1.Systematic review of measurement properties of liver cancer patient specific self-reported outcome assessment tools
Shiyan LU ; Xian LIU ; Xiaoxiao JIANG ; Yanping HUANG ; Hongxia XU
Chinese Journal of Nursing 2024;59(22):2734-2741
Objective To systematically evaluate the measurement properties and methodological quality of the liver cancer patients specific self-reported outcome assessment tools,and to provide a basis for healthcare professionals to select a high-quality scale.Methods Systematic search of PubMed,Embase,CINAHL,Web of Science,Cochrane Library,China National Knowledge Infrastructure,VIP Database,Wanfang Database,and China Biomedical Literature Database was conducted for studies related to the evaluation of the measurement properties of liver cancer specific self-reported outcome assessment tools.The search period was from the date of creation to February 1,2024,and 2 researchers independently conducted literature screening and data extraction according to the COSMIN selection criteria,and used the COSMIN Risk of Bias Inventory and Quality Criteria Scale to measure the methodological quality and measurement properties,and the final recommendations were formed.Results A total of 12 studies involving 8 specific self-reported outcome assessment tools for liver cancer patients were included.Finally,TSM-PLC was recommended at level A;EORTC QLQ-HCC18,QOL-LC,QLICP-LI were recommended at level C;FACT-HEP,MDASI-Periop-Hep,Quality of Life Scale for Liver Cancer Patients,and FHSI-8 were recommended at level B.Conclusion Compared to other scales,TSM-PLC has relatively good methodological quality and measurement properties,and is recommended for use as a priority.Due to its evaluation content mainly focusing on the patient's physical symptom distress,it can be used in conjunction with other scales to enhance the comprehensiveness of the evaluation.
2.Genome sequences of H7N9 avian influenza virus in poultry-related environment in Henan Province in 2023
Bicong WU ; Xue LUO ; Shidong LU ; Yun SONG ; Baifan ZHANG ; Haiyan WEI ; Yifei NIE ; Hui XIA ; Sijia WAN ; Ying YE ; Xueyong HUANG ; Wanshen GUO ; Hongxia MA
Chinese Journal of Microbiology and Immunology 2024;44(5):377-381
Objective:To analyze the genetic evolution and molecular characteristics of H7N9 avian influenza virus (AIV) isolated in a live poultry market.Methods:Samples such as poultry feces, sewage, and hair removal machine and chopping board swabs were collected. Real-time fluorescent quantitative PCR was used to detect influenza A virus and H7N9 AIV in the samples. The whole genome of H7N9 AIV was amplified with influenza A virus universal primers and sequenced. BLAST and MEGA X were used for sequence alignment, phylogenetic analysis and molecular characterization.Results:Seven poultry-related environment samples were collected in the live poultry market in Xuchang city in February 2023, and four were positive for H7N9 AIV. The whole genome sequences of three H7N9 AIV isolates were successfully obtained, and the isolates shared high nucleotide identity in different genes (98.37%-100.00%). BLAST analysis showed they were highly identical to H7N9 strains isolated from domestic poultry in China from 2020 to 2021. Genetic evolution analysis showed that the three isolates clustered in the same branch and were closer to the recent environmental isolates than to the recent strains isolated from human or avian. Through comparison with the sequences of the representative strains in different periods, it was found that the isolated strains in this study showed high avian pathogenicity with four amino acids KRAA inserted at the cleavage site; the hemagglutinin receptor-binding site was QSG, which was an avian binding receptor; there was a G186I mutation in hemagglutinin. Mammalian-adaptive mutation E627K was not detected in polymerase basic protein 2. Mutations (R292K and I38T) associated with drug resistance to neuraminidase inhibitor (oseltamivir) and polymerase acidic protein inhibitor (baloshavir) were not detected, suggesting that these isolates remained susceptible to these drugs. A S31N mutation was found in M2 protein, indicating they were resistant to alkamines.Conclusions:The three H7N9 AIV strains isolated in the live poultry market have high avian pathogenicity, but there are no significant increase in mutations related to the binding ability to human receptors, mammalian pathogenicity, viral transmissibility, or drug resistance as compared with previous representative strains causing human or avian infection.
