ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract（PAE） against human-derived lung adenocarcinoma organoids（LUAD-PDOs） and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid（Nor-PDOs） models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8（CCK-8） assay. Experimental groups included the model group（LUAD-PDOs）， normal group， model administration group（LUAD-PDOs+PAE）， and normal administration group（Nor-PDOs+PAE）. Hematoxylin-eosin（HE） staining was used to observe the pathological structures of PDOs， immunohistochemistry（IHC） was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7（CK-7） and Napsin A， TUNEL staining was applied to detect cell apoptosis. RNA sequencing（RNA-Seq） was conducted to identify differentially expressed genes（DEGs）， followed by Gene Ontology（GO）， Kyoto Encyclopedia of Genes and Genomes（KEGG）， and Gene Set Enrichment Analysis（GSEA）， alongside protein-protein interaction（PPI） network analysis to screen core mechanisms. Finally， key targets were validated by integrating external database analysis with immunofluorescence（IF）. ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L^-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures， whereas LUAD-PDOs displayed dense， solid structures. CCK-8 and TUNEL assays revealed that， compared with the model group， PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells， while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention（347 up-regulated and 372 down-regulated）（P<0.05）. GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism， including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway（P<0.05）. PPI network analysis indicated that breast cancer type 1 susceptibility protein（BRCA1） and checkpoint kinase 1（CHEK1） were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention（P<0.05）. Furthermore， survival analysis based on The Cancer Genome Atlas（TCGA） database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD（P<0.05）. ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis， its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway， with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.

ObjectiveTo characterize the evidence distribution and methodological quality of randomized controlled trials （RCTs） on oral Chinese herbal medicine （CHM） for atopic dermatitis （AD） based on evidence mapping. MethodsSeven databases （CNKI， Wanfang Data， VIP， CBM， Cochrane Library， PubMed， and Embase） and the Chinese Clinical Trial Registry were searched for the RCTs in Chinese and English. Evidence distribution was presented graphically and textually， and methodological quality was assessed via the Cochrane Risk of Bias tool （ROB 1.0）. ResultsA total of 168 RCTs were included. The number of annual publications showing an increasing trend， and 72.6% RCTs had sample sizes of 51-100 participants. The studies evaluated 108 distinct CHM interventions categorized as decoctions， granules， Chinese patent medicines， and extracts. Compound Glycyrrhizin was the most frequently used， followed by Xiaofengsan and Chushi Weiling decoction. Among the RCTs， 57.1% had the treatment courses of 4-8 weeks. Outcome measures predominantly focused on clinical response rate， skin lesion severity scores， and adverse events， with less attention to TCM symptom scores， skin barrier function， and relapse rates. The overall risk of bias was generally high. ConclusionWhile CHM for AD is a research hotspot and demonstrates clinical advantages， the related studies have problems such as unclear clinical positioning， poor research standardization and methodological quality， and insufficient prominence of TCM clinical advantages. Large-sample， methodologically rigorous， and high-quality studies are needed to enhance the evidence base for CHM in treating AD.

ObjectiveTo characterize the evidence distribution and methodological quality of randomized controlled trials （RCTs） on oral Chinese herbal medicine （CHM） for atopic dermatitis （AD） based on evidence mapping. MethodsSeven databases （CNKI， Wanfang Data， VIP， CBM， Cochrane Library， PubMed， and Embase） and the Chinese Clinical Trial Registry were searched for the RCTs in Chinese and English. Evidence distribution was presented graphically and textually， and methodological quality was assessed via the Cochrane Risk of Bias tool （ROB 1.0）. ResultsA total of 168 RCTs were included. The number of annual publications showing an increasing trend， and 72.6% RCTs had sample sizes of 51-100 participants. The studies evaluated 108 distinct CHM interventions categorized as decoctions， granules， Chinese patent medicines， and extracts. Compound Glycyrrhizin was the most frequently used， followed by Xiaofengsan and Chushi Weiling decoction. Among the RCTs， 57.1% had the treatment courses of 4-8 weeks. Outcome measures predominantly focused on clinical response rate， skin lesion severity scores， and adverse events， with less attention to TCM symptom scores， skin barrier function， and relapse rates. The overall risk of bias was generally high. ConclusionWhile CHM for AD is a research hotspot and demonstrates clinical advantages， the related studies have problems such as unclear clinical positioning， poor research standardization and methodological quality， and insufficient prominence of TCM clinical advantages. Large-sample， methodologically rigorous， and high-quality studies are needed to enhance the evidence base for CHM in treating AD.

