ObjectiveTo explore the listed varieties and prescription characteristics of Chinese patent medicines for stroke in China， explore the medication rules of Chinese medicine for stroke， and provide guidance for further clinical research and development of Chinese patent medicines. MethodsExcel 2021 and the Ancient and Modern Medical Record Cloud Platform （V2.3.5） were used to systematically mine and analyze the varieties and prescriptions of Chinese patent medicines for stroke in China. ResultsA total of 244 Chinese patent medicines （two for different dosage forms of the same prescription）， 1 736 approval documents for Chinese patent medicines， 792 manufacturers， and 83 varieties of protected Chinese patent medicines were finally included in the database. The top three dosage forms were capsules （75）， pills （53）， and tablets （42）. There were 28 Chinese patent medicines for stroke in the National Essential Drug Catalogue （2018）， 129 in the National Essential Medical Insurance， Industrial Injury Insurance and Maternity Insurance Drug Catalogue （2023）， and 4 in the National Non-prescription Drug Catalogue. Among the 138 prescriptions screened out， Chinese patent medicines mainly treated stroke patients with the syndrome of Qi deficiency and blood stasis. The top three most frequent medicinal herbs were Chuanxiong Rhizoma （63）， Pheretima （47）， and Salviae Miltiorrhizae Radix et Rhizoma （47）. The medicinal herbs used were mainly warm， pungent， with the meridian tropism to the liver meridian. The correlation analysis showed that the herb pair with the highest support was Astragali Radix-Chuanxiong Rhizoma， and that with the highest confidence was Carthami Flos-Chuanxiong Rhizoma. Five herb combinations were identified based on the cluster analysis. ConclusionThe Chinese patent medicines for stroke mainly treat patients with the syndrome of Qi deficiency and blood stasis. The medicinal herbs used in the prescriptions mainly have the functions of activating blood and resolving stasis， extinguishing wind and stopping convulsions. Drug compatibility usually focuses on activating blood and resolving stasis， as well as expelling phlegm and opening orifices. This review of the varieties and prescription characteristics of Chinese patent medicines for stroke helps optimize clinical decision-making， guide drug research and development， promote medical research and scientific progress， and provide more effective support and guarantee for the treatment of stroke patients.

OBJECTIVE: To explore the characteristics and rules of the locations of acupoints selected in weight loss after syndrome differentiation of acupuncture and moxibustion, and provide quantitative evidence for the location specificity of acupoint selection in weight loss. METHODS: Clinical research articles on acupoint selection based on syndrome differentiation of acupuncture and moxibustion in weight loss were retrieved in China National Knowledge Infrastructure (CNKI), from the inception to September 20th, 2024, and the data about acupoints and differentiated syndromes were extracted. Based on graph theory, the acupoint-syndrome network was established and its topological parameters such as node degree, value of betweenness centrality, description length and number of community were calculated. RESULTS: ①The description length of the limbs was 4 255.592, and that of the trunk was 3 274.312. The information contained in the acupoint-syndrome network for the acupoints on the limbs was greater than that for those on the trunk. ②The value of betweenness centrality and node degree showed a nonlinear relationship, with R²of 0.812 1 for the trunk and 0.321 8 for the limbs. The values of betweenness centrality for the acupoints on the trunk were uniformly distributed, and the difference among these values was much smaller than that for the acupoints on the limbs. It suggested that the distance from each trunk acupoint to network center was similar, and the importance among these acupoints to network was similar, while the importance among acupoints located on the limbs was different significantly. ③The frequency proportion of acupoints on the trunk showed uniform distribution among different syndromes, while that of some acupoints located on the limbs such as Taichong (LR3), Neiting (ST44) and Taixi (KI3) presented a correlation with the syndromes. CONCLUSION In weight loss with acupuncture and moxibustion, the correlation between the limb acupoints and syndromes is more diverse and specific than that between the trunk acupoints and syndromes. The differences in acupoint selection for simple obesity treated with acupuncture and moxibustion are mostly reflected in the acupoints on the four limbs rather than those on the trunk. It provides an approach to acupoint selection for "local weight loss" and "general regulation" in treatment with acupuncture and moxibustion.
Humans ; Acupuncture Points ; Moxibustion ; Weight Loss ; Acupuncture Therapy ; Obesity/physiopathology*

