Artificial intelligence (AI) technology has the potential to break through the limitations of the human brain by simulating its decision-making capabilities, and has been widely applied across various industries. However, whether this technology can be deeply integrated with the research of traditional Chinese medicine is a matter of concern. Here, the research status of AI in the field of clinical diagnosis and treatment of traditional Chinese medicine is reviewed, that is, the application of AI in data mining of literature, construction of a knowledge map, the realization of intelligent auxiliary diagnosis and treatment technology of traditional Chinese medicine, quality control of traditional Chinese medicine and development of new drugs are summarized and analyzed. Moreover, the application bottlenecks and solutions of this technology in the field of clinical diagnosis and treatment of traditional Chinese medicine are presented from various aspects such as data processing, information collection and analysis, and the selection and interpretability of AI models. It also explores and prospects the integration and development of AI and clinical diagnosis and treatment of traditional Chinese medicine, to provide references for artificial intelligence to better empower traditional Chinese medicine.

Based on the theory of classical prescription medicine and ancient books of Han and Tang dynasties, this paper discusses the formation process of Shaoyang disease and Jueyin disease, and explains the relationship between the two from the perspectives of meridians, pathogenesis and prescriptions, so as to provide a basis for the systematic differentiation and treatment of ‘semi-syndrome’. On the basis of ‘wei qi ying xue jing’, the ‘semi-syndrome’ was divided into five stages for differentiation and treatment. Among them, the ‘semi-syndrome’ Weifen is mainly based on Chaihu Guizhi Decoction, the Qifen is mainly based on Xiaochaihu Decoction, the Xuefen and Yingfen are respectively treated with Xiaoqianhu Decoction and Wumei Pill, and the Jingfen can be treated with Zengsunshenli Decoction. The systematic study of ‘semi-syndrome’ has expanded the development law and prescription of Shaoyang disease and Jueyin disease, and made the differentiation and treatment of the two diseases in clinical practice tend to be systematic, providing new ideas and perspectives for the clinical diagnosis and treatment of the two diseases.

‘Three ethereal souls and seven corporeal souls’ are an important part of Taoist thought, which is closely related to the theory of Shen in traditional Chinese medicine. By analyzing the literatures of Taoism and traditional Chinese medicine, this paper summarizes the connotation of the ‘three ethereal souls and seven corporeal souls’, and holds that the three ethereal souls are close to the Shen and dominate the life activities and thinking consciousness of the body, while the seven corporeal souls are close to the forms and dominate the physiological functions and pathological changes of the body, which together constitute the complete life system of the human body. At the same time, comparing the theory of ‘three ethereal souls and seven corporeal souls’ with the theory of Shen in traditional Chinese medicine, it is found that the Taoist ‘three ethereal souls and seven corporeal souls’, correspond with the Shen in traditional Chinese medicine in form, but they complement each other in content, and both of them take the disorder of form and spirit as the core mechanism. Based on this, combined with the essence of the two families, it is concluded that the treatment of mental disease should adhere to the dual spirit and regulation, brain and heart treatment; see its harm, form and spirit together. The three core treatment methods of refining and changing shape and soul harmonization are used to enrich and develop the theory of Shen in traditional Chinese medicine.

The debate over lung bi and lung flaccidity has a long history. This article systematically sorted out the relevant entries of lung bi and lung flaccidity in ancient medical books, and analyzed the similarities and outcome differences from four aspects: word source definition, etiology and pathogenesis, treatment methods and prescriptions, and outcome prognosis, clarifying the ancient people’s understanding of lung bi and lung flaccidity. In the process of clinical diagnosis of chronic lung diseases, it is necessary to examine the symptoms and causes, and to differentiate the relationship between the pathogenesis chain in lung bi and lung flaccidity and different stages, phenotype and (or) syndromes of the disease. It is not advisable to use metaphysical materialism to mechanically correspond the names of traditional Chinese medicine diseases with the whole disease or stages of Western medicine diseases, which violates the principle of deficiency and reality.

Traditional Chinese medicine (TCM) is a practical medicine, and its thinking method comes from the inductive deduction and logical reasoning of clinicians in the diagnosis and treatment process, and is supplemented by ancient Chinese philosophy. TCM clinical thinking is the core component of TCM clinical diagnosis and treatment, and it is the fundamental follow of TCM theoretical system, syndrome differentiation and treatment scheme and diagnosis and treatment technology. The purpose of this paper is to explore the construction path of TCM clinical thinking method, as well as its inheritance and application strategy under the background of the new era. Through the analysis and combing of the theoretical basis, thinking characteristics, formation mechanism and practical experience of TCM clinical thinking, this paper puts forward some possible paths for the future development of TCM clinical thinking, such as promoting the generalization of solving thinking, anchoring and transforming complex clinical data, and explaining the scientific connotation of differentiation and treatment, so as to promote the scientific, systematic and modern development of TCM clinical thinking.

