Transcriptional dysregulation in neurodegenerative diseases:who tipped the balance of Yin Yang 1 in the brain?

Yin Yang 1(YY1) is a multi-functional transcription factor that regulates gene expression in a range of cell types,including neurons.It controls neuronal differentiation,as well as neuronal specification and migration during the development of the mammalian nervous system.Besides,YY1 also mediates the transcription of genes that are required for neuronal survival.An impairment of the transcriptional function of YY1 causes neuronal death.This review summarizes recent research findings that unveil the dysfunction of YY1 in multiple neurodegenerative disorders.The expression of disease proteins perturbs the function of YY1 via distinct molecular mechanisms,including recruitment to protein aggregates,protein degradation and aberrant nuclear/cytoplasmic shuttling.Understanding the pathogenic roles of YY1 will further broaden our knowledge of the disease mechanisms in distinct neurodegenerative disorders.

Discussion about the Treatment of Alzheimer's Disease with Yisui Fuyong Decoction Based on Synaptic Plasticity

For Alzheimer's disease(AD),the earliest symptom is memory loss,which runs throughout the disease.The mutual growth and decline of long-term potentiation(LTP)and long-term depression(LTD)in synaptic plasticity is the basic condition of learning and memory.In the early stage of AD,there is no significant change in synaptic plasticity,so the treatment should mainly focus on warming yang and replenishing qi.In the middle stage of AD,LTP is continuously damaged and reduced,and synaptic plasticity is destroyed,such as weakness of the spleen and stomach,causing stagnation of endogenous retention of phlegm in the brain,so the treatment should focus on enriching yin and tonifying yang,resolving phlegm to remove stagnation.In the late stage of AD,due to excessive deposition of amyloid and other metabolites,neurotoxins are produced and brain atrophy is aggravated,such as depression leading to stasis,phlegm and stasis binding together,long term of stasis turning to heat toxin,which invades the brain,excessive heat damages yin,then both yin and yang are damaged,finally,the brain collateral loses nutrition,so the treatment should focus on replenishing essence and reinforcing marrow,detoxifying and resolving stasis.Yisui Fuyong Decoction can replenish essence and reinforce marrow to nourish yin,warm yang and tonify qi to strengthen yang,combine phlegm resolving,stasis elimination and collateral vessels dredging,realizing the treatment effects in all three stages of synaptic plasticity.

Dr.Zang Kuntang's Experience in Treating Diabetes

Dr. Zang Kuntang (臧堃堂), professor of the First PLA Military Medical University, has been engaged in the science of traditional Chinese medicine for more than 50 years, with a rich experience accumulated in the treatment of diabetes. It is a great honor for us to have the fortune to follow him in the clinic. The following is a summary of what we have learned from him.

Discussing the six meridional diseases of Shanghan Lun based on stress theory

As the theoretical source of Traditional Chinese Medicine clinical medicine,Shanghan Lun plays a vital role in guiding the diagnosis and treatment of clinical diseases.Stress is a systemic nonspecific and adaptive response that occurs when the body is stimulated by internal and external environmental factors.This paper discusses the correlation between the three phases of stress containing alarm,resistance,and exhaustion and the three yin and three yang diseases.It was concluded that sanyang diseases were related to the alarm stage and resistance stage,and sanyin diseases were related to the failure stage.The results indicated the essence of diseases of six meridians from the perspective of stress and provided reference for the diagnosis and treatment of six classics diseases.

Mechanism underlying treatment of diabetic kidney disease using Traditional Chinese Medicine based on theory of Yin and Yang balance

