The blood-brain barrier （BBB） is a physical and biochemical barrier that precisely regulates brain homeostasis and plays a central role in controlling the transport of endogenous and exogenous drugs and related metabolites across the blood-brain interface. These functions of the BBB are mediated by its major components， including brain microvascular endothelial cells （BMECs）， tight junction protein complexes， and influx and efflux transporter proteins. One of the pathological features of ischemic stroke （IS） is BBB disruption， which plays an important role in the development of post-stroke brain injury and subsequent neurological dysfunction. Therefore， given the increasing incidence of IS， there is an urgent need to develop new therapeutic strategies to prevent BBB dysfunction and thereby protect injured brain tissue after IS. This study describes the pathological mechanisms by which BMEC injury after IS leads to BBB dysfunction and elucidates the association between BMECs and IS， including the regulation of apoptosis， autophagy， inflammatory responses， oxidative stress， neurotoxic effects， and cerebral edema. In addition， this article summarizes Chinese herbal medicines that may prevent and treat IS by targeting BMECs. These include monomeric compounds and single herbs such as flavonoids， glycosides， phenols， phthalides， terpenoids， and Styrax. Traditional Chinese medicine （TCM） compound formulas and preparations include oral formulations such as Buyang Huanwu decoction， Sailuotong， Naoxintong capsules， Dandeng Tongnao capsules， and Shexiang Tongxin dropping pills， as well as injectable preparations such as Tongluo Jiunao injection， Xingnaojing injection， Danshen polyphenolic acid for injection， Yiqi Fumai injection， and Shuxuetong injection. This study aims to explore the protective effects of TCM against IS through targeted regulation of BMEC function， providing new insights into the mechanisms of IS and endovascular therapeutic strategies.

Objective Exploring genetic differences among geographic strains of Anopheles sinensis in China. Methods Based on the mitochondrial cytochrome oxidase subunit I(COⅠ )and ribosomal the second internal transcribed spacer(ITS2), genetic distance analyses were conducted on An. sinensis samples collected nationwide. Results Genetic differentiation was observed within An. sinensis geographic strains, primarily reflected in the genetic distances of COⅠ sequences, with some distances between samples exceeding those between closely related species. However, ITS2 sequences showed relatively low levels of differentiation within geographic strains. No significant separation was observed, and gene exchange exhibited a random pattern among geographic strains. Conclusions Significant differences in genetic distance were observed among An. sinensis samples, along with evidence of interspecific continuity among sibling species. For the identification of closely related species using wild-collected Anopheles mosquitoes samples, reliance solely on commonly used barcodes such as COⅠ and ITS2 may be insufficient. Additional molecular markers, including COⅡ and D3 gene fragments, should also be considered. Caution should be exercised when using COⅠ genes to identify cryptic species, especially within Anopheles mosquitoes.

Objective To develop a predictive model of acute hematologic toxicity (HT) based on preradiotherapy CT radiomic features combined with clinical and dosimetric characteristics for patients with cervical cancer undergoing definitive radiotherapy. Methods Data from 82 patients with cervical cancer who received definitive radiotherapy were retrospectively analyzed. The patients were divided into training and test sets at an 8:2 ratio, with grade ≥2 HT as the study endpoint. Clinical characteristics and dosimetric parameters of pelvic regions were collected, and 1 046 radiomic features were extracted from the overall pelvic structure using PyRadiomics. Radiomic features were processed using Z-score normalization, Spearman correlation analysis (>0.9), and LASSO regression for feature selection. A radiomics model was constructed using K-nearest neighbor machine learning with fivefold cross-validation. For 56 clinical and dosimetric features, independent predictors were identified through univariate and multivariate analyses to establish a clinical-dose model. A hybrid model was further constructed by combining the two sets of features. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), decision curve analysis, and calibration curves. Results Forty patients (48.8%) developed grade ≥2 HT. Univariate and multivariate analyses showed that V20 of the lumbosacral spine was significantly associated with grade ≥2 HT (P<0.05). The AUC values for the radiomics, clinical-dose, and hybrid models were 0.802, 0.750, and 0.861 in the training set, respectively, and 0.703, 0.633, and 0.781 in the test set, respectively. Conclusion Preradiotherapy CT radiomic features combined with dosimetric characteristics can predict the occurrence of acute hematologic toxicity in patients with cervical cancer, potentially facilitating early clinical intervention.

