1.Mechanisms of Curcumol in Inhibiting Proliferation and Migration in Non-small Cell Lung Cancer via JAK2/STAT3 Signaling Pathway
Yu QI ; Yihan YU ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Jixian ZHANG ; Bo XU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):34-45
ObjectiveTo investigate the inhibitory effects of curcumol (Cur) on the proliferation and metastasis of non-small cell lung cancer (NSCLC) cells and to explore the underlying mechanisms. MethodsIn vivo, a subcutaneous tumor xenograft model was established to evaluate the antiproliferative effect of Cur. In vitro, the cell counting kit-8 (CCK-8) assay was used to assess the effects of Cur at concentrations of 0, 60, 120, 240, 360, 480, 600, 720, 840, 960 μmol·L-1 on the viability of NCI-A549 and NCI-H23 cells, and to evaluate its inhibitory effect on the proliferation of human bronchial epithelial BEAS-2B cells. Wound healing and Transwell migration assays were conducted to assess changes in cell migratory capacity following Cur treatment. Immunohistochemistry (IHC-P) was used to investigate the regulatory effect of Cur on the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in tumor tissues. Western blot was performed to determine the protein expression levels of phosphorylated JAK2 (p-JAK2), phosphorylated STAT3 (p-STAT3), proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor A (VEGFA) in tumor tissues and cells. To further verify the role of the JAK2/STAT3 signaling pathway in the pharmacological effects of Cur, rescue experiments were performed using the pathway agonist colivelin. ResultsIn vivo experiments showed that, compared with the model group, the tumor volumes of subcutaneous xenografts in nude mice in both low- and high-dose Cur groups were significantly reduced (P<0.05), and the tumor inhibition rates were significantly increased (P<0.05). The inhibitory effect in the high-dose group was comparable to that of the cisplatin group, and the body weight of mice in the Cur groups remained stable throughout the experiment. In vitro, compared with the control group, Cur at concentrations of 120 and 240 μmol·L-1 inhibited the proliferation of NCI-A549 and NCI-H23 cells in a concentration-dependent manner (P<0.05), with a significant inhibitory effect observed at 360 μmol·L-1 (P<0.01), while no significant effect on the viability of BEAS-2B cells was observed. Migration assays demonstrated that, compared with the control group, Cur treatment significantly reduced the migration rates of both cell lines in a concentration-dependent manner (P<0.05), with an inhibitory effect at 360 μmol·L-1 comparable to that of the cisplatin group. Mechanistic validation showed that, compared with the control group, the protein expression levels of p-JAK2 and p-STAT3 in tumor tissues and cells were significantly downregulated in the Cur groups (P<0.01), and the expression levels of downstream proteins PCNA, MMP-2, MMP-9, and VEGFA were also significantly decreased with increasing Cur concentration (P<0.05). In the rescue experiments, compared with the control group, colivelin pretreatment increased cell proliferation and migration rates (P<0.05) and upregulated the expression of related proteins (P<0.05). Compared with the Cur group, the colivelin+Cur group showed significantly increased proliferation and migration rates (P<0.05), along with significantly upregulated protein expression levels (P<0.05). ConclusionCur can significantly inhibit the proliferation and metastasis of NSCLC both in vivo and in vitro, and its mechanism of action is closely associated with the inhibition of JAK2/STAT3 signaling pathway activation.