The pathogenic mechanism of diabetic kidney disease(DKD) is complex. The development of DKD cannot be fully explained by a single mechanism.Traditional Chinese Medicine(TCM) has been applied extensively for the treatment of DKD in China.However, studying the mechanism of DKD using theories and methods that are appropriate for TCM characteristics and searching for theoretical bases for TCM clinical application are topics that still need to be explored and researched. Activation of the transforming growth factor(TGF)-β1/Smad and PI3 K/Akt/mTOR signaling pathways functions as a self-protection mechanism against renal microinflammation in DKD. However, the persistent abnormal overactivation of reactions causes secondary cell dysfunction, cell apoptosis, increased extracellular matrix(ECM) secretion, and eventually renal fibrosis. During this process, the dysregulation of self-balance among a variety of signaling pathways and the loss of self-feedback regulatory mecha-nisms downstream of these signaling pathways are critical causes of the occurrence and development of DKD. TCM may both inhibit the expression or activation of "hyperactive" signaling pathways(NFB, Smad3, and PI3 K/Akt/mTOR) and increase the expression or activation of "deficient" signaling pathways(Smad7 and PTEN) to restore balance to cells with an abnormal pathophysiological status and achieve the goal of DKD treatment.

Analysis of Constitutional Factors in Patients with Gallstone Disease

Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution for gallstone disease, whereas the Balanced Constitution and Yin deficiency constitution have a lower tendency towards the development of the disease;gallstone disease is more prevalent among young men engaged in mental labor. Methods: A retrospective study was conducted on 180 patients with gallstone disease who were hospitalized in the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine (TCM), from July 2017 to July 2023. Additionally, 180 healthy individuals undergoing physical examinations at the Health Examination Center of the same hospital were selected as the normal control group. Both groups underwent general condition surveys, TCM constitution scales, Eysenck Personality Questionnaires, Brief Coping Styles Questionnaires, and Social Support Rating Scales to determine risk factors and common types. Results: Independent variables such as gender, Qi stagnation constitution, Balanced Constitution, negative coping scores, positive coping scores, and stressful life events were included in the model. The OR values for Balanced Constitution, gender, positive coping style, and overall social support were all less than 1, and the maximum value of the 95% confidence interval was also less than 1. After selecting the intercept into the model and analyzing the standardized regression coefficients, it was found that negative coping scores had a significant impact on the model, while stressful life events showed extremely high relevance to the study. Compared with the normal group, the frequency of Qi stagnation constitution in the study group significantly increased, with a significant difference (P χ2 = 11.109, P = 0.0009, indicating a significant difference (P χ2 = 4.0890, P = 0.0432, indicating a significant difference (P 0.05). However, when comparing mental workers with physical workers within the patient group, the frequency of Qi stagnation constitution in mental workers was significantly higher, with χ2 = 6.8467, P = 0.012, indicating a significant difference (P Conclusion: Qi stagnation constitution is a potential predisposing constitution for gallstone disease, whereas the tendency to develop the disease is relatively low for Balanced Constitution and Yin deficiency constitution. Gallstone disease is more commonly found in young male mental workers.

CLINICAL OBSERVATIONS ON FORTY CASES OF PARALYSIS AGITANS TREATED BY ACUPUNCTURE

Paralysis agitans is a kind of nervous diseases of common occurrence. It is clinically classified into the primary and the secondary, the former being called Parkinson’s disease and the latter the secondary Parkinson’s syndrome, but both being characterized by tremor, tetanic muscle tone and decrease in movement. It is generally considered as a syndrome with deficiency

应用阴阳锉跖趾关节成形治疗Freiberg病的临床研究

目的 探讨应用阴阳锉辅助进行跖趾关节成形配合间质填充治疗Freiberg病的临床疗效。方法 选取2019年8月至2023年9月郑州市骨科医院收治的30例Freiberg病患者。其中,男6例,女24例;年龄17~45岁,平均(26.5±6.8)岁。根据Smillie分期:Ⅲ期13例,Ⅳ期9例,Ⅴ期8例。均采用阴阳锉辅助进行跖趾关节成形配合间质填充治疗。术后采用AOFAS评分系统及跖趾关节屈伸活动度进行评价手术效果。结果 所有患者均获得随访,随访时间6~36个月,平均(26.5±13.9)个月。所有患者伤口均Ⅰ期愈合;AOFAS评分由术前(55.3±6.2)分提高到术后6个月的(90.8±5.9)分,差异有统计学意义(P<0.05),所有患者症状得到明显改变;跖趾关节活动度术前跖屈(20.3±5.3)°、背伸(15.2±5.6)°与术后6个月随访测量跖屈(18.9±5.1)°、背伸(14.1±5.2)°相比较,差异无统计学意义(P>0.05)。结论 采用阴阳锉辅助进行跖趾关节成形配合间质填充来治疗该疾病,该术式创伤小,操作简单,既减轻的疼痛症状,又保留了跖趾关节的外形及活动度,改善了患者的生活质量,是较为可靠的一种治疗方案,值得推广应用。

