最新刊期
卷 38 ， 期 2 ， 2024
- 摘要：Molecular targeted therapy is one of the main treatment options for metastatic colorectal cancer （mCRC）， and combined with chemotherapy， it can provide significant benefits in patients' overall survival （OS） and progression-free survival （PFS）. Commonly used molecular targeted drugs in clinic mainly includes small molecule signal transduction inhibitors and large molecule monoclonal antibodies. However， the problem of drug resistance in the later stage of targeted therapy becomes a key challenge for clinic treatment. Studies have shown that the mechanism of targeted drug resistance may be related to a variety of factors， including abnormalities in related cell signaling pathways such as epidermal growth factor receptor （EGFR）， vascular endothelial growth factor （VEGF）， human epidermal growth factor receptor 2 （HER2） and alterations in tumor microenvironment. In recent years， studies have found that traditional Chinese medicine are quite effective in reversing targeted drug resistance. Therefore， this article discusses the mechanisms of drug resistance to molecular targeted therapy in CRC， as well as the coping strategies of traditional Chinese medicine， and discusses the tradional Chinese medicine and its active ingredients that can reverse targeted drug resistance.关键词：targeted therapy;colorectal cancer;drug resistance;traditional Chinese medicine
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发布时间：2024-04-15
Scholar Forum
- 摘要：Objective： To investigate the effect of pulse-taking acupuncture combined with chin tuck against resistance （CTAR） training on swallowing function in nasopharyngeal carcinoma （NPC） patients with swallowing disorder （SD） after radiotherapy.MethodsA randomized controlled method was applied. Sixty NPC patients with SD after radiotherapy were randomly divided into the CTAR training group and combination group， 30 cases in each group. All the patients were treated with routine training. Based on above， the patients in the CTAR training group were treated with CTAR training， and the patients in the combination group were treated with pulse-taking acupuncture combined with CTAR training. The intervention period of both groups was 4 weeks. Before and after intervention， the water swallowing test （WST） grading and the videofluoroscopic swallowing study （VFSS） score of the two groups were evaluated and compared； the levels of albumin （ALB） and prealbumin （PA） of the two groups were detected and compared in order to evaluate the nutritional status of the patients； the incidence of aspiration was compared between the two groups； the swallowing-quality of life （SWAL-QOL） was used to evaluate the life quality of the patients in the two groups.Results①After intervention， the WST grading in both groups were better than that before intervention （P<0.05）， and the WST grading in the combination group was superior to the CTAR training group （P<0.05）. ②After intervention， the VFSS scores in both groups were significantly increased compared with those before intervention （P<0.05）， and the score of the combination group was higher than that of the CTAR training group （P<0.05）. ③After intervention， the levels of ALB and PA in both groups were significantly increased compared with those before intervention （P<0.05）， and the levels of ALB and PA in the combination group were higher than those in the CTAR training group （P<0.05）. ④In the 4 weeks of intervention， the incidence of aspiration was 3.33% in the combination group and 26.67% in the CTAR training group， and the incidence of aspiration in the combination group was obviously lower than that in the CTAR training group （P<0.05）. ⑤After intervention， the SWAL-QOL scores in both groups were significantly increased compared with those before intervention （P<0.05）， and the score of the combination group was higher than that of the CTAR training group （P<0.05）.ConclusionPulse-taking acupuncture combined with CTAR training can significantly improve the swallowing function and nutritional status in NPC patients with SD after radiotherapy， effectively reduce the incidence of aspiration， and enhance the life quality of the patients.关键词：nasopharyngeal carcinoma;radiotherapy;swallowing disorder;pulse-taking acupuncture;chin tuck against resistance training;swallowing function
