Glucocorticoid-induced osteoporosis(GIOP) is a serious metabolic bone disease caused by long-term application of glucocorticoids(GCs). Traditional Chinese medicine(TCM) has unique advantages in improving bone microstructure and antagonizing hormone toxicity. This paper systematically reviews the theoretical research, clinical application, and basic research progress of TCM intervention in GIOP. In terms of theoretical research, the theory of "kidney governing bone and generating marrow" indicates that the kidney is closely related to bone development, revealing that core pathogenesis of GIOP is Yin-Yang disharmony, which can be discussed using the theories of "Yin fire", "ministerial fire", and "Yang pathogen damaging Yin". Thus, regulating Yin and Yang is the basic principle to treat GIOP. In terms of clinical application, effective empirical prescriptions(such as Bushen Zhuanggu Decoction, Bushen Jiangu Decoction, and Zibu Ganshen Formula) and Chinese patent medicines(Gushukang Capsules, Hugu Capsules, Xianling Gubao Capsules, etc.) can effectively increase bone mineral density(BMD) and improve calcium and phosphorus metabolism. The combination of traditional Chinese and western medicine can reduce the risk of fracture and play an anti-GIOP role. In terms of basic research, it has been clarified that active ingredients of TCM(such as fraxetin, ginsenoside Rg_1, and salidroside) reduce bone loss and promote bone formation by inhibiting oxidative stress, ferroptosis, and other pathways, effectively improving bone homeostasis. Additionally, classical prescriptions(Modified Yiguan Decoction, Modified Qing'e Pills, Zuogui Pills, etc.) and Chinese patent medicines(Gushukang Granules, Lurong Jiangu Dropping Pills, Gubao Capsules, etc.) can improve bone marrow microcirculation, promote osteoblast differentiation, and inhibit bone cell apoptosis through multiple pathways, multiple targets, and multiple mechanisms. Through the above three aspects, the TCM research status on GIOP is elucidated in the expectation of providing reference for its diagnosis and treatment using traditional Chinese and western medicine treatment programs.
Osteoporosis/physiopathology* ; Humans ; Glucocorticoids/adverse effects* ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Medicine, Chinese Traditional ; Bone Density/drug effects*

OBJECTIVE: To evaluate the short-and medium-term efficacy of posterior medial branch block in the treatment of persistent pain after percutaneous vertebral augmentation. METHODS: From January 2018 to January 2023, a total of 1, 062 patients with osteoporotic vertebral compression fractures underwent percutaneous vertebral augmentation. Among them, 32 elderly patients who experienced persistent low back pain after surgery and subsequently received posterior medial branch block and cryoablation were included. Six patients died during follow-up, leaving 26 patients for final analysis (1 male, 25 females). The mean age was (82.96±5.66) years (ranged, 76 to 94 years). The mean body mass index was (23.76±3.08) kg·m^-2(ranged 18.1 to 27.2 kg·m^-2). The bone mineral density T-value ranged from -2.5 to -4.3 with a mean of (-3.09±0.56). The mean volume of bone cement injected was 6.00 (5.38, 7.00) ml. Fracture locations were T₁₁ (2 cases), T₁₂ (7 cases), L₁ (10 cases), L₂ (6 cases), and L₃ (1 case). The mean interval from vertebral augmentation to block treatment was (7.12±2.22) months (rangd 6 to 12 months). The vertebral augmentation procedures were percutaneous kyphoplasty(PKP) in 12 cases and percutaneous vertebroplasty (PVP) in 14 cases. At the 2nd week, 3rd month, and 6th month after the block, the numerical rating scale(NRS), Oswestry disability index(ODI), patient satisfaction, and pain relief rate at the 6th month were evaluated. Relationships between pain relief rate at the 6th month after the last treatment and possible influencing factors were analyzed. RESULTS: Compared with X-ray films after percutaneous vertebral augmentation, the X-ray films before block showed an increase in kyphotic angle and vertebral compression rate, with statistically significant differences(P<0.05). At the 2nd week, 3rd month, and 6th month after posterior medial branch block and cryoablation, NRS and ODI scores were significantly lower than before the block(P<0.05). Among the 26 patients, 5 received additional cryoablation. At the 6th month after the last treatment, 19 patients reported excellent or good satisfaction. Univariate binary Logistic analysis showed all P>0.05, and no independent factor affecting final satisfaction or pain relief at 6 months after the last treatment was identified. CONCLUSION Posterior medial branch block(with cryoablation) can effectively improve short-and medium-term symptoms and function in patients with persistent axial low back pain after percutaneous vertebral augmentation for osteoporotic vertebral fractures.