基于从阴引阳从阳引阴浅谈腰痛治腹临床应用

目前临床上针对各种原因导致的腰背疼痛,主要采用单纯背腰部取穴治疗。临床发现,许多腰痛患者在腹部表现出阳性反应点,通过查阅古籍和阅读相关文献,还可采取以“从阴引阳,从阳引阴”理论为基础的腹部取穴法来治疗腰部疼痛疾病,从整体观念出发,平衡阴阳,有助于提高临床疗效。此文通过探讨《黄帝内经》中“从阴引阳”理论和腰痛治腹的指导思想,以期拓宽临床诊疗思路。

基于太阳病误下变证论“膈病”

太阳病涵盖了伤寒由表到里的整个演变过程,由于患者禀赋强弱、感邪轻重、就诊是否及时等原因,在此阶段可能出现表里证,所以太阳病可用到下法,但由于对表里先后顺序及整体病势把握不准确而误下产生变证者不少。太阳病下之后结局有两种:(1)下之愈。(2)下之不愈,而不愈者又可分为三种情况:一是误治后邪气仍在表者,当以汗解之;二是有表里证者,表解乃可攻里,否则引邪入里,为逆;三是误下影响了太阳病自然发展轨迹,导致表证几无,而邪气入膈,从而产生变证。无论太阳病正常转归还是误下发为变证,“膈”均是邪气入里之“首站”。膈病主要是邪气侵扰使其失去阻隔、分界作用,导致清浊易位,上下隔拒,典型特点为清浊不分,“上逆”与“下趋”症状并见,治疗首当察其在膈上、膈下,遵循“病在膈上必吐,在膈下必利”的治疗原则,观其脉证,随证治之。

基于“阴病治阳”治则浅析“重阳思想”在抑郁症诊疗中的应用

从阴阳观来看,抑郁症主症、发病机制、患病人群性别差异、患病季节及时空差异具有阴之属性,在宏观疾病观上抑郁症属阴病范畴,因此将抑郁症的病机归为阳虚阴盛;基于《黄帝内经》“阴病治阳”的治则,浅析以扶阳为主的“重阳思想”在抑郁症诊疗过程中的应用。

病证结合骨质疏松模型大鼠骨骼的生物力学性能分析

背景:肾虚是骨质疏松症的最主要病机,对肾阳虚、肾阴虚与骨质疏松的关系研究有利于病证结合临床诊疗模式的发展。目的:评价右归丸对肾阳虚、肾阴虚大鼠股骨生物力学性能的影响差异,从生物力学角度论证骨质疏松症病证结合、因证施药的科学性。方法:手术摘除60只雌性SD大鼠双侧卵巢建立骨质疏松模型,10周后将大鼠随机分为肾阴虚组(n=30)和肾阳虚组(n=30),肾阳虚组臀部肌肉注射氢化可的松注射液,肾阴虚组灌胃甲状腺片混悬药液,1次/d,连续14 d。造模结束后,每组取20只灌胃右归丸混悬液,1次/d,连续12周,剩余10只作为对照不灌胃。灌胃结束后使用Micro-CT扫描测量股骨微结构参数,在力学试验机上对股骨分别进行三点弯曲、有限元仿真、股骨头压缩及表面压痕分布实验。结果与结论:①Micro-CT扫描显示,与肾阴虚组比较,肾阴虚+右归丸组股骨骨密度、骨体积分数、骨表面密度、骨小梁数量、骨小梁分离度升高(P<0.05);与肾阳虚组比较,肾阳虚+右归丸组股骨骨体积分数、骨表面密度、骨小梁数量及骨小梁厚度升高(P<0.05);②三点弯曲实验显示,与肾阳虚组相比,肾阳虚+右归丸组股骨弹性模量、最大抗弯强度和弯曲断裂强度均降低(P<0.05),韧性提高(P<0.05);③有限元仿真显示,右归丸能显著提高肾阳虚组大鼠股骨抗骨折能力,对肾阴虚组大鼠不产生明显作用;股骨头压缩实验显示,右归丸可增强肾阳虚组大鼠股骨头抵抗形变的能力,但右归丸对肾阴虚组和肾阳虚组大鼠股骨头表面性能的影响无显著区别;④结果表明,右归丸可增强肾阳虚骨质疏松骨骼生物力学性能,但对肾阴虚骨质疏松骨骼无显著影响。