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发布时间：2024-04-15 - 摘要：Chronic pain is one of the most difficult diseases to cure in the world. In the past， it was thought that the appearance of chronic pain was only related to the plasticity of neurons， but now more and more attention has been paid to the important involvement of non-neuronal cells， especially microglia. Electroacupuncture has gradually become an alternative therapy for chronic pain due to its safety and effectiveness， and its analgesic effect can be achieved by inhibiting the overactivation of microglia. Based on the regulation effect of electroacupuncture on the microglia activation in chronic pain， the analgesic mechanism of electroacupuncture is discussed， in order to provide a basis for the effectiveness of clinical electroacupuncture analgesia.关键词：chronic pain;electroacupuncture;analgesia;microglia;glial reaction
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发布时间：2024-04-15 - 摘要：Functional constipation is a common disease in the elderly. Studies have shown that acupuncture and moxibustion have good effects on increasing the patients' defecation frequency， improving defecation difficulty， reducing the recurrence rate of the disease， and improving the quality of life of the patients. Its mechanism of action is related to regulating the enteric nervous system and related neurotransmitters， improving anorectal dynamics-related indicators， and the regulation of the central nervous-gut-microbiome （brain-gut axis）. This article reviews the clinical and mechanism researches on the treatment of functional constipation in the elderly with simple acupuncture， the combination of acupuncture and medicine， acupoint catgut embedding， and auricular point pressure pills， etc.， so as to provide more ideas and directions for the research on the mechanism of acupuncture and moxibustion in treatment of functional constipation in the elderly.关键词：acupuncture and moxibustion;the elderly;functional constipation;mechanism of action
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发布时间：2024-04-15
Special column on acupuncture
- 摘要：Objective： To explore the anti-inflammatory effect of the components absorbed into serum of the aqueous extract of "Curculiginis Rhizoma and Epimedii Folium" （EX）.MethodsAutoDockTools software was used to dock the five components absorbed into serum of EX （Curculigoside， Icariin， Baohuoside I， Oricinol glucoside and Epimedin A） with target protein TREM2. CCK8 method was used to detect the effects of the five components on BV2 cell viability at different concentrations. LPS was used to stimulate BV2 or mouse bone marrow-derived BMDMs cells and Nigericin to stimulate LPS pretreated BMDMs cells to establish inflammatory models， and the effects of the five components on TNF-α and IL-1β levels in the cell supernatant were detected by ELISA.ResultsThe components absorbed into serum of EX including Curculigoside， Icariin， Baohuoside I and Epimedin A， bound very stably to TREM2， while the binding of Orcinol glucoside to TREM2 was relatively stable. Curculigoside， Icariin， Baohuoside I， Orcinol glucoside and Epimedin A all reduced the level of IL-1β produced by BMDMs at certain concentrations， while only high concentrations of Curculigoside and Icariin reduced the level of TNF-α produced by BMDMs.Conclusion5 components absorbed into serum of EX could all bind to TREM2 and inhibit downstream NF-κB or NLRP3 inflammatory pathways to improve inflammation， which might be an effective material basis for EX to regulate TREM2 to improve learning and memory ability and neuroinflammation， and work synergistically in EX.关键词：Curculiginis Rhizoma and Epimedii Folium;aqueous extract;TREM2;molecular docking;inflammation
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发布时间：2024-04-15 - 摘要：Colitis-to-colorectal-cancer transformation refers to the gradual development from inflammatory bowel disease into colorectal cancer （CRC）. "Deficiency-dampness-toxin" is closely related to the occurrence and development of CRC. "Deficiency-dampness-toxin" affects the microenvironment of tumor and promotes tumor growth， and it is also an important etiology and pathogenesis for the colitis-to-colorectal-cancer transformation. Yiyi Fuzi Baijiang Powder has the function of eliminating dampness， removing toxin and resolving abscess， tonifying deficiency， replenishing yang and removing pathogenic factors， which can delay the process of colitis-to-colon-cancer transformation caused by "deficiency-dampness-toxin". Therefore， the research group reviewed colitis-to-colorectal-cancer transformation， the role of tumor microenvironment， the understanding of Chinese medicine on colitis-to-colorectal-cancer transformation， especially the process of Yiyi Fuzi Baijiang Powder intervening in colitis-to-colon-cancer transformation， in order to provide new ideas for the treatment of colorectal-related diseases.关键词：Yiyi Fuzi Baijiang Powder;colitis;colorectal cancer;inflammation-cancer transformation
