BACKGROUND:The quadriceps strength of patients with osteoporosis and sarcopenia is significantly reduced,which can further reduce the function of the knee joint,affect the function of the lower limbs and even lead to a decrease in whole-body coordination.It is speculated that a reasonable quadriceps training program and personalized guidance are beneficial to the recovery of knee joint function in patients with osteoporosis and sarcopenia.OBJECTIVE:To observe the effect of short-term moderate-intensity resistance rehabilitation training on the mass and function of the quadriceps and knee joint function in patients with osteoporosis and sarcopenia.METHODS:Using the integrated physical examination and rehabilitation model,375 patients with osteoporosis and sarcopenia were screened at the Health Management Center of Shanghai Public Health Clinical Center.They underwent 12 weeks of combined/comprehensive exercise rehabilitation based on resistance exercise,including quadriceps resistance isotonic and isometric contraction training twice a week(3-5 sets each time,10-15 minutes per set)and aerobic exercise/balance exercise two or three times a week(30 minutes each time).Assessments and data collection were performed before rehabilitation training,12 weeks after rehabilitation training,and at follow-up 12 weeks after stopping rehabilitation training,mainly including knee joint range of motion and proprioception,quadriceps muscle strength,and cross-sectional area(magnetic resonance imaging results),pain,knee joint function(Hospital for Special Surgery score)and walking function("up-and-go"time and 6 m pace test results)as well as the patient's psychological status assessment.RESULTS AND CONCLUSION:All 375 patients completed 12 weeks of rehabilitation training and 12 weeks of follow-up without any adverse events.(1)Compared with before training,the patients' gait speed and knee range of motion increased significantly after 12 weeks of rehabilitation training(P＜0.01),the time of"stand-to-walk"decreased(P＜0.01),and the proprioception of the knee joint and the strength of the quadriceps femoris were significantly improved(P＜0.01);and at the follow-up visit 12 weeks after stopping training,the above indicators and functions of the patients were well maintained(P＞0.05).(2)Magnetic resonance imaging results showed that the effective cross-sectional area of the quadriceps femoris did not improve significantly after 12 weeks of rehabilitation training(P＞0.05);but the Hospital for Special Surgery score of knee joint function increased significantly(P＜0.01),and the visual analog pain scale score decreased significantly(P＜0.01),suggesting that this may be related to the improvement of quadriceps femoris quality by resistance rehabilitation training.(3)The results of the Hospital Anxiety and Depression Scale score showed that the anxiety and depression scores of the patients continued to decrease,both at 12 weeks of rehabilitation training and at 12 weeks after stopping training(P＜0.01).It is suggested that resistance rehabilitation training of the quadriceps can help patients with osteoporosis and sarcopenia to restore quadriceps muscle strength,increase range of motion,improve proprioception and joint stability,thereby enhancing knee joint function,reducing pain,improving depression and anxiety,and to a certain extent promoting the coordinated recovery of the musculoskeletal system.

Objective To evaluate the dissolution effects of pediatric ammonium urate stones in solutions with different pH values, so as to provide reference for the clinical treatment of this type of stones. Methods Eight pure ammonium urate stones(ammonium urate content ≥90%)of similar size and mass(median mass 4.6 g)were obtained from 8 children(＜14 years)undergoing percutaneous nephrolithotomy at the People's Hospital of Xinjiang Uygur Autonomous Region. The stones were placed in sodium chloride solutions with pH values of 5.0, 6.0, 7.0, and 8.5 and artificial urine with pH values of 4. 6, 5.0, 7.0, and 8.5 at a constant temperature of 37 ℃. The mass of the stones was recorded before placement and at 24, 48, and 72 h after placement. The dissolution rates of the stones were calculated. Results The pediatric ammonium urate stones could be dissolved in sodium chloride solution, and the total dissolution rate was the highest(94.6%)after 72 hours when the pH value was 6.0. The total dissolution rate of ammonium urate stones in artificial urine after 72 hours were all over 50%, and the total dissolution rate was the highest(79.7%)when the pH value was 4.6. Conclusion Pediatric ammonium urate stones are soluble in sodium chloride solution and artificial urine, and the total dissolution rate is higher in acidic environment.