Objective: To analyse and predict the key signalling pathways of Wenshenyang Decoction (WSY) in the treatment of chronic kidney disease (CKD) with kidney-yang deficiency syndrome by transcriptome and metabolomics, and to explore the protective effect of WSY on CKD rats with kidney-yang deficiency syndrome and its regulatory effect on HIF-1α/PKM2 signaling pathway. Methods: Fifty-eight SD rats were randomly divided into normal group (n=10) and model group (n=48). The CKD model was established by tail vein injection of adriamycin (DOX) (4 mg/kg) and the CKD with kidney-yang deficiency syndrome model was established by intramuscular injection of hydrocortisone (HYD) (10 mg/kg). The model animals were randomly divided into DOX group, HYD group, Zhenwu Decoction (ZWT) group (5.55 g·kg^-1·d^-1) and WSY group (2.38 g·kg^-1·d^-1), with 12 animals in each group. The general condition of the rats was observed and 24 h urine protein (24 h UPro) was determined. Serum samples were collected to determine renal function and related indicators (Scr, UA, BUN, TP, ALB). HE staining, Mallory staining and transmission electron microscopy were used to observe the pathological morphology of renal tissue. Key signalling pathways were predicted by transcriptomics and serum metabolomics. ELISA was used to determine the levels of LDH and PFK-1 in rat serum. Protein and mRNA expressions of HIF-1α, PKM2, GLUT1, Bcl-2 and Bax in renal tissue were detected by immunohistochemistry, Western Blot and Real-time PCR. Results: Compared with the DOX and HYD groups, WSY-treated rats exhibited significant improvements in general status, body weight, body temperature, and kidney index (P<0.01, P<0.05). Serum Scr, UA, and BUN levels were markedly reduced (P<0.05, P<0.01), while TP and ALB levels increased (P<0.05, P<0.01). Pathological staining revealed attenuated renal injury, and electron microscopy showed reduced segmental thickening of the glomerular basement membrane and podocyte fusion. Transcriptomic and metabolomic analyses indicated that WSY’s therapeutic mechanism may involve HIF-1α/PKM2 signaling pathway-mediated metabolic reprogramming and regulation of apoptotic genes. ELISA results showed that the levels of LDH and PFK-1 in serum of WSY rats were significantly lower than those of DOX and HYD (P<0.01). The results of immunohistochemistry staining, Western Blot and Real-time PCR showed that compared with DOX and HYD, the protein and mRNA expressions of HIF-1α, PKM2, GLUT1 and Bax in ZWT and WSY group renal tissues were significantly decreased (P<0.05, P<0.01), the expression of Bcl-2 protein and mRNA were significantly increased (P<0.05, P<0.01). Conclusion: WSY can protect renal function and ameliorate renal injury in CKD rats with kidney-yang deficiency syndrome, possibly by regulating metabolic reprogramming mediated by the HIF-1α/PKM2 signaling pathway and inhibiting the Bcl-2/Bax mitochondrial apoptosis pathway, thereby delaying the progression of CKD.

This paper examines the original meanings of ‘Yi’ and ‘Zhi’ in Huangdi Neijing from the perspective of tracing relevant literature from the Warring States, Qin and Han dynasties, and recognizes the similarities and differences between the two. The similarities both use ‘heart’ as the basic character shape, expressing a direct connection with the mind and spirit. The difference is ‘Yi’ refers to the primitive driving force behind a certain desire or impulse in the heart, which is a collection of preliminary plans or ideas established after summarizing past experiences; ‘Zhi’ is the repetitive process of movement towards ‘Yi’, and is the original driving force for ‘Yi’ to become reality. From the perspective of the disease characteristics in the original text of Huangdi Neijing, a full chain deduction has been conducted on the concepts of ‘Yi’ and ‘Zhi’, the clinical manifestations, etiology and pathogenesis, treatment principles, and prescriptions of Yi disease and Zhi disease. Supplementing the deficiencies in the study of the five emotion systems in Huangdi Neijing, it can provide guidance for the research of traditional Chinese medicine’s spiritual psychology.

During the Tang and Song dynasties, external alchemy declined while internal alchemy flourished. Quantitative and qualitative studies based on the texts of the Taoist canon clearly revealed the toxicity of external chemical substances. Mercury, cinnabar, three types of yellow minerals and lead, as the most commonly used ingredients in alchemy, contain elements such as mercury, arsenic, lead and sulfur, which are highly harmful to the human body. Although alchemists were aware of the dangers of toxicity, their theoretical justifications and efforts to detoxify practices did not yield significant results. As the result, many cases of poisoning or death occured. This caused both within and outside the Taoist community to question the belief in achieving immortality. At this time, internal alchemy, which shares theories, terminology, and goals with external alchemy, began a transition from ‘absorbing external qi' to ‘absorbing internal qi', which makes safe and efficient ‘embryonic respiration' practices replace the previously risky “holding one's breath” operation. Additionally, practitioners attempted to use the ‘internal alchemy not yet complete' as a contingent hypothesis to explain the failure of external alchemy, which accelerated the rapid development of internal alchemy.

Objective: To investigate the antipyretic effect of Angong Niuhuang Pill on cerebral hemorrhage and high fever rats, to study its impact on temperature regulation factors and its protective effect on damaged organs. Methods: Male SD rats were randomly divided into sham operation group, model group, chlorpromazine hydrochloride group (0.015 g/kg), Angong Niuhuang Pill high, medium, and low dose groups (0.6, 0.3, 0.15 g/kg). The cerebral hemorrhage and high fever rats were prepared by injection of type Ⅶ collagen. The postoperative temperature change curve of rats was monitored. The activity/content of positive and negative thermoregulatory mediators protein kinase A (PKA), cyclic adenosine monophosphate (cAMP), adenylate cyclase (AC), and argipressine (AVP) in brain tissue were detected. The levels of tumor necrosis factor-α (TNF-α), interleukin(IL)-1β, neuron specific enolase (NSE), s100-β protein, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine (CREA), and UREA in serum were measured. The pathological changes of brains, livers, and kidneys were also observed. Results: Compared with model group, Angong Niuhuang Pill at high, medium, and low doses steadily reduced the temperature of rats with cerebral hemorrhage and high fever (P<0.05, P<0.01), reduced the levels of TNF-α, IL-1β, NSE, and s100-β proteins in serum (P<0.05, P<0.01), and reduced the damages of brain, liver, and kidney tissues, thus exerting a protective effect on damaged organs. It also showed that Angong Niuhuang Pill at high dose reduced the activity of AC and the content of cAMP in brain tissues (P<0.05), Angong Niuhuang Pill at medium and low doses increased the content of AVP in the ventral septal area of the brain (P<0.01), Angong Niuhuang Pill at high and medium doses reduced the levels of AST and CREA in serum (P<0.05, P<0.01), Angong Niuhuang Pill at medium dose reduced the levels of UREA in serum (P<0.05). Conclusion: Angong Niuhuang Pill has a good antipyretic effect on rats with cerebral hemorrhage and high fever. Inhibiting the release of endogenous thermogenic cytokines, reducing the content of positive and negative body temperature regulators, and increasing the content of negative body temperature regulators may be the key links in its antipyretic effect. In addition, Angong Niuhuang Pill can protect the damaged brain, liver, and kidney caused by cerebral hemorrhage and high fever.