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发布时间：2024-04-15 - 摘要：Objective： To investigate whether Jianpi Xiaoying Formula improving Hashimoto's thyroiditis （HT） by regulating the proportion of helper T cells （Th）.MethodsForty female CBA/J mice were randomly divided into five groups： the normal control group， model control group， and the low， medium and high dose groups of Jianpi Xiaoying Formula， eight mice in each group. Except for the normal control group， the HT model was induced by subcutaneous injection of porcine thyroglobulin combined with iodized water feeding in mice of other groups. At the end of modeling， the mice in the normal control group and model control group were given 0.5 mL of drinking water by gavage every day， and the mice in the low， medium and high dose groups of Jianpi Xiaoying Formula were given aqueous solution of Jianpi Xiaoying Formula granules （with the doses of 8.632 g/kg， 17.264 g/kg and 34.528 g/kg respectively） by gavage every day， for consecutive 6 weeks. At the end of intervention， the levels of serum thyroid peroxidase antibody （TPOAb）， thyroglobulin antibody （TGAb）， free triiodothyronine （FT3）， free thyroxine （FT4） and thyrotropin （TSH） in mice were detected by enzyme-linked immunosorbent assay （ELISA）； the proportions of Th1， Th2， Th17 and regulatory T cell （Treg） in peripheral blood of mice were detected by flow cytometry； the gene expressions of tumor necrosis factor-α （TNF-α）， γ interferon （IFN-γ）， interleukin-17 （IL-17）， T-bet and RORγ‑t were detected by real-time fluorescence quantitative PCR； the protein expressions of T-bet and RORγ-t in spleen tissues were detected by Western blot； the pathological and morphological changes of thyroid tissue were observed by hematoxylin-eosin （HE） staining.Results①Compared with the model control group， the level of serum TPOAb of mice in the high dose group of Jianpi Xiaoying Formula was significantly decreased （P<0.05）， and the level of TGAb of mice in the low and high dose groups of Jianpi Xiaoying Formula was also significantly decreased （P<0.05）. ②Compared with the model control group， the serum FT3 and FT4 levels of mice in the high dose group of Jianpi Xiaoying Formula were significantly increased （P<0.05）. ③Jianpi Xiaoying Formula can improve the structure and colloid of thyroid follicles， make the follicle morphology regular， and reduce the degree of infiltration of inter-follicular lymphocytes and plasma cells in thyroid of the HT model mice. ④Compared with the model control group， the Th1 ratio in peripheral blood of mice in the low， medium and high dose groups of Jianpi Xiaoying Formula was significantly decreased （P<0.05）， and the Th17 ratio of mice in the low and high dose groups of Jianpi Xiaoying Formula was also significantly decreased （P<0.05）. ⑤Compared with the model control group， the relative expressions of T-bet and RORγ-t genes in the spleen tissues of mice in the low， medium and high dose groups of Jianpi Xiaoying Formula were significantly decreased （P<0.05）， the protein expressions of T-bet and RORγ-t in the high dose group of Jianpi Xiaoying Formula were significantly decreased （P<0.05）， and the protein expression of T-bet in the medium dose group of Jianpi Xiaoying Formula was significantly decreased （P<0.05）. ⑥Compared with the model control group， the relative expressions of TNF-α， IFN-γ and IL-17 genes of mice in each dose groups of Jianpi Xiaoying Formula were significantly decreased （P<0.05）.ConclusionJianpi Xiaoying Formula can inhibit the inflammatory response by down-regulating the transcription and differentiation of Th1 and Th17 and the secretion of their related inflammatory factors， thus improve HT.关键词：Hashimoto's thyroiditis;Jianpi Xiaoying Formula;helper T cell 1;helper T cell 17
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发布时间：2024-04-15 - 摘要：Objective： To study the therapeutic effect of Jianpi Huazhi Formula （JHF） on acute ulcerative colitis （UC） model mice， and explore its mechanism of action based on the expression levels of inflammatory factors in serum and colon tissue of mice.MethodsSeventy-six healthy male C57 mice were randomly divided into normal group， model group， mesalazine group， and low， medium， and high dose JHF groups. An acute UC mouse model was established by drinking 3% dextran sulfate sodium （DSS） solution. The low， medium， and high dose JHF groups were orally administered with 145.8， 291.5， 583.0 g/L JHF solution respectively， while the