ObjectiveThe widespread adoption of portable fundus cameras for primary care and community screening is hindered by limitations in current autofocus(AF) technologies. Image-based methods relying on sharpness evaluation require iterative searches, resulting in slow convergence, while projection-based techniques are susceptible to optical artifacts and calibration errors. To address these challenges, this study introduces a novel AF system based on direct wavefront sensing, designed to deliver simultaneous high speed, high precision, and operational robustness within the compact form factor essential for portable ophthalmic devices. MethodsOur approach fundamentally reimagines the AF process by directly measuring the ocular wavefront aberration. We developed a custom portable fundus camera integrating a miniaturized Shack-Hartmann wavefront sensor (SHWS) into the optical path. An 850 nm laser diode projects a point source onto the retina via oblique illumination to minimize corneal reflections. Light scattered from this spot carries the eye’s refractive error through the imaging optics and is directed to the SHWS, positioned at a plane optically conjugate to the primary color CMOS imaging sensor. A microlens array within the SHWS samples the incident wavefront, generating a pattern of focal spots on a CCD. Real-time centroid analysis of these spots provides a map of local wavefront slopes. These measurements are processed through a singular value decomposition (SVD) algorithm to fit a Zernike polynomial basis set, enabling real-time reconstruction of the wavefront phase. The defocus component (S) is extracted from the second-order Zernike coefficients, providing a direct, quantitative measure of the refractive error in diopters. This value serves as a precise error signal in a closed-loop control system, which commands a voice-coil actuated focusing lens to its null position in a single, deterministic step, eliminating the need for iterative search algorithms. ResultsComprehensive evaluation demonstrated the system’s high performance. Testing on a calibrated model eye (OEMI-7) established a highly linear relationship between the computed defocus S and the focusing lens position across a ±20 Diopter (D) compensation range, achievable within a 5 mm mechanical travel. The system achieved a focusing precision of 0.08 D, corresponding to an 18-fold improvement over a conventional projection spot-size method tested under identical conditions. The total focus acquisition time, encompassing wavefront measurement, computation, and lens actuation, averaged under 0.5 s. Clinical validation with 25 human volunteers (50 eyes, refractive range -15 D to +10 D) confirmed practical efficacy. The wavefront-sensing AF succeeded in 92% of attempts with a mean time of 0.5 s, substantially outperforming a projection-based benchmark which achieved only a 32% success rate with an average time of 4.25 s. The system provided instantaneous directional guidance and maintained stability during minor ocular movements. Objective assessment of image quality, via amplitude contrast of retinal vasculature, showed consistent and significant enhancement following AF correction across the entire tested diopter range. ConclusionThis work successfully implements and validates a direct wavefront-sensing autofocus paradigm for portable fundus cameras. By directly quantifying and compensating for the optical defocus aberration, this method bypasses the fundamental limitations of image-processing and projection-based techniques, enabling rapid, precise, and deterministic diopter compensation. The developed system delivers an exceptional combination of a wide operational range (±20 D), high accuracy (0.08 D), fast convergence (0.5 s), and a compact physical footprint. This technology provides a practical and high-performance focusing solution capable of enhancing the reliability, throughput, and diagnostic utility of portable retinal imaging in large-scale screening applications. Future efforts will be directed towards system cost optimization and performance adaptation for diverse ocular conditions.