OBJECTIVE Identify the incentive and constraint factors of artificial intelligence （AI） application in the pharmaceutical field， and promote the application of AI in the field of pharmacy. METHODS Based on the technology acceptance model （TAM）， technology-organization-environment （TOE） framework， and diffusion of innovation theory （DOI）， a TAM-TOE-DOI integrated framework was constructed through a four-stage research process of “theoretical review → dimension mapping → mechanism integration → proposition development”. Combining the analytical pathways of the above three theories in AI application in pharmacy with the integration mechanisms and core propositions of the TAM-TOE-DOI， literature review and deductive reasoning were employed to systematically identify the incentive and constraint factors of AI application in pharmacy from three levels：micro （TAM）， meso （TOE）， and macro （DOI）， and to propose optimization strategies. RESULTS & CONCLUSIONS At the micro level， the efficiency transformation and quality improvement brought by AI technology were the main incentive factors for perceived usefulness， while technological complexity and algorithmic opacity were the main constraint factors for perceived ease of use. At the meso level， the completeness of technological infrastructure， the strength of top management support and innovation climate， as well as external institutional pressure and competitive driving forces were the core incentive factors， whereas scarcity of organizational resources and talent shortage were the main constraint factors. At the macro level， relative advantage and observability were typical incentive factors， while technological complexity was a typical constraint factor. China’s health administration， medical insurance authorities， and other relevant departments should coordinate efforts at the macro， meso， and micro levels to advance AI application in pharmacy： optimizing human-computer interaction and implementing tiered training programs at the micro level； reinforcing organizational support systems and capacity building at the meso level； dismantling data barriers and building social trust at the macro level. Differentiated implementation pathways should be developed for medical institutions at different tiers.

BACKGROUND:The quadriceps strength of patients with osteoporosis and sarcopenia is significantly reduced,which can further reduce the function of the knee joint,affect the function of the lower limbs and even lead to a decrease in whole-body coordination.It is speculated that a reasonable quadriceps training program and personalized guidance are beneficial to the recovery of knee joint function in patients with osteoporosis and sarcopenia.OBJECTIVE:To observe the effect of short-term moderate-intensity resistance rehabilitation training on the mass and function of the quadriceps and knee joint function in patients with osteoporosis and sarcopenia.METHODS:Using the integrated physical examination and rehabilitation model,375 patients with osteoporosis and sarcopenia were screened at the Health Management Center of Shanghai Public Health Clinical Center.They underwent 12 weeks of combined/comprehensive exercise rehabilitation based on resistance exercise,including quadriceps resistance isotonic and isometric contraction training twice a week(3-5 sets each time,10-15 minutes per set)and aerobic exercise/balance exercise two or three times a week(30 minutes each time).Assessments and data collection were performed before rehabilitation training,12 weeks after rehabilitation training,and at follow-up 12 weeks after stopping rehabilitation training,mainly including knee joint range of motion and proprioception,quadriceps muscle strength,and cross-sectional area(magnetic resonance imaging results),pain,knee joint function(Hospital for Special Surgery score)and walking function("up-and-go"time and 6 m pace test results)as well as the patient's psychological status assessment.RESULTS AND CONCLUSION:All 375 patients completed 12 weeks of rehabilitation training and 12 weeks of follow-up without any adverse events.(1)Compared with before training,the patients' gait speed and knee range of motion increased significantly after 12 weeks of rehabilitation training(P＜0.01),the time of"stand-to-walk"decreased(P＜0.01),and the proprioception of the knee joint and the strength of the quadriceps femoris were significantly improved(P＜0.01);and at the follow-up visit 12 weeks after stopping training,the above indicators and functions of the patients were well maintained(P＞0.05).(2)Magnetic resonance imaging results showed that the effective cross-sectional area of the quadriceps femoris did not improve significantly after 12 weeks of rehabilitation training(P＞0.05);but the Hospital for Special Surgery score of knee joint function increased significantly(P＜0.01),and the visual analog pain scale score decreased significantly(P＜0.01),suggesting that this may be related to the improvement of quadriceps femoris quality by resistance rehabilitation training.(3)The results of the Hospital Anxiety and Depression Scale score showed that the anxiety and depression scores of the patients continued to decrease,both at 12 weeks of rehabilitation training and at 12 weeks after stopping training(P＜0.01).It is suggested that resistance rehabilitation training of the quadriceps can help patients with osteoporosis and sarcopenia to restore quadriceps muscle strength,increase range of motion,improve proprioception and joint stability,thereby enhancing knee joint function,reducing pain,improving depression and anxiety,and to a certain extent promoting the coordinated recovery of the musculoskeletal system.