The law is the measure of yin and yang qi, and the calendar is the embodiment of the view of time and space. The two are derived from the application of stars, which can be classified into all things, longitude and latitude. Time and space are the basis for the generation of the five elements. The law of time and space is systematic and holographic, which can interpret the thinking of the five elements in the five zang organs according to the trajectory of time and space. The five-element medicinal properties contained in the Fuxingjue Wuzang Yongyao Fayao are different from the Huangdi Neijing. It is based on the way of heaven and earth biochemistry. According to the classification of the physical properties of ‘the same shape and the same gas phase’, whether the medicinal taste and the rhythm of time and space are complied with or not, they belong to the ‘body’, ‘use’ and ‘transformation’ of the five zang organs, and are composed of ‘big and small tonic soup’ and ‘big and small diarrhea soup’ according to the order of time and space. The treatment of traditional Chinese medicine is based on the root of the root. Based on the concept of time and space of the calendar, the five flavor theory in the Fuxingjue Wuzang Yongyao Fayao is studied, and the relationship between the concept of time and space of the calendar and the ‘body’, ‘use’ and ‘transformation’ of the five flavors is discussed. The analysis of the five zang reinforcing and reducing decoction derived from the theory of five flavor reinforcing and reducing is the essence of traditional Chinese medicine to explore the medication rules of the five elements in the five-zang diseases, in order to trace the origin and clarify the principle of the five-zang reinforcing and reducing medication.

Asthma is a chronic airway inflammatory disease, professor HONG Guangxiang, a TCM master, believes that the disease has many ‘long-cherished roots’, which is a ‘chronic disease’. Based on the theory of ‘blood stagnation leads to fluid retention’, the theory of ‘three causes as one’ for asthma is proposed, with phlegm turbidity and blood stasis hidden in the lungs being the root of the disease. Professor HONG believes that the source of blood and water is the same and can metamorphose from each other; Blood and water occur together and can affect each other. In terms of treatment, when blood and water are treated at the same time, the key lies in ‘promoting qi, invigorating blood, and warming yang’. It means to open the cork, invigorate the blood and improve the water, and warm the yang and invigorate the qi. The purpose of this article is to summarize the clinical experience of professor HONG in the treatment of asthma, in order to develop new ideas for the treatment of asthma.

Traditional Chinese medicine diagnosis and treatment thinking and methods, as a multidimensional and complex system covering time and space, include syndrome differentiation, symptoms, diseases, etiology, time, constitution, state, and other contents. Modern Chinese medicine experts have proposed theories such as the state theory of traditional Chinese medicine and the five differentiation of traditional Chinese medicine. In the clinical application of traditional Chinese medicine diagnosis and treatment thinking, attention should be paid not only to the organic combination of multiple methods, but also to the simplification of the diagnosis and treatment system. In the future, a new TCM diagnosis and treatment model can be built by combining modern biological technology, laboratory tests, big data, statistics and other means and methods.

Thyroid nodules belong to the category of Chinese medicine ‘Ying Bing’. In recent years, the prevalence of thyroid nodules has been on the rise, and thyroid nodules of mutuyongyu depression were found to be more common during clinical diagnosis. By summarizing the clinical experience of TCM master professor ZHANG Lei in the treatment of thyroid nodules, this paper analyzes the core pathogenesis and unique symptoms of thyroid nodules of wood-earch stagnation and depression, and puts forward the use of Dayu Decoction to relieve the qi stagnation of the liver, transport the phlegm dampness of the spleen, and treats both the liver and the spleen, so as to achieve the goal of resolving the thyroid nodule. The clinical effect is accurate. This article shares a clinical case of Professor ZHANG Lei.

With the advancements in modern medicine’s understanding of the etiology and pathophysiology of high-altitude disease, traditional Chinese medicine (TCM) has accumulated substantial experience in the understanding and treatment of high-altitude disease in recent years. This paper systematically sorts out the etiology and pathogenesis of high-altitude disease from the special plateau environment, including the conditions of insufficient clear qi, dryness, cold, strong winds, and intense radiation at high altitude. From the perspective of integrity and innovation, the paper systematically discusses the TCM pathogenesis of acute altitude sickness, high-altitude pulmonary edema, high-altitude cerebral edema, high-altitude heart disease, and high-altitude polycythemia. Additionally, It explores the current state of TCM prevention and treatment based on modern research evidence and sorts out the key issues and future development strategies in TCM prevention and treatment.

Objective: To investigate the therapeutic effects of Qingre Huashi Kangdu Formula (QRHS) on lung injury in mice with dampness-heat obstructing the lung syndrome and explore its underlying mechanisms. Methods: Sixty male C57BL/6 mice were randomly divided into six groups: control group, model group, QRHS low-dose group, QRHS medium-dose group, QRHS high-dose group, and prednisone acetate (PAT) group. Except for the control group, all other groups were subjected to lung injury induced by dampness-heat stimulation, combined with lipopolysaccharide and treated with corresponding drugs. Pathological changes in lung tissue were observed using HE staining. Levels of white blood cells, neutrophils, and platelets were measured. Flow cytometry was used to assess M1/M2 macrophage polarization. ELISA was used to measure the levels of interleukin (IL)-2, IL-6, interferon-γ (IFN-γ), transforming growth factor-β (TGF-β), immunoglobulin (Ig) G, IgA, and IgM in lung tissue. Western Blot was used to measure the protein levels of NF-κB p65, p-NF-κB p65, RANK and RANKL in lung tissue. Results: Compared with the model group, the QRHS groups showed reduced alveolar wall thickness, decreased necrotic area, and alleviated inflammatory infiltration, levels of IL-2, IL-6, IFN-γ, IgG, IgA, and IgM in lung tissue were significantly decreased (expect for the level of IL-2 in QRHS low-dose group) (P<0.05, P<0.01), the level of TGF-β was significantly increased (P<0.01), the total number of monocytes and macrophages significantly decreased (P<0.01, P<0.05), with a significantly reduction in M1 macrophages (P<0.01, P<0.05) and a significantly increase in M2 macrophages (P<0.05, P<0.01), protein expression of NF-κB p65, p-NF-κB p65, RANK, and RANKL in QRSH high-dose group also significantly reduced (P<0.01, P<0.05). Conclusion: QRHS effectively treates mice with damp-heat-heat congested lung injury by down-regulating the NF-κB/RANK/RANKL signaling pathway, inhibiting M1-type macrophages and promoting M2-type macrophage polarization.

