Tripterygium wilfordii is a traditional Chinese medicinal herb with a long history of therapeutic use but remains controversial in modern medicine because of its potent toxicity. Among its diverse chemical constituents, the diterpenoid triptolide and the triterpenoid celastrol have emerged as prominent compounds due to their remarkable pharmacological activities, including antitumor, immunosuppressive, anti-obesity, and neuroprotective effects. However, their clinical translation is limited by toxicity concerns and restricted natural availability. This review summarizes the medicinal history and chemical constituents of T. wilfordii, with particular emphasis on the pharmacological mechanisms, structural modification strategies, and recent advances in the biosynthesis of triptolide and celastrol. In addition, we discuss perspectives on toxicity mitigation and lead compound development, aiming to provide theoretical guidance and valuable references for modern drug development and the green manufacturing of T. wilfordii-derived resources.

Adipose tissue macrophages (ATMs) are crucial immunomodulatory factors in the adipose tissue (AT) microenvironment, playing an irreplaceable role in maintaining the balance of the local immune system and regulating metabolic homeostasis. Under obese conditions, the excessive accumulation of lipids leads to abnormal expansion of adipose tissue, which further disrupts the homeostasis of the local microenvironment, including the imbalance of inflammatory factors, the occurrence of oxidative stress, and the damage of microcirculation. As an essential immune cell population in adipose tissue, ATMs are deeply involved in the occurrence and progression of metabolic disorders and multiple obesity-related diseases, and their functional abnormalities are closely related to the initiation and development of adipose tissue inflammation and systemic metabolic disorders. The interaction between ATMs and adipokines, including adiponectin, leptin, resistin and retinol-binding protein 4 (RBP4), acts as the core immunological and molecular mechanism linking adipose tissue inflammation to continuous disease deterioration, and this interaction is also a key research focus in the field of obesity-related diseases in recent years. This review discusses in detail the facilitating effect of the AT inflammatory microenvironment on the differentiation of peripheral monocytes into ATMs, elaborating on the specific molecular mechanisms by which various inflammatory mediators and abnormal metabolic products in the inflammatory microenvironment induce the differentiation of peripheral monocytes into functional ATMs. It also focuses on the regulatory mechanisms of chemokine-mediated ATM polarization and recruitment, including the specific roles of key chemokines like monocyte chemoattractant protein‑1 (MCP-1) and C‑X‑C motif chemokine ligand 10 (CXCL10) in mediating the recruitment of ATMs to adipose tissue, as well as the molecular pathways that regulate the switch between M1 pro-inflammatory phenotype and M2 anti-inflammatory phenotype of ATMs. In addition, this review explores the specific process by which ATMs trigger AT inflammation by secreting various pro-inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-1β, which further amplify the local inflammatory response and disrupt the metabolic homeostasis of adipose tissue. Furthermore, it analyzes the specific binding patterns and molecular characteristics of adiponectin, leptin, resistin and RBP4 with ATM surface receptors, and clarifies how the activation of downstream immune signaling pathways, such as Janus kinase‑signal transducer and activator of transcription (JAK-STAT), nuclear factor‑κB (NF‑κB), and phosphatidylinositol 3‑kinase‑protein kinase B (PI3K-AKT), triggered by these binding processes, induces the occurrence and development of various obesity-related diseases, including insulin resistance, cancer, metabolic-associated steatohepatitis (MASH) and cardiovascular diseases. This paper highlights the unique and crucial role of the interaction between ATMs and adipokines in the occurrence and progression of obesity-related diseases, emphasizing that this interaction is a key link connecting local adipose tissue inflammation to systemic metabolic disorders. It further summarizes the potential therapeutic strategies targeting the ATM-adipokine axis, and comprehensively illustrates three major clinical application barriers, namely biological complexity, technical bottlenecks, and clinical translation obstacles, in the process of applying these therapeutic strategies. For each barrier, this review puts forward corresponding feasible solutions and clear research directions, which not only enrich the theoretical system of the ATM-adipokine axis in the field of obesity research, but also provide a solid theoretical basis and practical ideas for the clinical intervention, prevention and treatment of obesity and its related diseases.

