arcopenia is a systemic skeletal muscle disorder characterized by a decrease in skeletal muscle mass and progressive decline in function， with multiple signaling pathways involved in its occurrence and development. Among them， the AMP-activated protein kinase （AMPK） signaling pathway， as a key pathway regulating cellular energy homeostasis， plays an important role in the regulation of skeletal muscle metabolism and functional maintenance by improving abnormalities in glucose and lipid metabolism， balancing skeletal muscle protein synthesis and degradation， improving mitochondrial function， promoting autophagy， and inhibiting inflammatory responses and oxidative stress. This article reviews the research progress on how various traditional Chinese medicine （TCM） monomers， including polyphenols， flavonoids， and terpenoids； various traditional Chinese medicine extracts， such as those from Lycium barbarum ， Asini Corii Colla， and Panax quinquefolium ， and TCM compounds， such as Guiqi zhuangjin decoction， Jianpi qiangji granules， and Qigu capsules， intervene in sarcopenia by regulating the AMPK signaling pathway to promote muscle protein synthesis， inhibit protein degradation， improve mitochondrial function， and alleviate inflammation and oxidative stress. Additionally， their molecular mechanisms are explored. The aim is to deeply elucidate the basis of TCM in the prevention and treatment of sarcopenia and to provide theoretical support for the development of related innovative drugs.

ObjectiveTo evaluate the clinical efficacy of Shenqi Yangxin decoction in the treatment of ischemic cardiomyopathy （ICM） with Qi and Yin deficiency and blood stasis syndrome and its effect on serum hydrogen sulfide （H₂S） and calcium ion （Ca²⁺）. MethodsA total of 64 ICM patients with Qi and Yin deficiency and blood stasis syndrome who met the inclusion criteria were randomly divided into a control group （n=32） and a treatment group （n=32）. All patients received conventional Western medicine treatment. The treatment group was additionally given Shenqi Yangxin decoction. The TCM syndrome score， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， 6-minute walk test （6MWT）， New York Heart Association （NYHA） cardiac function classification， and serum H₂S and Ca²⁺ levels were compared between the two groups pre- and post-treatment. ResultsTwo cases dropped out from each group during the study. Finally， 30 patients in each group were included in the analysis. There were no significant differences in age， gender， course of coronary heart disease， underlying diseases， and laboratory tests between the two groups. Compared with baseline， the TCM syndrome score， MLHFQ score， and NT-proBNP in both treatment group and control group decreased significantly （P<0.01）， LVEF， 6MWT， and H₂S increased significantly （P<0.01）， and serum Ca²⁺ increased （P<0.05）. Compared with the control group after treatment， the MLHFQ score and NT-proBNP in the treatment group decreased （P<0.05）， the TCM syndrome score decreased significantly （P<0.01）， LVEF， 6MWT， and serum Ca²⁺ increased （P<0.05）， and H₂S increased significantly （P<0.01）. The improvement degree of the NYHA cardiac function classification in the treatment group was higher than that in the control group， but there was no significant difference. ConclusionShenqi Yangxin decoction is effective in treating ICM patients with Qi and Yin deficiency and blood stasis， which could significantly improve cardiac function and quality of life， and its therapeutic effect may be related to the regulation of serum H₂S and Ca²⁺ levels.

ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective To analyze the clinical, imaging, pathological characteristics and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), so as to provide preference for the differential diagnosis and clinical management of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 14 patients diagnosed with renal MTSCC at the Eastern Theater Command General Hospital during June 2021 and Aug.2025.Relevant literature was reviewed.Results Of the 14 patients, 10 were female (71.4%) and 4 were male (28.6%), with a mean age of 56.9 years. Pathological staging included pT1a in 6 cases, pT1b in 7 cases, and pT2b in 1 case.The median tumor diameter was 4.5 (range 2.0-11.0) cm.Twelve cases (85.7%) were asymptomatic and detected incidentally.On ultrasonography, most tumors exhibited well-defined margins and regular morphology (9/10, 90%) and appeared as homogeneous hypoechoic masses (7/10, 70%).All lesions demonstrated hypovascular features on imaging studies.Ten patients (71.4%) underwent laparoscopic radical nephrectomy, and 4(28.6%) received partial nephrectomy.Histologically, a distinctive architecture composed of tubular structures, spindle-shaped cells, and mucinous stroma was exhibited.Immunohistochemically, the positive rates of PAX-8, VIMENTIN and CK7 in tumor cells were 100% (13/13), 91.7% (11/12) and 84.6% (11/13), respectively.The Ki-67 proliferation index ranged from 2.0% to 40.0%.During a median follow-up of 25.0 (range4.9-0.0) months, no local recurrence or distant metastasis was observed.Conclusion Renal MTSCC is a rare subtype of renal cell carcinoma, typically lacking specific clinical symptoms and characterized by hypovascular imaging features.The tumor generally follows an indolent course with a favorable prognosis.For localized tumors, partial nephrectomy should be the primary consideration.For cases with high-risk pathological features such as sarcomatoid changes, due attention should be paid to the potential invasiveness and follow-up should be closely conducted.

ObjectiveTo investigate the clinical efficacy of oral/ gastric tube/ jejunal tube administration or retention enema of Qingjie Huagong Formula （清解化攻方， QHF） mirabilite abdominal bag external application combined with conventional western medicine in patients with acute pancreatitis （AP）. MethodsA prospective， randomized， double-blind， placebo-controlled trial was conducted. A total of 128 AP patients were enrolled and randomly assigned to a control group and a treatment group， with 64 cases in each group. The control group received placebo and conventional western medicine， while the treatment group additionally received oral/ gastric tube/ jejunal tube administration or retention enema of QHF， and mirabilite abdominal bag external application. Both groups received treatment from admission to discharge as one complete course， with the maximum treatment duration not exceeding 14 days.The primary outcome was the severity grading of AP. Secondary outcomes were clinical efficacy， laboratory indicators including white blood cell count （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， blood urea nitrogen （BUN）， lactate （Lac）， and D-dimer， gastrointestinal function recovery indicators including time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition， total fluid volume administered within 24 h after admission， intra-abdominal pressure， length of hospital stay， hospitalization costs， and incidence of complications. ResultsDuring the treatment period， 3 cases dropped out in the control group and 9 cases in the treatment group， leaving 116 cases for final analysis （55 in the treatment group and 61 in the control group）. After treatment， the markedly effective rate and overall effective rate in the treatment group were 69.09% （38/55） and 92.73% （51/55）， respectively， which was higher than 49.18% （30/61） and 80.33% （49/61） in the control group. The severity of the disease in the treatment group was significantly lower than that in the control group （P＜0.05）. Compared to the control group， the treatment group showed significantly reduced levels of WBC， CRP， PCT， BUN， Lac， and D-dimer； the time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition were significantly shortened； the fluid volume administered within 24 h after admission and intra-abdominal pressure were significantly reduced， as well as the length of hospital stay and hospitalization costs （P＜0.05 or P＜0.01）. The incidences of acute kidney injury， systemic inflammatory response syndrome， and infected pancreatic necrosis in the treatment group were significantly lower than those in the control group （P＜0.05）. ConclusionQHF combined with conventional western medicine can significantly improve the inflammatory status of AP patients， promote gastrointestinal function recovery， reduce intra-abdominal pressure and fluid resuscitation requirements， lower the risk of certain complications， and shorten the length of hospital stay.

Regulated cell death （RCD） is a genetically determined， active and programmed form of cell death， mainly including apoptosis， autophagy， ferroptosis， pyroptosis， PANoptosis and other patterns. Dysregulation of RCD plays a pivotal role in the occurrence and progression of sarcopenia. Due to the advantages of abundant targets， diverse mechanisms of action and high safety profile， traditional Chinese medicine （TCM） has attracted considerable attention in regulating RCD， and preventing and treating sarcopenia. Through a review of the mechanisms of RCD in sarcopenia， and recent research progress on how TCM modulates RCD to improve sarcopenia， this paper reveals that single TCM herbs and their extracts （e.g.， Puerariae Lobatae Radix， and extracts of Schisandrae Chinensis Fructus， Myristicae Semen and Cistanches Herba）， active components and effective fractions of TCM （e.g.， resveratrol， polydatin， curcumin）， as well as TCM compound formulas （e.g.， Buzhong yiqi decoction， Erjing pills， Huangqi guizhi wuwu decoction， Shuanghe decoction）， can modulate RCD through multiple pathways， including the inhibition of apoptosis， pyroptosis， ferroptosis and PANoptosis， and the modulation of autophagy， thereby alleviating sarcopenia.

