OBJECTIVE To study the improvement effect and mechanism of Shengmai powder on heart failure （HF） mice with qi-yin deficiency. METHODS The mice were randomly divided into blank group （water）， model group （water）， Shengmai powder low-， medium-， and high-dose groups [2.61， 5.22 and 10.44 g/kg （based on crude drug dosage）] and positive control group （metoprolol， 30 mg/kg）， with 10 mice in each group. Except for the blank group， all other groups were subcutaneously injected with D-galactose， and a qi-yin deficiency HF mice model was established by continuous food restriction and weight-bearing swimming. At the same time of modeling， the corresponding medicine/water was gavaged once a day for five weeks. The general state of mice was recorded and the traditional Chinese medicine （TCM） syndrome score was evaluated. Behavioral experiments were conducted to investigate the total distance of open field action， the percentage of immobility time， and the swimming exhaustion time of mice. The contents of aspartate transaminase （AST）， creatine kinase （CK） and lactate dehydrogenase （LDH） in the serum of mice were detected； cardiac function indexes [heart rate， left ventricular ejection fraction （LVEF）， left ventricular end systolic diameter （LVESD）， left ventricular end diastolic diameter （LVEDD）， left ventricular mass index and whole heart mass index] were all detected； the histopathological morphology of mice myocardium was observed； the level of cardiomyocyte apoptosis in mice was detected； mRNA expression levels of B-cell lymphoma 2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Cleaved-caspase-3 in myocardial tissue of mice were detected； the phosphorylation levels of sarcoplasmic reticulum calcium regulatory related proteins [ryanodine receptor 2 （RyR2） and phospholamban （PLB）] in myocardial tissue of mice were detected. RESULTS Compared with the blank group， the body weight， total distance of open field action， swimming exhaustion time， LVEF， LVEDD， Bcl-2 mRNA expression level in myocardial tissue and PLB protein phosphorylation level in the model group were significantly reduced/shortened （P＜0.05）； TCM syndrome score， the percentage of immobility time， heart rate， LVESD， left ventricular mass index， whole heart mass index， cardiomyocyte apoptosis rate， the contents of CK， LDH and AST in serum， mRNA expression levels of Cleaved-caspase-3 and Bax and the phosphorylation level of RyR2 protein in myocardial tissue were significantly increased （P＜0.05）； there were inflammatory cell infiltration， disordered cell arrangement and obvious myocardial interstitial fibrosis in myocardial tissue. After the intervention of Shengmai powder， most of the above quantitative indexes in mice were significantly reversed （P＜0.05）， the inflammatory cell infiltration in myocardial tissue was reduced， and the degree of fibrosis was significantly reduced. CONCLUSIONS Shengmai powder can improve cardiac function， reduce the level of cardiomyocyte apoptosis and myocardial fibrosis in HF mice with qi-yin deficiency. Its mechanism may be related to the regulation of the expression of sarcoplasmic reticulum calcium regulation related proteins.

Acute kidney injury (AKI) is a critical clinical condition characterized by rapid renal function decline, with high morbidity, mortality, and healthcare costs. Traditional Chinese medicine (TCM) has shown potential effects on mitigating oxidative stress and programmed cell death in AKI models. Scutellaria barbata D. Don (SB) and Scleromitrion diffusum (Willd.) R. J. Wang (SD), a classic TCM herbal pair exhibited anti-inflammatory and antioxidant activities. Using advanced chromatographic separation technology, we enriched the effective fractions of water extracts from SB-SD, obtaining self-assembled herbal nanoparticles (SB and SD nanoparticles, SSNPs) rich in flavonoids and terpenoids. These SSNPs demonstrated robust antioxidant properties in vitro and mitigated AKI progression in vivo by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. Oral administration of SSNPs in mice resulted in absorption into the bloodstream, formation of a protein corona, reduced macrophage phagocytosis, and enhanced bioavailability and renal targeting. Furthermore, we investigated the self-assembly principle of SSNPs using representative flavonoids and terpenoids. Kinetic studies and in situ transmission electron microscopy (in situ TEM) revealed that these compounds self-assemble via supramolecular forces like hydrogen bonding and π-π interactions, forming stable nanostructures. This study elucidates the renoprotective effects and mechanisms of SB and SD, and provides a novel approach for the development of TCM-based nanomedicines, highlighting the potential of nano-TCM in AKI treatment.

ObjectiveTo investigate the change in the activity of hepatitis B virus （HBV）-specific CD8⁺ T cells after pegylated interferon-α-2b （PEG-IFN-α-2b） therapy in HBeAg-negative patients with chronic HBV infection. MethodsA total of 53 HBeAg-negative patients with chronic HBV infection who attended The First Affiliated Hospital of Xinxiang Medical University and Tangdu Hospital of Air Force Mdical University from April 2020 to June 2022 were enrolled and treated with PEG-IFN-α-2b （180 μg/week， subcutaneous injection） antiviral therapy. The study endpoint was HBsAg clearance （course of treatment<48 weeks） or 48 weeks （course of treatment≥48 weeks）. Peripheral blood mononuclear cells were isolated at baseline and study endpoint， and peripheral blood T cell counts were measured. Enzyme-linked immunospot assay was used to measure the frequency of HBV-specific CD8⁺ T cells secreting perforin， granzyme B， and interferon-γ. A total of 17 HLA-A^*02-restricted patients were selected， and CD8⁺ T cells were purified to establish direct- and indirect-contact co-culture systems for HBV-specific CD8⁺ T cells and HepG2.2.15 cells. The level of lactate dehydrogenase in supernatant was measured to calculate the mortality rate of HepG2.2.15 cells， and the levels of HBV DNA， cytotoxic molecules， and cytokines in supernatant were also measured. Flow cytometry was used to measure the expression of apoptosis ligands， and the cytotoxicity of HBV-specific CD8⁺ T cells was evaluated. The independent samples t-test or the paired t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test or the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups. ResultsThe HBsAg clearance rate at study endpoint was 30.19% （16/53）. There were no significant differences in peripheral blood T cell counts （CD3⁺， CD4⁺， and CD8⁺ T cells） between baseline and study endpoint （P>0.05）. At study endpoint， there was a significant increase in the frequency of HBV-specific CD8⁺ T cells secreting perforin， granzyme B， and interferon-γ （U=177.50， t=11.90， U=186.50， all P<0.001）， and the patients with HBsAg clearance had a significantly higher frequency of such HBV-specific CD8⁺ T cells than those without HBsAg clearance （U=120.50， t=2.73， U=121.50， all P<0.01）. In the direct- and indirect-contact co-culture systems at study endpoint， HBV-specific CD8⁺ T cells induced a significant reduction in HBV DNA in the supernatant of HepG2.2.15 cells （all P<0.001） and significant increases in the secretion of interferon-γ and tumor necrosis factor-α （all P<0.05）； in the direct-contact co-culture system， HBV-specific CD8⁺ T cells induced significant increases in the mortality rate of HepG2.2.15 cells （13.62%±3.27% vs 11.39%±2.40%， t=2.27， P=0.030） and the secretion of perforin and granzyme B （t=72.50， U=52.50， both P<0.05）. In the direct- and indirect-contact co-culture systems， compared with HBV-specific CD8⁺ T cells from the patients without HBsAg clearance， the HBV-specific CD8⁺ T cells from patients with HBsAg clearance had a significantly greater reduction in HBV DNA （P<0.05） and significant increases in the secretion of interferon-γ and tumor necrosis factor-α （P<0.05）. ConclusionPEG-IFN-‍α‍-2b therapy can help to achieve a relatively high HBsAg clearance rate in HBeAg-negative patients with chronic HBV infection， and the activity of HBV-specific CD8⁺ T cells is significantly enhanced， which is closely associated with HBsAg clearance.