Autism Spectrum Disorder （ASD） is a neurodevelopmental disorder with rapidly increasing global prevalence， characterized by core symptoms of social communication deficits and stereotyped repetitive behaviors. Although genetic predisposition， abnormal epigenetic regulation， perinatal environmental exposure， and nutritional-metabolic imbalances are recognized as major risk factors， the precise etiological mechanisms remain incompletely understood. Current clinical management primarily relies on behavioral interventions， with limited pharmacological options accompanied by adverse effects. Recent studies have demonstrated the unique therapeutic value of active components from Chinese herbal medicine in ASD intervention. This article reviews the mechanisms underlying various Chinese herbal active components in ASD treatment， including improvements in synaptic dysfunction， blood-brain barrier impairment， neurotransmitter regulation， cerebellar dysfunction， immune dysregulation and neuroinflammation， oxidative stress， programmed neuronal cell death， and lipid metabolism. These bioactive components exhibit multi-target and multi-pathway regulatory effects， providing novel therapeutic strategies and directions for ASD.

ObjectiveTo investigate whether Carthamus tinctorius L.-derived nanovesicles （CDNVs） can alleviate angiotensin Ⅱ （ANGⅡ）-induced cardiomyocyte （H9C2） hypertrophy by inhibiting the NF-κB signaling pathway and to elucidate the underlying molecular mechanisms. MethodsCDNVs were isolated and purified by ultracentrifugation combined with sucrose density gradient centrifugation， and their morphology and particle size distribution were identified by transmission electron microscopy and nanoparticle tracking analysis. Rat H9C2 cardiomyocytes were cultured in vitro and randomly divided into the normal control group （NC）， ANGⅡ （1.0 μmol/L） group， ANGⅡ+CDNVs group， and ANGⅡ+CDNVs+NF-κB activator 1 group. After 24 h of intervention， cell viability was detected by the CCK-8 assay， the expression of myocardial hypertrophy-related genes （ANP， BNP） was determined by qPCR， the relative cell area was measured by phalloidin staining， the expression of hypertrophy marker proteins and NF-κB pathway proteins （P-p65/p65， P-IκBα/IκBα） was examined by Western blot， and nuclear translocation of p65 was observed by immunofluorescence. Subsequently， NF-κB signaling pathway agonist activator 1 was added， and the expression of myocardial hypertrophy marker proteins and NF-κB pathway proteins was detected. ResultsCDNVs exhibited a typical round-like vesicle structure with an average particle size of 140.4 nm， which was consistent with the morphological characteristics of exosomes. ANGⅡ at concentrations of 0.1-1.0 μmol/L had no significant effect on cardiomyocyte viability. Compared with the NC group， ANGⅡ significantly upregulated the gene expression of ANP and BNP， increased the relative surface area of cardiomyocytes， elevated the levels of myocardial hypertrophy marker proteins and NF‑κB pathway proteins， and promoted the nuclear translocation of p65 （P<0.05）. Following treatment with CDNVs， all the above indicators were markedly reduced in comparison with the ANGⅡ group （all P<0.05）. However， all these experimental results were reversed after the addition of an NF‑κB agonist. ConclusionCDNVs alleviate ANGⅡ-induced H9C2 cell hypertrophy by inhibiting the NF-κB signaling pathway.