3.Anti-SARS-CoV-2 antibody levels in previously infected and re-infected populations in Henan Province, China
Yun SONG ; Shidong LU ; Bicong WU ; Haiyan WEI ; Wenhua WANG ; Yafei LI ; Xue LUO ; Jingjing PAN ; Hongxia MA ; Haifeng WANG ; Ying YE ; Wanshen GUO ; Xueyong HUANG
Chinese Journal of Microbiology and Immunology 2024;44(9):801-808
Objective:To analyze the reinfection rates in people previously infected with SARS-CoV-2 in Zhengzhou and Yuzhou cities (first infected with Delta/B.1.617.2 variant), and Anyang city (first infected with Omicron/BA.1.1 variant) in January 2022 and the population characteristics, and compare the differences in antibody levels among different populations.Methods:Serum samples were collected from 371 previously infected, 134 reinfected and 19 uninfected people for IgG antibody detection. Among them, serum samples from 45 previously infected, 44 reinfected and 19 uninfected people were tested with different novel coronavirus variants (early original strain, BA.5.2 variant, XBB.1.5 variant) for neutralizing antibody detection.Results:The rate of reinfection was 32.82% (85/259) in Zhengzhou and Yuzhou cities, and 19.92% (49/246) in Anyang city. The IgG antibody level in reinfected people was higher than that in previously infected and uninfected people ( P<0.05). The IgG antibody level in uninfected group was higher in people vaccinated within three months than in those vaccinated six months ago ( P<0.05). The IgG antibody level in the group receiving four doses of vaccine was higher than that in the group receiving three doses of vaccine ( P<0.05). The results of true virus neutralization antibody detection showed that in the Zhengzhou and Yuzhou cases, the level of neutralization antibody against the early original strain was higher than those against the BA.5.2 variant and the XBB.1.5 variant ( P<0.05), and the level of neutralizing antibody against BA.5.2 variant was higher than that against XBB.1.5 variant ( P<0.05). In Anyang city cases, the level of neutralizing antibody against the early original strain was higher than those against BA.5.2 variant and XBB.1.5 variant ( P<0.05); in the reinfected population, the level of neutralizing antibody against the early original strain was higher than that against the XBB.1.5 variant ( P<0.05). In addition, the levels of all neutralizing antibodies in both previously infected and reinfected people were higher than those in uninfected people ( P<0.05). The level of neutralizing antibody in the infected population in Zhengzhou and Yuzhou cities was higher than that in the infected population in Anyang city and in uninfected population ( P<0.05). The levels of antibodies against BA.5.2 and anti-XBB.1.5 variants in infected people in Zhengzhou and Yuzhou cities were higher than those in uninfected people ( P<0.05). The level of neutralizing antibody against BA.5.2 variants in the previously infected population in Anyang city was higher than that in the uninfected population ( P<0.05), and the level of neutralizing antibody against XBB.1.5 variants in the infected population in Anyang city was higher than that in the uninfected population ( P<0.05). Conclusions:After infection with SARS-CoV-2, the neutralizing antibodies produced in the human body have a certain cross-protection effect on other variants, but the antibody level will gradually decrease over time. Protection from a previous early SARS-CoV-2 variants infection against the current main circulating Omicron variants (such as XBB variants) is low, and the immunity conferred by pervious infection or booster vaccination may not be able to provide sufficient protection against new variants.
