Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyV G Zilov, L V Kosmodemyansky
The article considers placement of methods of traditional and complementary medicine in the public health system of the Russian Federation, focusing on prevention and management of chronic non-communicable diseases. The analysis of the evidence base on key methods of traditional and complementary medicine (acupuncture, phytotherapy, homeopathy, manual therapy, osteopathy) was carried out, including differentiated estimate of level of evidence for forms of homeopathy based on the latest systematic review of meta-analyses. The legal framework of its application in Russia are explored. The corresponding collisions and barriers are identified. The following proposals concerning integrative health care model are formulated: differentiated register of methods, clinical guidelines, pilot integration into compulsory health insurance system and enhancement of research.
Natural products, including isolated compounds, complex extracts, traditional medicinal preparations and marine, microbial, fungal and animal-derived materials, remain important sources of therapeutic agents and pharmacological discovery. However, variation in biological source materials, preparation methods, chemical composition and experimental design may compromise reproducibility and interpretation. This guideline presents the requirements of Basic & Clinical Pharmacology & Toxicology for studies involving natural products and their semisynthetic or biotransformed derivatives. It provides recommendations for documenting scientific and ethnopharmacological rationale, taxonomy, authentication, provenance, sustainable and lawful sourcing, extraction, chemical characterisation, dosing, bioactivity, safety and data accessibility. Particular emphasis is placed on studying the preparation actually administered, using pharmacologically relevant concentrations and doses, controlling vehicle effects and assay interference and aligning mechanistic and therapeutic claims with the supporting evidence. Complex mixtures do not necessarily need to be reduced to a single active constituent; however, their composition must be adequately characterised, and claims concerning individual constituents, additivity, synergy or antagonism require experimental substantiation. Computational, network and systems-pharmacology analyses should be transparent and reproducible, with experimental validation of central predictions. These recommendations apply equivalent standards to natural products and other interventions while recognising the additional information required to define complex biological materials and improve overall translational relevance.
Daru : journal of Faculty of Pharmacy, Tehran University of Medical SciencesSeyed Yaser Ghelmani, Seyede Hamide Rajaie, Roghayeh Zare, Narjes Hazar, Ali Khiveh, Morteza Zaboli Mahdiabadi, Seyed Hamdollah Mosavat, Morvarid Salamati, Maj…
BACKGROUND: Orthostatic hypotension (OH) and related symptoms are common complications in individuals with type 2 diabetes mellitus (T2DM). Antioxidant compounds, such as those found in rosehip fruit, may have the potential to alleviate orthostatic symptom burden. This study evaluated the effects of rosehip fruit extract on orthostatic symptoms in adults with T2DM. METHODS: This randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted over four weeks among 60 adults with T2DM and OH referred to the Yazd Center for Diabetes. Participants were randomly assigned to receive either rosehip fruit extract (two capsules daily, each containing 500 mg) or placebo. Orthostatic symptoms were assessed using the Orthostatic Intolerance Questionnaire (OIQ). Clinical relevance was evaluated using predefined minimal clinically important difference thresholds. RESULTS: Of the 60 randomized participants, 57 completed the 4-week intervention. At the end of the study, a greater proportion of participants in the rosehip group no longer met diagnostic criteria for orthostatic hypotension compared with the placebo group (prevalence ratio = 2.57, 95% CI: 1.18-5.62). The rosehip group experienced significantly greater reductions in OIQ scores compared with placebo, and these differences remained statistically significant after adjustment for baseline values and age (P = 0.001). The magnitude of symptom improvement in the rosehip group exceeded the predefined thresholds for clinical relevance. CONCLUSION: Rosehip extract significantly reduced orthostatic symptom burden and the prevalence of OH in patients with T2DM. Benefits were primarily reflected in symptomatic scores and systolic blood pressure. While promising and well-tolerated, these preliminary results require confirmation in larger, multicenter trials incorporating long-term objective hemodynamic monitoring.
MedicineNa Cao, Ya-Mei Bai, Wen-Ting Wu, Fei-Yu Cheng, Ying Chen, Ming Zhou, Yang Jiang, Ting Tang, Han Sun
This study aimed to evaluate the effectiveness of a project achievement-oriented Quality Control Circle (QCC) model in improving traditional Chinese medicine (TCM) nursing outcomes for elderly patients with conservatively treated distal radius fractures (DRFs). This retrospective comparative study included 112 elderly DRF patients admitted between June 2022 and December 2023. Based on the admission period, 56 patients (June 2022-March 2023) received routine care (control group), and 56 patients (March-December 2023) received a comprehensive TCM nursing model driven by a project-oriented QCC. Outcomes included complication rate, TCM intervention delivery rate, pain (Visual Analog Scale), swelling score, wrist function (Cooney score), and patient/staff satisfaction. Both groups received identical Menghe School bone-setting and small splint fixation. The intervention group additionally received a QCC-driven comprehensive TCM nursing model. The intervention group showed significantly lower total complication rates (3.6% vs 19.6%, relative risk = 0.18, P = .008), a higher TCM delivery rate (100% vs 64%, P < .05), greater reductions in pain and swelling, and higher Cooney scores (95 vs 75, P < .05) compared with the control group. All 9 quality indicators met or exceeded targets. Staff competency and team cohesion also improved. This retrospective study suggests that a project-oriented QCC model may enhance TCM nursing quality and short-term clinical outcomes in elderly DRF patients. However, given the study's observational design and single-center setting, these preliminary findings require validation through multicenter prospective trials with validated instruments and long-term follow-up. Robustness analysis using a propensity score-matched concurrent control group yielded consistent findings, supporting the validity of the primary results.
MedicineYe-Vin Lee, Jonghun Ahn, Euiju Lee, Chelin Park, Eui-Jin Son, Ja Yeon Jeong
RATIONALE: Brainstem hemorrhage is a rare but devastating subtype of intracerebral hemorrhage that frequently presents with impaired consciousness, quadriplegia, and recurrent infections. Integrative personalized medicine care (IPMC), which combines essential conventional treatments with personalized traditional Korean medicine interventions, has been suggested to improve functional outcomes and support immune regulation. By closely monitoring a patient with massive brainstem hemorrhage treated with IPMC, we observed neurological improvement, effective control of recurrent infections and inflammation, and sustained safety of long-term herbal medications. PATIENT CONCERNS: A 48-year-old female patient with a brainstem hemorrhage was managed at Kyung Hee University Hospital with IPMC for posthemorrhagic functional impairment and recurrent infection. DIAGNOSES: The patient was diagnosed with a massive pontine hemorrhage with posthemorrhagic functional impairment and recurrent infection. INTERVENTIONS: The patient received conventional treatment and integrative personalized traditional Korean medicine interventions, including herbal medications and acupuncture. OUTCOMES: We retrospectively analyzed the 2-year clinical course of the patient who received IPMC to evaluate the efficacy and safety of the treatment. Functional outcomes and inflammation control were assessed using standardized scales (modified Barthel index, Korean mini-mental state examination, Glasgow Coma Scale, global deterioration scale, level of consciousness, manual muscle testing, and Fugl-Meyer assessment) and hematological markers (C-reactive protein, neutrophil-to-lymphocyte ratio, and systemic inflammation response index). Liver and renal functions were monitored through laboratory tests (alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, blood urea nitrogen, serum creatinine, and estimated glomerular filtration rate). Regarding the efficacy of IPMC, functional improvements in neurological and motor outcomes were observed throughout the treatment period. Dependence on antibiotics progressively decreased, whereas the proportion of herbal medication-centered treatments increased. Infections with C-reactive protein levels <2.0 mg/dL were effectively managed with herbal medications alone. Furthermore, despite the long-term use of combined treatments, no hepatotoxicity or nephrotoxicity was observed, confirming the safety of IPMC. LESSONS: This case demonstrates the efficacy and safety of IPMC, which integrates herbal medications with conventional treatment, for managing posthemorrhagic functional impairment and recurrent infections. These findings provide a foundation for future prospective studies. Further research is required to strengthen this evidence and validate the effectiveness of IPMC.
