Arterial thrombosis remains a leading cause of cardiovascular morbidity and mortality despite widespread use of dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors. Although these agents reduce ischemic events, their efficacy is counterbalanced by dose-dependent bleeding and their inability to distinguish pathological platelet activation from physiological hemostasis.Recent advances in platelet biology have shifted therapeutic development toward hemostasis-sparing antiplatelet strategies— approaches designed to selectively inhibit thrombosis while preserving baseline hemostatic function. These strategies target upstream adhesion receptors (GPVI, GPIb–vWF, CLEC-2) and receptor-proximal intracellular signaling nodes (SYK, BTK, PI3Kβ, PLCγ2, NADPH oxidases) that are preferentially engaged under high-shear or strongly prothrombotic conditions. Early-phase clinical and translational studies of such agents demonstrate antithrombotic efficacy with minimal impact on bleeding time, supporting their mechanistic selectivity. In parallel, contemporary clinical practice increasingly utilizes individualized risk assessment, platelet function testing, and genetic profiling to tailor treatment intensity. This integration of mechanism-selective agents with patient-specific risk evaluation forms the basis of precision-based thrombosis prevention, a framework aimed at aligning the duration and depth of platelet inhibition with the dynamic balance between ischemic and bleeding risk. Together, these developments mark a paradigm shift from broad platelet suppression toward rational, context-adaptive, and safer antiplatelet therapy.

OBJECTIVE: Baicalein has been reported to have wide therapeutic effects that act through its anti-inflammatory activity. This study examines the effect and mechanism of baicalein on sepsis-induced cardiomyopathy (SIC). METHODS: A thorough screening of a small library of natural products, comprising 100 diverse compounds, was conducted to identify the most effective drug against lipopolysaccharide (LPS)-treated H9C2 cardiomyocytes. The core target proteins and their associated signaling pathways involved in baicalein's efficacy against LPS-induced myocardial injury were predicted by network pharmacology. RESULTS: Baicalein was identified as the most potent protective agent in LPS-exposed H9C2 cardiomyocytes. It exhibited a dose-dependent inhibitory effect on cell injury and inflammation. In the LPS-induced septic mouse model, baicalein demonstrated a significant capacity to mitigate LPS-triggered myocardial deficits, inflammatory responses, and ferroptosis. Network pharmacological analysis and experimental confirmation suggested that hypoxia-inducible factor 1 subunit α (HIF1-α) is likely to be the crucial factor in mediating the impact of baicalein against LPS-induced myocardial ferroptosis and injury. By combining microRNA (miRNA) screening in LPS-treated myocardium with miRNA prediction targeting HIF1-α, we found that miR-299b-5p may serve as a regulator of HIF1-α. The reduction in miR-299b-5p levels in LPS-treated myocardium, compared to the control group, was reversed by baicalein treatment. The reverse transcription quantitative polymerase chain reaction, Western blotting, and dual-luciferase reporter gene analyses together identified HIF1-α as the target of miR-299b-5p in cardiomyocytes. CONCLUSION Baicalein mitigates SIC at the miRNA level, suggesting the therapeutic potential of it in treating SIC through the regulation of miR-299b-5p/HIF1-α/ferroptosis pathway. Please cite this article as: Zhou WY, Du JK, Liu HH, Deng L, Ma K, Xiao J, Zhang S, Wang CN. Baicalein attenuates lipopolysaccharide-induced myocardial injury by inhibiting ferroptosis via miR-299b-5p/HIF1-α pathway. J Integr Med. 2025; 23(5):560-575.
Flavanones/pharmacology* ; Animals ; MicroRNAs/genetics* ; Lipopolysaccharides ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Ferroptosis/drug effects* ; Mice ; Myocytes, Cardiac/metabolism* ; Signal Transduction/drug effects* ; Rats ; Male ; Mice, Inbred C57BL ; Cardiomyopathies/etiology* ; Cell Line ; Sepsis/complications*