2.Anti-lung Cancer Mechanisms of Yang-warming Herbs and Formulas: A Review
Bo XU ; Yu QI ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Qing MIAO ; Yihan YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):70-79
Lung cancer, particularly non-small cell lung cancer (NSCLC), is the malignant tumor with the highest incidence and mortality in China and worldwide. In 2022, the global number of deaths reached 1.8 million, accounting for 18.7% of all cancer-related deaths, seriously threatening human health and life, and posing a severe challenge for prevention and treatment. Although treatment strategies for lung cancer have been continuously enriched in recent years, and progress has been made in targeted therapy and immunotherapy, long-term survival benefits remain limited due to primary or acquired drug resistance, low immune responsiveness, and chemotherapy-related toxicities. Therefore, there is an urgent need to explore safe and effective adjunctive therapeutic strategies. Traditional Chinese medicine (TCM), with its advantages of holistic regulation and individualized syndrome differentiation, has played an increasingly prominent role in comprehensive cancer treatment. TCM holds that "Yang deficiency leads to accumulation" is a key pathogenesis of tumors. Based on the theory that "Yang transforms Qi, while Yin forms substance", deficiency of Yang Qi results in impaired warming and transformation functions, leading to internal accumulation of Yin-cold. This is closely related to dysregulation of the immune microenvironment, "cold tumor" characteristics, and dysfunction of the neuroendocrine system in modern medicine. Accordingly, the therapeutic strategy of "warming Yang, supporting healthy Qi, and combating cancer" has gained increasing attention. In recent years, commonly used Yang-warming Chinese herbs, including Aconiti Lateralis Radix Praeparata, Zingiberis Rhizoma, Cinnamomi Cortex, Epimedii Folium, and Psoraleae Fructus, as well as their active constituents, have achieved notable progress in anti-lung cancer research by regulating multiple signaling pathways, inducing apoptosis, inhibiting metastasis, and reversing drug resistance. In addition, Yang-warming formulae such as Sini Tang and Yanghe Tang have shown promising effects in alleviating myelosuppression, improving cancer-related fatigue, managing malignant pleural effusion, and relieving cancer pain. These therapies exhibit toxicity-reducing and efficacy-enhancing effects, significantly improving patients' quality of life and survival benefits. To systematically summarize the roles and mechanisms of Yang-warming Chinese herbal medicines and compound formulae in lung cancer, this paper provides a comprehensive review of recent advances, aiming to offer insights for the clinical practice of TCM in the prevention and treatment of lung cancer.
3.Mechanisms of Curcumol in Inhibiting Proliferation and Migration in Non-small Cell Lung Cancer via JAK2/STAT3 Signaling Pathway
Yu QI ; Yihan YU ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Jixian ZHANG ; Bo XU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):34-45
ObjectiveTo investigate the inhibitory effects of curcumol (Cur) on the proliferation and metastasis of non-small cell lung cancer (NSCLC) cells and to explore the underlying mechanisms. MethodsIn vivo, a subcutaneous tumor xenograft model was established to evaluate the antiproliferative effect of Cur. In vitro, the cell counting kit-8 (CCK-8) assay was used to assess the effects of Cur at concentrations of 0, 60, 120, 240, 360, 480, 600, 720, 840, 960 μmol·L-1 on the viability of NCI-A549 and NCI-H23 cells, and to evaluate its inhibitory effect on the proliferation of human bronchial epithelial BEAS-2B cells. Wound healing and Transwell migration assays were conducted to assess changes in cell migratory capacity following Cur treatment. Immunohistochemistry (IHC-P) was used to investigate the regulatory effect of Cur on the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signaling pathway in tumor tissues. Western blot was performed to determine the protein expression levels of phosphorylated JAK2 (p-JAK2), phosphorylated STAT3 (p-STAT3), proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor A (VEGFA) in tumor tissues and cells. To further verify the role of the JAK2/STAT3 signaling pathway in the pharmacological effects of Cur, rescue experiments were performed using the pathway agonist colivelin. ResultsIn vivo experiments showed that, compared with the model group, the tumor volumes of subcutaneous xenografts in nude mice in both low- and high-dose Cur groups were significantly reduced (P<0.05), and the tumor inhibition