Metabolic dysfunction-associated steatotic liver disease (MASLD) comprises a spectrum of liver injuries, including steatosis to steatohepatitis (MASH), liver fibrosis, cirrhosis, and relevant complications. The liver mainly comprises hepatocytes, liver sinusoidal endothelial cells (LSECs), Kupffer cells (KCs), immune cells (T cells, B cells), and hepatic stellate cells (HSCs). Crosstalk among these different liver cells, endogenous aberrant glycolipid metabolism, and altered gut dysbiosis are involved in the pathophysiology of MASLD. This review systematically examines advances in understanding the molecular pathogenesis of MASLD, with a focus on emerging therapeutic targets and translational clinical trials. We first delineate the crucial regulatory mechanisms involving diverse liver cells and the gut-liver axis in MASLD development. These cell-specific pathogenic insights offer valuable perspectives for advancing precision medicine approaches in MASLD treatment. Furthermore, we evaluate potential therapeutic targets and summarize clinical trials currently underway. By comprehensively updating the MASLD pathophysiology and identifying promising strategies, this review aims to facilitate the development of novel pharmacotherapies for this increasingly prevalent condition.
Humans ; Fatty Liver/therapy* ; Animals ; Liver/pathology* ; Kupffer Cells/metabolism* ; Hepatocytes/metabolism* ; Hepatic Stellate Cells/metabolism*

The clinical antiprotozoal drug nitazoxanide has been demonstrated to improve the experimental diabetes mellitus, lipid metabolism disorders, atherosclerosis and inhibit inflammation. Since the pathogenesis of heart failure with preserved ejection (HFpEF) is multifactorial and closely associated with the aforementioned diseases, we aim to study the effect of nitazoxanide on high-fat diet (HFD) plus L-NAME (N ω-nitro-l-arginine methyl ester)-induced HFpEF and metabolic syndrome in mice. We found that oral nitazoxanide improved cardiac hypertrophy, cardiac fibrosis, cardiac diastolic dysfunction, increased blood pressure, impaired exercise tolerance, impaired glucose handling, serum lipid disorders, hepatic steatosis, increased weight of white adipose tissues and kidney fibrosis in HFD + L-NAME-treated mice. In the established HFD + L-NAME-induced HFpEF and metabolic syndrome mouse model, therapeutic treatment with nitazoxanide rescued HFD + L-NAME-induced pathological phenotypes as mentioned above. The in vitro experiments revealed that tizoxanide, the active metabolite of nitazoxanide, increased the basal mitochondria metabolism of cardiomyocytes, inhibited cardiomyocyte hypertrophy and collagen secretion from cardiac fibroblasts, and relaxed phenylephrine- and U46619-induced constriction of rat mesenteric arteries, indicating that the direct effect of tizoxanide might partly contribute to the protective effect of nitazoxanide against HFpEF in vivo. The present study suggests that nitazoxanide might be a potential drug for HFpEF and metabolic syndrome therapy.

Objective To establish a risk prediction scheme for recurrence of diabetic foot ulcer based on biochemical test indexes.Methods The clinical data of totally 198 patients with diabetic foot ulcer in the hos-pital from January 2016 to December 2019 were retrospectively analyzed,and randomly divided into a training group(n=139)and a verification group(n=59)according to a ratio of 7∶3.The general data of the training group and the verification group were compared.The training group was divided into recurrence group(n=75)and non-recurrence group(n=64)according to whether there was recurrence or not during following-up.General data of the recurrence group and the non-recurrence group were compared,and the influencing factors of recurrence of diabetic foot ulcer were analyzed by Logistic regression to establish a Nomogram model.Re-ceiver operating characteristic(ROC)curve was used to evaluate the prediction ability of the Nomogram mod-el for both the training group and the verification group,and the Nomogram model was internally verified by Bootstrap method.The clinical net benefit rate of this Nomogram model was verified by decision curve analy-sis(DCA).Results The recurrence rate of 198 patients was 53.03％(105/198).Glycosylated hemoglobin A1c(HbA1c,OR=1.86 6,95％CI:1.377-2.529),white blood cell count(WBC,OR=1.687,95％CI:1.094-2.602),C-reactive protein(CRP,OR=1.704,95％CI:1.145-2.537),platelet(PLT,OR=1.939,95％CI:1.270-2.961),serum creatinine(Scr,OR=1.687,95％CI:1.193-2.387),blood urea nitrogen(BUN,OR=1.685,95％CI:1.227-2.315),urine microalbumin-creatinine ratio(ACR,OR=1.842,95％CI:1.230-2.759),and vascular endothelial growth factor(VEGF,OR=1.829,95％CI:1.281-2.614)were risk factors for recurrence of diabetic foot ulcer(P＜0.05),albumin(ALB,OR=0.462,95％CI:0.287-0.742)and total bilirubin(TBIL,OR=0.506,95％CI:0.327-0.783)were protective factors for the recurrence of diabetic foot ulcer(P＜0.05).The area under the curve(AUG)of the Nomogram model was 0.928(95％CI:0.802-0.985),the sensitivity was 91.71％,and the specificity was 82.41％.The AUC of the prediction group was 0.775(95％CI:0.617-0.890),the sensitivity was 79.17％,and the specificity was 86.48％.Hosmer-Lemeshow goodness of fit test showed P values were both over 0.05 in the training group and the verification group,and the model calibration was well.The Nomogram model predicts that the training group could obtain net clinical benefits in the range of 0.00％to 96.00％,and the verification group can obtain net clinical bene-fits in the range of 0.00％to 95.00％.Conclusion HbA1c,WBC,CRP,PLT,Scr,BUN,ACR and VEGF are risk factors for the recurrence of diabetic foot ulcer,and ALB and TBIL are protective factors for the recur-rence of diabetic foot ulcer.Integrating these factors to construct a Nomogram model could predict the recur-rence of diabetic foot ulcer effectively.