To systematically review randomized controlled trials （RCTs） of traditional Chinese medicine （TCM） intervention in ulcerative colitis （UC）， and analyze the characteristics of these studies and their outcome indicators， thereby providing references for the design of future RCTs of TCM intervention in UC and offering evidence supporting the clinical application of TCM in UC. A computerized search was conducted in the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， SinoMed， PubMed， Cochrane Library， EMbase， and Web of Science databases for RCTs of TCM intervention in UC published from January 2021 to August 2024. The risk of bias was assessed， and outcome indicators were qualitatively analyzed. A total of 555 RCTs were included， with a sample size of 44 853 participants. The largest sample size was 218 cases， and the smallest was 28 cases， with most studies focusing on 60-100 participants. Of the 386 RCTs that explicitly reported TCM syndrome types， the top three were large intestine dampness-heat syndrome （31.05%）， spleen and kidney yang deficiency syndrome （12.47%）， and spleen deficiency with dampness syndrome （9.17%）. The interventions， ranked by frequency of use， included internal Chinese medicine compounds/preparations （64.5%）， Chinese medicine compounds/preparations with retained enema （18.2%）， internal Chinese medicine compounds/preparations + external TCM treatment （5.95%）， and external TCM treatment alone （4.86%）. The treatment duration was mainly 4-8 weeks （64.86%）， with 61 studies （10.99%） reporting follow-up time. A total of 157 outcome indicators were used， with a frequency of 3 460 occurrences， classified into six domains： TCM syndromes and symptoms （346 occurrences， 10%）， symptoms/signs （541 occurrences， 15.64%）， physical and chemical examinations （2 119 occurrences， 61.24%）， quality of life （107 occurrences， 3.09%）， long-term prognosis （61 occurrences， 1.76%）， and safety events （284 occurrences， 8.21%）. The analysis reveals several limitations in the outcome indicators of TCM intervention in UC， including the lack of a basis for sample size calculation， non-standardized TCM syndrome classification， absence of trial design and registration， inadequate blinding and allocation concealment， adherence issues with interventions， imbalanced selection of surrogate and endpoint indicators， inconsistency in the timing of outcome measurements， design issues that require standardization， and ethical and safety concerns. It is recommended that future studies actively construct a set of core indicators for UC that include standardized TCM syndrome classification， clear efficacy evaluation indicators， key endpoint indicators， and reasonable measurement time points. Long-term prognostic impacts， comprehensive assessments of patients' quality of life， and consideration of economic benefits should be emphasized， providing a basis for the clinical practice of TCM in the treatment of UC.

To systematically review randomized controlled trials （RCTs） of traditional Chinese medicine （TCM） intervention in ulcerative colitis （UC）， and analyze the characteristics of these studies and their outcome indicators， thereby providing references for the design of future RCTs of TCM intervention in UC and offering evidence supporting the clinical application of TCM in UC. A computerized search was conducted in the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， SinoMed， PubMed， Cochrane Library， EMbase， and Web of Science databases for RCTs of TCM intervention in UC published from January 2021 to August 2024. The risk of bias was assessed， and outcome indicators were qualitatively analyzed. A total of 555 RCTs were included， with a sample size of 44 853 participants. The largest sample size was 218 cases， and the smallest was 28 cases， with most studies focusing on 60-100 participants. Of the 386 RCTs that explicitly reported TCM syndrome types， the top three were large intestine dampness-heat syndrome （31.05%）， spleen and kidney yang deficiency syndrome （12.47%）， and spleen deficiency with dampness syndrome （9.17%）. The interventions， ranked by frequency of use， included internal Chinese medicine compounds/preparations （64.5%）， Chinese medicine compounds/preparations with retained enema （18.2%）， internal Chinese medicine compounds/preparations + external TCM treatment （5.95%）， and external TCM treatment alone （4.86%）. The treatment duration was mainly 4-8 weeks （64.86%）， with 61 studies （10.99%） reporting follow-up time. A total of 157 outcome indicators were used， with a frequency of 3 460 occurrences， classified into six domains： TCM syndromes and symptoms （346 occurrences， 10%）， symptoms/signs （541 occurrences， 15.64%）， physical and chemical examinations （2 119 occurrences， 61.24%）， quality of life （107 occurrences， 3.09%）， long-term prognosis （61 occurrences， 1.76%）， and safety events （284 occurrences， 8.21%）. The analysis reveals several limitations in the outcome indicators of TCM intervention in UC， including the lack of a basis for sample size calculation， non-standardized TCM syndrome classification， absence of trial design and registration， inadequate blinding and allocation concealment， adherence issues with interventions， imbalanced selection of surrogate and endpoint indicators， inconsistency in the timing of outcome measurements， design issues that require standardization， and ethical and safety concerns. It is recommended that future studies actively construct a set of core indicators for UC that include standardized TCM syndrome classification， clear efficacy evaluation indicators， key endpoint indicators， and reasonable measurement time points. Long-term prognostic impacts， comprehensive assessments of patients' quality of life， and consideration of economic benefits should be emphasized， providing a basis for the clinical practice of TCM in the treatment of UC.