OBJECTIVE: This study aimed to explore the interplay between the life-course body mass index (BMI) trajectories and insulin resistance (IR) on incident diabetes. METHODS: This longitudinal cohort included 2,336 participants who had BMI repeatedly measured 3-8 times between 1989 and 2009, as well as glucose and insulin measured in 2009. BMI trajectories were identified using a latent class growth mixed model. The interplay between BMI trajectories and IR on diabetes was explored using the four-way effect decomposition method. Logistic regression and mediation models were used to estimate the interaction and mediation effects, respectively. RESULTS: Three distinct BMI trajectory groups were identified: low-stable ( n = 1,625), medium-increasing ( n = 613), and high-increasing ( n = 98). Both interaction and mediation effects of BMI trajectories and IR on incident diabetes were significant ( P < 0.05). The proportion of incident diabetes was higher in the IR-obesity than in the insulin-sensitivity (IS) obesity group (18.9% vs. 5.8%, P < 0.001). After adjusting for covariates, the odds ratios (95% confidence intervals) of the IR, IS-obesity, and IR-obesity groups vs. the normal group were 3.22 (2.05, 5.16), 2.05 (1.00, 3.97), and 7.98 (5.19, 12.62), respectively. IR mediated 10.7% of the total effect of BMI trajectories on incident diabetes ( P < 0.001). CONCLUSION We found strong interactions and weak mediation effects of IR on the relationship between life-course BMI trajectories and incident diabetes. IS-obesity is associated with a lower risk of incident diabetes than IR-obesity.
Humans ; Insulin Resistance ; Body Mass Index ; Male ; Female ; Middle Aged ; China/epidemiology* ; Adult ; Longitudinal Studies ; Incidence ; Diabetes Mellitus/epidemiology* ; Aged ; Obesity/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; East Asian People

Liquid-liquid phase separation(LLPS)is the process where intracellular biomolecules rapidly form reversible high concentrations of liquid-phase condensates,resulting in the compartmentalization and the formation of intracellular membraneless organelles.LLPS is involved in various biological processes and pathologic processes,such as neurodegenerative diseases and cancers.Long noncoding RNAs(lncR-NAs)have been revealed to be closely related to phase separation.It has become a research hotspot in life science recently,because it provides new insight into the mechanism of lncRNAs.In this review,we focuses on the effect of lncRNA SLERT on the phase separation of nucleolar fibrillar center/dense fibrillar component(FC/DFC)by interacting with DDX21 protein as a molecular chaperone;LINC00657(NO-RAD)forms NP bodies with PUM proteins,which drives PUM protein liquid droplets and inhibits its ac-tivity,and promotes genomic stability;DilncRNA regulates DNA damage response small RNAs(DDR-NAs)and LLPS of p53 binding protein 1(53BP1)in response to DNA damage,and lncRNA LINP1 phase separation droplets bind to Ku protein to promote DNA damage repair;LncRNA SNHG9,MELTF-AS1 and MALR drive LATS1,YBX1 and ILF3 protein LLPS respectively to promote cancer,while GIR-GL and lncFASA act as tumor suppressor genes in cancer development through regulating the phase sepa-ration of CAPRIN1 and PRDX1 respectively;LncRNA XIST drives X chromosome inactivation by LLPS.In a word,we summarize the latest research progress about the functional roles of lncRNAs in FC/DFC nucleolus,genomic stability and DNA damage and repair,cancer and X-chromosome inactivation through regulating LLPS.This paper shows that lncRNAs can participate in multiple pathophysiological processes by regulating LLPS,which is expected to provide a new direction for the treatment of LLPS-mediated diseases.

Objective To investigate the effect and mechanism of methyl oxofulnonone A(META)on high glucose(HG)-induced H9c2 cell injury.Methods H9c2 cells were divided into control group(normal culture),model group(55 mmol·L-1 glucose)and experimental-L,-M,-H groups(55 mmol·L-1 glucose+12.5,25.0,50.0 μmol·L-1 META).Cell viability was detected by cell counting kit-8;intracellular reactive oxygen species(ROS)level was detected by DCFH-DA fluorescent probe;intracellular adenosine triphosphate(ATP)content was detected by luciferase;and autophagy-related protein expression was detected by Western blotting.Results The optical density values of 72-hour cells in the control group,model group and experimental-M,-H groups were 0.91±0.03,0.61±0.01,0.69±0.02 and 0.72±0.03;the ROS levels were(40.75±1.53)％,(43.73±1.30)％,(30.87±1.27)％and(28.28±1.43)％;the ATP contents were(8.16±0.71),(4.03±0.29),(5.29±0.31)and(5.83±0.31)nmol·mg-1;the relative expression levels of autophagy-related gene 5 protein were 1.05±0.06,1.46±0.09,0.98±0.11 and 0.89±0.09;the relative expression levels of ubiquitin-binding protein were 1.05±0.10,0.55±0.13,0.89±0.04 and 0.98±0.04;the ratios of microtubule-associated protein 1 light chain 3 11/Ⅰ protein were 1.09±0.09,1.82±0.05,1.67±0.29 and 1.09±0.15,respectively.Among the above indicators,there were statistically significant differences between the model group and the control and experimental-M,-H groups(P＜0.05,P＜0.01).Conclusion META significantly ameliorates H9c2 cardiomyocyte damage caused by high glucose,ameliorates oxidative stress,protects mitochondrial respiration and inhibits autophagy.