Objective:To establish the characteristic spectrum of Liushenqu standard decoction using ultra-high performance liquid chromatography (UPLC); To determine the contents of related index components; To evaluate the quality of Liushenqu standard decoction.Methods:UPLC method was used to establish characteristic spectrum of Liushenqu standard decoction. Chromatographic Fingerprint Similarity Evaluation System (2012 edition) was used for similarity analysis, the characteristic peak was assigned, and the content of its index components was determined.Results:The characteristic peaks of Liushenqu standard decoction were calibrated and 8 components were identified, namely uridine, adenosine, guanosine, 5-hydroxymethylfurfural, tryptophan, vanillic acid, ferulic acid and shaftaside. The contents of uridine, adenosine, tryptophan ferulic acid and shaftaside in 10 batches of Liushenqu standard decoction were simultaneously determined, and ranged from 0.036 1～0.383 9 mg/g, 0.030 7～0.170 2 mg/g, 0.007 0～0.060 2 mg/g, 0.001 0～0.005 0 mg/g, 0.000 8～0.013 8 mg/g, respectively. The transfer rates ranged from 44.2% to 50.8%, 60.1% to 67.7%, 60.4% to 76.4%, 62.7% to 77.4%, 50.7% to 61.4%, respectively.Conclusion:The established UPLC characteristic spectrum and content determination method are accurate and repeatable, which can provide references for quality control of Liushenqu standard granules.

Objective:To establish UPLC characteristic spectrum of Hujiao standard decoction and the determination method for the content of piperine.Methods:15 batches of freeze-dried powder of Hujiao standard decoction were prepared according to the traditional decocting method. The range of paste yield was determined, and the UPLC characteristic spectrum of the standard decoction was established. High-resolution mass spectrometry and control products were used to identify common peaks. Based on the common peak area, the weights of each peak were compared using entropy weight method, and correlation analysis and similarity evaluation were conducted using clustering analysis and grey correlation method; a method for determining the content of piperine in Hujiao decoction pieces and freeze-dried powder of standard decoction was simultaneously established, and the transfer rate was calculated.Results:The extraction rate of 15 batches of freeze-dried powder of Hujiao standard decoction ranged from 10.4% to 16.8%, with an average of 14.0%. The content of piperine ranged from 12.2 to 30.0 mg/g, with an average of 18.5 mg/g, and the transfer rate ranged from 4.0% to 7.8%, with an average of 5.8%. Six common peaks were identified in the established characteristic spectrum and identified by high-resolution mass spectrometry and control products respectively. Peak 1 was N-trans-feruloyltyramine, peak 3 was piperine and the similarity was 0.959-1.000. Clustering analysis and grey correlation analysis showed that there was little difference between quality of Piperis Fructus and origins.Conclusion:In this study, the characteristic spectrum and content determination method of freeze-dried powder of Hujiao standard decoction are established, which can provide references for quality detection and control of Hujiao standard decoction or its derivative products.