mesalazine group was orally administered with 10 g/L mesalazine solution. The symptoms of mice in each group were observed， the disease activity index （DAI） was scored， and the pathological changes of colon tissue were observed by hematoxylin-eosin （HE） staining. Serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， direct bilirubin （DBil）， total bilirubin （TBil）， albumin （ALB）， alkaline phosphatase （ALP）， γ-glutamyl transpeptidase （γ-GT）， total bile acid （TBA）， creatinine （Cre）， uric acid （UA） and blood urea nitrogen （BUN） were measured by rate method and endpoint method. The levels of interleukin （IL）-6， tumor necrosis factor-α （TNF-α） and IL-10 in serum and colon tissue of mice were determined by enzyme-linked immunosorbent assay （ELISA）.ResultsJHF could effectively improve clinical symptoms such as bloody stools and diarrhea in acute UC mice， improve body mass loss and colon length reduction of mice， reduce DAI score of mice （P<0.05）， alleviate the degree of pathological inflammation damage in colon tissue， reduce the expression levels of pro-inflammatory cytokines IL-6 and TNF-α， and increase the expression level of anti-inflammatory factor IL-10 （P<0.05， P<0.01）.ConclusionJHF has a good therapeutic effect on acute UC mice， and its mechanism of action may be to repair local damage to the colon mucosa of UC mice， regulate the levels of inflammatory factors in serum and colon tissue.关键词：Jianpi Huazhi Formula;ulcerative colitis;IL-6;TNF-α;IL-10
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发布时间：2024-04-15
Special column on anti-inflammatory of traditional Chinese medicine
- 摘要：Objective： To observe the clinical efficacy of Chaishao Decoction in the treatment of postoperative intestinal adhesion.MethodsA total of 80 patients with postoperative intestinal adhesion who met the criteria were included and randomly divided into the traditional Chinese medicine group and the control group， 40 cases in each group. The patients in both groups were treated with conventional supportive treatment with western medicine， and the patients in the traditional Chinese medicine group were treated with Chaishao Decoction based on above. The treatment course was 14 d. The clinical efficacy of the two groups was evaluated. Before and after treatment， the total scores of traditional Chinese medicine syndromes were compared between the two groups. The time of the first exhaust， the time of the first autonomic defecation and the time of hospital stay were compared between the two groups. Before and after treatment， the levels of interleukin （IL）-6 and IL-10 were detected and compared between the two groups.Results①After treatment， the total effective rate was 90.0% in the traditional Chinese medicine group and 75.0% in the control group， and the efficacy of the traditional Chinese medicine group was better than that of the control group （P<0.05）. ②After treatment， the total scores of traditional Chinese medicine syndromes in both groups were significantly decreased compared with those before treatment （P<0.05）， and the scores of the traditional Chinese medicine group were significantly lower than those of the control group （P<0.05）. ③The time of the first exhaust， the time of the first autonomic defecation and the time of hospital stay in the traditional Chinese medicine group were significantly shorter than those in the control group （P<0.05）. ④After treatment， the levels of IL-6 and IL-10 in both groups were decreased compared with those before treatment （P<0.05）， and the levels of IL-6 and IL-10 in the traditional Chinese medicine group were lower than those in the control group （P<0.05）.ConclusionChaishao Decoction combined with conventional western medicine can effectively relieve the discomfort symptoms in patients with postoperative intestinal adhesion， shorten the time of the first exhaust and defecation and the hospitalization time， and decrease the levels of serum inflammatory factors.关键词：intestinal adhesion;after laparoscopic surgery;Chaishao Decoction;integrated traditional Chinese and western medicine
