Aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders:progress of experimental models based on disease pathogenesis

Neuromyelitis optica spectrum disorders are neuroinflammatory demyelinating disorders that lead to permanent visual loss and motor dysfunction.To date,no effective treatment exists as the exact causative mechanism remains unknown.Therefore,experimental models of neuromyelitis optica spectrum disorders are essential for exploring its pathogenesis and in screening for therapeutic targets.Since most patients with neuromyelitis optica spectrum disorders are seropositive for IgG autoantibodies against aquaporin-4,which is highly expressed on the membrane of astrocyte endfeet,most current experimental models are based on aquaporin-4-IgG that initially targets astrocytes.These experimental models have successfully simulated many pathological features of neuromyelitis optica spectrum disorders,such as aquaporin-4 loss,astrocytopathy,granulocyte and macrophage infiltration,complement activation,demyelination,and neuronal loss;however,they do not fully capture the pathological process of human neuromyelitis optica spectrum disorders.In this review,we summarize the currently known pathogenic mechanisms and the development of associated experimental models in vitro,ex vivo,and in vivo for neuromyelitis optica spectrum disorders,suggest potential pathogenic mechanisms for further investigation,and provide guidance on experimental model choices.In addition,this review summarizes the latest information on pathologies and therapies for neuromyelitis optica spectrum disorders based on experimental models of aquaporin-4-IgG-seropositive neuromyelitis optica spectrum disorders,offering further therapeutic targets and a theoretical basis for clinical trials.

Glycolytic dysregulation in Alzheimer's disease:unveiling new avenues for understanding pathogenesis and improving therapy

Alzheimer's disease poses a significant global health challenge owing to the progressive cognitive decline of patients and absence of curative treatments.The current therapeutic strategies,primarily based on cholinesterase inhibitors and N-methyl-Daspartate receptor antagonists,offer limited symptomatic relief without halting disease progression,highlighting an urgent need for novel research directions that address the key mechanisms underlying Alzheimer's disease.Recent studies have provided insights into the critical role of glycolysis,a fundamental energy metabolism pathway in the brain,in the pathogenesis of Alzheimer's disease.Alterations in glycolytic processes within neurons and glial cells,including microglia,astrocytes,and oligodendrocytes,have been identified as significant contributors to the pathological landscape of Alzheimer's disease.Glycolytic changes impact neuronal health and function,thus offering promising targets for therapeutic intervention.The purpose of this review is to consolidate current knowledge on the modifications in glycolysis associated with Alzheimer's disease and explore the mechanisms by which these abnormalities contribute to disease onset and progression.Comprehensive focus on the pathways through which glycolytic dysfunction influences Alzheimer's disease pathology should provide insights into potential therapeutic targets and strategies that pave the way for groundbreaking treatments,emphasizing the importance of understanding metabolic processes in the quest for clarification and management of Alzheimer's disease.

New exploration on pathogenesis and early diagnosis of gestational diabetes

Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

Gut virome:New key players in the pathogenesis of inflammatory bowel disease

Inflammatory bowel disease(IBD)is a chronic inflammatory illness of the intes-tine.While the mechanism underlying the pathogenesis of IBD is not fully under-stood,it is believed that a complex combination of host immunological response,environmental exposure,particularly the gut microbiota,and genetic suscept-ibility represents the major determinants.The gut virome is a group of viruses found in great frequency in the gastrointestinal tract of humans.The gut virome varies greatly among individuals and is influenced by factors including lifestyle,diet,health and disease conditions,geography,and urbanization.The majority of research has focused on the significance of gut bacteria in the progression of IBD,although viral populations represent an important component of the microbiome.We conducted this review to highlight the viral communities in the gut and their expected roles in the etiopathogenesis of IBD regarding published research to date.

Pathogenesis and clinical management of arboviral diseases

Arboviral diseases are viral infections transmitted to humans through the bites of arthropods,such as mosquitoes,often causing a variety of pathologies associated with high levels of morbidity and mortality.Over the past decades,these infections have proven to be a significant challenge to health systems worldwide,particularly following the considerable geographic expansion of the dengue virus(DENV)and its most recent outbreak in Latin America as well as the difficult-tocontrol outbreaks of yellow fever virus(YFV),chikungunya virus(CHIKV),and Zika virus(ZIKV),leaving behind a substantial portion of the population with complications related to these infections.Currently,the world is experiencing a period of intense globalization,which,combined with global warming,directly contributes to wider dissemination of arbovirus vectors across the globe.Consequently,all continents remain on high alert for potential new outbreaks.Thus,this review aims to provide a comprehensive understanding of the pathogenesis of the four main arboviruses today(DENV,ZIKV,YFV,and CHIKV)discussing their viral characteristics,immune responses,and mechanisms of viral evasion,as well as important clinical aspects for patient management.This includes associated symptoms,laboratory tests,treatments,existing or developing vaccines and the main associated complications,thus integrating a broad historical,scientific and clinical approach.

