The gut microbiota plays a pivotal role in maintaining host metabolic homeostasis and overall physiological functions. Shenling Baizhu San (SLBZS), a time‐honored classical prescription for tonifying Qi, strengthening the spleen, removing dampness, and arresting diarrhea, has shown broad clinical efficacy in digestive disorders. Emerging evidence indicates that the metabolic fate, pharmacokinetics, and bioavailability of SLBZS's complex herbal constituents are profoundly influenced by interactions with specific intestinal microorganisms and their enzymatic repertoire. This review systematically summarizes advances in five key areas: (1) the major bioactive components of SLBZS and their modern therapeutic applications; (2) characterization of gut microbial communities and their relevant degradative enzymes; (3) in vitro and in vivo studies elucidating microbe‐mediated biotransformation of SLBZS constituents; (4) modulation of host signaling pathways—such as NF‐κB, peroxisome proliferator‐activated receptor, and AMPK—by SLBZS metabolites; and (5) the pharmacological implications of these microbial conversions for enhancing compound bioactivity and therapeutic outcomes. By integrating phytochemical analyses, microbial genomics, and metabolomics data, researchers have begun to identify the specific microbial taxa responsible for key hydrolysis, reduction, and deglycosylation reactions. Understanding these host–microbe–herb interactions not only sheds light on the mechanistic basis of SLBZS's efficacy, but also informs strategies to optimize its formulation and dosing. Such insights will facilitate the modernization and precision application of traditional Chinese medicine, ultimately improving patient prognosis in gastrointestinal and systemic diseases.
Jinhong tablet (JHT), a traditional Chinese patent medicine prepared from four Chinese medicinal materials, is highly effective in soothing the liver and relieving depression, regulating qi and promoting blood circulation, and regulating the stomach and relieving pain. It is clinically used to treat chronic superficial gastritis (CSG) with liver‐stomach disharmony. However, research on its pharmacokinetics remains limited. This study aims to investigate the pharmacokinetic characteristics of JHT in normal rats and examine its pharmacokinetic differences across normal, CSG, and intestinal microbial disorder rats. The chemical composition of JHT was identified using Orbitrap, and the main components were quantitatively analyzed. A network pharmacology screening framework was established to screen the key active ingredients of JHT in treating CSG. A quantitative method was developed to measure these ingredients in rat plasma. After oral administration of JHT at different doses, the pharmacokinetics of seven ingredients was evaluated in normal rats. Pharmacokinetic differences of four major compounds were further compared among normal, CSG, and fecal microbiota transplantation (FMT) rats. Gut microbiota changes in the three groups were analyzed using high‐throughput sequencing, and Spearman correlation analysis was conducted to explore the relationship between the in vivo exposure and microbial alterations. Leveraging network pharmacology analysis, we screened seven key active compounds of JHT in the treatment of CSG and conducted pharmacokinetic studies on them. In normal rats, all seven ingredients were rapidly absorbed. Tetrahydropalmatine, corydaline, costunolide, and rhamnosylvitexin showed good exposure, whereas dehydrocorydaline, allocryptopine, and palmatine hydrochloride had low exposure. Additionally, tetrahydropalmatine, corydaline, and costunolide exhibited linear pharmacokinetics between 0.7–5.6 g/kg, whereas rhamnosylvitexin and dehydrocorydaline were linear within 0.7 and 2.8 g/kg. In CSG and FMT rats, pharmacokinetic profiles changed. CSG increased the exposure and C max of costunolide and rhamnosylvitexin, whereas FMT enhanced the exposure of corydaline and C max of rhamnosylvitexin, which correlated with 20 altered gut bacterial genera. JHT exhibited linear pharmacokinetic characteristics within the appropriate dose ranges, and both the CSG pathological state and intestinal microbial disorder obviously affected its absorption and metabolism. These findings provide valuable insights for the mechanism research and clinical application of JHT.