基于“中医阴阳学说”探讨反应性星型胶质细胞A1/A2表型与阿尔茨海默病的关系

阿尔茨海默病(AD)是一种常见的神经退行性疾病,主要临床表现为认知和记忆障碍,发病机制异常复杂,涉及多种因素,防治不当,将给家庭和社会带来巨大负担。星形胶质细胞(AS)是中枢神经系统(CNS)中最丰富的一类神经胶质细胞,在AD的发生发展中扮演重要角色。在CNS受损后,AS被激活并改变其细胞特性,形成反应性星形胶质细胞(RAs),其表型可变为A1型AS(A1S)与A2型AS(A2S),两者在功能上分别表现为神经毒性与神经保护性。中医阴阳学说贯穿中医学的各个方面,用以解释人体生理和病理的变化,以及指导疾病的诊断、治疗和保健。A1S与A2S在功能上表现出双重特性,与中医阴阳学说有相似之处。因此,通过“抑阳扶阴”的方式,调整机体的“阴阳”平衡,有望抑制A1S的“阳性”作用,促进A2S的“阴性”作用,从而达到预防和治疗AD的目的。将中医阴阳学说与西医学相结合,不但有助于丰富中医阴阳理论的现代内涵,而且通过中医阴阳学说解读AS表型的变化,为中医药在防治AD方面提供新的靶点和思路。

从“阳病治阴”理论探讨强直性脊柱炎的治法

强直性脊柱炎是临床上一种高致残、高致畸率的慢性炎症性骨病,发病早期常因腰背部疼痛、僵硬感等非特异性症状被忽视。“阳病治阴”乃阴阳失调状态的治法之一。卢敏教授认为,强直性脊柱炎常督弱肾亏,内生阴邪,阴缠督阳,阳不胜阴,故阴阳失调,发病常兼糅寒、瘀、痰、湿阴之实邪。治则治法上,标实为盛除阴邪,本虚为主培督肾,同时辨阴证施以散寒、通瘀、蠲痰、逐湿之法化散阴毒,临证每获良效,可谓驱散阴邪以复督回阳以达“阳病治阴”之意。附验案1则以当参阅。

基于中医阴阳学说探讨巨噬细胞极化在糖尿病肾脏疾病中的作用

糖尿病肾脏疾病(DKD)是糖尿病严重的微血管并发症之一,免疫紊乱介导的慢性低度炎症是DKD发生的重要机制。巨噬细胞作为免疫炎症反应的重要参与者,可在不同的微环境下极化为促炎的M1表型和抑炎的M2表型。二者在功能上相互拮抗,且在DKD不同发展阶段可相互转化,与中医“阴阳学说”阴阳对立制约、互根互用、消长平衡、相互转化的内涵相似。M1、M2表型巨噬细胞比例失衡是导致DKD炎症反应和肾纤维化的重要因素。本文基于中医阴阳学说,阐释巨噬细胞极化对DKD的影响,提出以“损其有余”和“补其不足”为基本治则,调节巨噬细胞极化状态,恢复阴阳平衡,以期为DKD临床治疗提供思路。

