布,安全性高。

清金化痰汤加减对痰热郁肺型慢性支气管炎急性发作期的临床治疗效果

目的 探究清金化痰汤加减对痰热郁肺型慢性支气管炎急性发作期患者的应用价值。方法选取2019年1月—2022年10月青岛市黄岛区人民医院收治的80例痰热郁肺型慢性支气管炎急性发作期患者进行研究。依据抽签法分为对照组(40例)与研究组(40例),分别实施常规治疗、常规治疗+清金化痰汤治疗。比较两组炎症因子、治疗效果与中医证候积分等。结果 研究组治疗有效率为97.50%,高于对照组的72.50%,差异有统计学意义(χ^(2)=9.804,P<0.05)。研究组复发率低于对照组,差异有统计学意义(P<0.05)。研究组中医证候积分低于对照组,差异有统计学意义(P<0.05)。研究组炎症因子相关指标较对照组低,差异有统计学意义(P<0.05)。结论 清金化痰汤加减应用于痰热郁肺型慢性支气管炎急性发作期患者时,对炎症因子水平及中医证候的改善有一定促进作用,可提高整体治疗效果。

“林译小说”的现代阅读及其意义——以民初教育部褒奖小说为例

清末民初,“林译小说”影响很大,其中十几种为民初教育部所褒奖,以利于通俗教育。这十几种褒奖小说为国民所普遍阅读,其中首推《黑奴吁天录》,其“阅读”焦点在于借黑奴悲黄种人,体现出浓厚的启蒙色彩。对三种伦理小说的阅读,反映了读者对传统伦理的重视,尤其是通过西方小说发现中西在人伦上的相通之处,从而更加坚定了维护“伦理”的信念。对四种社会小说的阅读,体现了读者关注下层人民的悲悯情怀,更肯定了西方社会小说与我国古文在叙事技法上惊人的相似之处。对其他几种小说的阅读,各有侧重。对这些褒奖小说的阅读反映了读者思想观念的深刻变化。此外,考证与品评、批评这两种广义的“阅读”方式则大力促进了近代翻译小说批评的发展。

《褚氏遗书》对医学教育及人才培养的启发

《褚氏遗书》是我国现知最早的石刻医籍,作者为南北朝时期南齐政治家、医家褚澄。该书是中国医学史上的一部重要的理论性著作,其中诸多创见,对后世医家产生深远影响,足见其在知识传播及培养后学方面的价值。对《褚氏遗书》涉及的对医学教育及医学生成长具有启发作用的元素进行梳理,认为该书不仅体现了作者的学术思想,也反映了作者的治学理念,诸如严格要求自己,不断提高医疗水平;求业宜精,勤于思考,不墨守成规;重视实践,虚心求教等。这些观点对当代医学人才的成长均具有借鉴价值。

清金化痰汤联合穴位贴敷治疗小儿难治性支原体肺炎临床观察

目的:观察中西医结合治疗小儿难治性支原体肺炎的临床疗效。方法:选取符合纳入标准的难治性小儿支原体肺炎患儿91例,随机分为对照组44例,予阿奇霉素联合甲泼尼龙治疗;治疗组47例,在对照组基础上联合清金化痰汤及穴位敷贴治疗,14天后观察两组患儿的临床疗效。结果:治疗组总有效率为91.49%,明显高于对照组的72.73%,差异具有统计学意义(P﹤0.05);在改善难治性支原体肺炎的主要症状、生活质量以及促进病灶吸收等方面优于对照组,差异均有统计学意义(P﹤0.05)。结论:清金化痰汤联合穴位贴敷治疗小儿难治性支原体肺炎疗效较好。