Humans ; Male ; Female ; Aged ; Spinal Fractures/surgery* ; Aged, 80 and over ; Osteoporotic Fractures/surgery* ; Vertebroplasty/adverse effects* ; Nerve Block/methods*

OBJECTIVE: To explore and verify the effect and potential mechanism of Brucea javanica Seed Oil Emulsion Injection (YDZI) and Shengmai Injection (SMI) on peripheral microcirculation dysfunction in treatment of gastric cancer (GC). METHODS: The potential mechanisms of YDZI and SMI were explored through network pharmacology and verified by cellular and clinical experiments. Human microvascular endothelial cells (HMECs) were cultured for quantitative real-time polymerase chain reaction, Western blot analysis, and human umbilical vein endothelial cells (HUVECs) were cultured for tube formation assay. Twenty healthy volunteers and 97 patients with GC were enrolled. Patients were divided into surgical resection, surgical resection with chemotherapy, and surgical resection with chemotherapy combining YDZI and SMI groups. Forearm skin blood perfusion was measured and recorded by laser speckle contrast imaging coupled with post-occlusive reactive hyperemia. Cutaneous vascular conductance and microvascular reactivity parameters were calculated and compared across the groups. RESULTS: After network pharmacology analysis, 4 ingredients, 82 active compounds, and 92 related genes in YDZI and SMI were screened out. β-Sitosterol, an active ingredient and intersection compound of YDZI and SMI, upregulated the expression of vascular endothelial growth factor A (VEGFA) and prostaglandin-endoperoxide synthase 2 (PTGS2, P<0.01), downregulated the expression of caspase 9 (CASP9) and estrogen receptor 1 (ESR1, P<0.01) in HMECs under oxaliplatin stimulation, and promoted tube formation through VEGFA. Chemotherapy significantly impaired the microvascular reactivity in GC patients, whereas YDZI and SMI ameliorated this injury (P<0.05 or P<0.01). CONCLUSIONS YDZI and SMI ameliorated peripheral microvascular reactivity in GC patients. β-Sitosterol may improve peripheral microcirculation by regulating VEGFA, PTGS2, ESR1, and CASP9.
Humans ; Microcirculation/drug effects* ; Drugs, Chinese Herbal/administration & dosage* ; Stomach Neoplasms/physiopathology* ; Emulsions ; Male ; Plant Oils/administration & dosage* ; Brucea/chemistry* ; Middle Aged ; Female ; Drug Combinations ; Human Umbilical Vein Endothelial Cells/metabolism* ; Seeds/chemistry* ; Injections ; Vascular Endothelial Growth Factor A/metabolism* ; Aged ; Network Pharmacology

Curcumae Rhizoma, derived from the rhizome of Curcuma phaeocaulis, Curcuma kwangsiensis and Curcuma wenyujin, was called Ezhu in China. In the past, Curcumae Rhizoma extracts were obtained through water decoction or alternative methods, which showed significant anti-cancer effects. However, the mixed extracts contain various compound components of Curcumae Rhizoma, leading to an ambiguous mechanism of action for Curcumae Rhizoma extracts anti-cancer. Contemporary researchers have extracted the chemical components of Curcumae Rhizoma separately for experimental verification of its active ingredients in the anti-cancer field. Numerous studies demonstrated that curcumol, germacrone, β-elemene, and curcumin in Curcumae Rhizoma extracts have significant governing effects in anti-cancer activities. Pharmacological studies have shown that Curcumae Rhizoma suppresses cancer cell proliferation, invasion, and migration, triggering apoptosis and regulating cellular autophagy to achieve anticancer effects. Here, we summarized the research progress of Curcumae Rhizoma on anti-cancer effects from 2013 to 2022, aiming to explore the deeper molecular mechanisms of Curcumae Rhizoma's active components in cancer treatment.