Pakistan journal of pharmaceutical sciencesZhifeng Zhu, Fang Tao, Wei Li, Yutian Chang, Jing Ma
BACKGROUND: The Traditional Chinese Medicine (TCM) Inheritance Computing Platform (V3.0) provides advanced data-mining capabilities for analyzing large-scale clinical data, enabling systematic extraction of prescription patterns and therapeutic principles. OBJECTIVES: This systematic review applied the TCM Inheritance Computing Platform to summarize clinical practice patterns in rUTIs, focusing on the clinical experience of Professor Qu Wei and evidence from clinical trials conducted between 2022 and 2025. METHODS: Clinical trials were systematically retrieved from international registries (ClinicalTrials.gov, WHO ICTRP, ChiCTR, PubMed). Variables, including demographics, syndrome classification, interventions and outcomes, were standardized and encoded for analysis. Frequency analysis, association rule mining and hierarchical clustering were conducted to identify high-frequency symptoms, core prescriptions, herb compatibility patterns and therapeutic clusters. RESULTS: Thirty-eight clinical trials (3,462 patients) were analyzed, predominantly female (72.4%), aged 28-57 years, with 3-6 recurrent episodes annually. Damp-heat in the lower jiao (62.1%) was the most frequent TCM syndrome, followed by spleen-kidney qi deficiency (38.6%) and yin deficiency with heat (21.3%). Key herbs included Huang Bai (71%), Fu Ling (69%), Che Qian Zi (65%) and Bai Zhu (58%). Association rule mining highlighted core herb pairs such as Huang Bai-Fu Ling (support 61%, confidence 0.82). Cluster analysis revealed three therapeutic groups: (A) damp-heat clearing formulas, (B) damp-heat with qi stagnation and (C) kidney-tonifying prescriptions. Interventions reduced recurrence by 30-45%, improved symptoms, quality of life and showed immunomodulatory and microbiota-regulating effects. CONCLUSION: The TCM Inheritance Computing Platform effectively summarized rUTI practice patterns, validating damp-heat clearing and kidney-tonifying as core strategies. Herb pair associations strengthen evidence-based integration of TCM, offering a replicable, data-driven model for recurrent infection management.
Chinese journal of natural medicinesMingtao Zhu, Yu Wang, Haipeng Tang, Yanping Sun, Xiaotao Feng, Qiuhong Wang, Haixue Kuang
Alzheimer's disease (AD) is a severely debilitating condition that significantly hampers independent living, with no effective treatments currently available. Traditional Chinese medicine (TCM) has shown substantial promise in both preventing and alleviating AD symptoms. The medicinal properties-specifically hot, warm, cool, and cold-serve as a critical link between TCM theory and clinical application. However, the majority of research has concentrated on individual herbs for AD, with relatively few comprehensive studies exploring the biological mechanisms through which these herbs exert their medicinal properties. In this context, data mining, network pharmacology, and multi-omics approaches, including metabolomics, gut microbiota analysis, and proteomics, were employed to elucidate the effects and mechanisms of action of three hot/warm property herbs (THPH) and three cold/cool property herbs (TCPH) in the treatment of AD. Findings indicated that the herbs effective against AD primarily possess warm properties. THPH demonstrated a significant enhancement in cognitive, learning, and memory functions in AD rat models when compared to TCPH, potentially achieving therapeutic effects by boosting the synthesis of the neurotransmitter acetylcholine. Furthermore, THPH modulated energy metabolism, corrected metabolic imbalances in both brain and serum within AD rat models, inhibited oxidative stress, restored synaptic plasticity-related proteins and signaling pathways, and maintained intestinal microbiota homeostasis. Consequently, this study offers valuable insights into the therapeutic implications of the hot (warm) and cold (cool) properties of TCM in the management of Alzheimer's disease.
International journal of chronic obstructive pulmonary diseaseXulun Li, Haiqiang Wang, Huiqing Zhang, Xuebing Hu, Feng Gao, Bin Wang
This comprehensive meta-analysis on the efficacy and safety of traditional Chinese medicine (TCM) as an adjunctive therapy to conventional treatment of chronic obstructive pulmonary disease (COPD) with osteoporosis (OP) aimed to provide evidence and guidance for clinical practice. We systematically searched four international databases and four Chinese databases to identify relevant randomized controlled trials (RCTs) published up to November 2025. Meta-analysis and sensitivity analysis were performed in R using the meta and gemtc packages. The revised Cochrane risk of bias tool (ROB2) was employed to assess the quality of included studies to ensure their rigor and clinical applicability. A total of 11 eligible studies involving 944 patients were identified. The results indicated that compared with conventional Western medical therapy (CWMT) alone, CWMT plus TCM demonstrated a certain degree of improvement in the primary outcomes, namely bone mineral density (BMD) (standardized mean difference [SMD] = 0.71, 95% confidence interval [CI]: 0.34-1.07, I2 = 83.8%, PHEW < 0.001) and forced expiratory volume in 1 second (FEV1) (SMD = 0.54, 95% CI: 0.17-0.90, I2 = 76.5%, PHEW = 0.007). Statistically significant improvements were observed in some secondary outcomes. The original studies did not adequately report adverse events. The available data only suggested short-term tolerability. According to network meta-analysis results, among the three treatment approaches, the TLKRBS (tonifying the lung and kidney and resolving blood stasis) approach had the highest probability of being ranked first for increasing BMD (surface under the cumulative ranking curve [SUCRA] = 98.82%) and FEV1 (SUCRA = 99.99%), indicating a substantial effect on improvement. The combination of CWMT and TCM may yield more favorable outcomes compared to CWMT alone for treating COPD with OP. The meta-analysis results indicate that the therapeutic efficacy of TCM combined with CWMT may be improved to a certain extent compared with CWMT alone. However, the certainty of the evidence is limited due to small sample sizes, high heterogeneity, and risks of bias. Future high-quality RCTs with rigorous designs, larger sample sizes, and standardized outcome measures are warranted to strengthen the evidence base for the application of TCM in patients with COPD and comorbid OP and to further confirm its efficacy.
Journal of visualized experiments : JoVEJiaxuan Gong, Shaoyun Zhao, Ying Xiong, Que Liu, Jiayi Yang, Sirui Jin, Qile Qiu
Asthma is the most prevalent chronic inflammatory airway disease in children and is characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), and airway remodeling. In traditional Chinese medicine (TCM), spine-pinching manipulation (SP) is a widely used pediatric massage technique for managing asthma and other childhood diseases. Despite a history of clinical use spanning more than 1,000 years, SP remains largely unfamiliar outside China. Moreover, the mechanisms underlying SP remain insufficiently characterized. This article describes a feasible and standardized protocol for SP that replicates the essential procedures used in clinical practice. Application of the protocol improved airway inflammation, AHR, and airway remodeling in a juvenile rat model of asthma. To enhance reproducibility, key procedural parameters were standardized, including finger pressure, manipulation frequency, number of repetitions, and intervention duration. The standardized protocol in this study may serve as a reference for further research on SP standardization and its underlying mechanisms in experimental pediatric asthma.
Developmental neurobiologyMuhammad Wasim Usmani, Muhammad Zulqarnain Shakir, Muneeb Ahmad Khan, Muhammad Usman, Inam Ullah, Yang Mengjie, Ning Wang, Xinmin Liu
Bidirectional communication among the gut microbiota, immune system, and central nervous system shapes microglial maturation and responsiveness. This review evaluates microglia as context-dependent neuroimmune integrators rather than fixed M1/M2 populations. It organizes the literature into three linked layers: gut-derived signals and barrier physiology, microglial state transitions, and therapeutic modulation by Traditional Chinese Medicine (TCM). Experimental depletion, colonization, and metabolite studies provide causal evidence that the microbiota can modify microglial biology in animals; however, human evidence remains predominantly associative. Herbal formulations, isolated constituents, and acupuncture may alter microbial ecology, intestinal permeability, metabolite production, systemic inflammation, and microglial signaling. Yet most intervention studies measure only selected links in this chain and rely on rodent behavior, bulk cytokines, or limited polarization markers rather than direct, state-resolved microglial profiling. Therefore, improvements in cognition or inflammatory markers cannot by themselves, establish microbiota-mediated microglial reprogramming. We critically distinguish direct from indirect evidence, replace binary polarization language with state-specific terminology, and evaluate formulation standardization, bioavailability, safety, experimental confounding, and clinical generalizability. A credible translational program will require chemically defined interventions, causal perturbation of candidate microbes or metabolites, microglia-resolved multi-omics, preregistered clinical trials, and mediation analyses that connect target engagement to patient-relevant outcomes. TCM is thus best regarded as a testable source of multicomponent interventions, not yet a validated systems-level therapy for the gut-brain-immune axis.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerJialin Li, Faxiang Ji
OBJECTIVE: Chemotherapy-induced toxicities represent a major clinical challenge in gastric cancer treatment, with limited effective management strategies. Emerging evidence suggests that gut microbiota dysbiosis is a key driver of these adverse effects, while traditional Chinese medicine (TCM) shows potential in modulating gut microbial composition. This review aims to systematically summarize the molecular mechanisms and clinical evidence of TCM in alleviating chemotherapy-induced toxicities in gastric cancer through gut microbiota regulation and to identify current research gaps. METHODS: A systematic literature search was conducted using SCI-indexed studies, primarily published in recent years, with inclusion of foundational studies where necessary. The review focused on chemotherapy-induced gut microbiota dysbiosis and its role in toxicity, as well as the effects of TCM-including polysaccharides, flavonoids, and herbal formulations-on microbial composition, metabolic products such as short-chain fatty acids (SCFA), LPS, and inflammatory signaling pathways. RESULTS: Gut microbiota dysbiosis contributes to systemic inflammation primarily through activation of the LPS/TLR4/NF-κB/NLRP3 inflammasome pathway and reduced SCFA-mediated histone deacetylase inhibition. TCM regulates gut microbiota through a "structure-metabolite-immune" framework, restoring microbial diversity, increasing SCFA production, reducing LPS levels, and suppressing inflammatory signaling. Clinically, oral and injectable TCM formulations such as SFI and HCS have shown moderate- to high-quality evidence in improving immune function, alleviating myelosuppression, and reducing gastrointestinal toxicities, whereas evidence for external therapies remains limited. CONCLUSION: TCM represents a promising microbiota-targeted strategy for mitigating chemotherapy-induced toxicities in gastric cancer. Future studies should focus on STING signaling and the gut-brain axis, conduct large-scale randomized controlled trials (RCTs), and develop microbiota-based personalized TCM interventions to advance evidence-based integrative oncology.