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发布时间：2024-04-15 - 摘要：Objective： To observe the clinical efficacy of Taizishen Wuweizi Decoction combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant in the treatment of chronic persistent asthma in children.MethodsA total of 82 children with asthma in chronic persistent stage were included and randomly divided into the treatment group （42 cases） and the control group （40 cases）. The children in the control group were treated with conventional dose Budesonide and Formoterol Fumarate Powder Inhalant， and the children in the treatment group were treated with Taizishen Wuweizi Decoction orally combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant， with a course of 3 months. The clinical efficacy of the two groups was evaluated. The acute attacks of the two groups were compared. Before and after treatment， the traditional Chinese medicine syndrome scores of the two groups were evaluated and compared. Before and after treatment， the levels of serum total immunoglobulin E （TIgE） and fractional exhaled nitric oxide （FeNO） in the two groups were detected， and the ratios of measured value to the predicted value of forced expiratory volume in one second （FEV1） and forced vital capacity （FVC） and FEV1/FVC ratio in the two groups were compared.ResultsIn the course of treatment， two children in the treatment group were eliminated. Finally， 40 cases in the treatment group and 40 cases in the control group were included in the statistical analysis. ①After treatment， there was no statistically significant difference on clinical efficacy between the two groups （P>0.05）. ②In the course of 3-month treatment， six children in the treatment group and eleven children in the control group had acute attacks of asthma， with no statistically significant difference between the two groups （P>0.05）. ③After treatment， the scores of all the traditional Chinese medicine syndromes in the two groups were significantly decreased compared with those before treatment （P<0.05）， and the scores of phlegm， sweating， diet and stool syndromes in the treatment group were lower than those in the control group （P<0.05）. ④After treatment， the ratio of measured value to the predicted value of FEV1 in the treatment group was increased compared with that before treatment （P<0.05）， and the ratios of measured value to the predicted value of FEV1 and FVC and FEV1/FVC ratio in the treatment group were higher than those in the control group （P<0.05）. ⑤After treatment， the level of TIgE in the two groups was decreased compared with that before treatment （P<0.05）， the level of FeNO in the treatment group was also decreased compared with that before treatment （P<0.05）， and the level of TIgE in the treatment group was lower than that in the control group （P<0.05）.ConclusionTaizishen Wuweizi Decoction orally combined with low-dose Budesonide and Formoterol Fumarate Powder Inhalant can effectively improve the clinical symptoms in children with asthma in chronic persistent stage， reduce the risk of acute asthma attack， and improve the pulmonary function.关键词：asthma;chronic persistent stage;children;Taizishen Wuweizi Decoction;pulmonary function;fractional exhaled nitric oxide;integrated traditional Chinese and western medicine
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发布时间：2024-04-15
Clinical Research
- 摘要：Objective： To predict the active components of Salviae Miltiorrhizae Radix Et Rhizoma in the treatment of chronic pain using quantitative structure-activity relationship （QSAR） machine learning model and molecular docking technology， and to explore the molecular mechanism of Salviae Miltiorrhizae Radix Et Rhizoma in the treatment of chronic pain combined with the theory of "prolonged illness leading to stasis" and network pharmacology.MethodsFirst， the chemical components of Salviae Miltiorrhizae Radix Et Rhizoma and targets of chronic pain were collected through the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform （TCMSP） and the Human Genome database （GeneCards）， and the core targets were screened. And the protein interaction （PPI） network was analyzed by STRING database. Then， the intersection targets were analyzed by Gene Ontology （GO） enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. Finally， the QSAR machine learning model and molecular docking technology were used to screen the active ingredients and core targets of Salviae Miltiorrhizae Radix Et Rhizoma in the treatment of chronic pain.Results①Fifty-five intersection targets and 55 potential active components of Salviae Miltiorrhizae Radix Et Rhizoma in the treatment of chronic pain were screened. The core targets such as serine/threonine kinase 1（AKT1）， epidermal growth factor receptor （EGFR） and interleukin （IL）-6 were found through PPI analysis. ②Through the function enrichment analysis， 45 cell components， 87 molecular functions， 1 450 biological processes and 140 signaling pathways were obtained， involving signaling pathways such as phosphatidylinositol-3-kinase/protein kinase B（PI3K/AKT）， IL-17， hypoxia-inducible factor 1（HIF-1）， cyclic adenosine monophosphate （cAMP）， and mitogen-activated protein kinases （MAPK） signaling pathway. ③Through QSAR model and molecular docking， it was found that salvilenone， epidanshenspiroketallactone， salvianan A， isotanshinone Ⅱ and salvianolic acid C in Salviae Miltiorrhizae Radix Et Rhizoma were the active components for treating chronic pain.ConclusionThe active components of Salviae Miltiorrhizae Radix Et Rhizoma in treating chronic pain are diterpenoids， and its mechanism of action is probably related to the regulation of AKT1-mediated signaling pathways.关键词：chronic pain;Salviae Miltiorrhizae Radix Et Rhizoma;quantitative structure-activity relationship （QSAR）;machine learning;network pharmacology