rates were significantly increased (P<0.05). The inhibitory effect in the high-dose group was comparable to that of the cisplatin group, and the body weight of mice in the Cur groups remained stable throughout the experiment. In vitro, compared with the control group, Cur at concentrations of 120 and 240 μmol·L-1 inhibited the proliferation of NCI-A549 and NCI-H23 cells in a concentration-dependent manner (P<0.05), with a significant inhibitory effect observed at 360 μmol·L-1 (P<0.01), while no significant effect on the viability of BEAS-2B cells was observed. Migration assays demonstrated that, compared with the control group, Cur treatment significantly reduced the migration rates of both cell lines in a concentration-dependent manner (P<0.05), with an inhibitory effect at 360 μmol·L-1 comparable to that of the cisplatin group. Mechanistic validation showed that, compared with the control group, the protein expression levels of p-JAK2 and p-STAT3 in tumor tissues and cells were significantly downregulated in the Cur groups (P<0.01), and the expression levels of downstream proteins PCNA, MMP-2, MMP-9, and VEGFA were also significantly decreased with increasing Cur concentration (P<0.05). In the rescue experiments, compared with the control group, colivelin pretreatment increased cell proliferation and migration rates (P<0.05) and upregulated the expression of related proteins (P<0.05). Compared with the Cur group, the colivelin+Cur group showed significantly increased proliferation and migration rates (P<0.05), along with significantly upregulated protein expression levels (P<0.05). ConclusionCur can significantly inhibit the proliferation and metastasis of NSCLC both in vivo and in vitro, and its mechanism of action is closely associated with the inhibition of JAK2/STAT3 signaling pathway activation.
4.Anti-lung Cancer Mechanisms of Yang-warming Herbs and Formulas: A Review
Bo XU ; Yu QI ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Qing MIAO ; Yihan YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):70-79
Lung cancer, particularly non-small cell lung cancer (NSCLC), is the malignant tumor with the highest incidence and mortality in China and worldwide. In 2022, the global number of deaths reached 1.8 million, accounting for 18.7% of all cancer-related deaths, seriously threatening human health and life, and posing a severe challenge for prevention and treatment. Although treatment strategies for lung cancer have been continuously enriched in recent years, and progress has been made in targeted therapy and immunotherapy, long-term survival benefits remain limited due to primary or acquired drug resistance, low immune responsiveness, and chemotherapy-related toxicities. Therefore, there is an urgent need to explore safe and effective adjunctive therapeutic strategies. Traditional Chinese medicine (TCM), with its advantages of holistic regulation and individualized syndrome differentiation, has played an increasingly prominent role in comprehensive cancer treatment. TCM holds that "Yang deficiency leads to accumulation" is a key pathogenesis of tumors. Based on the theory that "Yang transforms Qi, while Yin forms substance", deficiency of Yang Qi results in impaired warming and transformation functions, leading to internal accumulation of Yin-cold. This is closely related to dysregulation of the immune microenvironment, "cold tumor" characteristics, and dysfunction of the neuroendocrine system in modern medicine. Accordingly, the therapeutic strategy of "warming Yang, supporting healthy Qi, and combating cancer" has gained increasing attention. In recent years, commonly used Yang-warming Chinese herbs, including Aconiti Lateralis Radix Praeparata, Zingiberis Rhizoma, Cinnamomi Cortex, Epimedii Folium, and Psoraleae Fructus, as well as their active constituents, have achieved notable progress in anti-lung cancer research by regulating multiple signaling pathways, inducing apoptosis, inhibiting metastasis, and reversing drug resistance. In addition, Yang-warming formulae such as Sini Tang and Yanghe Tang have shown promising effects in alleviating myelosuppression, improving cancer-related fatigue, managing malignant pleural effusion, and relieving cancer pain. These therapies exhibit toxicity-reducing and efficacy-enhancing effects, significantly improving patients' quality of life and survival benefits. To systematically summarize the roles and mechanisms of Yang-warming Chinese herbal medicines and compound formulae in lung cancer, this paper provides a comprehensive review of recent advances, aiming to offer insights for the clinical practice of TCM in the prevention and treatment of lung cancer.