4.Effects of Gouteng Jiangya Jieyu Prescription on Learning and Memory Ability and Hippocampal Autophagy-Related Protein Expression in Rats with Hypertension Complicated with Depression
Hongxia ZHAO ; Yeqian LIU ; Lei CHEN ; Lingge HUANG ; Hong LI ; Danfeng MA ; Chunming CHEN ; Shuiqing ZENG ; Weiqiong REN
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(5):646-655
Objective To study the effects of Gouteng Jiangya Jieyu Prescription(Uncariae Ramulus cum Uncis,Gastrodiae Rhizoma,Pheretima,Puerariae Lobatae Radix,Salviae Miltiorrhizae Radix et Rhizoma,etc.)on learning and memory ability,hippocampal inflammatory response and autophagy-related protein expression in rats with hypertension complicated with depression(HD).Methods Thirty spontaneously hypertensive rats(SHR)were randomly divided into model group,positive control group(Levamlodipine Besylate 0.45 mg·kg-1+Fluoxetine Hydrochloride 1.80 mg·kg-1)and Gouteng Jiangya Jieyu Prescription high-,medium-and low-dose groups(25.38,12.69,6.34 g·kg-1).Another 6 SD rats were used as blank control group.The SHR rats were intervened by chronic mild unpredictable stress combined with solitary rearing to replicate the HD rat model.At the same time,intragastric administration was given once a day for 6 weeks.The systolic blood pressure and diastolic blood pressure of rat tail artery were measured by non-invasive sphygmomanometer.The learning and memory ability of rats was detected by Morris water maze test.The ultrastructure of hippocampal neurons was observed by transmission electron microscope.The contents of interleukin-1β(IL-1β),IL-18 and IL-10 in hippocampus were detected by ELISA.The expression of autophagy-related proteins Beclin1 and Bcl-2 in hippocampus was detected by immunohistochemistry.The expression of autophagy-related proteins LC3Ⅰ and LC3Ⅱ in hippocampus was detected by Western Blot.Results Compared with the blank control group,the SBP and DBP of the rats in the model group were significantly increased from week 1-6(P<0.01).The escape latency was significantly prolonged on the third and fourth day(P<0.01).The first time of crossing the platform was significantly prolonged(P<0.01),the times of crossing the platform area was significantly reduced(P<0.05),and the retention time of the platform area was significantly shortened(P<0.01).The neuronal cell body was obviously swollen,the ridge was destroyed,the nucleus was shrunk,and a large number of autophagosomes appeared;the contents of IL-1β and IL-18 in hippocampus were significantly increased(P<0.01).The ratio of LC3Ⅱ/LC3Ⅰ protein expression and the expression of Beclin1 protein in hippocampus were significantly up-regulated(P<0.05,P<0.01),and the expression of Bcl-2 protein was significantly down-regulated(P<0.01).Compared with the model group,the SBP of rats in the low-dose group of Gouteng Jiangya Jieyu Prescription was significantly decreased at the weeks 1,3,4,5,6(P<0.01),and the DBP was significantly decreased at weeks 1,3,4,5(P<0.05,P<0.01).The SBP of the rats in the medium-dose group of Gouteng Jiangya Jieyu Prescription was significantly decreased at weeks 1,5,6(P<0.01),and the DBP was significantly decreased at week 4(P<0.05).The SBP of rats in the high-dose group of Gouteng Jiangya Jieyu Prescription was significantly decreased in the first week(P<0.01).The escape latency of rats in the high-and medium-dose groups of Gouteng Jiangya Jieyu Prescription was significantly shortened on the third day(P<0.05),and the escape latency of rats in the high-and low-dose groups of Gouteng Jiangya Jieyu Prescription was significantly shortened on the fourth day(P<0.05).The first crossing platform time of rats in the high-,medium-and low-dose groups of Gouteng Jiangya Jieyu Prescription was significantly shortened(P<0.01).The times of rats crossing the platform area in the medium-and low-dose groups of Gouteng Jiangya Jieyu Prescription were significantly increased(P<0.05),and the retention time in the platform area was significantly prolonged(P<0.05).In the administration group,the degree of hippocampal neuron damage was reduced,the nuclear shrinkage was significantly improved,and the autophagosomes were reduced.The contents of pro-inflammatory factors IL-1β and IL-18 in the hippocampus of rats in the high-and medium-dose groups of Gouteng Jiangya Jieyu Prescription were significantly decreased(P<0.05,P<0.01).The content of anti-inflammatory factor IL-10 in the hippocampus of rats in the high-dose group of Gouteng Jiangya Jieyu Prescription was significantly increased(P<0.01).The protein expression ratio of LC3Ⅱ/LC3Ⅰ in hippocampus of high-,medium-and low-dose groups of Gouteng Jiangya Jieyu Prescription was significantly down-regulated(P<0.01),and the expression of Bcl-2 protein was significantly up-regulated(P<0.01).The expression of Beclin1 protein in the hippocampus of the high-and medium-dose groups of Gouteng Jiangya Jieyu Prescription was significantly down-regulated(P<0.05,P<0.01).Conclusion Gouteng Jiangya Jieyu Prescription can reduce the tail arterial pressure of HD rats,improve their learning and memory ability,and alleviate hippocampal neuronal damage.The mechanism may be related to reducing the release of inflammatory factors,increasing the level of anti-inflammatory factors,and regulating the expression of hippocampal autophagy-related proteins LC3Ⅱ/LC3Ⅰ,Beclin1 and Bcl-2.