BACKGROUND: Older adults in real-world Chinese integrative-care settings often present with uneven patterns of functional limitation, cognitive impairment, and clinical vulnerability. Whether routinely collected geriatric and Traditional Chinese Medicine (TCM) constitution records can be organized into clinically interpretable profiles remains insufficiently described. METHODS: We conducted a cross-sectional analysis of 402 adults aged 60 years or older assessed during 2024-2025 in three Shanghai institutions: a hospital TCM department, a nursing home, and an elderly care center. Of 435 screened records, 33 (7.6%) were excluded due to missing data. Four routine continuous variables were analyzed: Barthel Index, education-adjusted Montreal Cognitive Assessment (MoCA), a study-specific tumor risk score, and a study-specific infection risk score. Standardized variables were summarized by principal component analysis (PCA; PC1 and PC2, cumulative variance 70.8%) and K-means clustering. TCM constitution and concurrent care disposition were examined as external descriptive variables and were not used to derive clusters. RESULTS: Participants had a mean age of 78.0 ± 9.6 years; 206 (51.2%) were women. Among candidate solutions (k = 2-6), the gap statistic and silhouette coefficient both favored k = 2 (gap = 0.152, SE = 0.016; silhouette = 0.287), but a three-profile solution (silhouette = 0.252; gap = 0.118, SE = 0.019) was retained as an exploratory descriptive summary based on prespecified clinical interpretability criteria. The three profiles were: Functionally Preserved Profile (n = 149, 37.1%; Barthel 76.9 ± 14.8, MoCA 18.2 ± 3.9, tumor risk 9.6 ± 4.5, infection risk 25.0 ± 11.8), Cognitive-Functional Vulnerability with Low Tumor-Risk Profile (n = 101, 25.1%; Barthel 47.0 ± 18.2, MoCA 12.0 ± 4.6, tumor risk 4.9 ± 3.1, infection risk 34.3 ± 13.5), and Multidomain High-Risk Profile (n = 152, 37.8%; Barthel 37.8 ± 19.8, MoCA 12.0 ± 5.1, tumor risk 15.2 ± 5.6, infection risk 46.8 ± 15.2). The Cognitive-Functional Vulnerability profile had the lowest tumor risk score among the three profiles while its MoCA score was identical to that of the Multidomain High-Risk Profile, confirming that the profiles represent distinct combinations of domain-specific vulnerabilities rather than a single ordinal gradient. A preserved-function/impaired-cognition subgroup was identified in 73 participants (18.2%). Among nine TCM constitution labels, Yang deficiency differed across profiles after Bonferroni correction (p = 0.003). CONCLUSIONS: Routine multidimensional assessment data can describe clinically recognizable vulnerability profiles among older adults in Chinese integrative-care settings. The three-profile solution represents an exploratory descriptive summary rather than a statistically optimal classification (silhouette coefficient = 0.252, indicating weak cluster separation; gap statistic favored k = 2). The most actionable observation was the functional-cognitive dissociation subgroup, which may be missed if function alone is assessed. TCM constitution contributed descriptive context but did not independently define the profiles. These findings require external, prospective validation before clinical deployment.
Journal of visualized experiments : JoVEJun Liu, Yunfang Zhang, Mengtong Han, Jialu Zhu, Lili Xu, Xueying Hu
Premature rupture of membranes (PROM) can increase the risk of intra-amniotic infection (IAC) and adverse maternal-neonatal outcomes. This retrospective study evaluated the diagnostic value of serum C-reactive protein (CRP) and interleukin-6 (IL-6) for intra-amniotic infection and included a retrospective observational comparison of integrated traditional Chinese medicine (TCM)-Western therapy with Western medicine alone in affected patients. First, 60 patients with premature rupture of membranes admitted from January to September 2024 were divided into infection and non-infection groups according to intra-amniotic infection status, and serum C-reactive protein and interleukin-6 levels were compared, and their discriminatory performance, individually and in combination, was evaluated using receiver operating characteristic (ROC) analysis. Second, 60 patients with premature rupture of membranes complicated by intra-amniotic infection admitted from September 2024 to May 2025 were retrospectively classified into an integrated therapy group or a Western medicine control group according to the treatment documented in their medical records. Serum C-reactive protein and interleukin-6 levels were higher in infected patients. ROC analysis yielded areas under the curve (AUCs) of 0.889 for CRP and 0.842 for IL-6, while the combined CRP/IL-6 model yielded an AUC of 0.914. Compared with Western medicine alone, integrated therapy was associated with a higher vaginal delivery rate, lower cesarean section rate, shorter time to regular contractions, shorter labor stages, and faster normalization of temperature and white blood cell count. These findings suggest that elevated serum CRP and IL-6 are associated with intra-amniotic infection and may provide useful discriminatory information for identifying IAC, with the combined model showing greater discrimination than either marker alone. Integrated TCM-Western therapy may also be associated with improved clinical recovery in selected patients with PROM complicated by IAC; however, these findings require validation in larger prospective studies.
Journal of cellular and molecular medicineChenrong Jin, Ding Du, Xiaorui Yu, Xiaoyan Ji, Xiuyun Zhang, Anning Li, Shuang Zu, Bo Qu, Daqing Zhao, Dianpeng Wu, Meichen Liu
Aging is a systemic decline in physiological integrity, driving chronic diseases such as neurodegeneration, cardiovascular disorders, and metabolic syndromes. Rapid global population aging urgently demands effective interventions. Traditional Chinese medicine (TCM) formulas, characterized by multi-component, multi-target, and multi-pathway synergy, offer a promising paradigm for delaying aging. This review systematically integrates recent advances in TCM formula-based anti-aging research, bridging classical TCM gerontology with the 14 modern hallmarks of aging. We categorize representative formulas into four mechanistic groups targeting mitochondrial homeostasis and autophagy, cellular senescence and inflammatory microenvironment, stem cell maintenance and epigenetic reprogramming, and gut microbiota and systemic metabolism, and explore their holistic efficacy, key bioactive constituents, and multi-component synergy. In terms of methodological innovations, we introduced network pharmacology combined with AI-driven target screening and proteomic aging clocks to assess biological age. We discussed challenges in chemical complexity, mechanistic completeness, and clinical translation, and proposed a roadmap for development. This review establishes an integrative model that integrates TCM principles with modern aging biology, offering insights for translational research toward healthy longevity.
The Journal of pharmacy and pharmacologyJunhua Li, Meng Cai, Hongxing Li, Hao Cui, Yixin Wang, Yi Zhang, Weihua Wang, Shuo Li
OBJECTIVES: Population ageing drives the need for interventions that extend healthspan. Ageing involves interconnected processes, including oxidative stress, mitochondrial dysfunction, chronic inflammation, metabolic dysregulation, impaired autophagy, genomic instability, proteostasis loss, stem cell exhaustion and gut microbiota dysbiosis. This review summarises ageing-related mechanisms and evaluates natural products and formulations derived from traditional Chinese medicine (TCM) as multi-target pharmacological modulators. METHODS: A narrative review was conducted to integrate evidence on ageing-related pathways and representative TCM-derived bioactive compounds, plant polysaccharides, herbal extracts and classical TCM formulations with reported geroprotective effects. Emphasis was placed on mechanisms involving redox homeostasis, inflammatory signalling, energy metabolism, autophagy, mitochondrial regulation and gut microbiota modulation. KEY FINDINGS: TCM-derived natural products and formulations modulate multiple ageing-related pathways rather than isolated targets. Representative constituents, including ginsenosides and plant polysaccharides, regulate oxidative stress, inflammatory responses, metabolic signalling and autophagy. Classical formulations exert multi-component effects on genomic stability, mitochondrial function, immune regulation and microbiota homeostasis. These findings support the potential of TCM-derived natural products and formulations as multi-target pharmacological strategies for healthy ageing.