AIM To investigate the effects of Qifu Yixin Granules on cardiac inflammation in a rat model of heart failure.METHODS The rats were induced into chronic heart failure(CHF)models by 6-week intraperitoneal injection of doxorubicin followed by the random assignment of the successful rat models into the model group,the captopril group(22.5 mg/kg),and the low-dose,medium-dose,and high-dose Qifu Yixin Granules groups(2.84,5.67,11.34 g/kg),in contrast to the normal rats of the blank group.The rats had their body weight monitored;their cardiac function assessed by echocardiography;their serum levels of NT-proBNP,TNF-α,IL-6,IL-1 and CRP measured by ELISA;their cardiac morphological alterations observed by HE and Masson staining;their cardiac protein expressions of TLR4,MyD88 and NF-κB detected by immunohistochemistry and Western blot;and their cardiac mRNA expressions of TLR4,MyD88 and NF-κB measured by RT-qPCR.RESULTS Compared to the blank group,the model group exhibited significantly reduced body weight,LVEF and LVFS(P＜0.01),alongside significantly elevated LVEDD,LVESD,and serum concentrations of NT-proBNP,TNF-α,IL-6,IL-1 and CRP(P＜0.01).Additionally,the model group displayed greater myocardial inflammatory cell aggregation,increased collagen deposition(P＜0.01);and upregulated myocardial protein and mRNA expressions of TLR4,MyD88 and NF-κB(P＜0.01).Compared to the model group,the groups intervened with captopril or medium/high dose Qifu Yixin Granules demonstrated significantly increased body weight,LVEF and LVFS(P＜0.05,P＜0.01);significantly reduced LVEDD,LVESD,and serum levels of the aforementioned indicators(P＜0.05,P＜0.01);mitigated inflammation and collagen deposition(P＜0.05,P＜0.01);and downregulated myocardial protein and mRNA expressions of TLR4,MyD88 and NF-κB(P＜0.05,P＜0.01).CONCLUSION Qifu Yixin Granules attenuate cardiac inflammation and improve cardiac function in doxorubicin-induced CHF rats;this therapeutic effect is mediated by inhibiting the activation of the TLR4/MyD88/NF-κB signaling pathway.

Objective:To discuss the role of M2 macrophages in epithelial-mesenchymal transition(EMT)and cisplatin(DDP)resistance in the non-small cell lung cancer(NSCLC),and to clarify the regulatory mechanism of nuclear factor κB(NF-κB)signaling pathway.Methods:The human monocytic leukemia THP-1 cells were selected and differentiated into M0 macrophages by phorbol myristate acetate(PMA)induction,followed by M2 macrophage polarization through interleukin(IL)-4 and IL-13 stimulation.Western blotting and immunofluorescence methods were used to detect the protein expression levels of CD163,CD86,and arginase-1(Arg-1)in M0 and M2 macrophages.The human NSCLC A549 cells were co-cultured non-contactly with M0 or M2 macrophages in Transwell chambers,and the cells were divided into A549+M0 group(A549 cells co-cultured with M0 macrophages),A549+M2 group(A549 cells co-cultured with M2 macrophages),and A549+M2+BAY11-7082 group(A549 cells co-cultured with M2 macrophages and treated with 10 mmol·L-1 NF-κB inhibitor BAY11-7082).Wound healing assay was used to detect the wound healing rate of the A549 cells in various groups;Transwell assay was used to detect the number of invasion A549 cells in various groups;cell counting kit-8(CCK-8)assay was used to detect the inhibitory rate of proliferation and half maximal inhibitory concentration(IC50)value of the A549 cells after treated with DDP in the co-culture system;Western blotting method was used to detect the expression levels of vimentin,E-cadherin,N-cadherin,transcription factor Snail,phosphorylated P65(p-P65),P-glycoprotein(P-gp),and programmed death-ligand 1(PD-L1)proteins in