5.Changes of hemodynamic parameters in normal pregnant women and their relationship with maternal basic characteristics
Zhenxuan HUANG ; Guimin LI ; Xiaofang ZHENG ; Wenshi WU ; Songquan WEI ; Hongxia ZHANG ; Yong WANG ; Dunjin CHEN ; Lin YU
Chinese Journal of Obstetrics and Gynecology 2024;59(5):375-382
Objective:To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics.Methods:A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline.Results:(1) CO ( r=0.155, P<0.001), TFC ( r=0.338, P<0.001), MAP ( r=0.204, P<0.001), and HR ( r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation ( r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age ( r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR ( P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy ( P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions:The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.
6.Clinical evaluation of preoperative nasal spray of low-dose dexmedetomidine in elderly patients by heart rate variability analysis
Yi FANG ; Hongxia LIU ; Yuhan HUANG ; Luyang MIAO ; Dai SHEN
Journal of Practical Stomatology 2024;40(1):87-90
Objective:To study the effects of low-dose dexmedetomidine via nasal spray on preoperative anxiety and tracheal intuba-tion induced stress response in elderly patients with maxillofacial surgery using heart rate variability(HRV).Methods:60 elderly pa-tients underwent maxillofacial surgery were randomly divided into the dexmedetomidine group(group D)and the control group(group C).Patients in the group D were treated with nasal spray of dexmedetomidine at 45 min preoperatively.Those in the group C were giv-en the same dose of normal saline spray at the same time.All patients were given intravenous combined with inhalation general anes-thesia.The hemodynamics,HRV index,sedation score and BIS value of the 2 groups of patients were compared at 3 time points,be-fore operation(T0),entrance(T1)and tracheal intubation(T2)respectively.Results:At T1,the average score of Ramsay in group D and group C was 2.8±0.7 and 1.1±0.39,BIS 87.3±6.1 and 97.4±0.5,SD1 20.9±7.0 and 15.4±5.4,SDNN 30.9±6.6 and 37.1±7.0,LF/HF 1.3±0.3 and 2.6±0.4,respectively(P<O.01).At T2,the average score of SD1 in group D and group C was 10.4±3.5 and 7.7±3.1,SDNN 59.2±6.5 and 70.1±7.1,LF/HF 5.l±0.5 and 7.5±0.5,respectively(P<0.01).Conclusion:Low-dose dexmedetomidine nasal spray can effectively relieve the preoperative anxiety of elderly patients in maxillofacial surgery and reduce the stress response of tracheal intubation.
7.Case study on functional orientation in a tertiary public hospital against the backdrop of performance appraisal of tertiary public hospitals
Wen ZHANG ; Xinxin ZHANG ; Ying XU ; Wenjia LI ; Xueli YAN ; Xiaozai ZHANG ; Xiaoyu YANG ; Ya KANG ; Yinghui HU ; Deying KONG ; Yiping GUO ; Yanghua ZHANG ; Shujuan FAN ; Yiping MU ; Hongxia LI ; Huang ZUO
Modern Hospital 2024;24(1):71-75
Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.