In recent years, the incidence of Hashimoto thyroiditis (HT) has shown a marked upward trend in China, and the current modern medical treatment strategy for this disease still shows insufficiency. External treatment of traditional Chinese medicine (TCM) methods make up for this aspect, and their treatment of HT is effective, with significant effects in reducing thyroid antibodies, alleviating inflammation indicators, shrinking thyroid size, and improving clinical symptoms. Combining Western medical diagnosis with traditional Chinese medicine differentiation, and achieving combined treatment of HT by integrating traditional Chinese and Western medicine will be the future trend. This paper summarizes and analyzes domestic research literature on TCM external treatment for HT over the past decade. It delves into the mechanisms, application sites, and methods of treatments such as acupoint plastering, herbal fumigation and immersion, iontophoresis/medicated patch therapy, common medicines of external treatment, interposed medicated cake moxibustion, acupuncture, and auricular seed embedding. This study aims to provide some help for improving the TCM external treatment scheme for HT and provide relevant reference basis for clinical treatment of HT.

The theories of ‘Guan, He and Shu’ come from the Huangdi Neijing, which is often mistaken as ‘Kai, He and Shu’. The names of ‘Guan, He and Shu’ are taken from the parts of a doorway, namely, the latch, the door panel, and the door shaft, respectively. They are represented by the six meridians and the lifting and lowering of the qi in and out of the internal organs, meridians, and acupoints in the Huangdi Neijing. The gates are divided into internal and external, which is the same in the human body. The six meridians, organs, meridians, and acupoints are divided into yin and yang. Those in yang focus on the entry and exit of qi, while those in yin focus on the rise and fall of qi. With this understanding, we can resolve various doubts in ancient books such as Huangdi Neijing and Shanghan Lun, and inspire future generations to apply and develop their theoretical connotations, such as the outstanding ones ‘Zangfu Bietong’.

Objective: To explore the effects of acupuncture and moxibustion on the DNA methylation profile of colonic tissues in Crohn disease (CD) rats from a whole-genome perspective. Methods: SD rats were randomly divided into a normal group, model group, herb-partitioned moxibustion group, and electroacupuncture group. CD models were established using TNBS enemas, and interventions were carried out at the Tianshu (bilateral) and Qihai acupoints. Disease activity index (DAI) scores and colonic histopathology and scores were used to evaluate the effects of interventions. Whole genome bisulfite sequencing (WGBS) and bioinformatics were employed to identify differentially methylated region (DMR) in promoter regions, with RT-qPCR used for transcriptional validation. Results: The model group showed partial colonic glandular loss, fissure-like ulcerations, and high inflammatory infiltration, with significantly increased DAI and histopathology scores compared to the normal group (P<0.01, P<0.05). And hypomethylation as the dominant DMR pattern. Both herbal-partitioned moxibustion group and electroacupuncture group showed colonic mucosal epithelial repair, reduced infammation, and signifcantly lower DAI and histopathology scores compared to the model group (P<0.05), with hypermethylation as the major DMR feature. And both herbal-partitioned moxibustion group and electroacupuncture group significantly downregulated the mRNA expression of Hspa5, Ctnnb1, Cox6b1, and Krt8 in the colon compared to the model group (P<0.01, P<0.05). Conclusion: Herb-partitioned moxibustion and electroacupuncture modulate DNA methylation in CD rats, increasing the DNA methylation in the promoter regions of colonic Hspa5, Ctnnb1, Cox6b1 and Krt8, which may serve as an epigenetic mechanism in acupuncture-based therapy for CD.