Objective To compare the cortical activation characteristic in the healthy subjects and hemiplegia patients during execut-ing treadmill walking with visual feedback(TWVF). Methods From August to November,2021,eight stroke patients with right hemiplegia(patient group)and eight healthy subjects(healthy group)in Fifth Hospital of Xiamen were recruited.Both groups wore functional near-infrared spectroscopy(fNIRS)caps and executed TWVF,respectively.Experimental block design for walking modes in-cluded the preparation period(10 s)and task period(five cycles of"step 30 s-rest 30 s").The cortical activation(β values)were measured.The regions of interest(ROI)included the pre-motor cortex(PMC),supplementary motor area(SMA),primary motor cortex(M1),primary somatosensory cortex(S1)and sensorimotor cortex(SMC,M1+S1). Results No activation in bilateral M1,and some significant activation(P<0.05)in the left hemisphere SAM,PMC and S1,were found during walking in the healthy group.M1 was activated more in the unaffected(right)hemisphere than in the affected(left)hemisphere during walking in the patient group(P<0.05),and less PMC activation was found(P<0.05).M1 in bilateral hemispheres,SMA in the unaffected hemisphere and PMC in the affected hemi-sphere were activated more in the patient group than in the healthy group(P<0.05). Conclusion The locomotor network of SMC-PMC-SMA are activated more in the hemiplegic patients than in the healthy pepole during walking.M1 are almost not activated in the healthy people during walking,and compensa-torily activated in M1 of the unaffected side in the hemiplegic patients.

Objective To investigate the morphological and proteomic differences in exosomes(EXOs)during the stor-age of leukocyte-free apheresis platelets(LFA-Plt),evaluate the quality of platelets in storage and predict the function of EXOs at different storage periods.Methods EXOs were isolated by ultracentrifugation,then the morphological observation was performed by electron microscope.Particle size analysis and WB protein index detection were performed.4D Label-free quantitative proteomics technology was used to perform quantitative and bioinformatics analysis on identified proteins.Protein differential analysis on the LFA-Plt EXO between group day 3 and day 5 was performed,and GO function and KEGG path-way enrichment analysis on differential proteins was conducted.Results Cup shaped,CD9/TSG101 enriched and Calnexin(-)EXO was successfully obtained.The particle size(nm)of LFA-Plt EXO for day 3 and day 5 were(82.2±19.6)and(83.4±19.4)respectively,and the protein concentration(μ g/uL)were(0.55±0.13)and(0.51±0.08)respectively,with no statistically significant difference between two groups(P＞0.05).1 504 proteins were identified in all samples.GO func-tional enrichment analysis showed that the LFA-Plt EXO proteins were mainly concentrated in the cell membrane,extracel-lular domain and proteasome core complex,and were related to the binding ability of proteins,ATP,calcium ions and GTP,and mainly participated in processes such as redox,protein hydrolysis and signal transduction.KEGG functional annotation showed that the EXO proteins mainly participated in material transportation and catabolism,genetic information processing,and were closely related to human tumors and viral bacterial infections,affecting the metabolism of human immune system.Compared with day 3,day 5 EXO showed significant up-regulation in 16 proteins.The GO enrichment analysis showed that 16 upregulated proteins were mainly associated with adenosine homocysteine activity and 6-phosphofructose kinase activity,and were mainly involved in the metabolism of organic nitrogen compound.KEGG enrichment pathway analysis showed that the most important function of upregulated proteins was participating in signaling pathway for oocyte maturation mediated by progesterone.Conclusion Under the preparation and storage conditions of LFA-Plt in our center,platelet quality can be relatively stable.The functions of EXO proteins varies with different storage periods,which may affect the effectiveness of platelet transfusion.

Objective To investigate the effect of Nutlin-3a,a mouse double minute 2 homolog(MDM2)inhibitor,on lipid metabolism of mouse adipose.Methods High-fat diet-induced obesity(DIO)C57BL/6J mice were randomly divided into a control group injected with DMSO and an experimental group injected with Nutlin-3a.Then we conducted glucose tolerance(GTT)and insulin tolerance(ITT)tests.The epididymal white adipose tissue(eWAT),inguinal white adipose tissue(iWAT)and brown adipose tissue(BAT)of animals were isolated and microscopy of WATs with hematoxylin-eosin(HE)staining was performed to observe the morphological changes of adipocytes.The expression of lipid metabolism related gene cell death-inducing DFF45-like effector C(CIDEC)in eWAT were detected by qPCR and Western blot.Results Compared with the control group,Nutlin-3a was found to promote the body weight(P＜0.001),but no effect on glucose tolerance and insulin sensitivity in DIO mice.Nutlin-3a treatment decreased the size of adipocytes and fat deposition in adipose tissue and downregulated the mRNA and protein levels of CIDEC in eWAT.Conclusions Nutlin-3a inhibits the formation of lipid droplets by downregulating expression of CIDEC in white adipose tissue.