8.Serological analysis of severe acute respiratory syndrome coronavirus 2-specific immunoglobulin G antibodies level in Henan Province
Yujiao MU ; Haiyan WEI ; Yafei LI ; Yun SONG ; Shidong LU ; Bicong WU ; Ying YE ; Xueyong HUANG ; Hongxia MA
Chinese Journal of Infectious Diseases 2024;42(2):98-102
Objective:To analyze the specific immunoglobulin G (IgG) antibodies level in the population after the coronavirus disease 2019 (COVID-19) pandemic in Henan Province.Methods:A total of 5 178 peripheral venous blood samples were collected from 10 districts (counties) in Henan Province according to the national seroepidemiological survey program for COVID-19, and the method of cluster random sampling was adopted from March 6 to 15, 2023. Descriptive analysis was used for the basic data, history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, SARS-CoV-2 infection of the respondents. The specific IgG antibody of SARS-CoV-2 was detected using chemiluminescence method. Statistical analysis was performed by using rank sum test, Kruskal Wallis test, and Dunn′s test.Results:The overall positive rate of SARS-CoV-2-specific IgG antibody was 83.35%(4 316/5 178). There were statistically significant differences in the specific IgG antibodies against SARS-CoV-2 produced by people of different sexes, different ages, infected or not, vaccinated or not, and vaccinated with different doses of SARS-CoV-2 vaccine ( Z=3.60, H=195.32, Z=6.10, 18.08, H=382.70, respectively, all P<0.001). The specific IgG antibodies produced by unvaccinated+ uninfected group, unvaccinated+ infected group, vaccinated+ uninfected group, and vaccinated+ infected group were 3.54(0.98, 11.00), 60.65(2.33, 84.80), 133.00(59.80, 173.00), and 142.00(98.30, 176.00), respectively. And the difference was statistically significant( H=354.62, P<0.001). The specific IgG antibodies of uninfected people increased with the increase of inoculum times( H=287.00 and 98.48, both P<0.001). The specific IgG antibodies of people who were not infected with SARS-CoV-2 in the groups of whose interval from the last inoculation of SARS-CoV-2 vaccine to blood collection was less than three months, three to six months and more than six months were 171.86(156.04, 196.57), 71.71(17.08, 110.38) and 132.14(57.59, 172.25), respectively, and the difference was statistically significant ( H=19.93, P<0.001). Among them, the absolute difference between the less than three months group and the three to six months group was statistically significant ( Z=3.67, P<0.001), and the absolute difference between the less than three months group and the more than six months group was statistically significant ( Z=3.47, P<0.001). The specific IgG antibodies level in the less than three months group was the highest. Conclusions:There is a certain correlation between the number of SARS-CoV-2 vaccine doses and the specific IgG antibodies level in uninfected people. The specific IgG antibodies could maintain a high level for three months after immunization.
9.Effect of Licoflavone A on Proliferation and Glycolysis of Gastric Cancer Cells Under Hypoxic Conditions
Huancheng DONG ; Yun SU ; Hongxia GONG ; Wangjie CAO ; Minjie YUAN ; Yongqi LIU ; Yong HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(13):120-127
ObjectiveTo investigate the effects of licoflavone A on the proliferation and glycolysis of gastric cancer cells in the hypoxic environment. MethodHuman gastric cancer AGS cells were classified into five groups: Normoxia, hypoxia, and low-, medium-, and high-dose (25, 50, 100 μmol·L-1, respectively) licoflavone A. The cells in other groups except the normoxia group were cultured in the environment with 5% O2 for 48 h. The cell counting kit-8 (CCK-8) and colony formation assay were employed to examine the proliferation of AGS cells. Cell migration was detected by the scratch assay. The protein and mRNA levels of hypoxia-inducible factor 1-alpha (HIF-1α), glucose transporter 1 (GLUT1), lactate dehydrogenase A (LDHA), pyruvate kinase M2 (PKM2), and hexokinase Ⅱ (HK2) in AGS cells were measured by Western blotting and real-time quantitative polymerase chain reaction (Real-time PCR), respectively. The corresponding kits were used to determine glucose uptake and HK activity. ResultThe CCK-8 results showed that compared with the hypoxia group, the high- and medium-dose licoflavone A groups showed decreased proliferation rate of AGS