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发布时间：2024-04-15 - 摘要：Objective： To investigate the anticancer activity of dihydroartemisinin（DHA）on RKO cells in vivo and its mechanism in vitro.Methods40 RKO tumor-bearing mouse models were established in specific pathogen-free male nude mice and randomly divided into model group，cisplatin group，high dose DHA（200 mg/kg）group，and low dose DHA（100 mg/kg）group，with 10 mice in each group. The body weight，tumor volume，tumor mass，tumor inhibition rate and serum，tumor necrosis factor-α（TNF-α）level of each group were compared. Hematoxylin-eosin （H&E） staining was used to observe tumor histopathological changes in nude mice of each group. MTT assay was used to detect the effects of DHA at different concentrations（25，50，100 μmol/L）on the proliferation of RKO cells within 0，24，48，and 72 h. Flow cytometry and Hoechst 33258 were used to detect the effects of DHA （0，50，95，150 μmol/L）on the cell cycle and apoptosis of RKO cells after 48 h intervention. Wound healing assay was used to observe the effect of 95 μmol/L DHA on cell migration. Real Time Quantitative PCR （RT-qPCR） was used to detect the effect of DHA on the mRNA expression levels of Caspase-3， Caspase-9， Bcl-2 and Bax. Western blot was used to detect the effect of DHA on the expression levels of Caspase-3， Caspase-9， Bcl-2， Bax， p38-MAPK， p-p38-MAPK， PI3K， p-PI3K， Akt， p-Akt and MMP-9.ResultsTumor volume and mass were significantly reduced and the serum level of TNF-α was lowered by 200 mg/kg DHA， and the tumor inhibition rate was 41.45%. The inhibitory effect on RKO cell proliferation was enhanced with increasing concentration of DHA. RKO cell cycle was arrested in the G2/M phase by （50，95，150 μmol/L）DHA，and the effect of promoting RKO cell apoptosis was enhanced with the increase of DHA concentration. The migration ability of RKO cells was significantly reduced after intervention with 95 μmol/L DHA for 12 and 24 h （P<0.01）. The mRNA expression levels of Caspase-3 and Caspase-9 in RKO cells were significantly up-regulated by 95 μmol/L DHA（P<0.01）， and Bax/Bcl-2 mRNA expression ratio was also significantly up-regulated（P<0.05）. The protein expressions of cleaved-Caspase-9/Caspase-9 and Bax/Bcl-2 in RKO cells were increased by 95 μmol/L DHA（P<0.01）， while the protein expression levels of MMP-9， p-P38 MAPK， p-PI3K， p-Akt and Akt were decreased（P<0.01）.ConclusionDHA has a good inhibitory effect on colorectal cancer，and its mechanism may be to trigger the endogenous apoptosis of RKO cells to prevent their proliferation and migration through inhibiting the MAPK/PI3K/Akt signaling pathway.关键词：dihydroartemisinin;colorectal cancer;RKO cells;cell apoptosis;MAPK/PI3K/Akt signaling pathway
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发布时间：2024-04-15
Experiment Research
- 摘要：Sepsis is a systemic inflammatory response caused by the dysregulations of host immune response to infection， leading to life-threatening organ dysfunction. The nucleotide binding oligomerization domain （Nod）-like receptor protein 3 （NLRP3） inflammasome plays an important role in the innate immune system. Studies have shown that activation of the NLRP3 inflammasome can lead to further aggravation of systemic inflammation during the process of multiple organ damage in sepsis. Therefore， it is crucial to elucidate the activation mechanism of NLRP3 inflammasome and its pathogenic role in multiple organ damage in sepsis. This article will review the latest progress of the above research， and elaborate the therapeutic effect of traditional Chinese medicine on sepsis from the perspective of NLRP3 inflammasome， so as to provide some references for the treatment of multiple organ damage in sepsis.关键词：NLRP3 inflammasome;sepsis;multiple-organ damage;inflammatory storm
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发布时间：2024-04-15
Review
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