ObjectiveTo verify the protective effect and pharmacological mechanism of Qishen granules against doxorubicin-induced cardiotoxicity， thus providing a basis for developing new drug options for clinical treatment of cardio-oncology disease. MethodsFifty mice were randomly assigned into a normal group （n=10） and a modeling group （n=40）. The model was established by intravenous injection of doxorubicin （5 mg·kg^-1） via the tail vein， once a week for 4 consecutive weeks. The normal group was injected with an equal volume of normal saline during the same period. The modeled mice were further assigned into four groups： doxorubicin （no drug control）， low-dose （3.33 mg·kg^-1） Qishen granules， high-dose （6.67 mg·kg^-1） Qishen granules， and enalapril （15 mg·kg^-1）. Mice were administrated with corresponding drugs by gavage for 4 consecutive weeks. At the end of the experiment， echocardiography， histopathological staining， and live-cell imaging were employed to determine relevant indicators， on the basis of which the protective effect of Qishen granules against doxorubicin-induced cardiotoxicity was evaluated. ResultsCompared with the normal group， doxorubicin treatment reduced the left ventricular ejection fraction （LVEF） （P<0.05） and caused pathological changes including disarrangement of cardiomyocytes， increased cell spacing， cardiomyocyte hypertrophy， and increased apoptosis in the heart tissue. Meanwhile， doxorubicin prolonged the mitochondria-lysosome contact time， downregulated the expression of TBC1 domain family member 15 （TBC1D15） （P<0.01）， upregulated the levels of microtubule-associated protein 1 light chain 3 （LC3） and sequestosome 1 （p62） （P<0.01）， and induced mitochondrial cristae breakage， resulting in mitochondrial dysfunction. Compared with the doxorubicin group， intervention with Qishen granules reversed the above indicators. It not only increased the LVEF （P<0.01） and alleviated pathological damage to the heart， but also upregulated the expression of TBC1D15 （P<0.01）， shortened the mitochondria-lysosome contact time （P<0.05）， and downregulated the protein levels of LC3 and p62. When TBC1D15 in cells was knocked down， the autophagy-activating and mitochondrion-protecting effects of Qishen granules partially disappeared. ConclusionQishen granules upregulate the expression of TBC1D15 to shorten the mitochondria-lysosome contact time， thereby activating autophagy and ultimately exerting a protective effect against doxorubicin-induced cardiotoxicity.

ObjectiveTo summarize the research results on the toxic mechanism and the relevant regulatory policies at home and abroad of pyrrolizidine alkaloids （PAs）， the main toxic components， in Senecionis Scandentis Herba， thereby providing insights into the clinical use and scientific regulation of Senecionis Scandentis Herba. MethodsMultiple Chinese and English databases including PubMed， ScienceDirect， Elsevier， China national knowledge infrastructure （CNKI）， Wanfang Data， and VIP were searched， with "Senecio，" "PSenecio scandens，" and "pyrrolizidine alkaloids" as search terms. The relevant articles published from 1959 to 2025 were retrieved and analyzed， and 79 articles were finally selected for review. ResultsThe chemical components of Senecionis Scandentis Herba include alkaloids， flavonoids， volatile oils， sesquiterpenes， jacaranone derivatives， and organic acids， among which alkaloids are the most toxic components， followed by jacaranone derivatives. PAs are metabolized into highly active pyrrole derivatives in the liver， which can cause serious adverse reactions such as sinusoidal obstruction syndrome and DNA damage. The content of PAs varies significantly due to the origin， harvest period， and medicinal parts. There have been reports of clinical liver injury caused by preparations containing Senecionis Scandentis Herba， and some preparations have a daily intake of PAs exceeding the international safety threshold. Currently， international organizations have set limited standards for PAs， while China only controls the content of adonifoline， and the supervision is not yet perfect. ConclusionAlthough Senecionis Scandentis Herba has medicinal value， its PAs have significant toxicological properties. This is a problem that cannot be ignored and needs to be overcome in the use of Senecionis Scandentis Herba. Therefore， it is necessary to strengthen the quality control of raw materials， establish a more comprehensive limited standard for PAs， and optimize the medication strategy in combination with traditional Chinese medicine theory to ensure the safety of clinical medication.