ObjectiveDiscriminating atypical hepatocellular carcinoma (HCC) from other malignancies in liver nodules classified as Liver Imaging Reporting and Data System category M (LR-M) remains a significant diagnostic challenge on conventional ultrasound examination. The LR-M category, originally intended to capture non-HCC malignancies, paradoxically contains up to 63% of atypical HCCs that deviate from classic enhancement patterns, leading to potential misdiagnosis and suboptimal treatment planning. While deep learning has shown promise in HCC diagnosis, most existing models rely exclusively on single-modality ultrasound, overlooking the diagnostic benefits of integrating complementary information from multiple imaging sources. To address this gap, we propose a novel attention-weighted tri-modal ultrasound network (TUS-Net) that integrates contrast-enhanced ultrasound (CEUS), B-mode ultrasound (BUS), and time-intensity curves (TICs) to improve diagnostic accuracy for these clinically challenging lesions. MethodsOur framework incorporates a three-dimensional convolutional neural network (C3D) backbone to extract spatiotemporal features from CEUS videos, capturing dynamic vascular patterns critical for lesion characterization. To effectively fuse complementary modalities, we introduce a dual-channel feature fusion module (DCFFM) that adaptively combines features from CEUS and BUS through channel-wise attention mechanisms, allowing the model to dynamically weigh the contribution of each modality based on diagnostic relevance. Additionally, we propose a temporal intensity feature fusion module (TIFFM) that leverages quantitative hemodynamic information from TICs to guide the model’s attention toward diagnostically critical temporal phases, such as arterial wash-in and portal venous washout. The model is further enhanced by automated lesion localization using YOLOX and class activation mapping for interpretability, ensuring that predictions align with clinically meaningful imaging features. ResultsEvaluated on a tri-modal ultrasound dataset comprising 161 patients with pathologically confirmed LR-M nodules (131 atypical HCC and 30 non-HCC malignancies), our model achieved an accuracy of 86.83%, a sensitivity of 92.50%, a specificity of 75.50%, and an AUC of 89.32% in screening atypical HCC. Compared to single-modality baselines, TUS-Net demonstrated superior specificity, a clinically critical metric given the higher risk associated with misclassifying non-HCC malignancies. Ablation studies confirmed the contribution of each module, with the full model outperforming both standard C3D and 3D ResNet backbones integrated with attention mechanisms. A reader study involving junior and senior radiologists further validated the clinical utility of AI assistance, showing consistent improvements in specificity and inter-reader consistency, particularly for less experienced clinicians. ConclusionThese results surpass existing benchmark models and demonstrate the potential of our approach to enhance diagnostic precision in clinically specific cases. By intelligently fusing multi-modal ultrasound data with attention-guided mechanisms, TUS-Net offers a reliable and interpretable tool that holds promise for improving the non-invasive diagnosis of atypical HCC in challenging LR-M liver nodules.

ObjectiveDiscriminating atypical hepatocellular carcinoma (HCC) from other malignancies in liver nodules classified as Liver Imaging Reporting and Data System category M (LR-M) remains a significant diagnostic challenge on conventional ultrasound examination. The LR-M category, originally intended to capture non-HCC malignancies, paradoxically contains up to 63% of atypical HCCs that deviate from classic enhancement patterns, leading to potential misdiagnosis and suboptimal treatment planning. While deep learning has shown promise in HCC diagnosis, most existing models rely exclusively on single-modality ultrasound, overlooking the diagnostic benefits of integrating complementary information from multiple imaging sources. To address this gap, we propose a novel attention-weighted tri-modal ultrasound network (TUS-Net) that integrates contrast-enhanced ultrasound (CEUS), B-mode ultrasound (BUS), and time-intensity curves (TICs) to improve diagnostic accuracy for these clinically challenging lesions. MethodsOur framework incorporates a three-dimensional convolutional neural network (C3D) backbone to extract spatiotemporal features from CEUS videos, capturing dynamic vascular patterns critical for lesion characterization. To effectively fuse complementary modalities, we introduce a dual-channel feature fusion module (DCFFM) that adaptively combines features from CEUS and BUS through channel-wise attention mechanisms, allowing the model to dynamically weigh the contribution of each modality based on diagnostic relevance. Additionally, we propose a temporal intensity feature fusion module (TIFFM) that leverages quantitative hemodynamic information from TICs to guide the model’s attention toward diagnostically critical temporal phases, such as arterial wash-in and portal venous washout. The model is further enhanced by automated lesion localization using YOLOX and class activation mapping for interpretability, ensuring that predictions align with clinically meaningful imaging features. ResultsEvaluated on a tri-modal ultrasound dataset comprising 161 patients with pathologically confirmed LR-M nodules (131 atypical HCC and 30 non-HCC malignancies), our model achieved an accuracy of 86.83%, a sensitivity of 92.50%, a specificity of 75.50%, and an AUC of 89.32% in screening atypical HCC. Compared to single-modality baselines, TUS-Net demonstrated superior specificity, a clinically critical metric given the higher risk associated with misclassifying non-HCC malignancies. Ablation studies confirmed the contribution of each module, with the full model outperforming both standard C3D and 3D ResNet backbones integrated with attention mechanisms. A reader study involving junior and senior radiologists further validated the clinical utility of AI assistance, showing consistent improvements in specificity and inter-reader consistency, particularly for less experienced clinicians. ConclusionThese results surpass existing benchmark models and demonstrate the potential of our approach to enhance diagnostic precision in clinically specific cases. By intelligently fusing multi-modal ultrasound data with attention-guided mechanisms, TUS-Net offers a reliable and interpretable tool that holds promise for improving the non-invasive diagnosis of atypical HCC in challenging LR-M liver nodules.