ObjectiveTo investigate the clinical efficacy of oral/ gastric tube/ jejunal tube administration or retention enema of Qingjie Huagong Formula （清解化攻方， QHF） mirabilite abdominal bag external application combined with conventional western medicine in patients with acute pancreatitis （AP）. MethodsA prospective， randomized， double-blind， placebo-controlled trial was conducted. A total of 128 AP patients were enrolled and randomly assigned to a control group and a treatment group， with 64 cases in each group. The control group received placebo and conventional western medicine， while the treatment group additionally received oral/ gastric tube/ jejunal tube administration or retention enema of QHF， and mirabilite abdominal bag external application. Both groups received treatment from admission to discharge as one complete course， with the maximum treatment duration not exceeding 14 days.The primary outcome was the severity grading of AP. Secondary outcomes were clinical efficacy， laboratory indicators including white blood cell count （WBC）， C-reactive protein （CRP）， procalcitonin （PCT）， blood urea nitrogen （BUN）， lactate （Lac）， and D-dimer， gastrointestinal function recovery indicators including time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition， total fluid volume administered within 24 h after admission， intra-abdominal pressure， length of hospital stay， hospitalization costs， and incidence of complications. ResultsDuring the treatment period， 3 cases dropped out in the control group and 9 cases in the treatment group， leaving 116 cases for final analysis （55 in the treatment group and 61 in the control group）. After treatment， the markedly effective rate and overall effective rate in the treatment group were 69.09% （38/55） and 92.73% （51/55）， respectively， which was higher than 49.18% （30/61） and 80.33% （49/61） in the control group. The severity of the disease in the treatment group was significantly lower than that in the control group （P＜0.05）. Compared to the control group， the treatment group showed significantly reduced levels of WBC， CRP， PCT， BUN， Lac， and D-dimer； the time to relief of abdominal pain， time to recovery of bowel sounds， and time to resumption of enteral nutrition were significantly shortened； the fluid volume administered within 24 h after admission and intra-abdominal pressure were significantly reduced， as well as the length of hospital stay and hospitalization costs （P＜0.05 or P＜0.01）. The incidences of acute kidney injury， systemic inflammatory response syndrome， and infected pancreatic necrosis in the treatment group were significantly lower than those in the control group （P＜0.05）. ConclusionQHF combined with conventional western medicine can significantly improve the inflammatory status of AP patients， promote gastrointestinal function recovery， reduce intra-abdominal pressure and fluid resuscitation requirements， lower the risk of certain complications， and shorten the length of hospital stay.

The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

Hypotension is a leading cause of age-related cognitive impairment. The available literature evidences that vascular factors are associated with dementia and that hypotension alters cerebral perfusion flow and can aggravate the neurodegeneration of Alzheimer's disease (AD). Despite the discovery of biomarkers and the recent progress made in neurovascular biology, epidemiology, and brain imaging, some key issues remain largely unresolved: the potential mechanisms underlying the neural deterioration observed in AD, the effect of cerebrovascular alterations on cognitive deficits, and the positive effects of hypotension treatment on cognition. Therefore, further well-designed studies are needed to unravel the potential association between hypotension and cognitive dysfunction and reveal the potential benefits of hypotension treatment for AD patients. Here, we review the current epidemiological, pathobiological, and treatment-related literature on neurovascular changes and hypotension-related cognitive dysfunction and highlight the unsettled but imminent issues that warrant future research endeavors.
Humans ; Hypotension/complications* ; Cognitive Dysfunction/etiology* ; Alzheimer Disease/epidemiology* ; Cerebrovascular Circulation/physiology* ; Cognition Disorders/etiology*