5.Proceedings of 7T MR Imaging Studies in Cerebral Small Vessel Disease
Zihao ZHANG ; Yun YUAN ; Peiyu HUANG ; He WANG ; Xin LOU ; Qi YANG ; Jie LU ; Yilong WANG
Chinese Journal of Medical Imaging 2025;33(5):512-518
Cerebral small vessel disease represents a group of common vascular disorders involving pathological changes in arterioles,capillaries and venules,with microvascular investigation remaining a key challenge in stroke.With high signal-to-noise ratio and high contrast enabled by enhanced field strength,7T MRI can surpass the resolution limits of 3T MRI,revealing structural and functional abnormalities in cerebral small vessels below 400 μm,as well as detecting subtle lesions in brain tissue.This paper reviews the research progress of multimodal high-resolution imaging techniques based on 7T MRI,such as time-of-flight angiography,phase contrast imaging and susceptibility imaging,in the study of cerebral small vessel disease.Utilizing these technologies,7T MRI can clearly display the structure of cerebral small vessels,such as the lenticulostriate arteries and deep medullary veins,and measure functional parameters like flow velocity and susceptibility.Additionally,it can sensitively detect cerebral microbleeds and cortical cerebral microinfarct.These imaging data provide valuable information for detecting early features of cerebral small vessel disease and assessing its progression,offering new insights into its pathogenesis.Combined with artificial intelligence-based image analysis methods,7T MRI holds great promise for early diagnosis and progression evaluation in cerebral small vessel disease.
6.Advances in the application of antiplatelet therapy in intravenous thrombolysis for acute ischemic stroke patients
Xiaohui ZI ; Xue XIA ; Jing LI ; Xiaoli ZHANG ; Quan ZHOU ; Anxin WANG ; Yilong WANG
Journal of Capital Medical University 2025;46(2):234-242
Acute ischemic stroke(AIS)is associated with high mortality and disability rates,presenting a substantial challenge to global public health challenge.Intravenous thrombolysis(IVT)is recognized as a cornerstone of early AIS treatment and is recommended as the standard therapeutic approach by both national and international guidelines.However,the clinical efficacy of IVT remains suboptimal due to several limitations,including a narrow therapeutic time window and the inevitable activation of the coagulation system and platelet aggregagation during thrombolysis.These factors may contribute to adverse outcomes such as early neurological deterioration(END)and vascular re-occlusion.Antiplatelet therapy(APT),which inhibits platelet aggregations,reduces microthrombus formation,and stabilizes the vascular endothelium with multifaceted mechanisms,has emerged as a promising adjunctive strategy to IVT,offering potential synergistic effects.This review summarized the latest evidence from both domestic and international studies,focusing on the mechanisms of APT,recent clinical advancements in IVT combined with APT,and the safety and efficacy of APT administration at different time windows relative to IVT.Emphasis is placed on the influence of various antiplatelet agents,dosing regimens,and initiation timing on therapeutic outcomes,alongside a comprehensive evaluation in the context of current guideline recommendations and clinical practice.Current guidelines recommend initiating APT 24 h after IVT,following imaging confirmation to exclude the risk of intracranial hemorrhage.However,the efficacy and safety of earlier APT initiation remain inconclusive.Individualized treatment strategies,such as early administration of low-dose,short-acting APT or combination therapy in specific patient subgroups,may effectively balance therapeutic benefits and risks.The adjunctive use of APT in IVT holds promise for enhancing efficacy and improving clinical outcomes,but precise stratification of safety and efficacy is essential.Future research should focus on optimizing combination IVT and APT strategies through individualized patient profiling,appropriate drug selection,and dynamic imaging monitoring to achieve precision management in AIS treatment.
