Pulmonary fibrosis（PF） is a progressive and life-threatening disease with limited therapeutic options， highlighting the urgent need for innovative drug discovery strategies. To address this challenge， the authors propose the formula-originated rational intelligent screening&translation（FIRST）， a systematic framework for developing anti-fibrotic monomers derived from classical traditional Chinese medicine（TCM）. The strategy integrates three key dimensions， including tissue-oriented intelligent screening of active compounds， structural optimization based on drug-target spatial interactions and plant biosynthetic pathways， and cross-scale validation of drug. We further highlight its applications in discovering tissue-oriented novel drugs from clinically validated TCM， the development and mechanistic elucidation of anti-fibrotic therapeutics， as well as the clinical translation and secondary development of candidate drugs. This strategy paves the way for first-in-class， formula-derived monomeric drugs with defined structures， clarified mechanisms， and proven safety， offering a transformative avenue to meet the urgent therapeutic needs of PF and setting a new paradigm for TCM-based drug innovation.

Pulmonary fibrosis（PF） is a progressive and life-threatening disease with limited therapeutic options， highlighting the urgent need for innovative drug discovery strategies. To address this challenge， the authors propose the formula-originated rational intelligent screening&translation（FIRST）， a systematic framework for developing anti-fibrotic monomers derived from classical traditional Chinese medicine（TCM）. The strategy integrates three key dimensions， including tissue-oriented intelligent screening of active compounds， structural optimization based on drug-target spatial interactions and plant biosynthetic pathways， and cross-scale validation of drug. We further highlight its applications in discovering tissue-oriented novel drugs from clinically validated TCM， the development and mechanistic elucidation of anti-fibrotic therapeutics， as well as the clinical translation and secondary development of candidate drugs. This strategy paves the way for first-in-class， formula-derived monomeric drugs with defined structures， clarified mechanisms， and proven safety， offering a transformative avenue to meet the urgent therapeutic needs of PF and setting a new paradigm for TCM-based drug innovation.

ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

Objective:To analyze the effect of rosuvastatin combined with sodium tanshinone Ⅱ A sulfonate(STS)on blood lipids,cardiac function and serum inflammatory factors in elderly patients with stable angina pectoris(SAP)and hyperlipidemia(HLP).Methods:This randomized controlled study enrolled 140 elderly patients with SAP and HLP admitted in the Third People's Hospital of Liaocheng between December 2021 and December 2023.Patients were divided into control group(n=70,took rosuvastatin orally)and combination group(n=70,treated with ro-suvastatin combined with STS).Both groups were treated for two weeks.Clinical effects,blood lipids,cardiac function and serum inflammatory factors and incidence of adverse reactions were compared between the two groups.Results:Total effective rate of combination group was significantly higher than that of control group(92.86％vs.80.00％,P=0.026).Compared with patients in control group,those in combination group had significant lower triglyceride(TG)[(1.42±0.39)mmol/L vs.(1.69±0.11)mmol/L],total cholesterol(TC)[(4.37±0.69)mmol/L vs.(5.25±0.43)mmol/L]and low density lipoprotein-cholesterol(LDL-C)[(2.62±0.39)mmol/L vs.(3.19±0.38)mmol/L],and significant higher high-density lipoprotein cholesterol(HDL-C)[(1.24±0.31)mmol/L vs.(1.10±0.22)mmol/L](P＜0.01 all).Compared with patients in control group,those in combination group had significant higher left ventricular ejection fraction(LVEF)[(59.13±5.46)％vs.(55.97±4.02)％,P＜0.001],and significant lower C-reactive protein(CRP)[(2.66±0.68)mg/L vs.(3.50±1.61)mg/L],tumor necrosis factor-α(TNF-α)[(93.34±19.26)pg/ml vs.(111.70±25.00)pg/ml]and interleukin-6(IL-6)[(76.28±23.88)pg/ml vs.(100.64±27.52)pg/ml](P＜0.001 all).There was no significant difference in the total incidence rate of adverse reactions between two groups(25.7％vs.14.3％,P=0.091).Conclusion:Rosuvas-tatin combined with STS is effective in the treatment of elderly patients with SAP and HLP.It is superior to rosuvas-tatin alone in terms of improving blood lipids,cardiac function and serum inflammatory factors.