Objective: To observe the changes of lung function in rats with idiopathic pulmonary fibrosis (IPF) under the regulation of iron autophagy-ferroptosis pathway by Shengxian Decoction, and revealing the scientific significance of IPF under the guidance of the ‘Da qi theory’. Methods: Forty-eight SPF rats were randomly divided into Sham group, Model group, Nintedanib group, and Shengxian Decoction group. Intratracheal drip Bleomycin (5 mg/kg) was used in order to prepare a rat model of IPF. Starting from the next day of modeling, the rats of Shengxian Decoction group were gavaged with an aqueous solution of Shengxian Decoction Chinese medicine granules (0.81 g/kg), the rats of Nintedanib group were gavaged with an aqueous solution of Nintedanib (0.1 g/kg), the rats of Model group and Sham group were gavaged with physiological saline solution (10 mL/kg), once a day for 28 consecutive days. Lung function was detected by awake and unrestrained animal lung function test system; pathomorphologic change in lung tissue was observed by HE and Masson staining; the expressions of α-smooth muscle actin (α-SMA) and Vimentin were detected by Western Blot to assess the degree of lung tissue fibrosis; the contents of Fe²⁺, malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were detected by chemiluminescence assay, and the expressions of solute carrier family 7 member 11 (SLC7A11) , ferritin heavy chain 1 (FTH1) , glutathione peroxidase 4 (GPX4) were detected by Western Blot, in order to observe the changes in ferroptosis of lung tissues; the expressions of nuclear receptor coactivator 4 (NCOA4), adenylate-activated protein kinase (AMPK), and Beclin1 were detected by Western Blot to observe the changes of iron autophagy in lung tissues. Results: Compared with the Sham group, the lung function indexes of rats in Model group significantly increased respiratory frequency (f) (P<0.01), and peak expiratory flow (PEF) and minute ventilation volume (MV) were significantly decreased (P<0.01); the lung tissue Szapiel score and Ashcroft score were significantly higher (P<0.01); the lung fibrosis indexes of α-SMA and Vimentin were significantly increased (P<0.01); Fe²⁺, MDA content were significantly increased (P<0.01), SOD, GSH-Px activitve were significantly decreased (P<0.01); the expression of NCOA4, AMPK, Beclin1 protein were significantly increased (P<0.01); the expression of SLC7A11, GPX4, FTH1 protein were significantly decreased (P<0.01). Compared with Model group, the lung function indexes of rats in Shengxian Decoction group, f was significantly decreased (P<0.01), PEF, MV were significantly increased (P<0.01); Szapiel score and Ashcroft score were significantly decreased (P<0.05, P<0.01); α-SMA, Vimentin were significantly decreased (P<0.01); Fe²⁺, MDA content were significantly decreased (P<0.05, P<0.01), SOD and GSH-Px activive were significantly increased (P<0.01, P<0.05); the expression of NCOA4, AMPK, Beclin1 protein significantly decreased (P<0.05); the expression of SLC7A11, GPX4, FTH1 protein significantly increased (P<0.01, P<0.05). Conclusion: Qi subsidence is an important mechanism of pulmonary dysfunction in IPF, and iron atophagy-ferroptosis pathway is involved in this process; Shengxian Decoction may exert a protective effect on pulmonary function in IPF by regulating the iron atophagy-ferroptosis pathway.

This article explores the framework of traditional Chinese medicine diagnosis and treatment for goiter by reviewing ancient literature and the Chinese Medical Classics from the Pre-Qin period to the Qing dynasty. It discusses the origin and evolution of goiter; its etiology is related to diet, soil and water, emotional factors, individual constitution, and the six pathogenic factors. Differentiation between goiter and tumor is emphasized. Pathological factors mainly include qi stagnation, phlegm coagulation, and blood stasis. Treatment principles include internal and external treatment methods of traditional Chinese medicine. The exploration of ancient literature provides inspiration and contemplation for modern clinical treatment of thyroid diseases and related conditions.

The intelligent inheritance model of famous old Chinese medicine doctors’ diagnosis and treatment experience can help traditional Chinese medicine inherit the essence, uphold the principle and make innovations, while realizing the sharing and application of achievements in a wider range. However, the current intelligent inheritance of famous old Chinese medicine doctors’ diagnosis and treatment experience still faces some urgent problems to be solved. Starting from a comprehensive analysis of the causes of the dilemma, this paper then deeply reflects on the nature of the problem, and finally attempts to propose solutions, hoping to provide ideas for solving the development difficulties encountered in the intelligent inheritance of famous old Chinese medicine doctors’ diagnosis and treatment experience.

Based on the traditional Chinese medicine theory of clarity and turbidity, this study explores the pathogenesis of ‘turbid-toxin’ and the therapeutic strategy of ‘powerful medicine with a gentle approach’. The theory of clarity and turbidity originates from the yin-yang doctrine, with the spleen and stomach serving as the pivot for the ascending and descending of qi, maintaining the balance of qi movement. Under pathological conditions, the interaction between clarity and turbidity disrupts the normal ascending and descending order, leading to the accumulation of turbid evils that interconnect with phlegm, blood stasis, and toxins to form turbid-toxin. This results in dysfunction of the viscera, and disorders in the movement of qi, blood, and body fluids, thereby triggering various diseases. The internal retention of turbid-toxin often leads to stubborn and difficult-to-treat conditions, necessitating a therapeutic approach that combines both pathogen-expelling and deficiency-supplementing measures. This study proposes the concept of ‘powerful medicine with a gentle approach’, which involves using sweet-tasting herbs to moderate the effects, or employing slow-release formulations such as pills or ointments to achieve pathogen-expelling without harming the healthy qi, and deficiency-supplementing without leaving behind pathogenic factors, thus treating both the symptoms and the root cause. This provides a new approach for clinical treatment.

Based on the theory of ‘mutual interference of clear and turbid qi’, it is believed that ‘mutual interference of clear and turbid qi’ is the main pathogenesis of dyslipidemia related dry eye. Mutual interference of clear and turbid qi are weak in the delicate transport of essence of water and grain, which is transformed into redundant lipid, deposited in the blood, and transformed into turbidity pathogen such as dampness, stasis and phlegm over time. Moist turbid retention and lucid yang failing to rise, turbid stasis obstructing collaterals and clear qi stagnation, and sputum turbid flow and blocking the clear orifices can lead to the occurrence and development of dyslipidemia related dry eye. In the treatment, it takes respectively eliminating dampness with aromatics and sending up the lucid yang, dispelling stasis and clearing turbidity and promoting qi circulation to remove meridian obstruction, and expelling phlegm turbid and resuscitation with pungent and warm natured drugs, in order to get well curative effect.

Objective: To analyze the influencing factors of traditional Chinese medicine (TCM) efficacy in AIDS using a joint model, aiming to provide evidence for the long-term clinical effectiveness of TCM in HIV/AIDS treatment. Methods: A 15-year retrospective cohort study was designed using data from the ‘HIV/AIDS Comprehensive Prevention and Treatment Data Information System’ and the ‘TCM Treatment for HIV/AIDS Project Database’. A joint model was constructed to analyze factors influencing TCM efficacy and evaluate its therapeutic outcomes. Results: This study included 2 078 AIDS patients. The joint model analysis demonstrated a statistically significant coefficient of 76.08 (P<0.05) for the TCM intervention group in longitudinal modeling, indicating a therapeutic association with increased CD4⁺T lymphocyte counts by 76.08 cells/μL compared to control groups. Conclusion: TCM treatment for AIDS not only reduces patient mortality but also enhances CD4⁺T lymphocyte count, providing valid evidence for the widespread recognition of the long-term clinical effectiveness of TCM in AIDS treatment.