Traditional mass measurement methods are not applicable in microgravity environments,and the main challenge for in-orbit body mass measurement technology based on inertial principles is to address the random errors brought about by the weightless environment.These include additional torques due to shifts in the center of mass,nonlinear accelerations due to non-rigid human bodies,mechanical energy consumption due to organ vibrations,and random vibrations of the measurement device itself.To address the above difficulties,the project proposes a technical scheme based on the principle of linear acceleration,designs and constructs a ground-specific air-floating experimental and simulation platform,studies key data such as motion trajectory,acceleration change,and vibration frequency amplitude during the mass measurement process,and simulates the changes in the center of mass and random vibrations of the human body in a weightless environment.The project has designed an adjustable posture bracket to adapt to changes in the center of mass,enhance body restraint,and greatly reduce shaking;it has also developed an integrated four-bar linkage motion guidance mechanism,high-precision integrated photoelectric distance measurement,and modular motion constant force measurement device to ensure the accurate measurement of acceleration and constant force data.The product has undergone simulation calculations,ground human applicability tests,and in-orbit applicability verification in the space station.Ground test results show that the device achieves a body mass measurement accuracy better than 0.5%,and the dispersion is better than 0.38%;after flight mission verification and evaluation,the in-orbit body mass measurement dispersion is less than 0.4%,which is superior to the SLAMMD,a mass measurement device of the same principle on the International Space Station,and is at the forefront internationally,achieving accurate body mass measurement.

Calvarial stem cells are essential for maintaining the health and function of the craniofacial complex and the central nervous system.Under physiological conditions,these stem cells primarily reside within specialized microenvironments known as stem cell niches,located in the bone marrow,periosteum,and sutures of cranial bones.The heterogeneous cellular populations within the microenvironment dynamically regulate the quantity and function of stem cells.Due to their distinct spatial distribution,these stem cells exhibit unique functional characteristics and play crucial roles in the development and progression of various diseases,as well as in relevant therapeutic applications.Herein,we summarize the latest research advances concerning various types of calvarial stem cells,elaborating on their respective functions,microenvironmental regulation,and therapeutic potential,thereby providing new perspectives for both basic research and clinical applications in this field.

Objective To explore the differences in positive psychological resources among elementary and secondary school students with and without non-suicidal self-injury(NSSI)behaviors.Methods Between September and October 2023,the assessment data of 56 870 students aged 9 to 18 years in Chengdu,Sichuan Province were collected.The R software package was used to evaluate the network structure and symptom centrality,and the global strength and structural differences of the networks of students with and without NSSI behaviors in elementary,junior high,and senior high schools were compared.Results The prevalence of NSSI among elementary and secondary school students stands at 12.21%.Specifically,it peaks in junior high school students,reaching 14.22%,followed by that in senior middle school students at 13.66%,and is lowest in elementary school students at 10.17%.Regarding the network structure in elementary school students,irrespective of the presence or absence of NSSI behavior,subjective support exhibits the strongest network strength,and family functioning demonstrates the highest closeness centrality.Among junior high school students without NSSI behaviors,the strongest network strength was observed in subjective support,whereas for those with NSSI behaviors,self-esteem showed the strongest network strength.In addition,subjective support exhibited the highest closeness centrality in both groups.In senior high school students,self-esteem was the factor with the strongest network strength for students with or without NSSI behaviors.For senior high school students without NSSI,subjective support had the highest closeness centrality,while for those with NSSI,expressive suppression showed the highest closeness centrality.The edge weights differed significantly among elementary school students in family functioning-self-esteem(E=0.093)and family functioning-objective support(E=0.087).For junior high school students,significant differences were found in objective support-subjective support(E=0.131)and family functioning-impulse control(E=0.109).Among senior high school students,significant differences were observed in impulse control-family function(E=0.133)and subjective support-utilization of support(E=0.130)(P<0.05).Conclusion Excessive family involvement in elementary school students and expressive suppression in senior high school students may be important influencing factors for NSSI behaviors.The lack of social support has a greater impact on junior and senior high school students.The strength of the connection among subjective support,objective support,and utilization of support is an important indicator.

Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students' spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P＜0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P＜0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.

The study aims to examine the effects and potential mechanisms of disulfiram (DSF) on cardiac hypertrophic injury, focusing on the role of transforming growth factor-β-activated kinase 1 (TAK1)-mediated pan-apoptosis (PANoptosis). H9C2 cardiomyocytes were treated with angiotensin II (Ang II, 1 µmol/L) to establish an in vitro model of myocardial hypertrophy. DSF (40 µmol/L) was used to treat cardiomyocyte hypertrophic injury models, either along or in combination with the TAK1 inhibitor, 5z-7-oxozeaenol (5z-7, 0.1 µmol/L). We assessed cell damage using propidium iodide (PI) staining, measured cell viability with CCK8 assay, quantified inflammatory factor levels in cell culture media via ELISA, detected TAK1 and RIPK1 binding rates using immunoprecipitation, and analyzed the protein expression levels of key proteins in the TAK1-mediated PANoptosis pathway using Western blot. In addition, the surface area of cardiomyocytes was measured with Phalloidin staining. The results showed that Ang II significantly reduced the cellular viability of H9C2 cardiomyocytes and the binding rate of TAK1 and RIPK1, significantly increased the surface area of H9C2 cardiomyocytes, PI staining positive rate, levels of inflammatory factors [interleukin-1β (IL-1β), IL-18, and tumor necrosis factor α (TNF-α)] in cell culture media and p-TAK1/TAK1 ratio, and significantly up-regulated key proteins in the PANoptosis pathway [pyroptosis-related proteins NLRP3, Caspase-1 (p20), and GSDMD-N (p30), apoptosis-related proteins Caspase-3 (p17), Caspase-7 (p20), and Caspase-8 (p18), as well as necroptosis-related proteins p-MLKL, RIPK1, and RIPK3]. DSF significantly reversed the above changes induced by Ang II. Both 5z-7 and exogenous IL-1β weakened these cardioprotective effects of DSF. These results suggest that DSF may alleviate cardiac hypertrophic injury by inhibiting TAK1-mediated PANoptosis.
Animals ; MAP Kinase Kinase Kinases/physiology* ; Rats ; Myocytes, Cardiac/pathology* ; Disulfiram/pharmacology* ; Cardiomegaly ; Apoptosis/drug effects* ; Cell Line ; Angiotensin II ; Necroptosis/drug effects* ; Interleukin-1beta/metabolism* ; Receptor-Interacting Protein Serine-Threonine Kinases/metabolism* ; Lactones ; Resorcinols ; Zearalenone/administration & dosage*