7.Effects of Jiuwei Jianbu Drink on Oxidative Stress and Inflammatory Injury in Rats with Knee Osteoarthritis via the HMGB1/RAGE/PI3K/Akt Signaling Pathway
Yilong ZHAO ; Zhaojian ZHANG ; Guowei WANG
Journal of Medical Research 2025;54(8):48-55
Objective To investigate the effects of Jiuwei Jianbu Drink on oxidative stress and inflammatory injury in rats with knee osteoarthritis via the high mobility group box-1 protein(HMGB1)/receptor for advanced glycation endproducts(RAGE)/phosphatidyli-nositol 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway.Methods A total of 60 rats were randomly divided into six groups according to the random number table method:blank control group,model group,positive drug group,and Jiuwei Jianbu Drink low-,medium-,and high-dose groups,with 10 rats in each group.Except for the blank control group,knee osteoarthritis models were estab-lished in the other groups,which were then subjected to corresponding treatments.Knee joint diameter and mechanical pain and thermal pain threshold changes were observed.Hematoxylin-eosin staining and safranin O/fast green staining were used to assess pathological changes in cartilage tissue.Oxidative stress markers and inflammatory factor levels in knee joint cartilage tissue of each group were meas-ured.Western blot was used to detect the expression of proteins related to the HMGB1/RAGE/PI3 K/Akt signaling pathway in knee joint tissues.Results Compared with the blank control group,the model group exhibited increased knee joint diameter and decreased mechan-ical pain and thermal pain threshold.Jiuwei Jianbu Drink at all doses groups and the positive control group significantly improved these in-dicators in a dose-dependent manner(P<0.05).Additionally,the Mankin score and Osteoarthritis Research Society International(OARSI)score in the model group were significantly higher than those in the blank control group,while Jiuwei Jianbu Drink intervention significantly reduced the OARSI score,with the best effect observed in the high-dose group(P<0.05).Compared with the blank con-trol group,the model group showed increased levels of nitric oxide(NO)and malondialdehyde(MDA),decreased levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and significantly elevated levels of tumor necrosis factor-alpha(TNF-α)and interleukin-1β(IL-1β).Compared with the model group,Jiuwei Jianbu Drink significantly inhibited oxidative stress and inflam-matory responses,especially at high doses(P<0.05).Moreover,the expression of HMGB1,RAGE,p-PI3K/PI3K,and p-Akt/Akt in the model group was higher than that in the blank control group,while Jiuwei Jianbu Drink intervention dose-dependently downregulat-ed the expression of these proteins(P<0.05).Conclusion Jiuwei Jianbu Drink alleviates oxidative stress and inflammatory injury in rats with knee osteoarthritis by inhibiting the HMGB1/RAGE/PI3K/Akt signaling pathway,thereby improving cartilage pathological chan-ges and demonstrating potential therapeutic value.
8.Yishen Shengyang formula ameliorates allergic rhinitis via Bach2-driven Treg cell regulation
Zhichao MA ; Chaohui ZHANG ; Yongjie YING ; Yilong WANG ; Qiaozhi JIN ; Wubing CHEN ; Baohong TAO
China Modern Doctor 2025;63(15):56-60
Objective To investigate the therapeutic effects and mechanisms of Yishen Shengyang formula in allergic rhinitis(AR)by regulating the transcription factor BTB and CNC homology 2(Bach2)to promote regulatory T cell(Treg cell)differentiation.Methods AR mouse models were established via ovalbumin(OVA)sensitization and randomly divided into control group,AR model group(AR group),Yishen Shengyang formula group and dexamethasone group.Nasal symptoms were evaluated using behavioral scores;Histopathological changes in nasal mucosa were observed via hematoxylin-eosin and periodic acid Schiff stain;Serum levels of OVA-specific immunoglobulin E(sIgE),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were measured by enzyme linked immunosorbent assay;Splenic Treg proportions were analyzed via flow cytometry;Bach2 protein expression was assessed by Western blot.Results Compared with control group,AR group mice showed significantly increased behavioral scores(P<0.05),goblet cell hyperplasia,inflammatory infiltration,elevated OVA-sIgE and IL-4 levels(P<0.05),reduced TGF-β(P<0.05),and decreased splenic Treg proportions and Bach2 expression(P<0.05).Yishen Shengyang formula treatment alleviated nasal symptoms(P<0.05),mitigated mucosal damage,decreased OVA-sIgE and IL-4,increased TGF-β(P<0.05),and upregulated Treg proportions and Bach2 expression(P<0.05),with efficacy comparable to dexamethasone.Conclusion Yishen Shengyang formula demonstrates potential therapeutic effects on allergic rhinitis by upregulating Bach2 expression and promoting Treg cell differentiation.This study provides a novel strategy and experimental basis for the traditional Chinese medicine treatment of AR.