the A549 cells in various groups.Results:The Western blotting results showed that compared with M0 group,the expression levels of CD163 and Arg-1 proteins in the macrophages in M2 group were significantly increased(P<0.05),while the expression level of CD86 protein was significantly decreased(P<0.05).The immunofluorescence results showed that compared with M0 group,the expression of CD163 protein in the macrophages in M2 group was enhanced and the expression of CD86 protein was weakened.The wound healing assay results showed that at 24 and 48 h of culture,compared with A549+M0 group,the wound healing rate of the A549 cells in A549+M2 group was significantly increased(P<0.05);in the co-culture system,compared with A549+M0 group,the wound healing rate of the A549 cells in A549+M2 group was significantly increased(P<0.05);compared with A549+M2 group,the wound healing rate of the A549 cells in A549+M2+BAY11-7082 group was significantly decreased(P<0.05).The Transwell assay results showed that compared with A549+M0 group,the number of invasion A549 cells in A549+M2 group was significantly increased(P<0.05);compared with A549+M2 group,the number of invasion A549 cells in A549+M2+BAY11-7082 group was significantly decreased(P<0.05);in the co-culture system,compared with A549+M0 group,the number of invasion A549 cells in A549+M2 group was significantly increased(P<0.05).The CCK-8 assay results showed that after treated with 2.50,5.00,10.00,20.00,and 40.00 mg·L-1 DDP,compared with A549+M0 group,the inhibitory rate of proliferation of the A549 cells in A549+M2 group was significantly decreased(P<0.05 or P<0.01),and the IC50 value was significantly increased(P<0.01);in the co-culture system,compared with A549+M0 group,the inhibitory rate of proliferation of the A549 cells in A549+M2 group was significantly decreased(P<0.05 or P<0.01),and the IC50 value was significantly increased(P<0.01);compared with A549+M2 group,the inhibitory rate of proliferation of the A549 cells in A549+M2+BAY11-7082 group was significantly increased(P<0.05),and the IC50 value was significantly decreased(P<0.05).The Western blotting results showed that compared with A549+M0 group,the expression level of E-cadherin proteins in the A549 cells in A549+M2 group was significantly decreased(P<0.05),while the expression levels of N-cadherin,vimentin,and Snail proteins were significantly increased(P<0.05);in the co-culture system,compared with A549+M0 group,the expression levels of vimentin,Snail,N-cadherin,and p-P65 proteins in the A549 cells in A549+M2 group were significantly increased(P<0.05),while the expression level of E-cadherin proteins was significantly decreased(P<0.05);compared with A549+M2 group,the expression levels of vimentin,N-cadherin,and p-P65 proteins in the A549 cells in A549+M2+BAY11-7082 group were significantly decreased(P<0.05),while the expression level of E-cadherin proteins was significantly increased(P<0.05);compared with A549+M0 group,the expression levels of P-gp and PD-L1 proteins in the A549 cells in A549+M2 group were significantly increased(P<0.05);in the co-culture system,compared with A549+M0 group,the expression levels of P-gp and PD-L1 proteins in the A549 cells in A549+M2 group were significantly increased(P<0.05);compared with A549+M2 group,the expression levels of P-gp and PD-L1 proteins in the A549 cells in A549+M2+BAY11-7082 group were significantly decreased(P<0.05).Conclusion:The M2 macrophages can regulate EMT in the NSCLC cells to promote the invasion and metastasis of tumor,and modulate the expressions of P-gp and PD-L1 to enhance DDP resistance,which is associated with the NF-κB signaling pathway.