Objective:To investigate the preferences and influencing factors of Traditional Chinese Medicine(TCM)health management services among community healthcare workers,providing a reference for promoting and spreading TCM health management services in communities.Methods:Based on a discrete choice experiment,a questionnaire survey was conducted among 596 community healthcare workers across 9 administrative districts in Beijing.A mixed logit model was used to analyze their preferences.Results:Changes in post-tax monthly income,expected efficacy,single-service duration,technical difficulty,patient compliance,and insurance coverage significantly influenced community doctors'service preferences.Changes in post-tax monthly income had the highest relative importance(35.11%),followed by insurance coverage(34.87%).Preferences varied among healthcare workers with different professional titles,backgrounds,weekly working hours,and whether the service was included in performance evaluations.Conclusion:Both economic and non-economic factors influence community healthcare workers'service preferences to varying degrees.Optimizing the combination of TCM health management service attributes can enhance community healthcare workers'willingness to provide such services.It is recommended to use a combination of economic and non-economic incentive measures and develop differentiated strategies for healthcare workers with different characteristics to meet their service preferences and promote the development of TCM health management services in communities.

BACKGROUND:How to improve the expansion of cells,reduce cell loss,increase homing rate and reduce apoptosis is the main problem in the preclinical research of human umbilical cord mesenchymal stem cells.Ginsenoside Rg1 can promote the proliferation and differentiation of mesenchymal stem cells in different microenvironments in vitro or in vivo,which may be a candidate drug to improve the efficiency of human umbilical cord mesenchymal stem cell transplantation.OBJECTIVE:To investigate the effect of human umbilical cord mesenchymal stem cells co-culture combined with ginsenoside Rg1 on pentobarbital sodium induced heart failure cell model.METHODS:H9C2 cells were divided into five groups:Control group,pentobarbital sodium group,human umbilical cord mesenchymal stem cell group,ginsenoside Rg1 group,and human umbilical cord mesenchymal stem cell+ginsenoside Rg1 group.H9C2 cells in the control group were cultured in normal DMEM for 24 hours.H9C2 cells in the other groups were cultured in DMEM containing 0.8％pentobarbital sodium for 7 minutes to establish a heart failure cell model.After modeling,above models were treated with human umbilical cord mesenchymal stem cells,ginsenoside Rg1,or their combination.CCK-8 assay and EdU staining were used to detect cell proliferation.TUNEL assay was used to detect cell apoptosis.Na+-K+-ATPase and Ca2+-Mg2+-ATPase activities were detected according to kit instructions.The mRNA levels of tumor necrosis factor α,interleukin 1β,and interleukin 6 in the supernatant were determined by ELISA.The mRNA levels of tumor necrosis factor α,interleukin 1β,interleukin 6,Bax,and Bcl2 in the cells were determined by RT-qPCR.The protein levels of Bax,Bcl2,Toll-like receptor 4,p65,and p-p65 were determined by western blot assay.RESULTS AND CONCLUSION:(1)Compared with the pentobarbital sodium group,H9C2 cell viability and EdU positive rate were increased;TUNEL positive rate and Bax mRNA and protein expression were decreased,and Bcl-2 mRNA and protein expression were increased;Na+-K+-ATPase activity decreased;Ca2+-Mg2+-ATPase activity increased;tumor necrosis factor α,interleukin-1β,and interleukin-6 levels decreased in H9C2 cell supernatant,and tumor necrosis factor α,interleukin-1β,and interleukin-6 mRNA expression decreased in H9C2 cells;the expression of toll-like receptor 4 and P-P65 protein decreased with significant difference in human umbilical cord mesenchymal stem cell group,ginsenoside Rg1 group and human umbilical cord mesenchymal stem cell+ginsenoside Rg1 group(P＜0.05).(2)Compared with human umbilical cord mesenchymal stem cell group and ginsenoside Rg1 group,the above indexes in human umbilical cord mesenchymal stem cells+ginsenoside Rg1 group were further improved(P＜0.05).The results showed that human umbilical cord mesenchymal stem cells combined with ginsenoside Rg1 promoted the viability of heart failure cells induced by pentobarbital sodium and inhibited inflammation mediated by the Toll-like receptor 4/nuclear factor κB pathway.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Objective To evaluate the efficacy and safety of ibuprofen in treating hemodynamically significant patent ductus arteriosus(hsPDA)in preterm infants of different postnatal ages at treatment initiation.Methods Clinical records of infants with gestational age<37 weeks who received ibuprofen for hsPDA in the Department of Neonatology,Fourth Hospital of Shijiazhuang,from January 2020 to December 2023 were retrospectively reviewed.One hundred eligible infants were divided by the postnatal age at the first ibuprofen administration into three groups:group A(≤4 days),group B(5-7 days),and group C(>7 days).Clinical efficacy and safety indicators were compared among groups.Results After treatment,cure rates were 92%in group A,72%in group B,and 60%in group C,and effective rates were 8%,25%,and 33%,respectively.Differences in clinical efficacy among the three groups were statistically significant(P<0.05).No significant differences were observed among groups in the incidence of pulmonary hemorrhage,gastrointestinal bleeding,cholestasis,bronchopulmonary dysplasia,necrotizing enterocolitis,intracranial hemorrhage,or acute kidney injury(P>0.05).Conclusions For hsPDA requiring pharmacologic therapy,earlier oral ibuprofen administration yields a higher ductal closure rate and does not increase the incidence of adverse events.