Objective: To develop and validate a clinically actionable prediction model for postoperative pulmonary complications (PPCs) in cardiac surgery patients, focusing on modifiable preoperative risk factors amenable to targeted optimization. Methods: In this prospective observational cohort study, 492 adults undergoing open-chest cardiac surgery between August 15, 2023 and December 31, 2023 were analyzed. Prespecified predictors included gas exchange variables, pulmonary function, inspiratory muscle strength, and physical performance. Univariable and multivariable logistic regression analyses were used to develop the prediction model. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Results: A total of 90 patients (14.1%) developed PPCs after surgery. Five independent predictors were identified: elevated arterial PaCO2 (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.00–1.26), oxygen desaturation (SpO2<93%) (OR 12.47, 95% CI 3.51–48.13), reduced gait speed (OR 0.17, 95% CI 0.04–0.71), lower FEV1/FVC ratio (OR 0.96, 95% CI 0.92–1.00), and diminished inspiratory muscle strength (MIP % predicted) (OR 0.96, 95% CI 0.92–0.99). The model demonstrated good discriminative ability with an AUC of 0.86 (95% CI 0.80–0.93) in the training cohort and 0.87 (95% CI 0.74–0.93) in the validation cohort. Conclusion This parsimonious model achieved high predictive accuracy using five modifiable physiological variables. By targeting abnormalities in gas exchange, pulmonary mechanics, muscle strength, and functional reserve, the model offers a practical tool to guide individualized prehabilitation strategies for reducing PPC risk in cardiac surgery patients.

Objective This study aims to assess the impact of four-dimensional cone-beam computed tomography (4D-CBCT) image guidance on setup error correction and target dose distribution optimization in patients receiving stereotactic body radiotherapy for lung cancer. Methods A total of 82 lung cancer patients treated with SBRT in our hospital between February 2023 and February 2025 were randomly selected as study subjects. Using a random number table, they were divided into two groups. The conventional group underwent positioning verification using traditional three-dimensional cone-beam CT, while the study group underwent verification using 4D-CBCT. Setup errors, target dose-volume parameters, organ at risk dose-volume parameters, and adverse reactions were compared between the two groups. Results The setup errors in the X, Y, and Z axes in the study group were 0.21, 0.19, and 0.23 mm, respectively, which were significantly lower than 0.58, 0.62, and 0.59 mm in the conventional group (P<0.05). The three-dimensional vector error was 0.34 (0.21, 0.48) mm in the study group, which was significantly lower than 0.98 (0.65, 1.32) mm in the conventional group (P<0.05). The rotational errors in left-right, anteroposterior, and superior-inferior directions in the study group were (0.25±0.12)°, (0.21±0.10)°, and (0.23±0.11)°, respectively; these values were significantly lower than (0.48±0.18)°, (0.42±0.15)°, and (0.45±0.16)° in the conventional group (P<0.05). The minimum dose received by 95% of the target volume [(59.45±0.85) Gy] and the percentage of the target volume receiving at least 100% of the prescription dose [(95.82±2.65)%] in the study group were higher than those in the conventional group [(58.90±1.20) Gy and (93.65±3.85)%]. The homogeneity index and conformity index in the study group were 1.07±0.03 and 1.15±0.05, respectively, which were lower than 1.12±0.05 and 1.23±0.08 in the conventional group (P<0.05). No significant differences were observed between the two groups in the volume of the lung receiving 5 Gy [(28.11±5.52)% vs. (28.85±6.24)%], the volume of the lung receiving 20 Gy [(12.84±3.56)% vs. (13.45±3.90)%], mean lung dose [(8.65±2.11) Gy vs. (8.95±2.34) Gy], maximum spinal cord dose [(18.54±3.62) Gy vs. (19.13±4.25) Gy], or mean heart dose[(14.85±4.22) Gy vs. (16.27±4.83) Gy](P>0.05). The incidence rates of radiation pneumonitis, radiation esophagitis, and skin reactions in the study group were 12.20%, 7.32%, and 4.88%, respectively, which were not significantly different from 17.07%, 9.76%, and 7.32% in the conventional group (P>0.05). Conclusion The 4D-CBCT can reduce setup errors, improve target dose accuracy and conformity in lung cancer patients undergoing SBRT, and minimize radiation exposure to normal tissues, making it worthy of clinical promotion.

