ObjectiveTo explore the material basis of the "interaction of blood stasis and toxin" mechanism in cerebral ischemia-reperfusion injury， as well as the protective role of Huoxue Huayu Jiedu prescription （HXHYJDF） against ferroptosis. MethodsSixty SPF-grade male SD rats were randomly divided into six groups： sham group， model group， deferoxamine （DFO） group （100 mg·kg^-1）， low-dose HXHYJDF group （4.52 g·kg^-1）， medium-dose HXHYJDF group （9.04 g·kg^-1）， and high-dose HXHYJDF group （18.07 g·kg^-1）， with ten rats in each group. Except for the sham group， the other groups were used to replicate the model of focal cerebral ischemia-reperfusion in the middle cerebral artery of rats by the reforming Longa method. Neurological function was assessed at 1^st， 3^rd， 5^th， and 7^th days post-reperfusion using the modified neurological severity scores （m-NSS）. Brain tissue pathology and the morphology of mitochondria were observed using hematoxylin-eosin （HE） staining and transmission electron microscopy. The contents of malondialdehyde （MDA）， glutathione （GSH）， divalent iron ions （Fe²⁺）， and reactive oxygen species （ROS） in the ischemic cerebral tissue were detected using enzyme-linked immunosorbent assay （ELISA）. Immunohistochemistry and Western blot （WB） were used to detect the expression of iron death marker proteins glutathione peroxidase 4 （GPX4）， ferroportin-1 （FPN1）， transferrin receptor protein 1 （TfR1）， and ferritin mitochondrial （FtMt） in brain tissue. ResultsCompared with the sham group， the mNSS score of the model group was significantly increased （P<0.01）. HE staining showed that the number of neurons in the cortex of brain tissue was seriously reduced， and the intercellular space was widened. The nucleus was fragmented， and the cytoplasm was vacuolated. The results of transmission electron microscopy showed that the mitochondria in the cytoplasm contracted and rounded， and the mitochondrial cristae decreased. The matrix was lost and vacuolated， and the density of the mitochondrial bilayer membrane increased. The results of ELISA showed that the content of GSH decreased significantly （P<0.01）， and the contents of MDA， Fe²⁺， and ROS increased significantly （P<0.01）. The results of immunohistochemistry and WB showed that the expression of GPX4 and FPN1 proteins was significantly decreased （P<0.01）， and the expression of FtMt and TfR1 proteins was significantly increased （P<0.01）. Compared with those of the model group， the m-NSS scores of the high-dose and medium-dose HXHYJDF groups began to decrease on the 3^rd and 5^th days， respectively （P<0.05， P<0.01）. The results of HE and transmission electron microscopy showed that the intervention of HXHYJDF improved the pathological changes of neurons and mitochondria. The results of ELISA showed that the content of GSH in the medium-dose and high-dose HXHYJDF groups increased significantly （P<0.01）， and the contents of MDA， Fe²⁺， and ROS decreased significantly （P<0.05， P<0.01）. The content of GSH in the low-dose HXHYJDF group increased significantly （P<0.01）， and the contents of MDA and ROS decreased significantly （P<0.01）. The results of immunohistochemistry showed that the expression of GPX4 and FPN1 in the high-dose HXHYJDF group increased significantly （P<0.01）， and the expression of FtMt and TfR1 decreased significantly （P<0.01）. The expression of GPX4 and FPN1 in the medium-dose HXHYJDF group increased significantly （P<0.05）， and the expression of TfR1 decreased significantly （P<0.01）. WB results showed that the expression levels of FPN1 and GPX4 proteins in the high-dose， medium-dose， and low-dose HXHYJDF groups were significantly up-regulated （P<0.01）， and the expression levels of FtMt and TfR1 proteins were significantly down-regulated （P<0.01）. ConclusionHXHYJDF can significantly improve neurological dysfunction symptoms in rats with cerebral ischemia-reperfusion injury， improve the pathological morphology of the infarcted brain tissue， and protect the brain tissue of rats with cerebral ischemia-reperfusion injury to a certain extent. Neuronal ferroptosis is involved in cerebral ischemia-reperfusion injury， with increased levels of MDA， Fe²⁺， ROS， and TfR1 and decreased levels of FtMt， FPN1， GPX4， and GSH potentially constituting the material basis of the interaction of blood stasis and toxin mechanism in cerebral ischemia-reperfusion injury. HXHYJDF may exert brain-protective effects by regulating iron metabolism-related proteins， promoting the discharge of free iron， reducing brain iron deposition， alleviating oxidative stress， and inhibiting ferroptosis.