Senna alexandrina has been widely used in traditional medicine for gastrointestinal, dermatological, metabolic, and musculoskeletal disorders. Despite extensive ethnobotanical knowledge, a comprehensive integration of its chemical constituents with pharmacological evidence remains limited. This review aimed to synthesize the traditional uses, pharmacological activities, and chemical constituents of S. alexandrina, highlighting the alignment between ethnobotanical applications and experimental evidence. Literature on ethnomedicinal usage, in vitro and in vivo pharmacological studies, and chemical characterization of S. alexandrina was systematically reviewed. A total of 219 chemical structures were compiled, along with the reported bioactivities and traditional applications. Extracts of leaves, pods, and aerial parts exhibit dose-dependent laxative, anticancer, anti-inflammatory, hepatoprotective, antioxidant, antimicrobial, antiviral, and metabolic regulatory activities. Anthraquinones, flavonoids, polysaccharides, and other secondary metabolites underpin these effects. The integration of 219 chemical structures, pharmacological data and traditional uses is rare and provides a unique resource for future mechanistic studies and drug discovery. The alignment between traditional usage and experimental pharmacology is promising, though the available evidence remains largely preclinical and extract based. Future research should isolate and characterize specific bioactive compounds to enable precise dosing, elucidate mechanisms, and advance clinical translation.
Molecular biology reportsR Dhanush, D K Naveen, H R Sneha, Seema Mudhol, Bharathi Doddla Raghunathanaidu
BACKGROUND: Wound healing, an important biological process, is a process through which the human body repairs its skin from injuries through organized cell function, molecular signaling, and tissue remodeling. Chronic or delayed wound healing remains a major public health challenge around the world. METHODS: A narrative review was conducted through searches in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library for articles published between January 2005 and June 2026 by searching keywords such as "wound healing," "hemostasis," "growth factors," "signaling pathways," "chronic wound," "scar," "wound microbiome," and specific traditional treatments. Non-peer-reviewed papers, conference abstracts, and duplicate records were excluded. Only peer-reviewed primary studies, systematic reviews, meta-analysis, and Cochrane reviews published in English were included. The quality of selected articles was assessed by applying SANRA guidelines for narrative reviews and AMSTAR-2 checklist for cited systematic reviews. RESULTS: Growth factors (PDGF, TGF-β, EGF, FGF, VEGF), their receptors and signaling pathways (SMAD, MAPK, PI3K/AKT, JAK/STAT, Wnt/β-catenin, Notch, Hippo/YAP-TAZ, mTOR and NF-κB) regulate the four overlapping stages of human skin wound healing (hemostasis, inflammation, and remodeling). Some bioactive substances which are antibacterial and regenerative in nature are contained in the local treatment methods like honey, Aloe vera, frog skin and maggot therapy; some of these treatments are backed up by Cochrane review-level evidence. CONCLUSION: A path to safer and more effective wound treatment can be seen by integrating the molecular pathway, chronic wound biology, current biological therapies and evidence-based traditional medicine.
Journal of pharmacopunctureMohammad Ebrahim Zohalinezhad, Leila Mohammad Taghizadeh Kashani, Meysam Shirzad, Azam Saffar, Leila Ghahramani, Seyed Nasser Ostad, Mohammad Mahdi Ahmadian-At…
OBJECTIVES: Traditional Persian medicine offers various topical treatments for hemorrhoids. This study investigated the efficacy of an herbal cream (HC) containing common myrtle, chamomile, wild leek, and Russian olive extracts. METHODS: This randomized triple-blind controlled trial compared the effects of the HC and a conventional cream (CC) on hemorrhoids. Standardization involved measuring the total phenolic content (TPC) and analyzing the HC by gas chromatography. In total, 110 outpatients with hemorrhoids were randomly assigned to intervention (n = 58) and control (n = 52) groups. The outcomes were evaluated using the visual analog scale (VAS [1-10]); anal pain, difficult defecation, and burning sensation) and four-point Likert scale anal bleeding and anal pruritus) during the intervention phase (14 days) and follow-up (28 days). RESULTS: The HC was safe and well tolerated, with no major adverse effects observed in toxicological or clinical evaluations. Physicochemical assays confirmed the quality parameters, and the TPC was determined. In the clinical trial involving 49 patients, both HC and CC reduced hemorrhoidal symptoms over time (p = 0.011). However, no significant treatment-group effect (p = 0.50) or treatment-by-time interaction (p = 0.77) was observed. Exploratory analyses indicated that the HC produced clinically meaningful reductions in bleeding and anal pain from baseline. CONCLUSION: The HC was safe and well tolerated in patients with grade I-II hemorrhoids. Although it did not show statistical superiority over the CC, potentially due to high dropout rates and limited sample size, HC was associated with clinically meaningful improvements in anal bleeding and pain along with favorable changes in other symptoms. These findings suggest that the HC has potential as a safe herbal alternative for hemorrhoid symptom relief, without side effects and an acceptable safety profile.
Journal of visualized experiments : JoVETian Xia, Rong Zhang, Yuanye Gu, Zhihua Tian, Zhili Zheng, Xinqiao Chu, Yishan Zhou, Shuxuan Chen, Weidong Li, Shaoli Wang, Huimin Liu, Zhen Liu
Real-world traditional Chinese medicine (TCM) outpatient records contain longitudinal information on diagnoses, syndrome elements, symptom narratives, and individualized prescriptions, but their semi-structured format complicates reproducible analysis. This article presents a source-audited protocol for converting de-identified case records into traceable aggregate tables and publication-ready visualizations. The workflow defines eligibility criteria and analysis units, preserves mappings between original and normalized terminology, verifies all reported numerators and denominators, and regenerates figures from versioned source tables. Applied to records from January 2015 through June 2024, the protocol identified 555 eligible prescription visits from 396 patients. The final dataset contained 324 normalized herb labels and 9,339 herb-use occurrences. The workflow generated parallel Western medicine and TCM disease spectra, an explicit syndrome-element spectrum and co-occurrence matrix, herb-frequency and materia medica profiles, a 37-term history-derived symptom spectrum, 15 directed association rules, hierarchical clustering, and diagnosis-stratified herb-use heatmaps. At least one prespecified history keyword was detected in 474 visits (85.41%). When permitted by institutional policy, a human-supervised artificial intelligence (AI) option may assist with terminology checks, cross-file consistency review, and caption-figure alignment. Any use of AI must be documented in a separate audit record and must not replace source-data review. By integrating governance, normalization, computation, clinical interpretation, and visual output into a single reproducible workflow, the method transforms dispersed clinical documentation into a reviewable research resource. The protocol can be adapted to other expert-practice datasets, multicenter terminology projects, and prospective clinical data platforms.
BMC complementary medicine and therapiesAhmed Zayed, Meryem El Jemli, Mourad Kharbach, My El Abbes Faouzi, Rasha Ali Radwan, Shahira M Ezzat
BACKGROUND: Traditional Moroccan herbal teas are widely consumed and have been traditionally used for managing chronic metabolic disorders, particularly type 2 diabetes mellitus (T2DM). Although these preparations have a long history of ethnomedicinal use, their phenolic composition and biological activities remain insufficiently characterized. Scientific validation is needed to support their traditional application and provide evidence for their potential relevance to T2DM management. This study aimed to characterize the phenolic profile, antioxidant potential, and carbohydrate-digestive enzyme inhibitory activity of 21 traditional Moroccan herbal teas used for glycaemic control. METHODS: Phenolic constituents were identified and quantified using HPLC-MS. Antioxidant capacity was evaluated through DPPH, ABTS, and FRAP assays. Inhibitory effects on α-amylase and α-glucosidase were assessed in vitro. Correlation analyses were conducted to explore associations between phenolic constituents and biological activities. FINDINGS: Marked variability in total phenolic content (TPC) was observed, with Mentha × piperita and Thymus broussonetii exhibiting the highest levels at 883.2 ± 13.0 and 746.8 ± 22.4 mg GAE/g dry weight, respectively. Antioxidant activity varied substantially among the investigated teas, with T. broussonetii (FRAP reducing power: 423.6 ± 9.8 µg/mL) and Mentha rotundifolia (162.6 ± 0.6 µg/mL) showing significant reducing capacities. TPC exhibited strong positive correlations with antioxidant indices (r = 0.93-0.96). Pelargonium graveolens presented potent α-amylase inhibition (IC50 = 2.98 ± 1.7 µg/mL), whereas Mentha viridis and Calamintha officinalis were among the most active α-glucosidase inhibitors (IC50 = 1.9 ± 0.4 and 1.2 ± 0.1 µg/mL, respectively). Negative correlations were found between rutin (r = - 0.49) and gallic acid (r = - 0.44) contents and α-amylase IC50 values. CONCLUSION: The investigated Moroccan herbal teas exhibited variable antioxidant and digestive-enzyme inhibitory activities that were associated with their phenolic composition. Variability among samples may reflect differences in plant species and environmental or agronomic factors. These findings provide comparative in vitro evidence supporting the traditional use of Moroccan herbal teas and highlight several species as promising sources of bioactive phenolics. However, the present findings do not establish therapeutic efficacy, and further in vivo, mechanistic, pharmacokinetic, and clinical studies are required to confirm their efficacy, safety, and clinical relevance.