Objective This study aims to assess the impact of four-dimensional cone-beam computed tomography (4D-CBCT) image guidance on setup error correction and target dose distribution optimization in patients receiving stereotactic body radiotherapy for lung cancer. Methods A total of 82 lung cancer patients treated with SBRT in our hospital between February 2023 and February 2025 were randomly selected as study subjects. Using a random number table, they were divided into two groups. The conventional group underwent positioning verification using traditional three-dimensional cone-beam CT, while the study group underwent verification using 4D-CBCT. Setup errors, target dose-volume parameters, organ at risk dose-volume parameters, and adverse reactions were compared between the two groups. Results The setup errors in the X, Y, and Z axes in the study group were 0.21, 0.19, and 0.23 mm, respectively, which were significantly lower than 0.58, 0.62, and 0.59 mm in the conventional group (P<0.05). The three-dimensional vector error was 0.34 (0.21, 0.48) mm in the study group, which was significantly lower than 0.98 (0.65, 1.32) mm in the conventional group (P<0.05). The rotational errors in left-right, anteroposterior, and superior-inferior directions in the study group were (0.25±0.12)°, (0.21±0.10)°, and (0.23±0.11)°, respectively; these values were significantly lower than (0.48±0.18)°, (0.42±0.15)°, and (0.45±0.16)° in the conventional group (P<0.05). The minimum dose received by 95% of the target volume [(59.45±0.85) Gy] and the percentage of the target volume receiving at least 100% of the prescription dose [(95.82±2.65)%] in the study group were higher than those in the conventional group [(58.90±1.20) Gy and (93.65±3.85)%]. The homogeneity index and conformity index in the study group were 1.07±0.03 and 1.15±0.05, respectively, which were lower than 1.12±0.05 and 1.23±0.08 in the conventional group (P<0.05). No significant differences were observed between the two groups in the volume of the lung receiving 5 Gy [(28.11±5.52)% vs. (28.85±6.24)%], the volume of the lung receiving 20 Gy [(12.84±3.56)% vs. (13.45±3.90)%], mean lung dose [(8.65±2.11) Gy vs. (8.95±2.34) Gy], maximum spinal cord dose [(18.54±3.62) Gy vs. (19.13±4.25) Gy], or mean heart dose[(14.85±4.22) Gy vs. (16.27±4.83) Gy](P>0.05). The incidence rates of radiation pneumonitis, radiation esophagitis, and skin reactions in the study group were 12.20%, 7.32%, and 4.88%, respectively, which were not significantly different from 17.07%, 9.76%, and 7.32% in the conventional group (P>0.05). Conclusion The 4D-CBCT can reduce setup errors, improve target dose accuracy and conformity in lung cancer patients undergoing SBRT, and minimize radiation exposure to normal tissues, making it worthy of clinical promotion.

Objective This study aims to assess the impact of four-dimensional cone-beam computed tomography (4D-CBCT) image guidance on setup error correction and target dose distribution optimization in patients receiving stereotactic body radiotherapy for lung cancer. Methods A total of 82 lung cancer patients treated with SBRT in our hospital between February 2023 and February 2025 were randomly selected as study subjects. Using a random number table, they were divided into two groups. The conventional group underwent positioning verification using traditional three-dimensional cone-beam CT, while the study group underwent verification using 4D-CBCT. Setup errors, target dose-volume parameters, organ at risk dose-volume parameters, and adverse reactions were compared between the two groups. Results The setup errors in the X, Y, and Z axes in the study group were 0.21, 0.19, and 0.23 mm, respectively, which were significantly lower than 0.58, 0.62, and 0.59 mm in the conventional group (P<0.05). The three-dimensional vector error was 0.34 (0.21, 0.48) mm in the study group, which was significantly lower than 0.98 (0.65, 1.32) mm in the conventional group (P<0.05). The rotational errors in left-right, anteroposterior, and superior-inferior directions in the study group were (0.25±0.12)°, (0.21±0.10)°, and (0.23±0.11)°, respectively; these values were significantly lower than (0.48±0.18)°, (0.42±0.15)°, and (0.45±0.16)° in the conventional group (P<0.05). The minimum dose received by 95% of the target volume [(59.45±0.85) Gy] and the percentage of the target volume receiving at least 100% of the prescription dose [(95.82±2.65)%] in the study group were higher than those in the conventional group [(58.90±1.20) Gy and (93.65±3.85)%]. The homogeneity index and conformity index in the study group were 1.07±0.03 and 1.15±0.05, respectively, which were lower than 1.12±0.05 and 1.23±0.08 in the conventional group (P<0.05). No significant differences were observed between the two groups in the volume of the lung receiving 5 Gy [(28.11±5.52)% vs. (28.85±6.24)%], the volume of the lung receiving 20 Gy [(12.84±3.56)% vs. (13.45±3.90)%], mean lung dose [(8.65±2.11) Gy vs. (8.95±2.34) Gy], maximum spinal cord dose [(18.54±3.62) Gy vs. (19.13±4.25) Gy], or mean heart dose[(14.85±4.22) Gy vs. (16.27±4.83) Gy](P>0.05). The incidence rates of radiation pneumonitis, radiation esophagitis, and skin reactions in the study group were 12.20%, 7.32%, and 4.88%, respectively, which were not significantly different from 17.07%, 9.76%, and 7.32% in the conventional group (P>0.05). Conclusion The 4D-CBCT can reduce setup errors, improve target dose accuracy and conformity in lung cancer patients undergoing SBRT, and minimize radiation exposure to normal tissues, making it worthy of clinical promotion.