Objective To investigate the effect and mechanism of methyl oxofulnonone A(META)on high glucose(HG)-induced H9c2 cell injury.Methods H9c2 cells were divided into control group(normal culture),model group(55 mmol·L-1 glucose)and experimental-L,-M,-H groups(55 mmol·L-1 glucose+12.5,25.0,50.0 μmol·L-1 META).Cell viability was detected by cell counting kit-8;intracellular reactive oxygen species(ROS)level was detected by DCFH-DA fluorescent probe;intracellular adenosine triphosphate(ATP)content was detected by luciferase;and autophagy-related protein expression was detected by Western blotting.Results The optical density values of 72-hour cells in the control group,model group and experimental-M,-H groups were 0.91±0.03,0.61±0.01,0.69±0.02 and 0.72±0.03;the ROS levels were(40.75±1.53)％,(43.73±1.30)％,(30.87±1.27)％and(28.28±1.43)％;the ATP contents were(8.16±0.71),(4.03±0.29),(5.29±0.31)and(5.83±0.31)nmol·mg-1;the relative expression levels of autophagy-related gene 5 protein were 1.05±0.06,1.46±0.09,0.98±0.11 and 0.89±0.09;the relative expression levels of ubiquitin-binding protein were 1.05±0.10,0.55±0.13,0.89±0.04 and 0.98±0.04;the ratios of microtubule-associated protein 1 light chain 3 11/Ⅰ protein were 1.09±0.09,1.82±0.05,1.67±0.29 and 1.09±0.15,respectively.Among the above indicators,there were statistically significant differences between the model group and the control and experimental-M,-H groups(P＜0.05,P＜0.01).Conclusion META significantly ameliorates H9c2 cardiomyocyte damage caused by high glucose,ameliorates oxidative stress,protects mitochondrial respiration and inhibits autophagy.

Liquid-liquid phase separation(LLPS)is the process where intracellular biomolecules rapidly form reversible high concentrations of liquid-phase condensates,resulting in the compartmentalization and the formation of intracellular membraneless organelles.LLPS is involved in various biological processes and pathologic processes,such as neurodegenerative diseases and cancers.Long noncoding RNAs(lncR-NAs)have been revealed to be closely related to phase separation.It has become a research hotspot in life science recently,because it provides new insight into the mechanism of lncRNAs.In this review,we focuses on the effect of lncRNA SLERT on the phase separation of nucleolar fibrillar center/dense fibrillar component(FC/DFC)by interacting with DDX21 protein as a molecular chaperone;LINC00657(NO-RAD)forms NP bodies with PUM proteins,which drives PUM protein liquid droplets and inhibits its ac-tivity,and promotes genomic stability;DilncRNA regulates DNA damage response small RNAs(DDR-NAs)and LLPS of p53 binding protein 1(53BP1)in response to DNA damage,and lncRNA LINP1 phase separation droplets bind to Ku protein to promote DNA damage repair;LncRNA SNHG9,MELTF-AS1 and MALR drive LATS1,YBX1 and ILF3 protein LLPS respectively to promote cancer,while GIR-GL and lncFASA act as tumor suppressor genes in cancer development through regulating the phase sepa-ration of CAPRIN1 and PRDX1 respectively;LncRNA XIST drives X chromosome inactivation by LLPS.In a word,we summarize the latest research progress about the functional roles of lncRNAs in FC/DFC nucleolus,genomic stability and DNA damage and repair,cancer and X-chromosome inactivation through regulating LLPS.This paper shows that lncRNAs can participate in multiple pathophysiological processes by regulating LLPS,which is expected to provide a new direction for the treatment of LLPS-mediated diseases.