Coronary artery disease (CAD) remains a major cause of morbidity and mortality worldwide. Although guideline-directed Western medical therapy improves cardiovascular outcomes, residual symptoms remain common. Integrated traditional Chinese and Western medicine is frequently used as an adjunctive strategy in China, but its real-world, short-term clinical associations require further characterization. This retrospective observational study included 215 patients with CAD treated between January 2022 and December 2024, including 106 patients receiving conventional Western medical therapy alone and 109 receiving adjunctive traditional Chinese medicine based on syndrome differentiation. Symptom status, laboratory parameters, overall clinical response, and documented adverse events were compared between groups. Because treatment allocation was nonrandom and the analyses were unadjusted for potential confounders, all between-group findings were interpreted as associations. No statistically significant differences were observed in the measured baseline demographic, clinical, or laboratory characteristics between the 2 groups. After treatment, the integrated-treatment group had lower rates of residual chest pain, chest tightness, and fatigue and greater changes in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fibrinogen, and D-dimer. The observed overall clinical response rate was higher in the integrated-treatment group (90.8% vs 76.4%, P = .004). Documented adverse-event incidence did not differ significantly between groups. In this retrospective real-world cohort, adjunctive traditional Chinese medicine was associated with greater short-term improvement in selected symptoms and laboratory parameters and a higher observed clinical response rate, without a detectable increase in documented short-term adverse events. These unadjusted observational findings are exploratory, do not establish causal superiority or improved cardiovascular prognosis, and are insufficient by themselves to modify current guideline-directed CAD practice.
JMIR medical informaticsJunyu Yao, Xingyue Gou, Wei Lai, Yuzhu Gao, Siqi Wang, Chuangan Zhou, Hui Ye, Jing Tian, Jun Yi, Dong Cao
BACKGROUND: Due to the heterogeneity of symptom terminology and the lack of industry standards, the same symptom is often described using multiple expressions. Current normalization approaches struggle to comprehensively retrieve standard terms when a raw term maps to multiple symptoms. OBJECTIVE: This study aimed to address the lack of industry standards for traditional Chinese medicine (TCM) symptom terminology. This study proposed the split-then-concatenate normalization framework (STC-NF), a novel approach based on fine-grained semantic classification and a 2-stage deep learning architecture that uses electronic medical records (EMRs) as the data source. METHODS: This study proposed a 2-stage deep learning framework, "split-then-concatenate." In the splitting stage, TCM symptom entities were categorized into 12 fine-grained semantic labels, and 3 named entity recognition (NER) models were trained to extract TCM symptom terminology from EMRs. In the concatenation stage, standard terms with the same concept as raw terms were identified using a Bidirectional Encoder Representations from Transformers (BERT)-based binary classification model. The standard terms with specific semantic labels were concatenated and reordered according to predefined rules to output structured text, thereby normalizing TCM symptom terminology. RESULTS: The proposed STC-NF model achieved an accuracy of 91.4% (180/197) and an F1-score of 360 out of 389 (92.5%) on the single-implication test set. For multi-implication terms, STC-NF achieved an accuracy of 84.3% (311/369) and an F1-score of 1958 out of 2316 (84.5%), outperforming sequence generation in accuracy by 33.1 percentage points. On the mixed test set containing both single- and multi-implication terms, STC-NF achieved an accuracy of 88.1% (990/1124) and an F1-score of 3862 out of 4385 (88.1%), exceeding the best-performing baseline model, multi-task candidate generator (MTCG), by 16.7 and 22.2 percentage points in accuracy and F1-score, respectively. CONCLUSIONS: In this study, we verified that the fine-grained semantic classification and the 2-stage "split-then-concatenate" framework effectively improved performance of named entity recognition and entity alignment, providing an improved approach to normalizing TCM symptom terminology.
Brain research bulletinYanjiao Li, Xialin Xue, Hongyu Luo, Dan Chen, Shuxian Yang, Xuekuan Huang, Yan Li
BACKGROUND: Vascular dementia (VaD), the second leading cause of dementia following Alzheimer's disease, results from the reduction in cerebral blood flow. Medicinal leeches (SZ) in traditional Chinese medicine (TCM), a classic remedy for promoting blood circulation and improving blood stasis, have shown capabilities to relieve neuroinflammation and repair the blood-brain barrier (BBB) integrity. However, the efficacy and the underlying mechanisms of medicinal leeches in treating VaD remain unclear. OBJECTIVE: This study aimed to explore the efficacy of medicinal leeches in treating VaD and its molecular mechanisms. METHODS: An in vivo VaD model of rats was created via a two-vessel occlusion (2VO) ischemia protocol. Learning and memory functions in rats were assessed via the water maze test, Y-maze test, and novel object recognition test. The neuronal injury in rat hippocampus was assessed by H&E and Nissl staining. Network pharmacology (NP) and molecular docking depicted a "SZ-Compounds-Targets" network and visualized the binding pattern between core components of medicinal leeches and key targets of VaD, respectively. Transmission electron microscopy (TEM), ELISA, quantitative PCR, and Western blotting were performed to validate the involvement of the TLR4/NF-κB signaling pathway in leech treatment against VaD. RESULTS: Medicinal leeches alleviated the cognitive deficits and neuronal injuries in VaD rats. Seven key targets were predicted as the leading contributors to the neuroprotective potential of medicinal leeches against VaD. Enrichment analyses further showed that the Toll-like receptor and NF-κB signaling pathways were enriched in the key targets of medicinal leeches. Experimental assays showed that expression levels of TLR4, MyD88, p-p65, and pro-inflammatory mediators were significantly elevated in VaD rats, which were further enhanced by LPS induction. Encouragingly, leech treatment significantly downregulated their levels. CONCLUSION: Medicinal leeches can effectively alleviate the learning and cognitive impairments, neurological pathology in the hippocampal CA1 region, and the loss of BBB integrity in VaD rats. Moreover, medicinal leeches can suppress the neuroinflammation in VaD rats through inhibiting the TLR4/NF-κB signaling pathway.
JMIR medical informaticsYuzhi Huo, Gao Deng, Li Kang, Haizhi Qin, Li Xiao, Ying Deng, Xin Chen, Dan Ding, Fei Wang, Mei Zhang, Min Chen
BACKGROUND: Traditional Chinese medicine (TCM) constitution is a structured health state taxonomy used in preventive care, but its relationship with routinely collected health examination data, disease-related markers, and longitudinal change remains difficult to interpret in clinical informatics settings. OBJECTIVE: This study aimed to develop and evaluate a longitudinal clinical informatics framework for characterizing TCM constitution as a computable, explainable, record-based phenotype using routine health examination records. METHODS: We conducted a retrospective longitudinal analysis of 47,417 examination-constitution records from 11,355 older adults examined between 2017 and 2026. Baseline analyses used the first available record per participant, and longitudinal analyses used 32,648 pairs of adjacent annual visits. The framework included bidirectional disease-constitution mapping, nonoverlapping multimarker burden modeling, lagged next-visit association models, constitution-state transition analysis, and temporal evaluation of routine examination-based label prediction models. Additional sensitivity analyses evaluated participant overlap across calendar-year splits, participant-disjoint temporal evaluation, BMI-only and BMI-plus-waist baselines, exclusion of anthropometric predictors, adiposity adjustment of longitudinal models, and new-onset and persistence outcomes. RESULTS: Phlegm-dampness showed the clearest record-based signature and was associated with higher cardiometabolic marker burden than balanced constitution (incidence rate ratio 1.65, 95% CI 1.60-1.70). In lagged models, its associations with a subsequent abdominal ultrasound abnormality flag and cardiometabolic risk clustering persisted after BMI adjustment, whereas associations with diabetes-related markers, proteinuria, dyslipidemia, and glucose abnormalities were substantially attenuated. Of 11,355 participants, 8122 appeared in at least 2 original calendar-year splits. In a participant-disjoint temporal sensitivity analysis with 1054 new test participants, extreme gradient boosting (XGBoost) identified phlegm-dampness label presence with an area under the receiver operating characteristic curve of 0.927 (95% CI 0.912-0.941). A BMI-only model achieved 0.923 (95% CI 0.907-0.938), whereas XGBoost without anthropometric predictors achieved 0.685 (95% CI 0.653-0.717). CONCLUSIONS: Routine health examination data captured a reproducible, predominantly adiposity-centered phlegm-dampness label phenotype in this cohort of older adults. High discrimination was retained in participant-disjoint evaluation but was nearly matched by the BMI-only model, and several longitudinal associations were explained by adiposity. The models should therefore be interpreted as decision-support and communication aids for an existing constitution assessment process and not as stand-alone diagnostic systems or comprehensive classifiers of TCM constitution.