A scoping review was performed to systematically search and summarize the clinical research in the treatment of dysmenorrhea with oral Chinese patent medicines. The oral Chinese patent medicines for treating dysmenorrhea in three major drug lists, guidelines, and textbooks were screened, and the relevant clinical trials were retrieved from eight Chinese and English databases. The key information of the included trials was extracted and visually analyzed. A total of 50 Chinese patent medicines were included, among which oral Chinese patent medicines for the dysmenorrhea patients with the syndrome of Qi stagnation and blood stasis accounted for the highest proportion, and the average daily cost varied greatly among Chinese patent medicines. A total of 150 articles were included, involving 22 Chinese patent medicines, among which Guizhi Fuling Capsules/Pills, Sanjie Zhentong Capsules, and Dan'e Fukang Soft Extract were the most frequently studied. These articles mainly reported randomized controlled trial(RCT), which mainly focused on the comparison of the intervention effect between Chinese patent medicines combined with western medicine and western medicine alone, and the sample size was generally 51-100 cases. The high-frequency outcome indicators belonged to nine domains such as effective rate, adverse reactions, and laboratory examinations. This study showed that oral Chinese patent medicines had advantages in the treatment of dysmenorrhea, and the annual number of related clinical trials showed an overall growing trend. However, there were still problems such as insufficient safety information and vague description of traditional Chinese medicine(TCM) syndromes types in the instructions of Chinese patent medicines. The available clinical research had shortcomings such as uneven distribution of Chinese patent medicines, limited research scale, poor methodological rigor, and insufficient standardization of outcome indicators. In the future, it is necessary to deepen the development of high-quality clinical research and improve the contents of the instructions to ensure the effectiveness and safety of the clinical application of oral Chinese patent medicines in the treatment of dysmenorrhea.
Dysmenorrhea/drug therapy* ; Humans ; Drugs, Chinese Herbal/administration & dosage* ; Female ; Administration, Oral ; Nonprescription Drugs/administration & dosage*

Yinyang Gongji Pills have the effects of strengthening the body resistance to eliminate pathogenic factors, removing stasis, and reducing swelling, which is a commonly used traditional Chinese medicine(TCM) formula for treating intestinal accumulation. A real-world, registered, and single-arm clinical trial was conducted to observe the clinical efficacy and safety of Yinyang Gongji Pills combined with capecitabine in the treatment of advanced colorectal cancer and analyze the clinical characteristics of the patients. A total of 60 patients with advanced colorectal cancer who refused or could not tolerate standard treatment of western medicine were included in the study. They were treated with Yinyang Gongji Pills combined with capecitabine until disease progression or intolerable adverse events occurred. The main observation indicators were progression-free survival(PFS) and safety. The treatment effects of the patients under different baseline characteristics were analyzed. The clinical trial has found that the median PFS of all enrolled patients was 7.3 months, with 30.1% of patients having a PFS exceeding 12.0 months. Layered analysis showed that the median PFS of patients with the onset site being the colon and rectum were respectively 8.4 and 4.7 months. The median PFS of patients with high, medium, and low tumor burden were respectively 7.0, 4.7, and 10.8 months. The median PFS of patients with wild-type and mutant-type RAS/BRAF were respectively 7.9 and 6.9 months. The median PFS of patients with KPS scores ≥80 and ≤70 were respectively 7.9 and 6.5 months. The median PFS of patients treated with Yinyang Gongji Pills for ≥6, 3-6, and ≤3 months were respectively 8.0, 5.2, and 4.2 months. The median PFS of patients with spleen, kidney, liver, and lung syndrome differentiation in TCM were respectively 8.3, 6.7, 7.3, and 5.6 months. The median PFS of patients with TCM pathological factors including phlegm, dampness, and blood stasis were respectively 7.0, 7.3, and 6.5 months. Common adverse reactions include anemia, decreased white blood cells, decreased appetite, fatigue, and hand foot syndrome, with incidence rates being respectively 44.2%, 34.6%, 42.3%, 32.7%, and 17.3%. The results showed that the combination of Yinyang Gongji Pills and capecitabine demonstrated potential clinical efficacy and good safety in this study. The patients have clinical characteristics such as low tumor burden, onset site at the colon, KPS scores ≥ 80, long duration of oral TCM, and TCM syndrome differentiation including spleen or liver.
