Natural products (NPs) are an important source of new drugs for the treatment of stroke. Identifying cellular targets for bioactive molecules is a major challenge and critical issue in the development of new drugs for stroke. Small-molecule probes play a unique role in target discovery. However, drawbacks to these probes include non-specificity, unstable activity, and difficulty in synthesis. Small-molecule probes based on NPs at least partially compensate for these shortcomings. NPs feature rich chemical and structural diversity, biocompatibility, and unique biological activities. These features could be exploited to provide new ideas and tools for target discovery. Small-molecule probes based on NPs provide a precise and direct search for interacting protein targets of NPs-active small molecules. This review explores the properties of small-molecule probes based on NPs and their applications in mechanistic studies of stroke and other diseases. We hope that this review will bring new perspectives to the mechanistic study of NPs-active small molecules and accelerate the translation of these ingredients into drug candidates for the treatment of stroke.

Objective:To understand the current research status, hot issues, and development trends of Taohong Siwu Decoction.Methods:Research literature about Taohong Siwu Decoction was retrieved from Wanfang Data, CBM, CNKI, and Chongqing VIP from January 1, 2014, to August 13, 2024. Excel 2024 software was used to analyze the annual number of publications, the source journals, literature types and the distribution of diseases and syndromes. CiteSpace 6.3.R3 software was used for visualization analysis on the authors, research institutions and key words.Results:A total of 2 519 articles were included, and the annual publication volume showed a fluctuating growth trend. There were 396 source journals, of which Medicine and Health published the most (80 articles); 208 authors were involved, and the core authors included Peng Daiyin of Anhui University of Chinese Medicine, Zhu Fuping of the First Affiliated Hospital of Hunan University of Chinese Medicine, Sun Shaoqiu of the Second Affiliated Hospital of Hunan University of Chinese Medicine and so on. The main research institutions in this field included Hunan University of Chinese Medicine and its affiliated hospitals. The high-frequency keywords included fracture, irregular menstruation, clinical efficacy, chloasma, Wuling Powder, experience of famous doctors, elderly, etc. Keywords could be clustered into 11 modules.Conclusions:The current research hotspots of Taohong Siwu Decoction mainly focus on the exploration of multi-system disease treatment, individualized syndrome differentiation and treatment, pharmacology and metabolic mechanism of Chinese materia medica, etc. Among them, the in-depth study of drug composition and metabolism, network pharmacology and mechanism is the research frontier in this field.

Objective To evaluate the clinical efficacy of haloperidol combined with auricular point pressing therapy in children with tic disorders.Methods A total of 120 pediatric patients diagnosed with tic disorders at the Department of Pediatric Rehabilitation,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province from March 2022 to March 2024 were enrolled.Participants were randomly divided into an observation group(n=60)and a control group(n=60)using a random number table.The control group received haloperidol alone,while the observation group received additional auricular point pressing therapy.Treatment duration was 12 weeks.After 3 months,clinical efficacy was assessed by comparing:Yale Global Tic Severity Scale(YGTSS)scores,serum 5-hydroxytryptamine(5-HT)and dopamine(DA)levels,immune function markers(CD3+,CD4+),and incidence of adverse reactions between groups.Results(1)The overall efficacy rate in the observation group was 91.67％(55/60),while that in the control group was 76.67％(46/60).The efficacy of the observation group was superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,the YGTSS scores of children in both groups was significantly improved(P＜0.05),and the observation group showed a significantly greater improvement in YGTSS scores than the control group,with a statistically significant difference(P＜0.05).(3)After treatment,the levels of 5-HT and DA in both groups of children were significantly improved(P＜0.05),and the observation group showed a significantly greater improvement in 5-HT and DA levels than the control group,with a statistically significant difference(P＜0.05).(4)After treatment,CD3+and CD4+levels were significantly improved in both groups(P＜0.05),and the observation group showed a significantly greater improvement in CD3+and CD4+levels than the control group,with a statistically significant difference(P＜0.05).(5)There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group,with a statistically significant difference(P＞0.05).Conclusion The combination of haloperidol and auricular point pressing therapy significantly improves clinical symptoms and immune function in children with tic disorders,demonstrating both efficacy and safety.