ObjectiveTo examine the influencing mechanisms and regional differences in accessible facility utilization behavior among residents in eastern and central-western China. MethodsData were collected through the online questionnaire administered to residents across China using snowball sampling. Descriptive analysis and chi-square tests were conducted to compare the basic characteristics of respondents between the two regions. Welch's t test was used to compare accessible facility utilization behavior and its influencing factors. Multigroup structural equation modeling (SEM) was applied to compare the influencing mechanisms of accessible facility utilization behavior between eastern and central-western China. ResultsA total of 1 039 valid responses were obtained, including 604 from the eastern region and 435 from the central-western region. Residents in eastern regions scored significantly higher than those in central-western regions on both facility-seeking (t = 4.057, P < 0.001) and actual-using (t = 4.551, P < 0.001) behavior. The structural equation models for both regions showed identical and satisfactory goodness-of-fit indices (GFI = 0.950, AGFI = 0.932, IFI = 0.947, CFI = 0.947, RMSEA = 0.028), and all measurement and structural invariance tests met the recommended criteria. Facility configuration showed no significant direct effect on utilization behavior in eastern China, whereas a negative direct effect was observed in central-western China (β = -0.171, P = 0.047), with its influence mainly exerted indirectly through social cognition and user experience. Social cognition and user experience had significant positive effects on utilization behavior (P < 0.001). Meanwhile, social cognition indirectly influences utilization behavior through the mediating path of usage experience. The direct effects of social cognition (β = 0.406) and user experience (β = 0.510) in central-western China were greater than those in eastern China (β = 0.369 and β = 0.335, respectively). The chain mediation effect of "configuration-cognition-experience-behavior" was statistically significant in both regions (P < 0.05), with larger indirect effects observed in central-western China. ConclusionFacility configuration has a limited direct effect on accessible facility utilization, whereas social cognition and user experience play a central role, particularly in central-western China. It is recommended that the construction and renovation of accessible facility be guided by population needs, accompanied by strengthened promotion of accessibility concepts and policies, and that a transition from hardware-oriented construction to service- and management-oriented governance of accessible environments should be promoted in central-western China.

Professor Zou Yunxiang proposed the"kidney essence theory"in 1955,which believes that the kidney,as an important excretory organ in the human body,participates in the body's metabolism,and the basis for producing this effect is the essence of the kidney.Subsequently,the Zou nephrology team established the core medical technique of"tonifying the kidney element"based on this foundation,constructed a system of syndrome differentiation and treatment for chronic kidney disease,proposed the traditional Chinese medicine names,causes,and mechanisms of chronic kidney disease,as well as four major methods for diagnosing and treating chronic kidney disease,and developed representative drugs representing the core medical technique of"tonifying the kidney element"-Huang-zhi Yishen Capsules and Shenwu Yishen Tablets.In addition,the Zou nephrology team has extensively applied and promoted the core medical technique of"tonifying the kidney element".