Objective To investigate the correlation and predictive value of serum ferritin(SF),25(OH)D and early renal damage in children with new type 1 diabetes mellitus(T1DM).Methods A total of 102 newly diagnosed T1DM children admitted to the Department of Endocrinology,Genetics and Metabolism of our hospital from January 2020 to June 2023 were collected as the study objects.According to UACR,the study subjects were divided into T1DM group<30 mg/g(n=50),microalbuminuria group 30～300 mg/g(MUAlb)group(n=32),and macroalbuminuria group>300 mg/g(CUAlb)group(n=20).Another 65 healthy children who underwent physical examination during the same period were selected as normal control(NC)group.General data and biochemical indexes of all groups were compared to analyze the correlation and predictive value of changes in SF and 25(OH)D levels with early renal damage.Results The levels of SF and TG in NC,T1DM,MUAlb and CUAlb groups increased in turn(P<0.05),while 25(OH)D decreased in turn(P<0.05).The levels of TC,FC-P,FPG and HbA1c in the T1DM,MUAlb and CUAlb groups were higher than those in the NC group(P<0.05),and the levels of FIns was lower than that in the NC group(P<0.05).The level of LDL-C in MUAlb and CUAlb groups were higher than in NC group(P<0.05),the levels of TC,FPG and HbA1c in MUAlb and CUAlb groups were higher than those in T1DM group(P<0.05),and UACR was higher than that in NC and T1DM groups(P<0.05).LDL-C in MUAlb group was higher than that in T1DM group(P<0.05).Blood urea in the CUAlb group were higher than those in the NC group(P<0.05),Scr and UACR was higher than that in the MUA1b group(P<0.05),and eGFR was higher than that in the T1DM,MUAlb,and CUAlb groups(P<0.05).Spearman correlation analysis showed that SF were positively correlated with TC,LDL-C,TG,UACR and HbA1c(P<0.05)and negatively correlated with 25(OH)D(P<0.05).25(OH)D was negatively correlated with TC,LDL-C,TG,UACR,HbA1c(P<0.05).Logistic regression analysis showed that SF and 25(OH)D were the influencing factors of early renal injury in children with T1DM.ROC curve analysis showed that the area under the curve of SF and 25(OH)D was 0.813 and 0.808,with the sensitivity 67.3%and 78.8%,the specificity 80.0%and 72.0%,and the cut-off values were 113.6 ng/ml and 54.17 nmol/L,respectively.Conclusions The changes in serum SF and 25(OH)D levels are associated with different stages of early renal damage and may be involved in the occurrence and development of early renal damage in children with T1DM.