Objective To investigate the effect and possible mechanism of microRNA-26a(miR-26a)on the syn-thesis of extracellular matrix(ECM)induced by high glucose(HG)in renal tubular epithelial cells(RTECs).Methods A model of diabetic kidney disease(DKD)was constructed by inducing RTECs with HG.MiR-26a was overexpressed in HG-induced RTECs,and RT-qPCR and Western blot were used to assess the effects of miR-26a on ECM synthesis and ferroptosis-related markers in HG-treated RTECs.Ferrostatin(Fer-1)was used to inhibit ferroptosis in the DKD model,and its impact on ECM synthesis was evaluated.RT-qPCR and Western blot were performed to measure ferroptosis-related markers,and fluorescence microscopy was used to observe the intensity of reactive oxygen species(ROS).Results Compared with the control group,the expression of miR-26a decreased in HG-treated cells,while the expression levels of ECM synthesis-related indexes fibronectin and collagen Ⅰ in-creased.After overexpressing miR-26a,the HG+miR-26a group showed a significant increase in miR-26a expres-sion and a decrease in fibronectin and collagen Ⅰ expression compared to the HG group.In terms of ferroptosis,the protein and mRNA expression of SLC7A11 and GPX4 significantly decreased,the expression of TFR-1 and AC-SL4 significantly increased,and the fluorescence intensity of ROS was significantly enhanced in the HG group com-pared with the control group.Inhibition of ferroptosis in the HG+Fer-1 group resulted in significant changes in fer-roptosis and ECM synthesis-related indicators expression levels compared to the HG group.Furthermore,re-expres-sion of miR-26a in the HG+miR-26a led to significant changes in ferroptosis-related indicators expression levels and decreased ROS fluorescence intensity compared to the HG group.Conclusions In HG-induced RTECs,miR-26a inhibits the occurrence of ferroptosis,thus reducing ECM synthesis.

Objective To investigate the association between intraoperative hypotension and post-operative acute kidney injury(AKI)in patients undergoing brain tumor resections.Methods A total of 428 patients undergoing elective craniotomy for tumor resection were selected,276 males and 152 females,aged≥18 years,BMI 15-36 kg/m2,ASA physical statusⅡ orⅢ.Based on postoperative occurrence of AKI,the patients were divided into two groups:the AKI group and the control group.This study defined three thresholds for hypotension,including MAP during surgery below 65 mmHg,60 mmHg,and 55 mmHg.Multivariate logistic regression was used to analyze the correlation between intraoperative hypotension and postoperative AKI under three thresholds.Results A total of 107 patients had postoperative AKI.The re-sults of multivariable regression analysis indicated that intraoperative MAP＜65 mmHg(OR = 1.11,95%CI 1.03-1.20,P = 0.010)and intraoperative MAP＜60 mmHg(OR = 1.12,95%CI 1.02-1.23,P = 0.017)were associated with postoperative AKI.Conclusion Intraoperative MAP＜65 mmHg or 60 mmHg is associated with postoperative AKI in patients undergoing brain tumor resection.

Objective To enhance the quality of medical services in the intensive care unit(ICU)of provincial traditional Chinese medicine(TCM)hospitals.Methods In November 2023,Sichuan Provincial Critical Care Medicine Quality Control Center of TCM launched the"quality control supervision project scoring standard for critical care medicine of TCM"to conduct quality control evaluation and business guidance for all TCM hospitals with independent ICU.The survey covered structural indicators,control indicators,participation of TCM,development of new technologies,and diagnosis and treatment programs for dominant diseases.Results In terms of structural indicators:a total of 110 TCM hospitals in the province have independent ICU,an increase of 1.12 times compared with 2019.The control indicators showed that the ICU patients admission rate was higher than that of the national ICU admission rate in 2017,and the admission rate of patients with acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score≥15 points increased.However,the mortality of ICU exceeded the national average.The implementation of core indicators had been significantly improved,but the incidence of outcome indicators such as ICU ventilator-associated pneumonia(VAP),ICU intravascular catheter-related bloodstream infection(CRBSI),and ICU catheter-related urinary tract infection(CAUTI)had increased since 2019,mainly in secondary hospitals.The average number of new technologies was about(5.5±3.4),the participation rate of TCM decreased,and the dominant diseases increased compared with 2019,mainly sepsis,respiratory failure and hemorrhagic stroke.Conclusions The number of ICU units in TCM hospitals at all levels in Sichuan province has grown rapidly,and key performance indicators have also improved compared to previous periods.However,greater efforts are still needed in preventing the occurrence rates of VAP,CRBSI,and CAUTI.There is a shortage of medical resources allocation,and the imbalance in regional medical resources and professional training remains an urgent issue to be addressed.Additionally,the participation rate of TCM and the dominant diseases need further enhancement.

Objective:To explore the facilitating and inhibitory factors influencing the behavior of young patients to share medical electronic word-of-mouth (eWOM) on internet platforms, so as to provide insights for the improvement of healthcare quality.Methods:In May 2022, 271 undergraduate students from universities in Zhejiang province were selected by convenient sampling to survey their motivations to share eWOM with a self-designed questionnaire. Multiple regression analysis was used to examine the impact of different motivational factors on the sharing intention of young patients.Results:Only 16 respondents (5.9%) had previously published medical eWOM. Egoistic motivation, altruistic motivation, medical experience, and comment habits were significant factors that promoted patients to share eWOM, with egoistic motivation ( β=0.212, P<0.001) having the greatest impact and comment habit ( β=0.139, P=0.003) having the least impact. Distrust, low self-efficacy and involvement, perceived reluctance, and perceived uselessness were significant factors inhibiting patients from publishing eWOM. Of them, distrust ( β=-0.161, P<0.001) and perceived reluctance ( β=-0.161, P=0.001) had the greatest impact, and low self-efficacy and involvement had the least impact ( β=-0.134, P=0.003). Conclusions:To enhance the positive attitude of young patients towards sharing eWOM, it is important to focus on their personal benefits and provide high-quality healthcare experiences. Building trust among patients in the platform is crucial, and efforts should be made to reduce operational barriers. Additionally, educating and raising awareness among young patients regarding the significance and influence of healthcare reviews is important.