ObjectiveTo investigate the potential machanism of Xiaozhong Zhitong Mixture （消肿止痛合剂， XZM） in the treatment of diabetes foot ulcer （DFU）. MethodsFifty SD rats were randomly divided into blank group， model group， XZM group， inhibitor group， XZM plus inhibitor group （combination group）， with 10 rats in each group. Except for the blank group， rats were fed with high-sugar， high-fat， high-cholesterol diet， intraperitoneally injected with streptozotocin， and subjected to skin defect to establish DFU model. After successful modeling， the XZM group and the combination group were given 1 ml/（100 g·d）of XZM by gavage， while the blank group， model group， and inhibitor group were all given an equal volume of 0.9% sodium chloride injection by gavage. Thirty minutes later， the inhibitor group and the combination group were intraperitoneally injected with 5 mg/（kg·d） of Notch1 inhibitor DAPT. All groups were treated once a day. After 14 days of administration， the skin tissue from the dorsal foot of the blank group rats and wound tissue from the other groups were collected. The pathological changes of granulation tissue in the wound were detected using hematoxylin eosin （HE） staining. The microvascular density （MVD） in wounds was detected through immunohistochemical staining. Real time fluorescence quantitative polymerase chain reaction （RT-PCR） and western blotting were used to detect the mRNA and protein levels of Notch1 homolog （Notch1）， Delta-like ligand 4 （Dll4）， Delta-like ligand 4 （VEGF）， and angiopoietin 2 （Ang-2）， respectively. ResultsHistological results showed that the epidermal structure in the dorsal foot skin tissue of the rats in the blank group was intact. In the wound tissue of the model group， the epidermis exhibited excessive keratinization， vacuolar cytoplasm， and a large number of inflammatory cells infiltrating the tissue， while in the XZM group， a large amount of scab formation was observed in the epidermis， with no significant inflammatory cell infiltration and a noticeable increase in fibroblasts. In the combination group and the inhibitor group， partial epidermal scab formation was observed in the wound tissue with a small amount of inflammatory cell infiltration. Compared to those in the blank group， the MVD in the wound tissue increased in the model group， as well as the mRNA expression and protein levels of Notch1 and Dll4， while VEGFA and Ang-2 mRNA expression and protein levels significantly decreased （P＜0.05 or P＜0.01）. Compared to those in the model group， the MVD in the wound tissue of all medication groups significantly increased， and the mRNA and protein levels of Notch1 and Dll4 decreased， while VEGFA and Ang-2 mRNA expression and protein levels increased （P＜0.05 or P＜0.01）. Compared to the XZM group， the inhibitor group and the combination group showed decreased MVD in wound tissue， increased Notch1 and Dll4 mRNA and protein levels， and decreased expression of VEGFA and Ang-2 mRNA and proteins （P＜0.05 or P＜0.01）. ConclusionXZM can effectively promote wound healing in DFU rats， and its mechanism of action may be related to the inhibition of Dll4/Notch1 signaling pathway in the wound tissue， therey promoting angiogenesis.

In recent years, idiopathic macular hole (IMH) surgery has a very high success rate due to the development of small-gauge vitrectomy, while the recovery of visual acuity is not satisfactory.Current studies have found that continuity of retinal blood vessels in the macular area and changes in retinal and choroidal perfusion are closely related to the formation and healing of MH, and have a significant impact on the visual prognosis in IMH patients.This article reviews the research progress on variations of parameters for retinal and choroidal vessels in IMH patients, as well as their relationship with visual prognosis.For retinal parameters, the changes in the foveal avascular zone, superficial and deep capillary plexus density, paracentral intraretinal cystoid spaces, retinal vessels position are discussed.Relevant research related to choroidal blood flow perfusion changes and the effects of different surgical methods on macular perfusion in patients with IMH are summarized to provide basis for further understanding the etiology and prognosis of IMH.

Fragility fractures represent the final clinical manifestation of osteoporosis and are influenced by a range of risk factors. This article discusses the findings from two large-scale studies utilizing biobank and genomic data to investigate the relationships among obesity, type 2 diabetes and fracture risk, and to explore their implications for health management. The studies suggest that general obesity(defined by body mass index, BMI), central obesity(defined by waist circumference), and peripheral obesity exert different effects on fracture risk in older adults. Specifically, individuals who are overweight based on BMI have a lower fracture risk compared to those with normal weight, whereas an increased waist circumference is associated with a higher fracture risk. Moreover, genetic research indicates that genetically determined type 2 diabetes is not causally associated with increased fracture risk. In contrast, observational studies have reported a higher fracture risk in patients with type 2 diabetes; however, this association becomes non-significant after adjusting for diabetes-related risk factors. These findings highlight that maintaining a moderately elevated BMI may benefit bone formation in the elderly by providing mechanical loading to stimulate bone formation. Additionally, effective management of type 2 diabetes complications is essential for reducing fracture risk, and a certain degree of obesity may confer a protective effect against fractures in individuals with type 2 diabetes.

In recent years, idiopathic macular hole (IMH) surgery has a very high success rate due to the development of small-gauge vitrectomy, while the recovery of visual acuity is not satisfactory.Current studies have found that continuity of retinal blood vessels in the macular area and changes in retinal and choroidal perfusion are closely related to the formation and healing of MH, and have a significant impact on the visual prognosis in IMH patients.This article reviews the research progress on variations of parameters for retinal and choroidal vessels in IMH patients, as well as their relationship with visual prognosis.For retinal parameters, the changes in the foveal avascular zone, superficial and deep capillary plexus density, paracentral intraretinal cystoid spaces, retinal vessels position are discussed.Relevant research related to choroidal blood flow perfusion changes and the effects of different surgical methods on macular perfusion in patients with IMH are summarized to provide basis for further understanding the etiology and prognosis of IMH.

Fragility fractures represent the final clinical manifestation of osteoporosis and are influenced by a range of risk factors. This article discusses the findings from two large-scale studies utilizing biobank and genomic data to investigate the relationships among obesity, type 2 diabetes and fracture risk, and to explore their implications for health management. The studies suggest that general obesity(defined by body mass index, BMI), central obesity(defined by waist circumference), and peripheral obesity exert different effects on fracture risk in older adults. Specifically, individuals who are overweight based on BMI have a lower fracture risk compared to those with normal weight, whereas an increased waist circumference is associated with a higher fracture risk. Moreover, genetic research indicates that genetically determined type 2 diabetes is not causally associated with increased fracture risk. In contrast, observational studies have reported a higher fracture risk in patients with type 2 diabetes; however, this association becomes non-significant after adjusting for diabetes-related risk factors. These findings highlight that maintaining a moderately elevated BMI may benefit bone formation in the elderly by providing mechanical loading to stimulate bone formation. Additionally, effective management of type 2 diabetes complications is essential for reducing fracture risk, and a certain degree of obesity may confer a protective effect against fractures in individuals with type 2 diabetes.