Objective: To investigate the mechanical parameters of the supine homeopathic stretching-traction technique (SHST), preliminarily summarize its mechanical characteristics and related laws, analyze the factors influencing the mechanical features of this technique, providing parameter basis for its standardization and biomechanical experiments. Methods: Mechanical parameters, including total traction force (F_t), left hand force (F_l), and right hand force (F_r), were collected using pressure-sensing gloves and a custom-made traction device from 30 healthy volunteers during the operation of the SHST by its founder. Correlation analysis was performed between the parameters and individual factors of the subjects. Results: A total of 30 healthy subjects were included, with all manipulations performed by the same physician. The peak F_t was (134.85±3.36) N, peak F_l was (34.03±6.31) N, and peak F_r was (107.34±19.95) N. The plateau period F_t was (114.96±3.55) N, F_l was (28.11±5.38) N, and F_r was (92.57±17.94) N. The right hand force direction was obliquely upward at 5.53(2.07, 9.35)°, while the left hand force direction was obliquely downward at 26.98(19.73, 29.96)°. F_t was positively correlated with height and weight (r>0.3, P<0.05); F_l was positively correlated with weight, neck circumference, and head circumference (r>0.3, P<0.05); F_r showed no correlation with individual subject factors. Conclusion: This study applies modern biomechanical measurements to systematically quantify the mechanical characteristics of the SHST for the first time, reveales the asymmetric distribution of forces during the operation, with a force ratio of approximately 3∶1 between the primary and assisting hands. Additionally, it suggestes that individual factors of the subjects had certain influences on some mechanical parameters of the technique, to provide important parameter basis for the standardized operation and further research on the biomechanical mechanisms of the SHST.

The term ‘Dan Fang', originally referring to the art of alchemy and the refining of minerals and metals, has gradually shifted its meaning from the realm of external alchemy to the field of medicine due to the historical medicinal use of these materials. This convergence of practices naturally led to a transition from ‘art' to ‘medicine' in the context of Dan Fang. This transformation is particularly evident in the medical texts authored by physicians throughout the ages. The enthusiasm of the Northern Song dynasty rulers for medicine, especially for formulaic medicine, propelled nationwide efforts to compile and collect Dan Fang. Daoist Dan Fang, which had not been widely accepted by orthodox medicine during the Tang dynasty, was extensively included in formularies such as Taiping Sheng Hui Fang and Taiping Huimin Heji Ju Fang. The methods of preparation were also refined to mimic the processing techniques of medical prescriptions, leading to a significant evolution in the meaning of Dan Fang, thus becoming the widely recognized medical ‘Dan Fang' of today.

Bupleuri Radix, first recorded in Shennong’s Herbal Classic, is widely used in clinical practice. There are great differences in the understanding of the efficacy of Bupleuri Radix between ancient and modern times. Before the Jin and Yuan dynasties, the academic circles believed that its efficacy was biased towards descending; after the Jin and Yuan dynasties, the doctor’s understanding of it turned to rising yang. This is inseparable from the influence of the Yishui School, and the previous descending effect gradually receded; during the period of the Republic of China, doctors denied the efficacy of rising yang and returned to the Han and Tang traditions. There are two opposite effects of a drug, which is related to the safety and effect of clinical medication. The reason for this difference depends on dosage, decoction and compatibility.

‘Theory of xiang fire’ is a dynamic theory of dynamic balance between yin and yang, first proposed by ZHU Danxing. Xiang fire is the original driving force of human physiological activities, originating from the Mingmen and regulated by the spleen and stomach qi. It is stored in the kidneys, rises to the liver, is governed by the Sanjiao, descends to the gallbladder, and returns to the right kidney. Xiang fire’s uncontrolled movements can consume vital energy, damage yin and essence, consume fluids and blood, disrupt normal functioning, and cause internal heat. Modern xiang fire disease factors have increased significantly, and the discussion of ‘xiang fire’ is highly consistent with the function of thyroid hormones in modern medicine. The symptoms of ‘irritability’ ‘anger’ ‘palpitations’ and ‘insomnia’ caused by xiang fire’s uncontrolled movements are highly consistent with the clinical symptoms of Ying qi, so treating Ying qi from the perspective of xiang fire is a reasonable approach that deserves further exploration.

Sarcopenia is a complex age-related syndrome primarily characterized by the progressive loss of skeletal muscle mass and decline in muscle function. Current studies report significant variations in its prevalence, while the underlying pathogenesis remains multifaceted and overlapping. Due to the absence of specific clinical manifestations, there are notable differences in the diagnostic criteria for sarcopenia at the international level. Although research on sarcopenia is still in its early exploratory stages, therapeutic approaches are gradually being translated into clinical applications. This article provides a comprehensive review of the existing consensus and literature on sarcopenia, with a focus on its definition, epidemiology, pathogenesis, diagnostic criteria, and treatment strategies.

Allergic asthma (AA) and atopic dermatitis (AD) are common atopic comorbidities. Research data indicate that nearly 20% of patients with AD also suffer from asthma. Currently, the global incidence of AD and AA continues to rise, with neither condition having a fully satisfactory therapy. These two allergic diseases are prone to relapse, resulting in a significant economic burden. Therefore, reducing adverse drug reactions and alleviating symptoms are urgent concerns. Based on the traditional Chinese medicine (TCM) theory of ‘lung dominating skin and hair', we propose the concept of ‘lung and skin-hair comorbidity'. By studying the clinical manifestations and pathogenesis of AA-AD comorbidity, to explore potential TCM intervention targets. Our goal is to regulate the functions of the viscera, strengthen the skin and hair protection barrier, and promote the prevention and treatment of allergic diseases by modulating the functions of the lung and skin-hair.