基于“阴阳自和”理论探讨足细胞自噬在糖尿病肾脏疾病中的作用

自噬是一种双向调节机制,指降解代谢产物,自我更新,生成能量的过程。在糖尿病肾脏疾病(diabetic kidney disease,DKD)发生发展过程中,足细胞构成肾小球滤过屏障,其自噬功能缺陷,可破坏滤过屏障,导致蛋白尿的产生以及肾小球硬化。从中医角度分析,这一过程蕴含了中医“阴阳自和”的理论内涵。DKD异常为本虚标实之证,以脾肾阴阳自和能力下降为本,气血阴阳失调日久,痰瘀毒胶结为标。适量的足细胞自噬能够降解废物——“阴”,生成能量——“阳”,保证机体微环境的阴阳自和,与阴阳消长、阴阳自和维持阴平阳秘的中医平衡过程不谋而同。故文章从“阴阳自和”角度探讨足细胞自噬在DKD过程中的作用,拟为防治DKD提供一些新思路。

基于《黄帝内经》阴阳“五态人”理论浅析肺系疾病辨证保健

肺系疾病病种多、病位广,是现代医学治疗的难点及热点,结合中医“治未病”理念,可以降低肺系疾病的发生。辨证保健的目标是在疾病发生前开展精准的个性化保健,其兼具中医整体思维和辨证思维。肺系疾病的辨证保健关键点是对人的健康状态与发病趋势进行辨识,而阴阳“五态人”理论正是《黄帝内经》中对人健康状态和发病趋势的描述。运用阴阳“五态人”理论指导肺系疾病的辨证保健可提高肺系疾病保健的有效性,拓展疾病预防思路,为正确地选择保健措施提供保障,提高中医“治未病”在疾病预防中的优势地位,促进保健事业的发展,满足大众对健康的追求。

基于自噬和阴阳的微观联系探索恶性血液病的防治

目的探索恶性血液病中阴阳理论与自噬的微观联系,为临床诊疗提供依据。方法系统查询和分析相关文献,从生理、病理、诊治多方面分析恶性血液病中阴阳与自噬之间的联系。结果恶性血液病发病、进展和转变过程中阴阳失调是自噬功能异常所致,西医能通过上调自噬诱发II性程序性死亡达到治疗效果,即“重阳必阴”,但同时也诱发机体产生耐药。结论中医治疗恶性血液病注重改善异常自噬状态,诱导机体恢复“阴阳平衡”,配合西药能有效提高疗效、避免耐药、缓解毒性。

符文彬教授从阳论治焦虑相关性失眠经验撷要

本研究介绍符文彬教授运用精灸技术治疗焦虑相关性失眠的临证经验。符文彬教授认为焦虑相关性失眠的基本病机在于“阴阳失和,气血失调”,更指出“阳虚”是其发病的本质。治疗焦虑相关性失眠,符文彬教授重视阳气与神之间的关系,主张从阳论治,以阳驭神,以温阳开郁、调畅神机为治法。在长期的临床实践中提出一种“精而效验”的精灸技术,常选用引气归元、五脏俞以及大接经等穴位治疗,收获良效。本研究总结了符文彬教授治疗焦虑相关性失眠的经验,旨在进一步探讨精灸技术在诊疗中的应用,为临床治疗焦虑相关性失眠提供新的思路。

基于自噬调控探讨平衡阴阳治疗慢性肾脏病理论创新和临床实践

慢性肾脏病(chronic kidney disease,CKD)是由各种原因引起的以肾脏结构损害和功能障碍为主要表现的慢性疾病,其进展呈进行性、不可逆性。自噬是清除衰老细胞和受损的胞质蛋白的自稳机制,自噬失调则会加速肾脏病的进展,这与中医阴阳平衡理论有着相似的内涵。因此,自噬可能是CKD中阴阳平衡的微观基础。CKD初期,自噬水平尚稳定,宜选方用药遵循调和;中后期肾中自噬水平异常,络脉不和,当调和肾络、心肾平调。当前研究已证实一些中药成分及复方制剂可以通过调节自噬保护肾脏,自噬不足时,当“益火之源”,选用性味辛温、苦寒的温阳益气、活血泄浊之品提升自噬水平、加快代谢效率,维持细胞更新与凋亡的平衡;自噬过度时,应“壮水之主”,选用酸甘、苦咸之品等益肾填精、补血祛瘀之品降低自噬水平,通过“滋补”或“去瘀生新”的方式避免细胞凋亡与损伤,从而延缓CKD进展。