Objective:To investigate the characteristics of regional brain functional centrality(DC)in patients with levodopa-induced dyskinesia(LID)and to explore the pathogenesis of LID.Methods:A total of 33 PD patients with LID(PD-LID), 41 PD patients without LID(PD-nLID)and 37 healthy controls from the First Affiliated Hospital of Nanjing Medical University were enrolled in this study.Differences in DC among the three groups were compared and the correlation between Z-DC values of the brain regions with differences and the scores of the involuntary movement scale(items 1-7)was analyzed.Results:Compared with Controls, PD-LID patients showed increased DC in the right amygdala(extending to the right globus pallidus)(MNI: x=30, y=-3, z=-18, t=4.00, P<0.05 after AlphaSim correction)and in the right postcentral gyrus(MNI: x=57, y=-9, z=39, t=-3.59; MNI: x=42, y=-33, z=57, t=-4.23, P<0.05 after AlphaSim correction)and reduced DC in the right superior parietal lobule(MNI: x=24, y=-51, z=72, t=-3.95, P<0.05 after AlphaSim correction).Compared with the PD-nLID group, the PD-LID group showed increased DC in the right globus pallidus(MNI: x=30, y=-12, z=-3, t=3.09, P<0.05 after AlphaSim correction).DC changes in the right globus pallidus were positively correlated with AIMS score( r=0.482, P=0.004). Conclusions:The enhancement of DC function in the right globus pallidus may be closely related to the onset and severity of LID.

Objective:To detective the cut-off values of amino acid levels in premature infants in Sichuan.Methods:Data of newborns screening for inherited metabolic diseases (IMD) by tandem mass spectrometry in Sichuan Province from January 2018 to December 2019 were retrospectively analyzed.They were divided into premature infant group ( n=2 264, 1 312 males and 952 females) and full-term infant group ( n=53 275, 28 269 males and 25 006 females). The cut-off values of amino acids in dry blood spots were expressed as percentage ( P0.5 - P99.5), and rank sum test was used for comparison between preterm and full-term infants. Results:(1) The distribution of 11 amino acids [alanine (ALA), arginine (ARG), citrulline (CIT), glycine(GLY), leucine (LEU), methionine (MET), ornithine (ORN), phenylalanine (PHE), proline (PRO), tyrosine (TYR) and valine (VAL)] in premature infants were abnormal.(2) The cut-off values of amino acids in premature infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.34-47.04 μmol/L, CIT: 5.66-32.02 μmol/L, GLY: 181.48-909.93 μmol/L, LEU : 71.10-283.29 μmol/L, MET: 4.21-34.51 μmol/L, ORN: 40.58-293.76 μmol/L, PHE: 23.60-106.30 μmol/L, PRO: 77.76-358.24 μmol/L, TYR: 27.52-352.91 μmol/L, VAL: 53.74-228.37 μmol/L.(3) The cut-off values of amino acid in full-term infants were as follows: ALA: 135.20-552.33 μmol/L, ARG: 1.30-42.73 μmol/L, CIT: 5.92-30.35 μmol/L, GLY: 208.17-980.09 μmol/L, LEU: 72.91-287.49 μmol/L, MET: 4.27-33.90 μmol/L, ORN: 48.40-305.59 μmol/L, PHE: 27.63-92.27 μmol/L, PRO: 97.38-372.75 μmol/L, TYR: 40.19-276.54 μmol/L, VAL: 65.75-237.92 μmol/L.(4) Except for PHE ( Z=-0.58, P>0.05), the other indicators were significantly different between 2 groups [ALA ( Z=-15.32, P<0.05), ARG ( Z=-5.62, P<0.05), CIT ( Z=-5.86, P<0.05), GLY ( Z=-14.52, P<0.05), LEU ( Z=-5.62, P<0.05), MET ( Z=-5.22, P<0.05), ORN ( Z=-13.01, P<0.05), PRO ( Z=-22.09, P<0.05), TRY ( Z=-2.09, P<0.05), VAL ( Z=-17.82, P<0.05)]. Conclusions:The establishment of the cut-off values of amino acids in premature infants in Sichuan provides a theoretical basis for laboratory diagnosis of IMD screening, which enhances the accuracy of diagnosis and avoids excessive medical treatment.

Stroke self-management model is still in the exploratory stage, lacking of systematic and well-informed intervention measures. The concept of stroke self-management, assessment tools, influencing factors and intervention measures and methods based on influencing factors were reviewed in this paper. The purpose of this study was to provide some reference for the formulation of stroke health management intervention program and the development of rigorous stroke health management practice research.