Objective To explore the correlation between the systemic immune-inflammation index(SII)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN).Methods A total of 350 patients who underwent renal biopsy and were initially diagnosed with primary IgAN were selected.The clinical and pathological data of the patients were collected,and SII was calculated.According to the median SII level of 554.78 in peripheral blood,the IgAN patients were divided into the low SII group(SII≤554.78,175 cases)and the high SII group(SII>554.78,175 cases).Based on the presence or absence of endocapillary hyperplastic(E)lesion,350 patients were also divided into the E0 group(279 cases,79.7%)and the E1 group(71 cases,20.3%).Multivariate Logistic regression analysis was conducted to determine the influencing factors of E1 in IgAN patients.A predictive model was established,and the predictive value of the model was evaluated using the receiver operating characteristic(ROC)curve.Results There were higher systolic blood pressure(SBP),platelet count(PLT),neutrophil count(NEU),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),total cholesterol(TC),serum creatinine(Scr),serum C3 and 24-hour urine protein levels in the high SII group than those of the low SII group,while the lymphocyte count(LYM)was lower(P＜0.05).In terms of pathological manifestations,the proportion of E1 was higher in the high SII group than that of the low SII group(P＜0.05).There were lower PLT,NEU,NLR,PLR,Scr and 24-hour urine protein in patients of the E0 group than those of the E1 group,while higher Hb,LYM and ALB levels in the E0 group than those of the E1 group(P＜0.05).Multivariate Logistic regression analysis showed that elevated SII,Scr and 24-hour urine protein levels were independent risk factors for E1 lesion in IgAN patients(P＜0.05).The area under the curve(AUC)of the predictive model for E1 lesion in IgAN patients was 0.781(95%CI:0.722-0.840).Conclusion SII can reflect the clinical and pathological severity in IgAN patients,providing new insights for clinical evaluation of the disease progression in IgAN patients.

Objective Based on the three tools of the AGREE Next Steps Consortium(AGREE Ⅱ),China Clinical Guidelines Evaluation System(AGREE-China)and Scientificity Transparency Applicability Rankings(STAR),the methodological quality of Chinese medicine clinical treatment guidelines for coronary heart disease published by domestic institutions was systematically evaluated.Methods Computer system retrieval of China National Knowledge Infrastructure(CNKI),WanFang Data,Chinese Science and Technology Journal Database(VIP),China Biology Medicine(CBM)and Yimai Tong,and collect clinical practice guidelines of traditional Chinese medicine for coronary heart disease issued by domestic institutions(including expert consensus).The search period was from the establishment of the database to December 31,2023.Results A total of 21 guidelines were included.AGREE Ⅱ recommended 13 for grade A and 8 for grade B.The approval-China review strongly recommends 12,weakly recommends 8,and does not recommend 1.The highest STAR rating is a 4.0 star recommendation and the lowest is a 1.5 star recommendation.Conclusions There are a large number of TCM diagnosis and treatment guidelines and expert consensus on coronary heart disease in China,but the quality is uneven.It is suggested that the future guideline formulation should pay attention to the evidence-based principle,promote the standardization and standardization of the guideline formulation,and improve the scientific and applicability of the guideline.

Objective To review literature on exercise-based pre-rehabilitation before surgery in patients with lung cancer,hence to provide a guidance for development of standardised programs for pre-rehabilitative exercise.Methods Following the Australian JBI Evidence-based Health Care Centre Scope Review guidelines,a comprehensive search was conducted across the databases of PubMed,Embase,Web of Science,CINAHL,CNKI,WanFang Data and SinoMed.The search covered the inception of databases to 29th February,2024.The retrieved literature was then screened and relevant information was extracted.Results A total of 20 articles were included in this review.Exercise-based pre-rehabilitation for lung cancer patients was mainly divided into single-modality pre-rehabilitation and multimodal pre-rehabilitation(exercise combined with interventions in nutrition,psychology and health behaviour).The period of intervention for exercise-based pre-rehabilitation was typically 2-3 weeks before surgery,with 3-5 sessions per week.The outcome indicators mainly included respiratory function,capacity of physical activity,quality of life,psychological status and postoperative complications.Conclusion The preoperative exercise-based pre-rehabilitation before surgery for the patients with lung cancer is feasible and effective in enhancing physical function of the patients.Further studies can focus on the development of patient-centred standardised exercise pre-rehabilitation programs.