Objective:This study aims to compare the efficacy on patients with severe coronary artery calcification(CAC)coronary heart disease(CHD)between common balloon predilation and spinous process balloon predilation and their effect on short-term incidence of major adverse cardiovascular events(MACE).Methods:This retro-spective study enrolled 110 severe CAC patients with CHD who underwent percutaneous coronary intervention(PCI)in Beijing Pinggu District Hospital between January 2017 and January 2022.According to therapeutic pro-gram,they were divided into spinous process balloon group(n=55)and common balloon group(n=55),each group received corresponding balloon predilation before PCI.Application effect,perioperative complications and incidence of MACE within 6 months were compared between two groups.Results:Immediate surgical success rate in spinous process balloon group was significantly higher than that of common ballon group(92.73％vs.78.18％,P=0.031).Compared with patients in common balloon group,those in spinous process balloon group had signifi-cant lower times of balloon predilation[(2.79±0.14)times vs.(7.29±2.24)times],operation time[(1.24±0.29)h vs.(1.59±0.34)h]and incidence of perioperative complications(3.64％vs.14.55％),and significant larger lumen diameter after PCI[(3.79±0.26)mm vs.(3.29±0.24)mm](P＜0.05 or＜0.01).There was no significant difference in incidence of MACE within 6 months between two groups(P=0.428).Conclusion:The ap-plication of spinous process balloon predilation could significantly reduce times of balloon predilation,operation time,improve surgical success rate and reduce risk of short-term MACE in severe CAC patients with CHD.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To analyze the effect of rosuvastatin combined with sodium tanshinone Ⅱ A sulfonate(STS)on blood lipids,cardiac function and serum inflammatory factors in elderly patients with stable angina pectoris(SAP)and hyperlipidemia(HLP).Methods:This randomized controlled study enrolled 140 elderly patients with SAP and HLP admitted in the Third People's Hospital of Liaocheng between December 2021 and December 2023.Patients were divided into control group(n=70,took rosuvastatin orally)and combination group(n=70,treated with ro-suvastatin combined with STS).Both groups were treated for two weeks.Clinical effects,blood lipids,cardiac function and serum inflammatory factors and incidence of adverse reactions were compared between the two groups.Results:Total effective rate of combination group was significantly higher than that of control group(92.86％vs.80.00％,P=0.026).Compared with patients in control group,those in combination group had significant lower triglyceride(TG)[(1.42±0.39)mmol/L vs.(1.69±0.11)mmol/L],total cholesterol(TC)[(4.37±0.69)mmol/L vs.(5.25±0.43)mmol/L]and low density lipoprotein-cholesterol(LDL-C)[(2.62±0.39)mmol/L vs.(3.19±0.38)mmol/L],and significant higher high-density lipoprotein cholesterol(HDL-C)[(1.24±0.31)mmol/L vs.(1.10±0.22)mmol/L](P＜0.01 all).Compared with patients in control group,those in combination group had significant higher left ventricular ejection fraction(LVEF)[(59.13±5.46)％vs.(55.97±4.02)％,P＜0.001],and significant lower C-reactive protein(CRP)[(2.66±0.68)mg/L vs.(3.50±1.61)mg/L],tumor necrosis factor-α(TNF-α)[(93.34±19.26)pg/ml vs.(111.70±25.00)pg/ml]and interleukin-6(IL-6)[(76.28±23.88)pg/ml vs.(100.64±27.52)pg/ml](P＜0.001 all).There was no significant difference in the total incidence rate of adverse reactions between two groups(25.7％vs.14.3％,P=0.091).Conclusion:Rosuvas-tatin combined with STS is effective in the treatment of elderly patients with SAP and HLP.It is superior to rosuvas-tatin alone in terms of improving blood lipids,cardiac function and serum inflammatory factors.

ObjectiveThe aim of this study was to investigate the prophylactic effects of caloric restriction (CR) on lipopolysaccharide (LPS)-induced septic cardiomyopathy (SCM) and to elucidate the mechanisms underlying the cardioprotective actions of CR. This research aims to provide innovative strategies and theoretical support for the prevention of SCM. MethodsA total of forty-eight 8-week-old male C57BL/6 mice, weighing between 20-25 g, were randomly assigned to 4 distinct groups, each consisting of 12 mice. The groups were designated as follows: CON (control), LPS, CR, and CR+LPS. Prior to the initiation of the CR protocol, the CR and CR+LPS groups underwent a 2-week acclimatization period during which individual food consumption was measured. The initial week of CR intervention was set at 80% of the baseline intake, followed by a reduction to 60% for the subsequent 5 weeks. After 6-week CR intervention, all 4 groups received an intraperitoneal injection of either normal saline or LPS (10 mg/kg). Twelve hours post-injection, heart function was assessed, and subsequently, heart and blood samples were collected. Serum inflammatory markers were quantified using enzyme-linked immunosorbent assay (ELISA). The serum myocardial enzyme spectrum was analyzed using an automated biochemical instrument. Myocardial tissue sections underwent hematoxylin and eosin (HE) staining and immunofluorescence (IF) staining. Western blot analysis was used to detect the expression of protein in myocardial tissue, including inflammatory markers (TNF-α, IL-9, IL-18), oxidative stress markers (iNOS, SOD2), pro-apoptotic markers (Bax/Bcl-2 ratio, CASP3), and SIRT3/SIRT6. ResultsTwelve hours after LPS injection, there was a significant decrease in ejection fraction (EF) and fractional shortening (FS) ratios, along with a notable increase in left ventricular end-systolic diameter (LVESD). Morphological and serum indicators (AST, LDH, CK, and CK-MB) indicated that LPS injection could induce myocardial structural disorders and myocardial injury. Furthermore, 6-week CR effectively prevented the myocardial injury. LPS injection also significantly increased the circulating inflammatory levels (IL-1β, TNF-α) in mice. IF and Western blot analyses revealed that LPS injection significantly up-regulating the expression of inflammatory-related proteins (TNF-α, IL-9, IL-18), oxidative stress-related proteins (iNOS, SOD2) and apoptotic proteins (Bax/Bcl-2 ratio, CASP3) in myocardial tissue. 6-week CR intervention significantly reduced circulating inflammatory levels and downregulated the expression of inflammatory, oxidative stress-related proteins and pro-apoptotic level in myocardial tissue. Additionally, LPS injection significantly downregulated the expression of SIRT3 and SIRT6 proteins in myocardial tissue, and CR intervention could restore the expression of SIRT3 proteins. ConclusionA 6-week CR could prevent LPS-induced septic cardiomyopathy, including cardiac function decline, myocardial structural damage, inflammation, oxidative stress, and apoptosis. The mechanism may be associated with the regulation of SIRT3 expression in myocardial tissue.

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.