Objective:To evaluate the diagnostic efficacy of artificial intelligence-assisted cytology in detecting esophageal cancer and precancerous lesions.Methods:Outpatients who were scheduled for endoscopic examination at the Second Affiliated Hospital of Baotou Medical College from June 21, 2021 to May 12, 2022 were selected. Artificial intelligence-assisted cytology and painless gastroscopy (add narrow-band imaging and biopsy pathology when need) (hereinafter referred to as gastroscopy) were performed. The detection rates of esophageal cancer and precancerous lesions by the two methods were compared. Taking gastroscopy as the standard, sensitivity, specificity, positive predictive value, negative predictive value of artificial intelligence-assisted cytology diagnosis were calculated to verify its diagnostic efficacy.Results:A total of 849 patients meeting the inclusion criteria were included. Artificial intelligence-assisted cytology detected 365 cases of esophageal lesions, with a detection rate of 42.99%. One hundred cases of esophageal cancer, precancerous lesions, and atypical squamous cell hyperplasia were detected, with a detection rate of 11.78%. Gastroscopy detected 281 cases of esophageal lesions, with a detection rate of 33.10%. Eighty cases of esophageal cancer and precancerous lesion were detected, with a detection rate of 9.42%. The sensitivity and specificity of artificial intelligence-assisted cytology diagnosis were 81.25% (65/80) and 95.45% (734/769), respectively. The positive predictive value was 65.00% (65/100), and the negative predictive value was 98.00% (734/749). The area under the receiver operating characteristic curve of artificial intelligence-assisted cytology in dectecting esophageal cancer and precancerous lesions was 0.785.Conclusion:Artificial intelligence-assisted cytology demonstrates relatively high sensitivity and specificity in diagnosing esophageal cancer and precancerous lesions, exhibiting good diagnostic performance for esophageal lesions.

Objective To develop a deep learning model based on fundus retinal images to improve the detection rate of mild cognitive impairment(MCI)in patients with coronary heart disease,achieve early intervention and improve prognosis.Methods The study was a single-center cross-sectional study that retrospectively included patients diagnosed with coronary heart disease(CHD)by coronary angiography(≥50％ stenosis of at least one coronary vessel)from Beijing Anzhen Hospital between November 2021 and December 2022.The whole data set was randomly divided into the training set and the testing set according to the ratio of 8∶2 for model development.After that,the patient data of the same center from January 2023 to April 2023 were included in the time verification method to verify the model.The diagnostic criteria for MCI were MMSE＜27 or MoCA＜26.Four kinds of convolutional neural network(CNN)architectures were used to train fundus images,and a comprehensive vision model of MCI detection was established through model integration.The area under the curve(AUC),sensitivity and specificity of the receiver operating curve(ROC)were used to evaluate the performance of the AI model.Results We collected 5 880 eligible fundus images from 3 368 CHD patients.Based on the results of the MMSE scale,the algorithm was labeled,including 2 898 males and 527 MCI patients.The AUC of the deep learning model in the test group is 0.733(95％CI 0.688-0.778),and the sensitivity of the algorithm in the test group is 0.577(95％CI 0.528-0.625)by using the operating point with the maximum sum of sensitivity and specificity.With a specificity of 0.758(95％CI 0.714-0.802),corresponding to a validated AUC of 0.710(95％CI 0.601-0.818).Based on the results of the MoCA scale,the algorithm labels 2 437 males and 1 626 MCI patients.The AUC of the deep learning model in the test group was 0.702(95％CI 0.671-0.733).The operating point with the maximum sum of sensitivity and specificity was selected,and the sensitivity of the algorithm was 0.749(95％CI 0.719-0.778)and the specificity was 0.561(95％CI 0.527-0.595),corresponding to the AUC value of the verification group was 0.674(95％CI 0.622-0.726).Conclusions The deep learning algorithm model based on fundus images has good diagnostic performance,and may be used as a new non-invasive,convenient and rapid screening method for MCI in CHD population.