AVAPS通气模式联合TCM监测在慢性阻塞性肺疾病急性加重期患者脱机中的应用价值

目的探讨AVAPS通气模式联合经皮氧/二氧化碳检测仪(TCM)监测在慢性阻塞性肺疾病急性加重(AECOPD)患者有创-无创序贯通气中的应用价值。方法选取行有创通气的老年慢阻肺患者120例,根据无创呼吸机的不同通气模式,将患者脱机后随机分为S/T组及AVAPS组,每组患者60例。所有患者在“出窗”时记录呼吸频率(RR)、心率(HR)、血氧饱和度(SpO_(2))、吸氧浓度(FiO_(2))、序贯性器官功能衰竭评分(SOFA)、白细胞总数、降钙素原、血小板、白蛋白及肌酐等指标,并记录无创机械通气6h后呼吸频率(RR)、心率(HR)、血氧饱和度(SpO_(2))及吸氧浓度(FiO_(2))等指标。同时记录二氧化碳分压(PaCO_(2)),行经皮二氧化碳分压(PtcCO_(2))监测,比较PtcCO_(2)与PaCO_(2)的相关性及治疗前后各生理参数的差异。比较两组患者48h再插管率、距插管时间、ICU住院时间。分析撤机后行无创机械通气6h后PtcCO_(2)变异度对48h再插管的预测效能。结果两组患者“出窗”时各生理参数及PtcCO_(2)值,均无统计学差异(P>0.05)。与S/T组比较,无创通气6h后,AVAPS组的生理参数RR、HR、PtcCO_(2)变异度及ROX指数均有所改善,差异有统计学意义(P<0.05),且AVAPS组的48h再插管率优于S/T组,且距插管时间更长(P<0.05)。ROC曲线分析显示,通气6h后的PtcCO_(2)变异度对AVAPS组患者48h再插管具有一定的诊断效能,其敏感度为92.30%,特异度为82.60%,AUC为0.898。结论AVAPS通气模式联合PtcCO_(2)在重症慢阻肺有创-无创“序贯”治疗的运用,能有更好的生理参数,更低的再插管率,以及更为优势的“人机协调性”。

基于TCM模式的护理干预对胃癌手术患者负性情绪及生活质量的影响

分析胃癌手术患者在倡导TCM的理念下所实施的护理,对其心态和生活健康情况的影响。方法 将2021年3月至2022年3月本院接诊的胃癌手术患者共计92例全部作为研究对象,进行研究分析,利用红蓝球法分为对照组、观察组,每个小组46例患者。对照组实施传统护理,观察组在TCM的理念下进行护理。对比两组护理后的心态、睡眠和生活健康情况。结果 观察组总体心态好转情况均好于对照组,差异表现显著(P<0.05);观察组睡眠好转情况强于对照组,差异表现显著(P<0.05);观察组生活健康评分比对照组更好,差异显著(P<0.05)。结论 对于胃癌手术患者,可采取TCM的理念下的康复护理,能够显著改善患者的心理状态,提高其睡眠情况,同时生活更加健康。

Study on the TCM Pathogenesis of Angiopathic Complications of Type Ⅱ Diabetes

Excess production of reactive oxygen species (ROS) of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes. TCM holds that the damp from the dysfunction of spleen, kidney and liver is the causative factor of complications of diabetes. This is similar to the mechanism of ROS resulting in angiopathic complications of diabetes. When the angiopathic complications of type II diabetes mellitus (T2DM) are differentiated as caused by turbid damp in TCM can be explained as ROS. Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis, the treating principle should be dissolving the damp to remove the obstruction.

Gut flora in multiple sclerosis:implications for pathogenesis and treatment

Multiple sclerosis is an inflammatory disorder chara cterized by inflammation,demyelination,and neurodegeneration in the central nervous system.Although current first-line therapies can help manage symptoms and slow down disease progression,there is no cure for multiple sclerosis.The gut-brain axis refers to complex communications between the gut flo ra and the immune,nervous,and endocrine systems,which bridges the functions of the gut and the brain.Disruptions in the gut flora,termed dys biosis,can lead to systemic inflammation,leaky gut syndrome,and increased susceptibility to infections.The pathogenesis of multiple sclerosis involves a combination of genetic and environmental factors,and gut flora may play a pivotal role in regulating immune responses related to multiple scle rosis.To develop more effective therapies for multiple scle rosis,we should further uncover the disease processes involved in multiple sclerosis and gain a better understanding of the gut-brain axis.This review provides an overview of the role of the gut flora in multiple scle rosis.