The Eph/ephrin signaling system has emerged as an important regulator of oncogenic processes, yet its specific involvement in rectal adenocarcinoma (READ) pathogenesis requires further elucidation. This study employed an integrative analytical approach combining computational biology with experimental validation to characterize Eph/ephrin family members in READ, with emphasis on EFNA3 . We employed an integrative multi‐omics approach combining bioinformatics analysis with experimental validation. Transcriptomic data from the Cancer Genome Atlas and Genotype‐Tissue Expression were analyzed to evaluate Eph/ephrin family expression, clinical correlations, and immune infiltration patterns. Functional validation was performed using CCK‐8, wound healing, transwell migration assays, and Western blotting. Our integrated multi‐omics analysis identified EFNA3 as a dual‐function biomarker with both prognostic and immunological relevance in READ. Specifically, EFNA3 expression was elevated in READ tissues and correlated with poor patient prognosis. Functional characterization revealed that EFNA3 contributes to an immunosuppressive tumor microenvironment, marked by reduced cytotoxic lymphocyte infiltration and downregulation of key immune checkpoints. Mechanistically, EFNA3 overexpression promoted rectal cancer cell proliferation and migration, with pathway analysis and Western blot validation implicating Phosphoinositide 3‐Kinase (PI3K)/Ak strain Transforming (AKT)/Mechanistic Target of Rapamycin (mTOR) signaling activation. Furthermore, EFNA3 expression exhibited significant correlations with drug sensitivity and potential associations with traditional Chinese herbs, suggesting its broader implications in therapeutic response and alternative medicine approaches. Our findings establish EFNA3 as a key regulator of READ progression, driving both tumor aggressiveness and immune evasion. These results provide a translational framework for targeting EFNA3 ‐mediated pathways, suggesting combined PI3K/AKT/mTOR inhibition and immune modulation as a potential therapeutic strategy for aggressive READ.
Rheumatoid arthritis (RA) is a chronic, highly disabling autoimmune disease. Although modern medical treatments have made progress, challenges such as suboptimal efficacy, relapse, difficulties in comorbidity management, and side effects persist. Traditional Chinese medicine (TCM) demonstrates unique advantages in the treatment of RA throughout the entire course of the disease, particularly in early intervention, consolidation during remission, reducing the side effects of Western medicines, and preventing relapse. Based on this, the article explores the research paradigm and scientific and technological strategic approaches for RA, which is recognized as a disease with clinical advantages in TCM. It proposes a three‐pronged approach: optimizing the integrated traditional Chinese and Western medicine diagnostic and treatment system, strengthening comprehensive prevention and control of RA‐related complications and comorbidities, and establishing a chronic disease management system for RA based on TCM theories. Through the synergy of clinical and basic research, the aim is to clarify the advantageous aspects of TCM in RA diagnosis and treatment, develop effective treatment protocols, enhance RA prevention and management, and underscore the value of TCM.
Rheumatoid arthritis (RA) is a common autoimmune disease with bone destruction as the core pathology, which belongs to the category of “impediment disease” in traditional Chinese medicine (TCM), and its etiology and pathogenesis are still not completely clear. It is characterized by high prevalence, high disability rate, and high recurrence rate, which seriously affects human health and has become a worldwide research hot spot. At present, although modern medicine has made significant progress in the treatment of RA bone destruction, such as biologics and small‐molecule targeted drugs, it still faces problems such as poor efficacy, drug resistance, drug side effects, and long‐term treatment costs. It has been found that the use of TCM decoction and acupuncture in combination with Western medicine for the treatment of RA bone destruction can enhance the efficacy of the treatment while reducing the adverse effects of Western medicine. However, no one has systematically reviewed the current research status on the combination of Chinese and Western medicine in the treatment of RA bone destruction. Therefore, this paper reviews the research progress of combined Chinese and Western medicine in the treatment of RA bone destruction, aiming to promote the application of combined Chinese and Western medicine in clinical practice and provide new treatment ideas for the clinical treatment of RA bone destruction.
In acupuncture randomized controlled trials (RCTs), the proper interpretation of results requires a thorough understanding of key statistical concepts such as p -value, effect size, and the minimal clinically important difference (MCID). This paper explores the relationships among these metrics and their implications for assessing the clinical significance of acupuncture interventions. Through case studies, the paper highlights the limitations of relying solely on p -values for determining the clinical relevance of outcomes. Although statistically significant results may be reported, these studies often fail to meet the prespecified MCID, raising concerns about their real-world applicability. This paper argues that p -values must be interpreted alongside effect size and MCID to ensure that reported benefits reflect meaningful improvements for patients. By examining both short- and long-term outcomes, this analysis emphasizes the need for a holistic approach when evaluating acupuncture RCTs, ensuring that statistical findings are translated into clinically significant improvements.