Alcoholic liver disease (ALD) is a liver-damaging disease caused by long-term excessive alcohol consumption, and its pathological mechanism involves multiple factors such as oxidative stress, inflammatory response and lipid metabolism disorder. Citrus aurantium and Kudzu are the most representative hangover medicine pairs in traditional Chinese medicine, and with their unique pharmacological properties and efficacy, they have shown great potential value in dealing with ALD. This article will systematically review the mechanism of action of the two single and combined applications in the treatment of ALD, and summarize the clinical studies that further validate their potential to improve liver function and liver fibrosis. Although existing studies have confirmed its efficacy, there is still a need to further explore the pharmacokinetic properties of the active ingredients, standardized formulation processes and large-scale clinical validation to promote their transformation into safe and efficient TCM preparations. This paper will provide a theoretical basis and research direction for the in-depth development of Kudzu and Citrus aurantium and the prevention and treatment of ALD in traditional Chinese medicine.

‘Disease-pulse-syndrome combined treatment’ is the title of all the articles in Shanghan Zabing Lun, which is ZHANG Zhongjing’s original traditional Chinese medicine (TCM) diagnosis and treatment mode. However, the current understanding of ‘disease-pulse-syndrome combined treatment’ is complex, and the clinical diagnosis and treatment models are diverse, resulting in different curative effects. From the perspective of TCM state, this paper interprets the diagnosis and treatment mode of ‘disease-pulse-syndrome combined treatment’ as “six differentiation methods combined treatment of ‘disease differentiation, symptorn differentiation, syndrome differentiation, pathogenesis differentiation, individual differentiation and time differentiation’”, by deeply grasping the state caused by the overall influence of ‘nature, society and individual’. It is expected to comprehensively clarify the thinking logic of ‘disease-pulse-syndrome combined treatment’ of medical sage, and infer the original meaning and the original intention. It is of great significance for better inheriting and developing the diagnosis and treatment mode of ‘disease-pulse-syndrome combined treatment’ in modern times.

As the core category of Taoism, the original meaning of ‘the way of life’ refers to the Tao giving birth to all things. Traditional Chinese medicine (TCM) has absorbed the Taoist idea of ‘harmonizing qi’, ‘heaven and earth merging qi’, which is a necessary condition for all things to ‘the way of life’. In terms of understanding the relationship between heaven and man, we inherit the idea of respecting the Tao and valuing Te. Among the four great realms and all things, human beings are valued above all else. Humans are born with a ‘flow of Te and qi’, and the value and significance of life lies in the accumulation of essence, the perfection of the spirit, and the integrity of the Tao, achieving the unity of heaven and man and the harmony of heaven and man. On the practical level, following the concept of doing without action and letting nature take its course, following the mechanism of the birth of all things, and the door of growth and development, has formed the TCM bioethics of following the natural path and using principles to follow.

Objective: To explore the distribution of clinical symptoms and syndrome types of Hashimoto thyroiditis (HT) complicated with hypothyroidism patients. Methods: This was a prospective multi-center observational cross-sectional study. From November 2020 to November 2021, HT patients with hypothyroidism were selected from the thyroid disease department of three hospital. The symptom information of HT patients was collected through the traditional Chinese medicine (TCM) syndrome scale, and the symptoms were standardized, and statistical analysis and cluster analysis were performed using SPSS 26.0 software. Results: A total of 210 cases of HT complicated with hypothyroidism were collected in this study. After standardizing the name, 64 TCM symptoms and signs with a frequency of more than 10% were screened. The most common symptoms were fatigue (78.10%), irritability (71.90%), memory loss (67.62%), anxiety (60.95%), depression and sadness (57.14%), dry mouth (53.81%), and lower limb soreness and heaviness (50.00%). The most common sign was goiter (65.71%); 10 tongue signs with frequency greater than 10% were white fur (74.76%), thin fur (67.62%), and tooth marks on the tongue edge (35.24%); 4 pulse types with frequency greater than 10% were screened, the most common pulse was string pulse (48.10%). After cluster analysis, two TCM syndrome types were obtained: Liver stagnation and spleen deficiency, phlegm dampness accumulation syndrome; Prolonged liver depression leads to deficiency of qi and yin. Conclusion: This study shows that HT complicated with hypothyroidism could be divided into two types, which provides a scientific basis for clinical differentiation and treatment, and helps to guide clinical drug use and new drug development.

Bipolar disorder (BD) is a common and complex psychiatric disorder disease. Congenital inheritance is the basic factor of BD, and emotional trauma is the key factor of BD, zangfu dysfunction is an important factor in the development of BD, and liver stagnation and spleen deficiency is an important pathogenesis of BD. Traditional Chinese medicine (TCM) treatment of this disease has the advantages of targeting both symptoms and root causes, fewer adverse reactions, and higher safety. Liver stagnation and spleen deficiency as an important pathogenesis of BD provides a strong theoretical basis for the treatment of BD with the method of soothing liver and invigorating spleen. Studies suggest that Xiaoyao Power, a representative formula of soothing liver and invigorating spleen, and its bioactive components exhibit strong potential in the treatment BD with liver stagnation and spleen deficiency syndrome. Potential mechanisms include alleviating neuroinflammation, enhancing neurotransmitters and neurotrophic factors, and reducing oxidative stress. This article discusses the application of Xiaoyao Power of soothing liver and invigorating spleen in BD from the aspects of etiology, pathogenesis, treatment principles and methods, and formula-syndrome correspondence.

Tripterygium wilfordii, a typical representative of traditional Chinese medicine (TCM) with the function of removing rheumatism and treating rheumatic immune diseases in the field of TCM in China, shows certain adverse reactions while exerting therapeutic effects. Reproductive toxicity has become an important factor restricting its clinical application. This article summarized the research progress of TCM syndrome and treatment of tripterygium wilfordii in terms of etiology, pathogenesis, syndrome type, evaluation index and TCM treatment, and provided ideas for the diagnosis and treatment of tripterygium wilfordii reproductive toxicity.