中医药团体标准评价体系(SCORE-TCM)解读

本文全面解读了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine,SCORE-TCM)。SCORE-TCM是结合定性与定量评价,全面评估中医药团体标准在制定主体、文本编写、技术内容、推广应用和实施效益等几方面特征的综合评价工具。文中详述了SCORE-TCM的构建目的、定义和构建过程,解释了评价指标体系中的各项指标,并对每项指标的评价材料进行介绍。本文旨在帮助中医药团体标准的制定者、第三方评价机构和其他相关方更好地理解SCORE-TCM各评价条目的含义,更有效地运用于中医药团体标准的自评价或第三方评价,SCORE-TCM将为《中医药团体标准管理办法》的贯彻实施,以及中医药团体标准的高质量发展提供技术支持。

TCM diagnosis and treatment theory of chronic complete occlusion of coronary artery based on etiology and pathogenesis

Chronic total occlusive disease of the coronary artery belongs to the category of"chest palsy"and"true heart pain"in traditional Chinese medicine.Its etiology has two aspects:deficiency of blood,blood stasis,qi stagnation,and phlegm.Failure can be caused by deficiency or disease.The pathogenesis of this disease is caused by obstruction of the heart pulse,and its pathogenesis can be transformed into each other.The theory of traditional Chinese medicine believes that the general rule is not painful.Therefore,the treatment of coronary CTO lesions should be based on the combination of Tong and Tong tonic.The chronic complete occlusive disease of the coronary artery can be treated through Xuanbi Tongyang,Huoxue Tongluo,and Aroma Wentong.Based on the Chinese medicine's understanding of the etiology and pathogenesis of coronary CTO lesions,it provides a basis for the diagnosis and treatment of traditional Chinese medicine,solves the problems of interventional medicine in western medicine,and gives play to the unique advantages of traditional Chinese medicine for clinical diagnosis and treatment.

NLRP3 inflammasome plays a vital role in the pathogenesis of age-related diseases in the eye and brain

Key points:With aging,there is increased nucleotide-binding oligomerization domain-(NOD-)like receptor(NLR) protein-3(NLRP3) activation in neural and ocular tissues.Activation of the NLRP3 inflammasome appears to be a common denominator in the pathogenesis of age-related diseases of the eye and brain.Pharmacological inhibition of the NLRP3 inflammasome may be a potent therapy for preventing the development and progression of age-related eye and brain diseases.

Exploring the autophagy-related pathogenesis of active ulcerative colitis

BACKGROUND The pathogenesis of ulcerative colitis(UC)is complex,and recent therapeutic advances remain unable to fully alleviate the condition.AIM To inform the development of novel UC treatments,bioinformatics was used to explore the autophagy-related pathogenesis associated with the active phase of UC.METHODS The GEO database was searched for UC-related datasets that included healthy controls who met the screening criteria.Differential analysis was conducted to obtain differentially expressed genes(DEGs).Au-tophagy-related targets were collected and intersected with the DEGs to identiy differentially expressed autophagy-related genes(DEARGs)associated with active UC.DEARGs were then subjected to KEGG,GO,and DisGeNET disease enrichment analyses using R software.Differential analysis of immune infiltrating cells was performed using the CiberSort algorithm.The least absolute shrinkage and selection operator algorithm and protein-protein interaction network were used to narrow down the DEARGs,and the top five targets in the Dgree ranking were designated as core targets.RESULTS A total of 4822 DEGs were obtained,of which 58 were classified as DEARGs.SERPINA1,BAG3,HSPA5,CASP1,and CX3CL1 were identified as core targets.GO enrichment analysis revealed that DEARGs were primarily enriched in processes related to autophagy regulation and macroautophagy.KEGG enrichment analysis showed that DEARGs were predominantly associated with NOD-like receptor signaling and other signaling pathways.Disease enrichment analysis indicated that DEARGs were significantly linked to diseases such as malignant glioma and middle cerebral artery occlusion.Immune infiltration analysis demonstrated a higher presence of immune cells like activated memory CD4 T cells and follicular helper T cells in active UC patients than in healthy controls.CONCLUSION Autophagy is closely related to the active phase of UC and the potential targets obtained from the analysis in this study may provide new insight into the treatment of active UC patients.