This study employed the "disease-medicine-dose" pattern to mine the medication rules of traditional Chinese medicine(TCM) prescriptions containing Astragali Radix in ancient Chinese medical books, aiming to provide a scientific basis for the clinical application of Astragali Radix and the development of new medicines. The TCM prescriptions containing Astragali Radix were retrieved from databases such as Chinese Medical Dictionary and imported into Excel 2020 to construct the prescription library. Statical analysis were performed for the prescriptions regarding the indications, syndromes, medicine use frequency, herb effects, nature and taste, meridian tropism, dosage forms, and dose. SPSS statistics 26.0 and IBM SPSS Modeler 18.0 were used for association rules analysis and cluster analysis. A total of 2 297 prescriptions containing Astragali Radix were collected, involving 233 indications, among which sore and ulcer, consumptive disease, sweating disorder, and apoplexy had high frequency(>25), and their syndromes were mainly Qi and blood deficiency, Qi and blood deficiency, Yin and Yang deficiency, and Qi deficiency and collateral obstruction, respectively. In the prescriptions, 98 medicines were used with the frequency >25 and they mainly included Qi-tonifying medicines and blood-tonifying medicines. Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Ginseng Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, and Citri Reticulatae Pericarpium were frequently used. The medicines with high frequency mainly have warm or cold nature, and sweet, pungent, or bitter taste, with tropism to spleen, lung, heart, liver, and kidney meridians. In the treatment of sore and ulcer, Astragali Radix was mainly used with the dose of 3.73 g and combined with Glycyrrhizae Radix et Rhizoma to promote granulation and heal up sores. In the treatment of consumptive disease, Astragali Radix was mainly used with the dose of 37.30 g and combined with Ginseng Radix et Rhizoma to tonify deficiency and replenish Qi. In the treatment of sweating disorder, Astragali Radix was mainly used with the dose of 3.73 g and combined with Glycyrrhizae Radix et Rhizoma to consolidate exterior and stop sweating. In the treatment of apoplexy, Astragali Radix was mainly used with the dose of 7.46 g and combined with Glycyrrhizae Radix et Rhizoma to dispell wind and stop convulsions. Astragali Radix can be used in the treatment of multiple system diseases, with the effects of tonifying Qi and ascending Yang, consolidating exterior and stopping sweating, and expressing toxin and promoting granulation. According to the manifestations of different diseases, when combined with other medicines, Astragali Radix was endowed with the effects of promoting granulation and healing up sores, tonifying deficiency and Qi, consolidating exterior and stopping sweating, and dispelling wind and replenishing Qi. The findings provide a theoretical reference and a scientific basis for the clinical application of Astragali Radix and the development of new medicines.
Drugs, Chinese Herbal/history* ; Humans ; Medicine, Chinese Traditional/history* ; History, Ancient ; Astragalus Plant/chemistry* ; China ; Astragalus propinquus

This study explored the prescription pattern of traditional Chinese medicine(TCM) in the treatment of hypertensive left ventricular hypertrophy(LVH), so as to provide a relevant theoretical basis for the clinical diagnosis and treatment of hypertensive LVH. The study systematically searched the databases of CNKI, Wanfang, VIP, and SinoMed to screen out the qualified literature on TCM treatment of hypertensive LVH and used Microsoft Excel 2021 to establish the relevant prescription database. It also counted the frequency, property, flavor, and meridian affiliation of TCM in the prescriptions and classified their efficacy. The study used Lantern 5.0 and Rstudio software to analyze the hidden structural models and association rules of the high-frequency TCM with a frequency of >3.50% and adopted Origin 2024 software to visualize the data, so as to explore the prescription pattern of TCM in treating hypertensive LVH. The results showed that a total of 128 TCM prescriptions were included, involving 163 TCM with a total frequency of 1 242. The high-frequency TCM included Salviae Miltiorrhizae Radix et Rhizoma, Uncariae Ramulus Cum Uncis, Gastrodiae Rhizoma, Poria, and Chuanxiong Rhizoma, with the main efficacy from blood-activating and stasis-resolving herbs, tonic herbs, and liver-calming and wind-extinguishing herbs. The latent structure analysis(LSA) identified 10 latent variables, 20 latent classes, 7 comprehensive clustering models, and 23 core prescriptions. It was speculated that the common syndromes of hypertensive LVH included blood stasis obstructing the collaterals, ascending hyperactivity of liver Yang, Yin deficiency with Yang hyperactivity, and intermingled phlegm and blood stasis. The association rule analysis yielded 33 strong association rules, with the highest comprehensive association rule being Gastrodiae Rhizoma→Uncariae Ramulus Cum Uncis. Hypertensive LVH is characterized by asthenia in origin and asthenia in superficiality, with Yin deficiency and Qi deficiency as the origin and blood stasis and phlegm as the superficiality. Clinical treatment focuses on activating blood circulation, resolving stasis, tonifying Qi, and nourishing Yin, combined with syndrome-specific therapies such as calming wind and stopping convulsions, clearing heat, eliminating dampness and resolving phlegm, and promoting diuresis and reducing swelling.
Drugs, Chinese Herbal/therapeutic use* ; Data Mining ; Humans ; Hypertension/complications* ; Hypertrophy, Left Ventricular/physiopathology* ; Medicine, Chinese Traditional ; Drug Prescriptions

Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome