1.Chufeng Yisuntang Ameliorates PM2.5-induced Dry Eye via ROS/p38 MAPK Signaling Pathway
Yuan ZHONG ; Pan ZHAO ; Shi TAN ; Yu TANG ; Dongdong LI ; Lihao CHEN ; Jun PENG ; Qinghua PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):191-200
ObjectiveTo establish a mouse model of particulate matter 2.5 (PM2.5)-induced dry eye and investigate whether Chufeng Yisuntang can ameliorate the PM2.5-induced ocular surface damage by regulating the reactive oxygen species (ROS)/p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway. MethodsSixty 8-week-old male C57BL/6J mice were used. Ten were randomly selected as the control group. The remaining 50 mice received topical instillation of 1 drop (0.1 mL) of 5 g·L-1 PM2.5 suspension in both eyes, four times daily. Successfully modeled mice were randomized into four groups (n=10): Model, p38 MAPK inhibitor, Chufeng Yisuntang, and combination (Chufeng Yisuntang at 7.3 g·kg-1 + p38 MAPK inhibitor SB203580 at 5 mg·kg-1). Chufeng Yisuntang was administered via gavage, and the inhibitor group via intraperitoneal injection. The control and model groups received equal volumes of distilled water by gavage. All treatments lasted for 4 weeks. General conditions were dynamically observed. Tear secretion, tear film break-up time, and corneal fluorescein staining were assessed. After intervention for 4 weeks, hematoxylin and eosin (HE) staining was used to examine the histopathological changes. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure serum levels of ROS, malondialdehyde (MDA), superoxide dismutase (SOD) 1, and SOD2. Western blot and Real-time PCR were employed to determine the protein and gene levels, respectively, of p38 MAPK, B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and cysteinyl aspartate-specific proteinase-3 (Caspase-3) in the corneal tissue. ResultsCompared with the control group, the model group exhibited reduced tear secretion volume and tear film breakup time, along with increased corneal fluorescein staining scores (P<0.01). Compared with the model group, the Chufeng Yisuntang group, p38 MAPK inhibitor group, and combination group demonstrated increased tear secretion volume and tear film breakup time, along with decreased corneal fluorescein staining scores (P<0.01). HE staining revealed that compared with the control group, the model group exhibited marked increases in corneal epithelial cell layers and epithelial thickness, along with reduced meibomian gland acini and intensely stained, densely packed nuclei around the acini. Compared with the model group, the Chufeng Yisuntang group, p38 MAPK inhibitor group, and combination group showed intact corneal structure, improved cell morphology, and reduced damage severity. ELISA revealed elevated ROS and MDA levels (P<0.01) and decreased SOD1 and SOD2 levels (P<0.01) in the model group compared with the control group. Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination lowered ROS and MDA levels (P<0.01), while raising SOD1 and SOD2 levels (P<0.05, P<0.01). Western blot revealed that compared with the control group, the model group exhibited increased protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01) and reduced protein level of Bcl-2 (P<0.01). Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination down-regulated the protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), while up-regulating the protein level of Bcl-2 (P<0.01). Compared with the Chufeng Yisuntang group, the combination group exhibited decreased protein levels of p38 MAPK, Bax, and Caspase-3 (P<0.01) and increased protein level of Bcl-2 (P<0.01). Real-time PCR revealed that compared with the control group, the model group exhibited upregulated mRNA levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), and downregulated mRNA level of Bcl-2 (P<0.01). Compared with the model group, Chufeng Yisuntang, p38 MAPK inhibitor, and the combination down-regulated the mRNA levels of p38 MAPK, Bax, and Caspase-3 (P<0.01), while up-regulating the mRNA level of Bcl-2 (P<0.05, P<0.01). Compared with the Chufeng Yisuntang group, the combination group exhibited decreased mRNA levels of p38 MAPK, Bax, and Caspase-3 expression (P<0.05, P<0.01) and increased mRNA level of Bcl-2 (P<0.01). ConclusionChufeng Yisuntang may partially protect against PM2.5-induced corneal injury by inhibiting the ROS/p38 MAPK pathway, enhancing antioxidant defense, and reducing epithelial apoptosis.
2.Research Progress on Regulation of Relevant Pathways by Traditional Chinese Medicine for Prevention and Treatment of Parkinson's Disease
Zhonghao GUO ; Quan LI ; Pengyu PAN ; Tengyu ZHAO ; Zeyuan AN ; Yuan LIU ; Yanyan ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):333-342
Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor impairments, with its pathological mechanisms involving multiple processes such as the degeneration of dopaminergic neurons and the abnormal aggregation of α-synuclein. Current Western medical treatments face challenges including diminished long-term efficacy and motor complications. In recent years, Traditional Chinese Medicine (TCM) has demonstrated advantages in the prevention and treatment of PD through its systematic regulatory capabilities, featuring multi-component, multi-target, and multi-pathway approaches.This article systematically reviews the roles of seven key signaling pathways-NF-κB, AMPK/mTOR, PI3K/Akt, MAPKs, Nrf2/ARE, Wnt/β-catenin, and BDNF/TrkB-in the pathological process of PD and the regulatory mechanisms of TCM. Research indicates that active ingredients of Chinese herbs and compound formulations can synergistically modulate these pathways, exerting comprehensive effects in inhibiting neuroinflammation, alleviating oxidative stress, promoting autophagy to clear abnormal proteins, and enhancing neurotrophic support. These signaling pathways form a complex regulatory network through crosstalk among key nodal molecules, constituting an intricate regulatory system in PD pathology. The multi-target intervention characteristics of TCM align well with this network-based regulatory requirement, achieving integrated anti-inflammatory, antioxidant, autophagy-regulating, and neurorestorative effects through synergistic multi-pathway modulation. This article systematically outlines the mechanisms of TCM in the coordinated regulation of multiple pathways, providing a theoretical basis for elucidating the pathological process of PD and the intervention mechanisms of TCM, while also offering new perspectives and directions for modern research on TCM in the prevention and treatment of PD.
3.Shuhe Granules (舒和颗粒) in Treating Rheumatoid Arthritis Comorbid with Insomnia with Kidney-Heart Deficiency and Qi-Blood Disharmony Syndrome:An Exploratory Single-Arm Clinical Trial
Yonghao PAN ; Yuxi LI ; Yu GAO ; Xiangbin CHEN ; Kaixin GAO ; Runyue HUANG ; Fei TAN ; Jiamin YUAN ; Biyun XU ; Zhimin YANG
Journal of Traditional Chinese Medicine 2026;67(16):1743-1751
ObjectiveTo investigate the clinical effects and safety of Shuhe Granules (舒和颗粒) in patients with rheumatoid arthritis (RA) comorbid with insomnia. MethodsA single-arm prospective exploratory design was adopted. Thirty RA patients comorbid with insomnia and diagnosed with the traditional Chinese medicine (TCM) syndrome of kidney-heart deficiency and qi-blood disharmony were enrolled. On the basis of maintaining their original RA treatment regimens, all patients received oral Shuhe Granules, one dose per day, for 12 consecutive weeks. The outcomes were assessed before treatment and at weeks 4, 8, and 12 after treatment. Sleep and related psychosomatic function were evaluated using the insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), fatigue severity scale (FSS), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), and Montreal cognitive assessment (MoCA) scores. RA-related assessments included the 28-joint disease activity score based on C-reactive protein (DAS28-CRP), pain visual analog scale (VAS), tender joint count (TJC28), swollen joint count (SJC28), morning stiffness duration, and health assessment questionnaire (HAQ) score. Laboratory parameters included erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), anti-cyclic citrullinated peptide antibody (anti-CCP), and rheumatoid factor (RF) levels. A literature-based historical control group was established through literature retrieval and meta-analysis. The ISI, PSQI, DAS28-CRP, and pain VAS scores were compared between the treatment group in the present study and the historical control group. Safety assessments were also performed. ResultsCompared with baseline before treatment, ISI and PSQI scores decreased at weeks 4, 8, and 12, while MoCA scores increased at weeks 4, 8, and 12. FSS scores decreased at weeks 4 and 12. At weeks 8 and 12, GAD-7 scores, DAS28-CRP scores, duration of morning stiffness, TJC28, and SJC28 were reduced. At week 12, PHQ-9, pain VAS, and HAQ scores significantly decreased (P<0.05). FSS and DAS28-CRP scores at week 12 were lower than those at week 4, and CRP levels at week 8 were lower than those at week 4 (P<0.05). Compared with the historical control group, the treatment group showed superior improvement in ISI and PSQI scores (P<0.001); however, no statistically significant differences were observed between the two groups in DAS28-CRP or pain VAS scores (P>0.05). No serious adverse events occurred during the study, and the 4 reported mild adverse events were all considered unrelated to the study medication. ConclusionShuhe Granules significantly improve sleep quality, fatigue, emotional status, cognitive function, RA-related symptoms, and joint function in patients with RA comorbid insomnia, with good safety and tolerability.
4.Modified Guizhi Fulingwan Regulates miR-34a-5p/DLL1/Notch Signaling Pathway to Promote Apoptosis and Inhibit Prostate Cancer
Yuanguang DONG ; Ying YANG ; Penghao SUN ; Yang HONG ; Lu PAN ; Jiapeng LI ; Lijiang ZHOU ; Di ZHANG ; Mingdian YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):122-133
ObjectiveTo explore the molecular mechanism through which modified Guizhi Fulingwan (MGZFLW) promotes apoptosis and inhibits prostate cancer through the miR-34a-5p/δ-like protein 1 (DLL1)/Notch signaling pathway based on the traditional Chinese medicine theory of Yang transforming Qi while Yin constituting form. MethodsThe optimal intervention conditions of MGZFLW-containing serum and docetaxel (DXT) were screened by the cell counting kit-8 (CCK-8) method. Human prostate cancer cells (PC-3) were allocated into blank, MGZFLW (10%), and DXT (30 nmol·L-1) groups. The effects of MGZFLW-containing serum on the migration and proliferation of PC-3 cells were evaluated by cell scratch and colony formation assays, and the apoptosis of PC-3 cells was detected by terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. The cells were transfected with miR-34a-5p mimics and miR-34a-5p inhibitor. The mRNA levels of miR-34a-5p, DLL1, Notch1 and its downstream effector factors Notch1 intracellular domain (NICD1), Hes family basic helix-loop-helix transcription factor 1 (Hes1), and hairy/enhancer-of-split related with YRPW motif 1 (Hey1) were determined by Real-time PCR. The protein levels of DLL1, Notch1, NICD1, Hes1, and Hey1 were determined by a WES fully automatic protein system. The effect of miR-34a-5p on the DLL1-mediated Notch pathway was evaluated based on the results. Further, after MGZFLW-containing serum intervention, the expression of DLL1 and Notch1 was detected by the immunofluorescence (IF) assay, and the mRNA and protein levels of miR-34a-5p/DLL1/Notch pathway-related molecules were quantified by Real-time PCR and the WES fully automatic protein system, respectively, to explore the regulatory effect of MGZFLW-containing serum on the miR-34a-5p/DLL1/Notch pathway. ResultsMGZFLW-containing serum inhibited the viability, migration, and proliferation and promote the apoptosis of PC-3 cells (P<0.01). The overexpression of miR-34a-5p down-regulated the mRNA and protein levels of key molecules in the DLL1/Notch signaling pathway and promoted cell apoptosis (P<0.01), while inhibition of miR-34a-5p had the opposite effects. MGZFLW-containing serum reversed the activation of the DLL1/Notch pathway and the inhibition of apoptosis caused by miR-34a-5p inhibition, up-regulated the expression of miR-34a-5p, and down-regulated the expression of related molecules in this pathway (P<0.01). ConclusionMGZFLW can up-regulate the expression of miR-34a-5p to inhibit the DLL1/Notch signaling pathway and promote the apoptosis of prostate cancer cells, thereby inhibiting prostate cancer. This study provides experimental evidence for clarifying the molecular mechanism of the anti-prostate cancer effect of this formula.
5.Application of Novel Environmentally Friendly Reagents in Pathological Section Preparation and Immunohistochemistry
Jieying LI ; Shujun LIANG ; Ying DING ; Shuying LIU ; Lina QIN ; Zhaoliang PAN ; Lianqiang FENG ; Huijie YUAN
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(3):509-517
ObjectiveTo explore the application effects of environmentally friendly reagents versus traditional reagents in tissue processing, paraffin sectioning, hematoxylin-eosin (HE) staining, special staining, and immunohistochemistry. MethodsPancreatic, renal, splenic, hepatic, pulmonary, skeletal muscle, and cardiac tissues were collected from mice and New Zealand rabbits, and randomly divided into a traditional group (Group A), an environmentally friendly reagent I group (Group B), and an environmentally friendly reagent Ⅱ group (Group C). The processed tissue sections from all three groups were subjected to paraffin sections, HE staining, phosphotungstic acid-hematoxylin staining, and Mallory trichrome staining. The pancreatic tissue sections were subjected to immunohistochemical detection of insulin protein. Evaluation criteria included tissue morphological integrity, embedding operability, section quality, and staining effects. ResultsNo significant differences were observed among the three groups of samples in terms of fixation efficacy, embedding operations, and section quality. After HE staining, all groups exhibited bright nuclear and cytoplasmic staining with clear contrast, with excellent-and-good rates of 98%, 99%, and 97% for Groups A, B, and C, respectively, showing no statistically significant differences (A vs. B, P=0.561; A vs. C, P=0.651). In phosphotungstic acid-hematoxylin staining, Groups A and C showed clear structural contrast and bright staining for striated muscle and collagen fibers, whereas Group B exhibited uneven staining. The excellent-and-good rates were 100%, 10%, and 95% for Groups A, B, and C, respectively, with significant differences between Group A and Group B (P<0.01) but no statistical difference between Group A and Group C (P=0.311). In Mallory trichrome staining, Groups A and B outperformed Group C. The excellent-and-good rates were 95%, 90%, and 15% for Groups A, B, and C, respectively, with significant differences between Group A and Group C (P<0.01), but no statistical difference between Group A and Group B (P=0.548). Immunohistochemical results showed that Group A had a clean background with no non-specific staining, while Groups B and C exhibited significant non-specific staining, with statistically significant differences in non-specific staining rates between the groups (A vs. B, 5% vs. 100%, P<0.01; A vs. C, 5% vs.100%, P<0.01). ConclusionIn HE staining, environmentally friendly reagents demonstrated effective tissue fixation and staining results comparable to traditional reagents, meeting the teaching requirements. For special staining, Group B and Group C performed better in Mallory trichrome staining and phosphotungstic acid-hematoxylin staining, respectively. However, environmentally friendly reagents exhibited non-specific staining issues in immunohistochemistry, where further optimization is required.
6.Anti-diabetic Effects of Different Components of Hibiseu Manihot L.Fructus
Yongchen PAN ; Liping CHEN ; Shaodan LIN ; Xiubi XIONG ; Guangying LI ; Jiewei WU ; Jie YUAN
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(7):1765-1772
Objective To investigate the therapeutic effects and mechanisms of Hibiseu Manihot L.fructus on type 2 diabetes mellitus(T2DM)mice.Methods T2DM mice were randomly divided into normal group,model group,positive drug group,Hibiseu Manihot L.fructus total extract group,water-solube part group,and Hibiseu Manihot L.fructus ethyl acetate fraction group,with 10 mice in each group.After 4 weeks of treatment,anti-diabetic effects were evaluated by monitoring body mass,fasting blood glucose(FBG),oral glucose tolerance test(OGTT),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),and area under the blood glucose curve(AUC).Liver tissue status was assessed through liver index and hematoxylin-eosin(HE)staining.Results Compared with the model group,the water-solube part and total extract group showed significant improvements in mental status,food intake,body mass,excretion,and the FBG elevation was effectively suppressed,OGTT,FINS,AUC,HOMA-IR and liver index were significantly decreased(P<0.05 or P<0.01),the histopathological analysis revealed improved liver tissue morphology.Regarding channel protein expression,compared with the model group,the water-solube part group exhibited significantly upregulated phosphorylation levels of protein kinase B(AKT)and phosphatidylinositol 3-kinase(PI3K)in mouse liver tissue(P<0.05),furthermore,the positive drug group,total extract group,and water-solube part group all demonstrated markedly increased phosphorylation of adenosine monophosphate-activated protein kinase(AMPK)in hepatic tissues(P<0.05).Conclusion The water-solube part of fructus of Hibiseu Manihot L fructus.effectively alleviates T2DM symptoms(polyphagia,polydipsia,polyuria,weight loss)and glucose metabolism disorders,with hepatoprotective effects potentially mediated through PI3K/AKT pathway activation and enhanced p-AMPK expression.
7.PRELIMINARY INVESTIGATION OF EHRLICHIA AND NEOEHRLICHIA IN RODENTS AT THE IMPORTANT PORTS ALONG THE"BELT AND ROAD"
Xiao-Long ZHANG ; Jia XU ; Shi-Liang MA ; Pi-Zheng WANG ; Juan PAN ; Jia-Yuan CAO ; Zhi-Wen SUN ; Hui-Lin GUO ; Li-Li XIAO
Acta Parasitologica et Medica Entomologica Sinica 2025;32(3):160-166
Objective This study aimed to investigate natural infection of rodents with Ehrlichia and Neoehrlichia at major Chinese land-border ports along the"Belt and Road".Methods In 2022,rodents were monitored in 10 ports in northern and southern China and identified based on diagnostic morphological characteristics.The 16S rRNA genes of Ehrlichia and Neoehrlichia were detected by PCR using universal primers from rodent samples and phylogenetic analysis was performed based on the sequences of the detected positive pathogens.Results A total of 356 rodents were sampled,including 2 orders,5 families,15 genera,and 20 species.Predominantly,73,61,56,and 58 were Meriones unguiculatus(20.51%),Rattus norvegicus(17.13%),Apodemus agrarius(15.73%),and Microtus gregalis(16.29%).Only one Microtus fortis from Suifenghe Port was infected with Ehrlichia sp.Moreover,12 rodents were infected with Neoehrlichia spp.(overall positivity rate:3.37%).Conclusions Natural infections with Ehrlichia spp.and Neoehrlichia spp.were demonstrated in rodents at important Chinese land-border ports.The positivity rate of Neoehrlichia spp.was high in some ports,indicating that surveillance for ticks and their prevention and control measures should be intensified in these regions.
8.A CASE OF SUSPECTED HYPEREOSINOPHILIA ASSOCIATED WITH HEPATIC SPARGANOSIS
Li-Yuan PAN ; Ju LIU ; Sheng-Xun ZHAO
Acta Parasitologica et Medica Entomologica Sinica 2025;32(3):179-183
Hypereosinophilia is the term given to a group of highly heterogeneous diseases that are characterized by an increase in the absolute count of peripheral eosinophils,which can accumulate in one or more organs.Although parasitic infection is one of the common causes of eosinophilia,it is often ignored.So far,no clear diagnostic guideline for hepatic sparganosis exists worldwide,and only scattered cases have been reported.We reported a case of a patient with hypereosinophilia induced by hepatic sparganosis,with multiple organ involvement,and discussed the clinical characteristics and treatment plan.This report will help clinicians better understand the differential diagnosis of hepatic sparganosis and the diagnosis and treatment of hypereosinophilia.
9.Targeted screening and profiling of massive components of colistimethate sodium by two-dimensional-liquid chromatography-mass spectrometry based on self-constructed compound database
Xuan LI ; Minwen HUANG ; Yue-Mei ZHAO ; Wenxin LIU ; Nan HU ; Jie ZHOU ; Zi-Yi WANG ; Sheng TANG ; Jian-Bin PAN ; Kee-Lee HIAN ; Yao-Zuo YUAN ; Taijun HANG ; Hai-Wei SHI ; Hongyuan CHEN
Journal of Pharmaceutical Analysis 2025;15(2):401-410
In-depth study of the components of polymyxins is the key to controlling the quality of this class of antibiotics.Similarities and variations of components present significant analytical challenges.A two-dimensional(2D)liquid chromatography-mass spectrometry(LC-MS)method was established for screening and comprehensive profiling of compositions of the antibiotic colistimethate sodium(CMS).A high concentration of phosphate buffer mobile phase was used in the first-dimensional LC system to get the components well separated.For efficient and high-accuracy screening of CMS,a targeted method based on a self-constructed high resolution(HR)mass spectrum database of CMS components was established.The database was built based on the commercial MassHunter Personal Compound Database and Library(PCDL)software and its accuracy of the compound matching result was verified with six known components before being applied to genuine sample screening.On this basis,the unknown peaks in the CMS chromatograms were deduced and assigned.The molecular formula,group composition,and origins of a total of 99 compounds,of which the combined area percentage accounted for more than 95%of CMS components,were deduced by this 2D-LC-MS method combined with the MassHunter PCDL.This profiling method was highly efficient and could distinguish hundreds of components within 3 h,providing reliable results for quality control of this kind of complex drugs.
10.Toxicological evaluation of aristolochic acid II following single and repeated oral administration over a 24-week period
Yan YI ; Chunying LI ; Yong ZHAO ; Jingzhuo TIAN ; Yuan WANG ; Yushi ZHANG ; Suyan LIU ; Chen PAN ; Lianmei WANG ; Shuangrong GAO ; Jianyin HAN ; Zhong XIAN ; Chenyue LIU ; Dunfang WANG ; Jing MENG ; Meiting LIU ; Aihua LIANG
Science of Traditional Chinese Medicine 2025;3(4):366-377
Background: Aristolochic acid II (AAII), a major nephrotoxic and carcinogenic component of aristolochic acids (AAs), has been less studied compared with its well-characterized analog, aristolochic acid I (AAI). Although AAs are known to induce carcinogenesis via DNA adduct formation, the toxicity mechanisms, environmental prevalence, and long-term health impacts of AAII remain poorly understood. Objective: This study aimed to systematically evaluate AAII’s acute and chronic toxicity, carcinogenic mechanisms, and environmental exposure patterns using integrated murine models and phytochemical analyses to clarify its toxicological profile and associated health risks. Methods: C57BL/6J mice were used in the following experiments: (1) determination of AAII content in 3 commonly used Aristolochia medicinal materials via liquid chromatography-mass spectrometry/mass spectrometry; (2) acute toxicity testing with single doses of 10, 20, or 40 mg/kg; and (3) chronic exposure with 1 or 10 mg/kg administered every other day for 24 weeks, followed by 21 to 40 weeks of postexposure monitoring. Histopathological examination, whole-exome sequencing, biochemical assays, and micronucleus tests were performed to assess multi-organ damage, tumorigenesis, genomic mutation signatures, and direct clastogenicity. Phytochemical analyses were used to evaluate environmental distribution. Results: (1) A single 40 mg/kg dose of AAII induced dose-dependent renal tubular degeneration without hepatotoxicity; (2) the 10 mg/kg group showed significant mortality (20%), tumor incidence (33.3%, primarily forestomach and bladder transitional cell carcinomas), persistent renal interstitial fibrosis, and subclinical hepatic injury. Chronic exposure to 1 mg/kg still induced 13.3% mortality and 15.5% tumor incidence over a 64-week period; (3) whole-exome sequencing revealed a predominance of C>T mutations and pathway enrichment in chemical carcinogenesis and cytochrome P450-mediated metabolism, indicating reactive metabolite-driven mechanisms distinct from classical AA-DNA adducts; and (4) no histopathological changes were observed in nontarget organs (brain, heart, and testes), and micronucleus assays confirmed the absence of direct clastogenicity. Conclusion: This study highlights the delayed carcinogenic risks of low-dose chronic AAII exposure and emphasizes the need to update regulatory frameworks to ensure the safe use of aristolochiaceae-containing herbal products.

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