Over 40%of critically ill patients will develop coagulopathy.Once critically ill patients are complicated with coagulopathy,the incidence of bleeding and mortality can increase by more than 4 times.Early identification of coagulopathy and accurate evaluation of coagulation function are essential for correcting coagulopathy as soon as possible.Therefore,Chinese Society of Thrombosis,Hemostasis and Critical Care,Chinese Medicine Education Association,together with Chinese People's Liberation Army Professional Committee of Critical Care Medicine updated the"Chinese expert consensus on standardized assessment of severe coagulopathy(2025 Edition)"on the basis of the"Consensus of Chinese experts on standardized evaluation of coagulation dysfunction in severe patients"formulated in 2022.This consensus includes four parts:classification and typing,etiology and mechanism,assessment methods,and diagnostic criteria of severe coagulopathy,with a total of 14 recommendations,aiming to provide corresponding guidance for clinical practice.

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 examine and compare the effect of personalized progressive aerobic-exercise and resistance-training prescriptions on anxiety of undergraduates.Methods This was a randomized controlled trial.Sixty-six undergraduates with anxiety were recruited and randomized into an aerobic ex-ercise(AE)group,a resistance exercise(RE)group and a control group,each of 22.The aerobic and resistance exercise groups underwent 12-week aerobic and resistance exercise respectively,while the control group only received health education.Before as well as after 4-,8-and 12-week interven-tion,and 4 weeks after the intervention,all groups were evaluated using Self-Rating Anxiety Scale(SAS)and Chinese College Students Mental Health Scale--Anxiety Subscale(CCSMHS-AS).More-over,before and 16 weeks after the intervention,all groups were assessed physical activity(PA)us-ing the International Physical Activity Questionnaire-Short Form(IPAQ-SF).Results The average SAS scores of the AE and RE groups decreased significantly from 6.95±6.32 and 56.41±5.45 before the intervention to 38.29±5.82 and 41.18±7.51 after 12-week exercise,while the average CC-SMHS-AS score decreased significantly from 20.00±5.66 and 19.41±3.70,to 13.18±4.81 and 14.32±4.16 during the same period of time(P<0.01 for all).Four weeks after the intervention,the SAS score of the AE group was significantly higher than 4 weeks earlier(49.18±11.84 vs.38.29±5.82,P<0.01),while that of the RE group increased without significant differences compared with 4 weeks earlier(42.50±9.57 vs.41.18±7.51,P>0.05),with the value of both groups significantly lower than right after the intervention(P<0.01,P<0.05).In the control group,the SAS score de-creased significantly from 55.73±5.27 before the intervention to 47.09±5.55 right after the interven-tion,and further to 46.95±9.70 4 weeks later(P<0.05),but no significant differences were ob-served in the CCSMHS-AS score(P>0.05).Meanwhile,right after the intervention,the average SAS scores of the AE and RE groups were significantly lower than the control group(P<0.01,P<0.05),without significant differences among the three groups 4 weeks after the intervention(P>0.05).The CC-SMHS-AS scores of AE group right after and 4 weeks after the intervention were significantly higher than the control group(P<0.01),but no significant differences were found in it between either the AE and RE group,or the RE and control group(P>0.05).Besides,the PA levels of the AE and RE groups 4 weeks after the intervention were significantly higher than before the intervention,while no significant changes were observed in the PA level of the control group(P>0.05).Conclusion Twelve-week personalized progressive aerobic-exercise and resistance-training prescriptions both result in a similar effect on relieving anxiety and improving spontaneous PA of college students.However,the prognosis of aerobic exercise is poorer than the other.

Over 40%of critically ill patients will develop coagulopathy.Once critically ill patients are complicated with coagulopathy,the incidence of bleeding and mortality can increase by more than 4 times.Early identification of coagulopathy and accurate evaluation of coagulation function are essential for correcting coagulopathy as soon as possible.Therefore,Chinese Society of Thrombosis,Hemostasis and Critical Care,Chinese Medicine Education Association,together with Chinese People's Liberation Army Professional Committee of Critical Care Medicine updated the"Chinese expert consensus on standardized assessment of severe coagulopathy(2025 Edition)"on the basis of the"Consensus of Chinese experts on standardized evaluation of coagulation dysfunction in severe patients"formulated in 2022.This consensus includes four parts:classification and typing,etiology and mechanism,assessment methods,and diagnostic criteria of severe coagulopathy,with a total of 14 recommendations,aiming to provide corresponding guidance for clinical practice.