International journal of molecular sciencesNana Li, Chonkit Lio, Zhenlian Lu, Jinfang Luo
Ferroptosis is an iron-dependent form of regulated cell death characterized by the lethal accumulation of lipid peroxides and has emerged as an important contributor to the initiation, progression, and amplification of inflammatory responses. DNA methylation, histone modifications, and noncoding RNA-mediated regulation influence ferroptosis by modulating multiple molecular pathways, thereby shaping the inflammatory microenvironment. Active constituents and compound formulas of traditional Chinese medicine (TCM) exhibit multi-target, multi-pathway regulatory properties that enable the simultaneous regulation of epigenetic modifications, ferroptosis, and inflammation. However, the molecular mechanisms linking these processes have not been systematically summarized. This review discusses the molecular mechanisms underlying ferroptosis, the epigenetic mechanisms that regulate ferroptosis, and the reciprocal interplay between ferroptosis and inflammation. It further highlights recent advances in understanding how active constituents and compound formulas of TCM modulate ferroptosis through epigenetic regulation to alleviate inflammatory injury. By integrating current evidence, this review provides mechanistic insights into the epigenetic basis of the anti-inflammatory actions of TCM and underscores the therapeutic potential of epigenetic modulation of ferroptosis for the treatment of inflammatory diseases.
NutrientsXin-Qian Rong, Xiao-Meng Zhang, Cheng Lu, Yong Tan
Traditional Chinese medicine (TCM) polysaccharides are important active components of traditional Chinese medicine, and their anti-inflammatory, immunomodulatory, and mucosal barrier protective effects have attracted widespread attention. Since most traditional Chinese medicine polysaccharides are difficult to be completely digested and absorbed in the gastrointestinal tract, their interventional effects on respiratory diseases may be closely related to the selective utilization by gut microorganisms and the regulation of the gut-lung axis. Therefore, the structural and functional interactions between traditional Chinese medicine polysaccharides and gut microbiota have gradually become an important direction in traditional Chinese medicine pharmacology and microecology research. This review mainly explores two core questions: first, how traditional Chinese medicine polysaccharides that can act on the gut-lung axis drive candidate gut bacteria and metabolic networks; second, how polysaccharide-driven candidate bacteria and metabolic networks regulate pulmonary infection, allergic inflammation, chronic airway injury, and fibrosis through the intestinal mucosal barrier, immune cell reprogramming, and cross-organ signal transmission. Accordingly, this narrative mechanistic review examines selected preclinical studies on traditional Chinese medicine polysaccharides regulating the gut-lung axis, focusing on summarizing the continuous mechanisms by which different polysaccharides promote the proliferation of related microbial communities and metabolite production through selective feeding of gut microorganisms, stabilize intestinal mucosal immunity, and exert pulmonary interventional effects. This review aims to deepen the understanding of the interaction mechanisms among traditional Chinese medicine polysaccharides, microorganisms, and the host, provide some reference for establishing a mechanistic evidence framework for gut-lung axis research and screening potential active polysaccharides with relevant structures and microbiota effects.
Zhonghua shao shang yu chuang mian xiu fu za zhiX B Fu
Based on the author's personal experience, this paper presents a comparative systematic review of the internationalization path and prospects of a discipline system for wound repair with Chinese characteristics from the 1990s to the new era. This trajectory of internationalization has significantly contributed to the development of China's disciplinary framework in construction of the discipline system for wound repair, basic research, clinical management, talent cultivation, and in serving the vast number of patients. All of these practices played an important role in construction of a wound repair discipline system with Chinese characteristics. These experiences have significant reference value for further constructing and improving the Chinese-characteristic wound repair discipline system in the new era.
International journal of molecular sciencesKitti Leesiam, Arunporn Itharat, Weerachai Pipatrattanaseree, Puritat Kanokkangsadal, Thishnapha Vudhironarit, Vilailak Tiyao, Sunita Makchuchit, Pranporn Kuro…
Rang Chuet is a traditional Thai medicinal plant widely used for detoxification, although the name is applied to several botanically distinct species. This study investigated the ethnopharmacological basis and potential molecular mechanisms underlying this practice by integrating practitioner knowledge, botanical authentication, phytochemical profiling, and molecular docking. Structured interviews were conducted with 30 experienced traditional medicine practitioners from five regions of Thailand to document the therapeutic use and preparation of Rang Chuet. Botanical identification confirmed three species marketed under this name: Crotalaria spectabilis Roth, Curcuma rangjued Saensouk & Boonma, and Thunbergia laurifolia Lindl. Most practitioners used Rang Chuet primarily for detoxification, with C. spectabilis and T. laurifolia being the predominant species. LC-MS/MS analysis identified fifteen phytochemicals, including compounds common to both species, such as apigenin, quercetin, and caffeic acid, together with species-specific constituents including rosmarinic acid and α-spinasterol in T. laurifolia. Molecular docking suggested that selected phytochemicals may interact with xenobiotic-sensing receptors, with α-spinasterol showing favorable binding to the Pregnane X Receptor (PXR) and apigenin and catechin to the Aryl Hydrocarbon Receptor (AhR). However, C. spectabilis is a recognised source of hepatotoxic pyrrolizidine alkaloids, and because molecular docking cannot distinguish agonist from antagonist activity or establish functional receptor activation, these predicted interactions should not be interpreted as evidence of detoxification efficacy or safety. These findings provide a scientific framework linking traditional knowledge, botanical diversity, phytochemical composition, and potential receptor-mediated mechanisms, and highlight the public health risk of botanical substitution under the shared vernacular name "Rang Chuet." These findings are hypothesis-generating and warrant future functional and toxicological validation, particularly regarding C. spectabilis.
Hyperuricemia (HUA) is a metabolic disorder caused by dysregulated uric acid metabolism and constitutes the principal biochemical basis of gout. Persistent elevation of serum uric acid above the saturation threshold promotes monosodium urate crystal deposition in joints, soft tissues, and the kidneys, triggering inflammation and tissue injury. The rising global prevalence of HUA and gout, together with an evident trend toward younger onset, has imposed an increasing public health burden. Traditional Chinese Medicine has been widely used in their management because of its holistic therapeutic approach and favorable safety profile. Among the bioactive constituents derived from Chinese medicinal materials, saponins have attracted particular attention for their multi-target pharmacological actions. Saponin compounds derived from Chinese medicinal materials exert anti-hyperuricemic and anti-gout effects by modulating purine-metabolizing enzymes, regulating urate transporters, restoring gut microbiota homeostasis, and suppressing inflammatory signaling pathways. This review summarizes the pathogenesis of HUA and gout and synthesizes current evidence on the therapeutic mechanisms of saponins derived from Chinese medicinal materials, providing a theoretical basis for the development of novel therapeutic strategies.
Patient education and counselingYan Liu, Yuezhuo Wang, Xinran Liu
OBJECTIVE: Social media has become an increasingly important channel for public health information seeking and patient education. However, little is known about how Traditional Chinese Medicine (TCM) practitioners perceive and engage with social media in their professional practice. This study explores TCM practitioners' perceptions of social media in health communication, identifies key factors influencing its adoption and use, examines perceived barriers and challenges, and assesses its implications for doctor-patient communication. METHODS: Semi-structured, in-depth interviews were conducted with 31 TCM practitioners working in Shanghai. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis involving iterative coding, theme development, and interpretation. RESULTS: TCM practitioners expressed mixed and context-dependent attitudes toward social media, ranging from active engagement to deliberate avoidance. Beyond commercial considerations, participants viewed social media as a means of disseminating TCM knowledge and sustaining cultural traditions. Social media was perceived as facilitating initial trust-building with patients, although long-term trust was seen to depend on clinical competence and treatment outcomes. Practitioners also reported greater willingness to present diverse personal identities online and to engage in more relational forms of interaction with patients. Institutional differences were evident between public and private healthcare settings. Public hospital practitioners faced stricter organizational constraints on social media use. CONCLUSION: Social media plays a multifaceted role in TCM practice, supporting patient education, cultural transmission, and evolving forms of doctor-patient communication. Adoption is shaped by professional values, institutional contexts, and tensions between visibility, trust, and regulation. PRACTICE IMPLICATIONS: Context-sensitive guidance should distinguish general health education from individualized advice, establish tiered institutional review, and help practitioners communicate limitations, manage expectations, and maintain professional boundaries.