A Discussion on TCM Treatment and the Pathogenesis of Membranous Nephropathy in Primary Nephrotic Syndrome

Objective:To investigate the TCM treatment principle of membranous nephropathy and its effect.Methods:A total of 56 patients were selected from the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine.They were then divided into the control group(western medicine standard therapy)and the study group(Qidi Gushen prescription),with 28 patients in each group.The treatment effect,treatment safety,and patients’satisfaction were observed and compared between the two groups.Results:The results showed that the treatment effect of the study group was 96.43%,which was significantly better compared with the control group(75.00%)(p<0.05);in terms of safety,the probability of adverse events was 7.14%in the study group and 32.14%in the control group,in which the difference was statistically significant(p<0.05);in addition,the study group’s satisfaction with the treatment measures was significantly higher than that of the control group(p<0.05).Conclusion:In treating membranous nephropathy,traditional Chinese medicine can be tailored to its pathogenesis,which is not only beneficial to the treatment effect,but also has a high safety profile.

Research progress of TCM multi-target intervention in the pathogenesis of liver failure

Liver failure is a serious liver damage caused by many factors,leading to severe impairment or decompensation of synthesis,detoxification,metabolism and biotransformation,and a group of clinical symptoms mainly manifested by jaundice and coagulation dysfunction.Traditional Chinese medicine belongs to the categories of"acute yellow"and"jaundice",and the incidence is mostly related to"poison,phlegm,stasis,and deficiency".Traditional Chinese medicine has the advantages of multi-component,multi-path and multi-target in the intervention of liver failure.This article summarizes the traditional Chinese medicine intervention in liver failure in terms of innate immunity,cytokine effects and oxidative stress.

TCM抗阻训练在肥胖型阻塞性睡眠呼吸暂停低通气综合征患者中的应用

目的:探讨过渡期护理(TCM)抗阻训练在肥胖型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的应用效果。方法:选取2022年1月1日~2023年1月1日接受治疗的102例肥胖型OSAHS患者作为研究对象,根据随机数字表法将其分为对照组和研究组各51例。对照组行常规抗阻训练,研究组行TCM抗阻训练;对比两组入院次日、出院1个月时体质指标[包括体质量指数(BMI)、颈围、腹围]、嗜睡程度[采用中文版Epworth嗜睡量表(ESS)]及生活质量[采用睡眠呼吸暂停低通气综合征生命质量评估表(QOL-OSAHS)]。结果:共有102例患者参与研究,其中对照组有1例在中途失访剔除,最后101例患者完整参与研究。出院1个月时,两组BMI、颈围、腹围及均ESS评分均低于入院次日(P<0.05),且研究组低于对照组(P<0.05);出院1个月时,两组QOL-OSAHS评分高于入院次日(P<0.05),且研究组高于对照组(P<0.05)。结论:TCM抗阻训练可有效改善肥胖型OSAHS患者体质指标,提升睡眠质量和生活质量。

Mechanism of sex hormone level in biological clock disorder induced acne and analysis of TCM Pathogenesis

Acne vulgaris is a common chronic inflammatory disease of pilosebaceous units. And sex hormone level disorder has became a hot research topic in the pathogenesis of acne. Studies show that the biological clock disorder can result in the disorder of sex hormone levels which causes or aggravates acne. Biological clock disorder coincides naturally with "sleep rhythm disorder" in Traditional Chinese Medicine(TCM). In this paper, we will discuss the modern medical mechanism of the biological clock disorder resulting in acne from the angle of sex hormones, and analyze the TCM pathogenesis of the disease caused by the disorder of the biological clock.

基于SCORE-TCM的中医药团体标准抽样评价方案设计

目前,各社会团体积极参与中医药标准的制定和发布,特别是“十四五”以来,中医药团体标准化工作更是迎来了提质增效的关键阶段。深入评估社会团体发布的中医药标准质量,是推进中医药团体标准工作的关键环节和重点任务。前期已研制并形成了中医药团体标准评价体系(System of Consortium Standards Rating and Evaluation of Traditional Chinese Medicine, SCORETCM)。在上述背景下,本研究通过专家共识法,设计了一套基于SCORE-TCM的中医药团体标准抽样评价方案,应用场景为对于特定社会团体发布的标准,或各团体发布的特定技术类别的标准进行快速评估。该方案涵盖了标准抽样、材料收集、标准评价、结果解读的完整流程,为中医药团体标准的抽样评价工作提供了参考方案。

Chen Shigong,Founder of“TCM Orthodox School of External Medicine”

Chen Shigong,styled name Yuren,was also known by the literary name Ruoxu.Coming from Donghaichongchuan(present Nantong City,Jiangsu Province)he was a famous traditional Chinese medicine(TCM)specialist of external medicine of the Ming Dynasty(1368-1644).The Orthodox Lineage of External Medicine(Wai Ke Zheng Zong)written by him has been valued as the founder of the TCM Orthodox School of External Medicine.