cells at the time point of 24 h (P<0.01) and all the licoflavone A groups demonstrated decreased proliferation rate at the time point of 48 h (P<0.01). Compared with the normoxia group, the hypoxia group showed increased number of clone formation of AGS cells (P<0.01), which was decreased after the treatment with licoflavone A at high, medium, and low doses (P<0.01). Compared with the normoxia group, the hypoxia group showed increased migration of AGS cells (P<0.01), which was attenuated by the high, medium, and low doses of licoflavone A (P<0.01). Compared with the normoxia group, the hypoxia group showed up-regulated mRNA levels of GLUT1, LDHA, PKM2, and HK2 (P<0.05, P<0.01). Compared with those in the hypoxia group, the mRNA levels of GLUT1, LDHA, PKM2, and HK2 in the high-dose licoflavone A group, GLUT1, LDHA, and HK2 in the medium-dose licoflavone A group, and HK2 in the low-dose licoflavone A group were down-regulated (P<0.05, P<0.01). The protein levels of HIF-1α, GLUT1, LDHA, PKM2, and HK2 in the hypoxia group were higher than those in the normoxia group (P<0.05, P<0.01). Compared with those in the hypoxia group, the protein levels of HIF-1α, GLUT1, LDHA, PKM2, and HK2 in the high-dose licoflavone A group and HK2 in the medium- and low-dose licoflavone A groups were down-regulated (P<0.05, P<0.01). The glucose uptake and HK activity were elevated in the hypoxia group compared with those in the normoxia group (P<0.01). Compared with the hypoxia group, high-dose licoflavone A decreased the glucose uptake and HK activity, and medium-dose licoflavone A decreased the HK activity (P<0.01). ConclusionLicoflavone A inhibits the proliferation of AGS cells under hypoxic conditions by regulating glycolysis in gastric cancer.
10.Therapeutic Effect of Traditional Chinese Medicine on Myocardial Fibrosis Via Modulation of Signaling Pathways: A Review
Jingshun YAN ; Linping ZHU ; Hongxia ZHANG ; Danni HUANG ; Xinliang LYU ; Wenyue LI ; Xiaofeng LI ; Yuhong LI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(13):230-239
Myocardial fibrosis (MF) is a prevalent pathological process in a spectrum of cardiac conditions, including myocardial infarction, hypertensive heart disease, and dilated cardiomyopathy. It is marked by an overabundance of extracellular matrix deposition, diminished myocardial compliance, and impaired cardiac function, which can lead to arrhythmias and sudden cardiac death. The current therapeutic approach primarily aims to suppress the progression of fibrosis, yet the therapeutic outcomes are poor. The pathogenesis of MF involves multiple signaling pathways, including the transforming growth factor-beta (TGF-β)/Smads signaling pathway, nuclear factor-kappa B (NF-κB) signaling pathway, phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, and mitogen-activated protein kinase (MAPK) signaling pathway. Traditional Chinese medicine (TCM) boasts a rich history in the treatment of cardiovascular diseases, offering distinctive benefits such as minimal side effects and high safety, and it has demonstrated promising therapeutic effects in the treatment of MF. In recent years, research has turned its attention to the application of TCM in modulating the signaling pathways associated with MF. It has been demonstrated that TCM can modulate the MF-related signaling pathways to exert anti-inflammatory effects, regulate cellular autophagy, cell proliferation, and apoptosis, reduce myocardial oxidative stress and damage, and inhibit the activation of fibroblasts and collagen synthesis, thereby exhibiting the potential to mitigate or even reverse the progression of MF. Experimental research and clinical observations indicate that TCM formulas such as Yixin Futing decoction, Luhong prescription, Zhilong Huoxue Tongyu capsules, and Kangjian Yixin prescription can effectively ameliorate MF and enhance cardiac function through the multi-component regulation of multiple cellular pathways. Specific TCM constituents, including isoliquiritigenin and astragaloside, have been shown to inhibit the expression of TGF-β1, thereby disrupting the Smad signaling pathway. Compounds like glycyrrhizic acid and allicin can suppress the NF-κB signaling pathway and curtail collagen synthesis in myocardial cells, and forsythoside can activate the PI3K/Akt signaling pathway, contributing to its anti-fibrotic effects.

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