Aim To clarify the mechanism by which Qishen Yixin Granules improved microcirculation vas-cular endothelial dysfunction(VED)in mice,through activating the Nrf2/HO-1 signaling pathway to regulate oxidative stress.Methods C57 mice were randomly divided into six groups:blank group,model group,pos-itive drug group,and low-,medium-,and high-dose groups of Qishen Yixin Granules.The VED model was established by long-term infusion of Ang Ⅱ combined with a high-fat diet.Each treatment group received the corresponding drug intervention.After four weeks of drug intervention,cardiac function was assessed by echocardiography.Carstairs staining was used to ob-serve the formation of microthrombi in myocardial tis-sue.The micro vascular ischemia was evaluated by Hei-denhain staining.The ultrastructure of endothelial cells was observed by electron microscopy.The levels of EMPs,ROS,NO,ET-1,TF,TM,VWF,and TXA2 in serum were measured by ELISA.The expression levels of MDA,SOD,and GSH-Px in mouse heart tissue were determined by chemical methods.Cardiac microvascu-lar density and the expression of Nrf2,Keap1,and HO-1 proteins were detected by Immunohistochemical stai-ning.The protein expressions of Keap1,cytoplasmic Nrf2,nuclear Nrf2,and HO-1 in myocardial tissue were detected by Western blot.Results Qishen Yixin Granules could effectively improve the cardiac function of mice,alleviate the damage of endothelial cells and endothelial function.They could up-regulate serum NO levels and the activities of antioxidant enzymes SOD and GSH-Px,while down-regulating the expression of ROS and vascular inflammatory injury factors such as ET-1,VWF,TXA2,TF,TM,and EMPs.Qishen Yixin Granules also increased the positive counts of CD34,Nrf2,and HO-1,as well as microvessel density.Fur-thermore,they inhibited the expression of MDA,Keap1,and cytoplasmic Nrf2 protein in myocardial tis-sue,while increasing the expression of nuclear proteins HO-1 and Nrf2.Conclusions Qishen Yixin Granules may inhibit oxidative stress and inflammatory response by regulating the Nrf2/HO-1 signaling pathway,thereby improving vascular endothelial damage and cardiac function in VED mice.