Objective: To investigate the effects of Buzhong Yiqi Decoction on regulating the pathway of indoleamine 2,3-dioxygenase-1 (IDO1)/kynurenine (Kyn)/aryl hydrocarbon receptor (AhR) and improving the immune imbalance of helper T cell 17 (Th17)/regulatory T cell (Treg) in experimental autoimmune thyroiditis (EAT) rats. Methods: Twenty-four 8-week-old SD rats were randomly divided into blank group, model group, Buzhong Yiqi Decoction group and selenium yeast group, with 6 rats in each group. The blank group was fed with distilled water, and the other groups were fed with high iodine drinking water and immune injection. After the rat model of EAT was formed, the mice were anesthetized and killed after 8 weeks of intragastric administration according to the grouping. Serum thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), AhR, Kyn and IDO1 were detected by ELISA, and the changes of thyroid tissue were observed by HE staining; The proportion of Th17 and Treg cells in peripheral blood of rats was detected by flow cytometry. Results: Compared with the blank group, the serum levels of TGAb and TPOAb in the model group were increased (P<0.05), the serum level of AhR was decreased (P<0.05), the percentage of Treg cells in peripheral blood was decreased (P<0.05), and the ratio of Th17/Treg cells was increased (P<0.05); Compared with the model group, the serum levels of TGAb and TPOAb in the Buzhong Yiqi Decoction group and the selenium yeast group were decreased (P<0.05), the serum expressions of AhR and Kyn in the Buzhong Yiqi Decoction group were increased (P<0.05), the percentage of Treg cells in peripheral blood was increased (P<0.05), and the ratio of Th17/Treg cells was decreased (P<0.05); The levels of TPOAb in Buzhong Yiqi Decoction group were lower than those in selenium yeast group (P<0.05). Conclusion: Buzhong Yiqi Decoction can alleviate the thyroid structural damage and reduce thyroid antibodies in EAT rats, which may be related to the activation of IDO1/Kyn/AhR signaling pathway to improve the balance of Th17/Treg cells.

Neizheng is an important content in Chinese culture, which has unique exposition and practical application in Chinese medicine, Confucianism, Taoism, Buddhism and other schools, and various academic schools have their own names, such as introspection of Confucianism, introspection of Buddhism and Taoism, inner vision and reflect of traditional Chinese medicine, etc..In this paper, the historical evolution of internal syndrome and various expositions are discussed in a framework, and the historical evolution of Neizheng and different interpretations of Neizheng are clear, which is conducive to the in-depth study of the theory and application of Neizheng.

Objective: To investigate the pathogenesis of psoriasis based on keratinocyte endoplasmic reticulum stress (ERS) and the therapeutic mechanism of Guben Qushi Huayu Formula (GQHF). Methods: A psoriasiform mouse model was established using Imiquimod (IMQ), with Psoriasis area and severity index (PASI) and Baker scores were evaluated. Immunohistochemistry/immunofluorescence detected the expression of ERS-related proteins (GRP78, XBP1s) and proliferation markers (Ki-67, PCNA) in skin lesions. Drug-containing serum of GQHF was prepared from SD rats. Thapsigargin-induced ERS was applied to HaCaT cells, Western Blot or immunofluorescence was used to analyze ERS-related proteins, proliferation markers, and inflammatory cytokines (IL-17A, IL-18, IL-1β). Results: IMQ treatment significantly increased PASI and Baker scores compared to the blank group (P<0.01), accompanied by typical psoriatic histopathology. Elevated expressions of Ki-67, PCNA, GRP78, and XBP1s were observed in lesions (P<0.01, P<0.05). High- and low-dose GQHF interventions reduced PASI and Baker scores (P<0.01, P<0.05), with high-dose GQHF markedly downregulating GRP78, XBP1s, PCNA and Ki-67 (P<0.01, P<0.05). In HaCaT cells, compared with the blank group, the model group upregulated GRP78 and XBP1s (P<0.01) and increased IL-17A, IL-18 and IL-1β levels (P<0.05), high and low-dose interventions with GQHF drug-containing serum reduced the expression of GRP78, XBP1s and IL-17A, IL-18, IL-1β (P<0.01, P<0.05). Conclusion: GQHF alleviates psoriasis by inhibiting keratinocyte proliferation, modulating ERS, and attenuating inflammatory responses, providing novel insights into its therapeutic mechanisms.

Objective: To compare the central response characteristics of individuals under different functional states during immediate intradermal acupuncture at ‘Siguan’ acupoints. Methods: Twenty patients with tension-type headache (TTH) and forty healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans and fMRI scans with immediate intradermal acupuncture at ‘Siguan’ acupoints. The regions with similar and different changes in brain functional activities during immediate intradermal acupuncture between TTH patients and HCs were detected based on the fractional amplitude of low-frequency fluctuation (fALFF) analysis method. Results: TTH patients showed a targeted downregulation of the fALFF value in the right precentral gyrus and had a more extensive modulation on the limbic-paralimbic system during instant intradermal acupuncture at ‘Siguan’ acupoints. Both groups exhibited an increase in the fALFF values in the superior frontal gyrus, the middle frontal gyrus, and a decrease in the lingual gyrus, the middle/inferior occipital gyrus, precentral/postcentral gyrus during acupuncture procedure. Conclusion: The widespread changes of functional activities in brain regions related to pain regulation and the limbic-paralimbic system may represent the specificity of central responses to needling the ‘Siguan’ acupoints in TTH state. And the modification of functional activity in the cognitive, visual and sensorimotor cortexes is a common brain response characteristic observed in both TTH patients and HCs during instant intradermal acupuncture at ‘Siguan’ acupoints.