JMIR research protocolsAswani P S, Amit Kumar Rai, Bhagwan Sahai Sharma, Azeem Ahmad, Pratap Shankar Kizhakke Meladam, Rohit K S, Lisha S Raj, Rakesh Rana, Bhogavalli Chandra Sekhara…
BACKGROUND: The leading cause of disability worldwide is low back pain. The incidence of herniated disc is approximately 5 to 20 cases per 1000 adults per year, and herniated disc is prevalent in people in their third to fifth decade of life, with a male-to-female ratio of 2:1. In Ayurveda, the condition grudhrasi is considered analogous to radiculopathy. In conventional medicine, the first line of treatment includes conservative management, such as patient education, manual therapy, and nonsteroidal anti-inflammatory drugs. Ayurvedic treatments are used to manage lumbar radiculopathy. OBJECTIVE: This clinical study aims to compare the safety and efficacy of an Ayurvedic treatment protocol with standard care in patients with lumbar disc herniation with radiculopathy. METHODS: This is an open-label, randomized, controlled, parallel group clinical trial with a sample size of 80 participants who will be randomly allocated to 2 groups. The intervention group will receive an Ayurvedic treatment protocol, and the control group will be treated with conventional care, including physiotherapy, for a period of 60 days. The changes in the numeric pain rating scale and visual analog scale score and the Oswestry Disability Index (version 2.0) score will be considered the primary outcome measures and will be recorded at baseline (day 1) and on day 8 (after completing inpatient [IP] treatment), day 30, and day 60. The secondary outcome, quality of life, will be recorded at baseline (day 1) and on day 8 (after completing IP treatment), day 30, and day 60. The occurrence of adverse events and the need for rescue analgesic medications will be considered other secondary outcome measures and will be recorded on day 8 (after completing IP treatment), day 30, and day 60. RESULTS: The study was funded in March 2023, and the study period is 36 months. Participant enrollment began in November 2023. A total of 136 participants were screened, of whom 80 were enrolled in the study. Data analysis is in progress, and the study outcomes are expected to be published by December 2026. CONCLUSIONS: The outcome of this trial may provide scientific evidence regarding the safety and efficacy of Ayurvedic treatment for lumbar disc herniation with radiculopathy. The study may also contribute to the development of evidence-based integrative management strategies and standardized treatment protocols for this condition. TRIAL REGISTRATION: Clinical Trial Registry of India CTRI/2023/05/052859; https://tinyurl.com/y6h4b5kb. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/82936.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerYu Song, Xinyu Zhou, Yao Luo, Hongying Guo, Ying Xia, Fang Ni, Shuang Geng
BACKGROUND: Fatigue is a prevalent symptom in lung cancer patients and adversely affects their health and quality of life. While some evidence suggests that Traditional Chinese Medicine (TCM)-based non-pharmacological therapies can effectively alleviate cancer-related fatigue (CRF), it remains unclear which therapy is most effective for managing CRF in this population. OBJECTIVE: To compare the effects of different TCM-based non-pharmacological therapies on reducing CRF in lung cancer patients. METHODS: We searched eight databases from their inception to 24 November 2025. Following literature screening, the quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias 2.0 tool. A network meta-analysis was conducted to evaluate the relative efficacy of the TCM-based non-pharmacological therapies. Statistical analyses were performed using STATA 18.0 software. RESULTS: A total of 32 RCTs involving eight TCM-based non-pharmacological therapies were included. The network meta-analysis results indicated that moxibustion (SMD = -2.56, 95% CI = -3.60 to -1.51) and auricular acupressure (SMD = -1.82, 95% CI = -3.61 to -0.03) were significantly more effective than usual care in improving CRF. Furthermore, moxibustion showed a significant advantage over qigong (SMD = -2.12, 95% CI = -3.58 to -0.65). CONCLUSION: Current evidence shows that moxibustion and auricular acupressure may be the most promising TCM-based non-pharmacological therapies for alleviating CRF in lung cancer patients, whereas qigong appears less effective. However, given the considerable risk of bias across the included studies, these conclusions require further validation through more rigorously designed, high-quality clinical trials.
MedicineHongpeng Yu, Xiaotong Wei, Shaodan Hu, Huan Ding, Zhenghua Cao, Feng Sun, Li Shi
Xiaoqinglong Decoction (XQLD) is a traditional Chinese herbal formula widely used in clinical practice to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with notable efficacy. Studies indicate that XQLD can effectively modulate the inflammatory response during the acute infectious phase of AECOPD; however, its underlying mechanism of action remains unclear. This study employed network pharmacology, molecular docking, and molecular dynamics simulations to investigate the potential target genes of XQLD and its possible mechanisms of action in treating AECOPD. Active ingredients and related targets of XQLD were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, SwissTargetPrediction, and UniProt. AECOPD-related targets were collected from GeneCards, DrugBank, online Mendelian inheritance in man, and PharmGKB. Common targets between the active ingredients of XQLD and AECOPD were screened. A protein-protein interaction network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins database and visualized with Cytoscape. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed using the Database for Annotation, Visualization and Integrated Discovery database. Molecular docking and molecular dynamics simulations were conducted using AutoDock Vina and GROMACS, respectively, to evaluate the binding affinity and stability between core targets and active components. The results revealed that the active ingredients of XQLD, including quercetin, luteolin, and kaempferol, target multiple genes such as nuclear factor kappa B subunit 1, signal transducer and activator of transcription 1, mechanistic target of rapamycin kinase, caspase-3, BCL2‑Like 1, and MYC, primarily through the TNF and PI3K/Akt signaling pathways. Molecular docking and dynamics simulations confirmed stable binding between core targets and active ingredients, particularly between glyuranolide and signal transducer and activator of transcription 1, which merits further investigation. XQLD may alleviate AECOPD progression by regulating the inflammatory response, hypoxia, and apoptosis through multi-component, multi-target, and multi-pathway mechanisms. These findings provide a theoretical basis for further experimental research and potential clinical application of XQLD.
MedicineDa-Eun Yoon, Yoonjeong Seo, Heeyoung Moon, Shin Ho Kong, Changwoo Nam, Joowon Hwang, Karam Kim, Man-Heum Kwon, Hyun-Woo Jin, Yeonhee Ryu, In-Seon Lee, Younbyou…
In Traditional East Asian Medicine, acupoints are selected based on clinical symptoms and pattern identification. Since treatment plans target specific diseases and patterns, acupoints may be selected based on clinical indications or pattern-related considerations. This study aimed to examine the associations between acupoint use and deficiency-excess, cold-heat, and dryness-dampness pattern scores. Data were collected from the medical records of 423 outpatients with various pain disorders. Clinicians assigned semi-quantitative scores for deficiency-excess, cold-heat, and dryness-dampness on a -5 to +5 scale as part of the study assessment. Mean scores across the 3 pattern dimensions were calculated for the 30 most frequently prescribed acupoints, followed by hierarchical clustering. Two- to six-cluster solutions were compared using silhouette scores, and a five-cluster partition was retained for descriptive interpretation and further assessed for bootstrap stability. Across the 423 cases, ST36, LR3, and LI4 were the most commonly used acupoints for pain management. These 30 acupoints showed heterogeneous profiles across the 3 pattern dimensions. Hierarchical clustering provided an exploratory five-group representation, although no uniquely optimal cluster solution was identified. Commonly used acupoints showed heterogeneous profiles across clinician-assigned deficiency-excess, cold-heat, and dryness-dampness scores. These findings provide an exploratory description of pattern-related tendencies in real-world acupoint selection. Further prospective studies using standardized pattern assessment and adjustment for disease- and clinician-related factors are required to validate these associations.
Journal of helminthologyA Khan, S K Panda, M Yaghoobi, Q Ullah, H Hu, L Schoofs, W Luyten
Traditional systems of medicine have acted as a primary health care modality for resource-constrained regions of the world since time immemorial. This study investigates the anthelmintic activity of 17 ethnobotanically selected medicinal plants from the Swat region of Pakistan and characterises their phytochemical profiles. The anthelmintic activity of plant extracts prepared in five different solvents (hexane, acetone, ethanol, methanol, and water) was determined by using Caenorhabditis elegans as a model, followed by assessment of the phytochemistry as well as thin-layer chromatographic profiling of the acetone plant extracts. The anthelmintic results revealed that 48% of the extracts showed significant activity against C. elegans, with Ajuga bracteosa and Punica granatum extracts, followed by Berberis lyceum, Mentha longifolia, and Artemisia maritima, being the most potent. Among solvents, acetone proved to be the most effective extractant solvent. The phytochemical analysis and TLC profiling revealed various phytochemical groups in selected plant extracts. These findings support the significance of ethnomedicinal herbs in the discovery of novel antiparasitic drug candidates. To the best of our knowledge, this is the first study to document the anthelmintic properties of selected plants from the Swat region of Pakistan, along with phytochemical screening and TLC profiling. This study indicates that the plants with potent anthelmintic activity, such as A. maritima, M. longifolia, B. lyceum, A. bracteosa, and P. granatum, could be potential candidates for anthelmintic drug discovery.