The tumor microenvironment (TME) plays a pivotal role in tumorigenesis and metastasis, with cancer-associated fibroblasts (CAFs) and neutrophil extracellular traps (NETs) identified as key contributors to its dynamic regulation. This review elucidates the multifaceted roles of CAFs and NETs in tumor progression and clarifies their intricate cross talk. The underlying mechanisms by which these components promote tumor growth, metastasis, and immune evasion are also discussed. Promising therapeutic strategies include both direct targeting of CAFs and inhibition of their downstream effectors. Likewise, the disruption of NET formation using DNase or peptidylarginine deiminase 4 inhibitors represents a potential avenue for anticancer therapy. In addition, the review highlights the regulatory effects of natural products and traditional Chinese medicines on CAF–tumor interactions. Despite these advances, further investigation is necessary to facilitate clinical translation. Overall, this review provides a comprehensive understanding of the TME and promote the development of innovative therapies targeting CAF–NET cross talk to improve cancer prognosis.
This study aimed to investigate the comorbid mechanisms linking type 2 diabetes mellitus (T2DM) and vascular dementia (VaD), focusing on the roles of astrocytes and neurons, and to identify potential therapeutic traditional Chinese medicines (TCMs) and compounds. T2DM (GSE161355) and VaD (GSE122063) transcriptomic datasets were retrieved from the Gene Expression Omnibus database. Differential expression analysis, functional enrichment, and druggability assessment were conducted to identify potential core targets. Corresponding TCMs and compounds were predicted by using the TCMSP and HERB databases, followed by analyses of their pharmacokinetics, toxicity, and binding affinity. In astrocytes, eight core genes (e.g., HSP90AA1, HIF1A, PTEN) were identified and primarily enriched in autophagy and inflammatory pathways. Eight TCMs, including Corydalis yanhusuo and Phellodendron chinense , were predicted to be relevant. Indigo exhibited a relatively strong binding affinity to HSP90AA1 (−10.0 kcal/mol). In neurons, eight core genes (e.g., NFKB1, CYCS, PTGS2) were enriched in apoptosis and neuroinflammation pathways. Potential TCMs, such as Tripterygium wilfordii , were identified. Palmatine showed a relatively strong binding affinity to PTGS2 (−8.1 kcal/mol). Most predicted TCMs were characterized as bitter and cold in property, associated with the liver meridian, and attributed with heat-clearing effects. Our findings suggest that the comorbidity of T2DM and VaD may involve dysregulated inflammatory and apoptotic pathways in astrocytes and neurons. The predicted TCMs and compounds represent multitarget intervention candidates, consistent with TCM theories of “Yin deficiency with internal heat” and “phlegm-stasis transforming into heat.” These findings provide a theoretical basis for future experimental validation and the development of TCM-based therapies.
Chronic pelvic inflammatory disease (CPID) is a persistent upper reproductive tract disorder characterized by microbial dysbiosis, pelvic adhesions, and infertility. Guizhi Fuling capsule (GZFLC), a multiherb traditional formula, has demonstrated therapeutic potential for CPID. A CPID rat model was established via mixed-pathogen infection. Evaluations included uterine histopathology, inflammatory cytokine levels (interleukin-6, tumor necrosis factor-α, interleukin-18, interleukin-1β), coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen), uterine metabolomics, 16S rRNA sequencing, and metagenomic sequencing to assess microbial composition and functional pathway alterations. CPID rats exhibited weight loss, uterine structural damage, elevated inflammation, and a hypercoagulable state. Uterine metabolomics showed significant reductions in key TCA cycle intermediates (α-ketoglutarate, isocitrate). 16S rRNA sequencing revealed enrichment of the pathogenic bacterium Clostridia_UCG-014 . Metagenomic analysis indicated upregulation of quorum sensing (QS) pathway genes (thoil-activated cytolysin, TrbB, Gmr) and downregulation of CAZymes, specifically glycoside hydrolase 2 and carbohydrate esterase 1. Correlation analysis suggested that GZFLC modulates specific microbial taxa, influencing host metabolites and inflammatory responses. GZFLC likely alleviates CPID by exerting anti-inflammatory effects, restoring TCA cycle energy metabolism, reshaping gut microbiota structure, inhibiting QS signaling, and improving polysaccharide metabolic functions.
The NLR family pyrin domain-containing 3 (NLRP3) inflammasome is a vital part of the innate immune response, whilst its aberrant activation drives the progression of several noncommunicable diseases. It induces caspase-1 activation and the downstream substrates involved with the processing and secretion of the pro-inflammatory cytokines IL-1β and IL-18 and TNF-α. Activation of this complex often involves the adapter ASC and upstream sensors including NLRP1, NLRP3, NLRC4, AIM2, and pyrin, which are activated by different stimuli including infectious agents and changes in cell homeostasis, and play key roles in inflammation, development, and related cell death. However, the molecular mechanisms that integrate multiple inflammasome sensors to facilitate optimal host defense remain unknown; therefore, treatment is challenging. Natural medicine and small molecule-based therapies have been well-documented for their effectiveness in modulating inflammatory pathways and reestablishing the lost proteostasis inside the cells to combat several chronic diseases related to inflammation. Traditional Chinese medicines (TCMs) have potent clinical effects against NLRP3 inflammasome activation and could be used as complementary therapy. Therefore, this review summarizes various similar reports and highlights the important effects of nutraceuticals and bioactive compounds derived from medicinal plants on NLRP3 inflammasome activation and their possible mechanisms of action. Thus, TCM prescriptions, herbs, and bioactive compounds can be considered novel, practical, and accessible agents in chronic inflammatory diseases by inhibiting NLRP3 inflammasome activation.