Humans ; Capecitabine/adverse effects* ; Colorectal Neoplasms/mortality* ; Drugs, Chinese Herbal/adverse effects* ; Male ; Middle Aged ; Female ; Aged ; Adult ; Treatment Outcome

This study aimed to investigate the effect and mechanism of Buyang Huanwu Decoction in regulating endoplasmic reticulum stress via the inositol-requiring enzyme 1α(IRE1α)/apoptosis signal-regulating kinase 1(ASK1)/c-Jun N-terminal kinase(JNK) pathway to improve neurological function in rats with cerebral ischemia/reperfusion injury(CIRI). SPF-grade male sprague-dawley(SD) rats were randomly divided into Sham group, model group, Buyang Huanwu Decoction group, and edaravone group. Except for the Sham group, the other groups were subjected to the modified suture method to establish a middle cerebral artery occlusion/reperfusion(MCAO/R) model. After treatment, neurological function was assessed using the Zea Longa scoring system. Gait analysis was used to detect the motor function. Detection of relative infarct area in brain tissue using 2,3,5-triphenyltetrazolium chloride(TTC) staining. Nissl staining was used to observe the structure of neuronal cells. Western blot and real-time fluorescence quantitative PCR(RT-qPCR) were used to detect IRE1α, ASK1, JNK, B cell lymphoma-2(Bcl-2), Bcl-2 related X protein(Bax), and Caspase-3 in the brain tissue. Immunohistochemistry was used to detect the positive expression of IRE1α, ASK1, and JNK. Immunofluorescence was used to detect the fluorescence expression levels of Bax, Bcl-2, and Caspase-3. The results showed that compared with the Sham group, the model group exhibited increased neurological scores(P<0.01), increased ratio of ground contact area and strength in both forelimbs(P<0.01), enlarged relative infarct area of brain tissue(P<0.05), and a reduced number of Nissl staining-positive cells(P<0.01). The protein and mRNA expression levels of IRE1α, ASK1, JNK, Bax, and Caspase-3 in brain tissue were significantly elevated, while those of Bcl-2 were decreased(P<0.05). Compared with the model group, both the Buyang Huanwu Decoction group and edaravone group showed reduced neurological scores(P<0.05), decreased ratio of ground contact area and strength in both forelimbs(P<0.05), smaller relative infarct area(P<0.05), alleviated neuronal damage, and increased number of Nissl staining-positive cells(P<0.05). The expression levels of IRE1α, ASK1, JNK, Bax, and Caspase-3 protein and mRNA in brain tissue were significantly reduced, while those of Bcl-2 were significantly increased(P<0.05). The results indicated that Buyang Huanwu Decoction can effectively improve brain injury in CIRI rats, and its mechanism of action may be related to regulating the endoplasmic reticulum stress IRE1α/ASK1/JNK signaling pathway.
Animals ; Male ; Rats, Sprague-Dawley ; Protein Serine-Threonine Kinases/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; MAP Kinase Kinase Kinase 5/genetics* ; Ischemic Stroke/physiopathology* ; Humans ; MAP Kinase Signaling System/drug effects* ; Apoptosis/drug effects* ; Endoribonucleases/genetics* ; JNK Mitogen-Activated Protein Kinases/genetics* ; Endoplasmic Reticulum Stress/drug effects* ; Multienzyme Complexes