ObjectiveTo verify the protective effect and pharmacological mechanism of Qishen granules against doxorubicin-induced cardiotoxicity， thus providing a basis for developing new drug options for clinical treatment of cardio-oncology disease. MethodsFifty mice were randomly assigned into a normal group （n=10） and a modeling group （n=40）. The model was established by intravenous injection of doxorubicin （5 mg·kg^-1） via the tail vein， once a week for 4 consecutive weeks. The normal group was injected with an equal volume of normal saline during the same period. The modeled mice were further assigned into four groups： doxorubicin （no drug control）， low-dose （3.33 mg·kg^-1） Qishen granules， high-dose （6.67 mg·kg^-1） Qishen granules， and enalapril （15 mg·kg^-1）. Mice were administrated with corresponding drugs by gavage for 4 consecutive weeks. At the end of the experiment， echocardiography， histopathological staining， and live-cell imaging were employed to determine relevant indicators， on the basis of which the protective effect of Qishen granules against doxorubicin-induced cardiotoxicity was evaluated. ResultsCompared with the normal group， doxorubicin treatment reduced the left ventricular ejection fraction （LVEF） （P<0.05） and caused pathological changes including disarrangement of cardiomyocytes， increased cell spacing， cardiomyocyte hypertrophy， and increased apoptosis in the heart tissue. Meanwhile， doxorubicin prolonged the mitochondria-lysosome contact time， downregulated the expression of TBC1 domain family member 15 （TBC1D15） （P<0.01）， upregulated the levels of microtubule-associated protein 1 light chain 3 （LC3） and sequestosome 1 （p62） （P<0.01）， and induced mitochondrial cristae breakage， resulting in mitochondrial dysfunction. Compared with the doxorubicin group， intervention with Qishen granules reversed the above indicators. It not only increased the LVEF （P<0.01） and alleviated pathological damage to the heart， but also upregulated the expression of TBC1D15 （P<0.01）， shortened the mitochondria-lysosome contact time （P<0.05）， and downregulated the protein levels of LC3 and p62. When TBC1D15 in cells was knocked down， the autophagy-activating and mitochondrion-protecting effects of Qishen granules partially disappeared. ConclusionQishen granules upregulate the expression of TBC1D15 to shorten the mitochondria-lysosome contact time， thereby activating autophagy and ultimately exerting a protective effect against doxorubicin-induced cardiotoxicity.

ObjectiveTo summarize the research results on the toxic mechanism and the relevant regulatory policies at home and abroad of pyrrolizidine alkaloids （PAs）， the main toxic components， in Senecionis Scandentis Herba， thereby providing insights into the clinical use and scientific regulation of Senecionis Scandentis Herba. MethodsMultiple Chinese and English databases including PubMed， ScienceDirect， Elsevier， China national knowledge infrastructure （CNKI）， Wanfang Data， and VIP were searched， with "Senecio，" "PSenecio scandens，" and "pyrrolizidine alkaloids" as search terms. The relevant articles published from 1959 to 2025 were retrieved and analyzed， and 79 articles were finally selected for review. ResultsThe chemical components of Senecionis Scandentis Herba include alkaloids， flavonoids， volatile oils， sesquiterpenes， jacaranone derivatives， and organic acids， among which alkaloids are the most toxic components， followed by jacaranone derivatives. PAs are metabolized into highly active pyrrole derivatives in the liver， which can cause serious adverse reactions such as sinusoidal obstruction syndrome and DNA damage. The content of PAs varies significantly due to the origin， harvest period， and medicinal parts. There have been reports of clinical liver injury caused by preparations containing Senecionis Scandentis Herba， and some preparations have a daily intake of PAs exceeding the international safety threshold. Currently， international organizations have set limited standards for PAs， while China only controls the content of adonifoline， and the supervision is not yet perfect. ConclusionAlthough Senecionis Scandentis Herba has medicinal value， its PAs have significant toxicological properties. This is a problem that cannot be ignored and needs to be overcome in the use of Senecionis Scandentis Herba. Therefore， it is necessary to strengthen the quality control of raw materials， establish a more comprehensive limited standard for PAs， and optimize the medication strategy in combination with traditional Chinese medicine theory to ensure the safety of clinical medication.