Objective To explore the application effect of enhanced recovery after surgery(ERAS)strategy in secondary cesarean delivery.Methods A total of 90 puerperae who underwent elective secondary cesarean delivery in our hospital were enrolled and randomly divided into the observation group and the control group,with 45 cases in each group.Puerperae in the observation group adopted ERAS management,and puerperae in the control group adopted routine management.The postoperative recovery indicators,clinical outcome indicators,scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Kolcaba general comfort questionnaire(GCQ)of puerperae between the two groups were compared.Results The obstetric quality of recovery-11(ObsQoR-11)score 24 hours after surgery of puerperae in the observation group was higher than that in the control group(P<0.05),the recovery time of postoperative bowel sounds and first defecating time were shorter than those in the control group(P<0.05),the height of uterine fundus 72 hours after surgery was lower than that in the control group(P<0.05),the incidences of moderate to severe pain at rest and during cough were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of neonatal transfer to the intensive care unit or the incidence of jaundice between the two groups(P>0.05);while the incidences of intraoperative hypotension,nausea and vomiting,chills,and postoperative abdominal distension,nausea and vomiting of puerperae in the observation group were lower than those in the control group(P<0.05),postoperative vaginal bleeding volume within 24 hours was less than that in the control group(P<0.05).After intervention,the SAS,SDS and GCQ scores of puerperae in both groups were lower than those before intervention(P<0.05),and the SAS and SDS scores of puerperae in the observation group were lower than those in the control group(P<0.05),the GCQ score was higher than that in the control group(P<0.05).Conclusion ERAS strategy used for secondary cesarean delivery can improve clinical outcomes and psychological state of puerperae,increase comfort level,and promote postoperative recovery.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Two novel diketopiperazines (1 and 5), along with ten known compounds (2-4, 6-12) demonstrating significant skin inflammation inhibition, were isolated from a marine-derived fungus identified as Aspergillus sp. FAZW0001. The structural elucidation and configurational reassessments of compounds 1-5 were established through comprehensive spectral analyses, with their absolute configurations determined via single crystal X-ray diffraction using Cu Kα radiation, Marfey's method, and comparison between experimental and calculated electronic circular dichroism (ECD) spectra. Compounds 1, 2, and 8 exhibited significant anti-inflammatory activities in Propionibacterium acnes (P. acnes)-induced human monocyte cell lines. Compound 8 demonstrated the ability to down-regulate interleukin-1β (IL-1β) expression by inhibiting Toll-like receptor 2 (TLR2) expression and modulating the activation of myeloid differentiation factor 88 (MyD88), mitogen-activated protein kinase (MAPK), and nuclear factor κB (NF-κB) signaling pathways, thus reducing the cellular inflammatory response induced by P. acnes. Additionally, compound 8 showed the capacity to suppress mitochondrial reactive oxygen species (ROS) production and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome activation, thereby reducing IL-1β maturation and secretion. A three-dimensional quantitative structure-activity relationships (3D-QSAR) model was applied to compounds 5-12 to analyze their anti-inflammatory structure-activity relationships.
Humans ; Aspergillus/chemistry* ; Diketopiperazines/isolation & purification* ; Anti-Inflammatory Agents/isolation & purification* ; Interleukin-1beta/genetics* ; Toll-Like Receptor 2/immunology* ; Propionibacterium acnes/drug effects* ; NF-kappa B/genetics* ; Molecular Structure ; Myeloid Differentiation Factor 88/immunology* ; Monocytes/immunology* ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Cell Line

Ambient air pollution is increasingly being recognized as a risk factor for heart failure; however, its effects on cardiac biomarkers remain unclear. This scoping review assessed the existing evidence on the association between air pollution and cardiac biomarkers in heart failure, described the key concepts, synthesized data, and identified research gaps. Following the PRISMA-ScR guidelines, PubMed, Embase, Web of Science, and CNKI databases were searched for studies on air pollution, heart failure, and biomarkers. A total of 765 records were screened, and 81 full texts were assessed for eligibility, resulting in 15 studies. The results showed that the exposure to particulate matter was associated with elevated N-terminal pro-B-type natriuretic peptide and troponin levels. Several studies have linked particulate matter exposure to a higher cardiovascular risk and heart failure biomarkers. Inflammatory and oxidative stress markers were consistently elevated across studies, supporting the biological relevance of these associations. However, few studies have focused specifically on populations with heart failure or clinically relevant biomarkers, and the evidence for gaseous pollutants remains inconclusive. These findings highlight the need to integrate environmental risk assessment into heart failure care and inform policy efforts to reduce the pollution-related cardiovascular burden. Further research should address these gaps through improved exposure assessments and the integration of mechanistic evidence.
Heart Failure/epidemiology* ; Biomarkers/metabolism* ; Humans ; Air Pollution/adverse effects* ; Air Pollutants/adverse effects* ; Particulate Matter/adverse effects* ; Environmental Exposure ; Natriuretic Peptide, Brain/blood* ; Oxidative Stress ; Troponin/blood*

Professor Zou Yunxiang proposed the"kidney essence theory"in 1955,which believes that the kidney,as an important excretory organ in the human body,participates in the body's metabolism,and the basis for producing this effect is the essence of the kidney.Subsequently,the Zou nephrology team established the core medical technique of"tonifying the kidney element"based on this foundation,constructed a system of syndrome differentiation and treatment for chronic kidney disease,proposed the traditional Chinese medicine names,causes,and mechanisms of chronic kidney disease,as well as four major methods for diagnosing and treating chronic kidney disease,and developed representative drugs representing the core medical technique of"tonifying the kidney element"-Huang-zhi Yishen Capsules and Shenwu Yishen Tablets.In addition,the Zou nephrology team has extensively applied and promoted the core medical technique of"tonifying the kidney element".