Drug design, development and therapyYuan-Yuan Li, Shi-Han Sun, Yan Jiang, Chen-Chen Liu, Shi-Qi Cheng, Jin-Wen Wu, Ming-Tai Chen, Xiao-Lin Li, Gang Luo, Meng-Nan Liu
Heart failure (HF) represents the terminal stage of diverse cardiovascular pathologies and has emerged as a global public health crisis, characterized by increasing prevalence and persistently poor long-term prognosis. Although modern pharmacological therapies have advanced considerably, high rates of disease recurrence and recurrent hospitalizations continue to profoundly impair patients' quality of life. Traditional Chinese medicine (TCM) has been reported in preclinical and some clinical studies to offer potential benefits, particularly in enhancing cardiac function, alleviating clinical symptoms, and slowing disease progression. Numerous TCM compound formulations are commonly used in clinical practice in China and are gradually attracting international research attention. Nevertheless, the inherent complexity of TCM compositions, their multi-target mechanisms of action, and the lack of clarity regarding their molecular underpinnings remain substantial obstacles to broader acceptance within contemporary medicine. In recent years, driven by the rapid evolution of high-throughput sequencing technologies, transcriptomics has become a pivotal tool in TCM research, facilitating the exploration of disease mechanisms and drug targets. This narrative review synthesizes research progress on TCM interventions for HF from a transcriptomic perspective. It traces the development of major transcriptomic technologies, critically evaluates their respective strengths and limitations, and synthesizes current findings on how TCM modulates differentially expressed genes, signaling pathways, and cellular processes at multiple regulatory levels. Furthermore, it examines the potential therapeutic impact of TCM on key pathological pathways, including myocardial remodeling, energy metabolism dysregulation, and inflammatory responses. By identifying existing research gaps and outlining future directions, this review seeks to elucidate the mechanisms of TCM treatment for HF through modern scientific frameworks, thereby offering novel insights for addressing this challenging condition.
Global public healthHanhua Wang, Yang Yang, Yingying Ji, Jinjin Huang
Public county-level Traditional Chinese Medicine (TCM) hospitals are critical for integrating traditional and modern medicine, yet their heterogeneous development potential hinders policy implementation. Using Zhejiang Province as a case and an integrated Resource Dependence-Complex Systems framework, this study employed a mixed-methods design-cluster analysis of 78 county-level units and in-depth interviews with 24 key stakeholders-to identify four developmental archetypes. Findings reveal that hospital potential is an 'emergent property' stemming from the interplay between external resource dependence and internal institutional adaptation. We propose a 'diagnose-classify-prescribe' differentiated governance framework, which tailors roles such as 'innovation catalyst' or 'system stabiliser' to specific contexts. This approach offers a transferable pathway for moving beyond one-size-fits-all policies and contributes to integrating traditional medicine into diverse local health systems globally.
Explore (New York, N.Y.)Mohammad Mehdi Zarshenas, Ali Kashkooe, Mohammad Amin Annabi, Maryam Shayesteh, Maryam Mosaffa-Jahromi, Mehdi Pasalar
BACKGROUND: Severe acute respiratory infections remain a major cause of global morbidity and mortality, particularly in low-resource settings where supportive treatment options are limited. Identifying safe, accessible adjunctive therapies is therefore a clinical priority. This study examined whether Polypodium vulgare L. root decoction, used as an adjunct to standard care, could influence prespecified longitudinal clinical and laboratory parameters, particularly vital-sign and oxygenation trajectories, during the 14-day follow-up period in adults hospitalized with mild to moderate severe acute respiratory infection. METHODS: In this randomized, multicenter trial with blinded outcome assessment, adults were assigned to receive P. vulgare root decoction plus standard care or standard care alone. Nine clinical and laboratory parameters were monitored over 14 days, and daily changes between groups were analyzed using longitudinal generalized estimating equations. Plant material was authenticated following ConPhyMP guidelines, and a voucher specimen (TM-1179) was deposited at the Shiraz University of Medical Sciences Herbarium. RESULTS: Eighty-eight participants completed the study (44 per arm). Adjunct P. vulgare therapy produced a faster reduction in heart rate (P < 0.0001) and a greater daily improvement in oxygen saturation (P = 0.004) compared with standard care alone. Conversely, reductions in inflammatory markers-erythrocyte sedimentation rate and C-reactive protein-were slower in the P. vulgare group (P < 0.0001), and the absolute neutrophil count increased more rapidly in the experimental arm than in the control arm (P = 0.003). No serious or fatal adverse events occurred in either group. CONCLUSIONS: Use of P. vulgare root decoction alongside standard care may enhance cardiorespiratory recovery in adults with mild to moderate severe acute respiratory infection, although its effects on inflammatory biomarkers appear variable. Larger, controlled trials are needed to confirm these findings and to clarify the therapeutic value of this adjunctive approach. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT20120506009651N4; registered 07 June 2022).
JMIR research protocolsDevipriya Soman, Ramesh Nv, Pravith Nk
BACKGROUND: Vamana (therapeutic emesis) and Virechana (therapeutic purgation) are the two major biopurification procedures enlisted in Ayurveda. Studies explicitly showcasing their clinical efficacy are documented in substantial numbers. Ritu sodhana (seasonal purification) imparts rejuvenation in healthy individuals. However, its efficacy for health span and decelerating the aging process in healthy individuals remains a gray area. OBJECTIVE: This study's objective is to explore the effect of ritu sodhana on modifying serum levels of malondialdehyde (MDA), total superoxide dismutase (T-SOD), and telomerase activity. METHODS: The study was prospectively registered in the Clinical Trial Registry-India (CTRI; CTRI/2024/02/062176), uses a pre-posttest study design, and includes 53 participants 35 years to 65 years old. The study is exploratory and lacks a control group. Those with a BMI between 18.5 kg/m2 and 25 kg/m2, with stable weight for 3 months immediately prior to the study, with madhyama koshta (medium nature of bowel evacuation, as assessed using aquestionnaire), who are Vamanarha (eligible for therapeutic emesis) and Virechanarha (eligible for therapeutic purgation), and who do not meet the exclusion criteria will be included in the study. The interventions include emesis in the spring and purgation in the autumn season, preceded by Snehana (oleation) and Swedana (fomentation) and followed by the Samsarjana karma (specialized menu of diets) depending on the measurement of purification. Trial duration will range from 18 days to 20 days for each participant, and the total study duration will be 3 years. The serum levels of MDA, SOD, and telomerase activity will be measured on day 0 and on the next day following completion of the Samsarjana karma (18th-20th day). Continuous variables for primary biological endpoints including serum MDA, T-SOD, and telomerase activity will be evaluated using paired-samples t tests or Wilcoxon signed-rank tests, with potential missing data managed under a missing completely at random assumption using available case analysis (pairwise deletion) cross-verified by a conservative baseline observation carried forward (BOCF) sensitivity test. The effect size will be also determined. RESULTS: Recruitment began in March 2025. Data for 27 participants who voluntarily participated in Vasantha Vamana were collected in March 2025 and April 2025. Data analysis is pending, and the study is expected to be completed by the end of December 2026. CONCLUSIONS: The study will provide hypothesis-generating evidence, and the data will serve as a necessary precursor to adequately powered, confirmatory trials on the aging process.
Medical oncology (Northwood, London, England)Yu Sun, Yandong Li, Haopeng Jiang, Xueyan Liu, Shuai Yu, Yuqi Liu
Metastatic colorectal cancer (mCRC) presents a stark immuno-oncologic dichotomy: while microsatellite instability-high (MSI-H) tumors respond to immune checkpoint inhibitors (ICIs), the vast majority of microsatellite-stable (MSS) cases remain refractory, underscoring a critical need for novel strategies to convert "cold" tumors into "hot" ones. This review advances the hypothesis that Traditional Chinese Medicine (TCM) can serve as a formula-defined ecological conditioner within the tumor-immune-soil nexus. We propose a mechanistic blueprint where TCM formulas, rather than acting as nonspecific immunostimulants, function as multi-target systems that re-engineer the tumor microenvironment. The framework integrates three actionable pillars: (1) remodeling the gut microbiome to restore immune-competent consortia and metabolic flux, (2) reprogramming the myeloid compartment away from suppressive M2 macrophages and MDSCs toward immunostimulatory states, and (3) inducing immunogenic cell death to generate critical danger signals. By translating classical concepts like the Gan Pi axis into modern immunometabolism, we propose that TCM can prime the "soil" to sensitize MSS mCRC to ICI therapy. However, realizing this potential requires a paradigm shift from descriptive reports to rigorous, biomarker-driven trials. A crucial point is that the nature of a significant portion of existing human evidence remains observational, cross-sectional, or case-control; this limits causal inference and hinders the reconstruction of the long-term temporal sequence extending from the reciprocal dynamics of the immune system and microbiome to cancer progression or treatment response. We conclude that the future of TCM-ICI integration lies in standardized, chemically characterized formulas evaluated within adaptive platform trials, utilizing spatial transcriptomics and microbiome-humanized models to validate true cold-to-hot conversion.