9.Analysis of drug application and management of cancer pain in hospice patients in Zhejiang Province
Mengting GU ; Yanfei XIA ; Yilong YANG ; Qiaozhen XIANG ; Yu ZHANG ; Qichen CHAI ; Jiaojiao CHU ; Xinyu CHEN
Chinese Journal of Geriatrics 2025;44(3):353-358
Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.
10.Correlation between preoperative knee extensor and flexor muscle strength and postoperative gait function in total knee arthroplasty
Yilong ZHANG ; Wanling WU ; Wenwu YANG ; Hongtao WU ; Wengang LIU ; Minyi HE ; Chuanxi ZHAO
Chinese Journal of Tissue Engineering Research 2025;29(27):5819-5825
BACKGROUND:Gait dysfunction is one of the significant reasons for patient dissatisfaction following total knee arthroplasty.Clinical studies have identified a relationship between the preoperative strength of the quadriceps and hamstring muscles and postoperative gait dysfunction,but the exact nature of this correlation is not yet fully understood.OBJECTIVE:To investigate the correlation between the preoperative strength of the quadriceps and hamstring muscles and postoperative gait dysfunction in total knee arthroplasty.METHODS:A retrospective analysis was conducted on longitudinal data from 70 patients who underwent unilateral primary total knee arthroplasty.Preoperative measurements included peak torque of the extensor and flexor muscles,peak torque/body weight,and total work.Six months postoperatively,the Timed Up and Go Test and gait speed were measured.Ridge regression analysis was used to identify factors influencing postoperative gait function.RESULTS AND CONCLUSION:(1)Preoperative peak torque,peak torque/body weight,and total work of the extensor muscles,as well as the peak torque and total work of the flexor muscles,showed a very strong positive correlation with postoperative gait speed(P<0.001).The preoperative flexor muscle peak torque/body weight had a strong positive correlation with postoperative gait speed(P<0.001).Preoperative extensor and flexor muscle peak torques,peak torque/body weight,and total work showed a very strong negative correlation with results from postoperative Timed Up and Go Test(P<0.001).(2)Ridge regression analysis indicated a 94.2%likelihood that preoperative extensor muscle peak torque,peak torque/body weight,and total work,along with flexor muscle peak torque and total work,had a positive impact on gait speed after total knee arthroplasty(P<0.001).The preoperative flexor muscle peak torque/body weight had a negative impact on postoperative gait speed(P<0.001).There was an 87.7%likelihood that preoperative extensor and flexor muscle peak torques,peak torque/body weight,and total work,along with flexor muscle peak torque and total work,had a negative impact on postoperative Timed Up and Go Test(P<0.05),while the flexor muscle peak torque/body weight had no impact on the Timed Up and Go Test(P>0.05).(3)It is indicated that the strength of the quadriceps and hamstring muscles prior to total knee arthroplasty correlates with postoperative gait speed and Timed Up and Go Test,and can predict the outcomes of postoperative gait function.Enhancing preoperative knee muscle exercises may be a way to reduce the incidence of gait dysfunction following total knee arthroplasty.

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