Objective:To assess the efficacy and safety of Gongxuening Capsules in reducing post-abortion bleeding following artificial abortion.Methods:A multicenter, randomized, double-blind study was conducted. From May 31, 2022 to March 31, 2023, 484 women who underwent vacuum aspiration abortion for early intrauterine pregnancy were enrolled in 11 centers and randomly assigned to control group and the study group at a 1∶1 ratio using a center-block randomization method. Control group were administered a placebo of Gongxuening Capsules for 9 d, while the study group received the actual Gongxuening Capsules for the same duration. The outcomes measured included vaginal bleeding volume, duration of vaginal bleeding, endometrial thickness, time to menstrual recovery, and complications.Results:1) A total of 484 subjects were enrolled, and 472 completed the study. Totally 450 subjects were included in the efficacy analysis set, with 224 in control group and 226 in the study group; 468 subjects were included in the safety analysis set, with 236 in control group and 232 in the study group. The baseline characteristics of the two groups were comparable (all P>0.05). 2) The vaginal bleeding volume was lower in the study group [(13.30±12.14) mL] than in control group [(19.00±17.67) mL, P<0.001]. The proportion of subjects in the study group with bleeding days less than 4 d [29.65% (67/226)] was higher than that in control group [19.20% (43/224), P=0.010]. 3) No significant differences were observed between the two groups in terms of time to menstrual recovery and endometrial thickness (all P>0.05). 4) In the study group, 3 subjects experienced non-therapeutic-related complications, while 11 subjects in control group. The incidence of complications was lower in the study group [1.29% (3/232)] than in control group [4.66% (11/236), P=0.033]. Conclusion:The administration of Gongxuening Capsules to women following artificial abortion significantly reduced vaginal bleeding volume and was associated with good safety, with the treatment being well-tolerated by the subjects.

Aim To investigate the effects of astragalo-side Ⅳ(AS-Ⅳ)on proliferation,apoptosis and the discoid domain receptor 1/phosphatidylinositol 3-ki-nase/protein kinase B(DDR1/PI3K/Akt)signaling pathway of HL-60 cells in acute myeloid leukemia.Methods The experiment was divided into the control group(Control),AS-Ⅳ intervention group,control+DDR1 gene interference group(Control+sh-DDR1),AS-Ⅳ+DDR1 gene overexpression group(AS-Ⅳ+OVE-DDR1)and AS-Ⅳ+OVE-DDR1+PI3K inhibi-tor group(AS-Ⅳ+OVE-DDR1+LY294002).After 72 h of AS-Ⅳ intervention,the proliferation inhibition rate was measured by CCK-8;apoptosis was detected by flow cytometry and Hoechst33258 staining;and the expression levels of DDR1/PI3K/Akt signaling path-way proteins,proliferation and apoptosis-related pro-teins were detected by Western blot.Results Com-pared with the Control group,the AS-Ⅳ group showed significantly lower proliferation rate and higher apopto-sis rate(P＜0.01),cells showed apopt otic morpholog-ical changes such as nuclear sequestration and nuclear fragmentation,and the expression of DDR1,p-PI3K,p-Akt,CyclinD1 and Bcl-2 proteins were significantly lower and caspase-3 protein expression was significant-ly higher(P＜0.01).Compared with the AS-Ⅳ group,cell proliferation rate was significantly higher and apoptosis rate was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly higher and Bcl-2 protein expression was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01).Compared with the AS-Ⅳ+OVE-DDR1 group,the cell proliferation rate was significantly lower and apoptosis rate was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly lower and Bcl-2 protein expression was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01).Conclu-sion AS-Ⅳ can inhibit proliferation and promote ap-optosis in acute myeloid leukemia HL-60 cells by a mechanism related to the inhibition of DDR1/PI3K/Akt signaling pathway.