In this review, a comprehensive and systematic evaluation of the phytochemical constituents, traditional medicinal applications, current pharmacological research, toxicity, and nanobiotechnology of black cumin has been undertaken. An exhaustive database retrieval was conducted to collect scientific information about Nigella sativa L. from 1956 to 2025 using PubMed, Scopus, ISI Web of Science, SciFinder, and CABI. Search was carried out using the keywords “ Nigella sativa ,” “ Nigella oil,” “Ethnobotany,” “Phytochemistry,” “Pharmacological activity,” “Toxicity,” and “Nanotechnology.” Several important phytochemicals are found in the seeds of N . sativa L., and many of which seem to have a good impact on human health and are put to important use in the Ayurvedic, Unani, and Siddha systems of medicine. Among the active compounds, thymoquinone is the most important, forming about 30%–48% of the oil fraction. Besides thymoquinone, a wide range of phytochemicals such as thymohydroquinone, dithymoquinone, p ‐cymene, sabinene, carvacrol, 4‐terpineol, kaempferol (glucoside) t ‐anethol, longifolene (sesquiterpene), α ‐pinene, α ‐hederin (pentacyclic triterpene), and thymol have also been reported. Current research has provided scientific evidence for the traditional uses of black cumin, especially antioxidant, anti‐inflammatory, antibacterial, antifungal, antiviral, anticancer, antidiabetic, neuroprotective, gastroprotective, and antiarthritic effects. The review provides an in‐depth analysis of the phytochemistry, traditional uses as well as potential pharmacological properties of N . sativa L. Since the plant is being extensively investigated for its medicinal properties, this review provides valuable up‐to‐date information on the current research status and will act as a reference for future research and applications of this important medicinal plant.
Objective: This study aims to analyze the formulation rules of Ciwujia (Acanthopanax Radix et Rhizoma)-containing health products and investigate the potential mechanisms. Methods: By searching the Ciwujia-containing health products from the special food information inquiry platform of the State Administration for Market Regulation and MedSciNet, the basic information, including efficacy, tropism of taste, dosage form, health function etc., was analyzed using R language software packages and Excel. The formulation rules and core drug combinations were analyzed using the Apriori algorithm of IBM SPSS Modeler 18.0. By searching TCMID and other databases and reviewing relevant literature, the chemical components and potential targets database of Ciwujia was constructed. The protein–protein interaction network was analyzed using R package, String database, and Cytoscape software to screen for key components and targets related to health functions. Gene ontology functional annotation and Kyoto encyclopedia of genes and genomes pathway enrichment analysis were performed. Finally, molecular docking was used to verify the binding affinity of core targets and key components. Results: A total of 315 cases of Ciwujia-containing health products were collected. The major health functions were to relieve physical fatigue and immune enhancement. A total of 205 effective components and 775 targets related to Ciwujia were obtained. By intersecting the genes related to Ciwujia and immune enhancement, 212 key target genes were identified. Ciwujia has an effect on immune enhancement through signaling pathways such as C-type lectin receptor, toll-like receptor, and NOD-like receptor. Molecular docking results also indicated a spontaneous and stable binding between the key components of Ciwujia and the core targets. Conclusions: Through data mining, network pharmacology, and molecular docking research, this study analyzed the relevant information of Ciwujia-containing health products, preliminarily revealing its potential targets and mechanism pathways of immune enhancement and providing a theoretical basis for the development of future health products.
Diabetic foot is a chronic refractory wound associated with high disability and mortality rates, which not only threatens the health of patients but also imposes a heavy medical burden on patients and their families. Chinese medicine has been widely used to treat diabetic foot. As a traditional Chinese medicine, ulcer oil possesses a number of beneficial properties. It can clear heat and toxins, activate blood and tissue regeneration, reduce swelling, and alleviate pain. Moreover, ulcer oil can regulate inflammation, promote capillary neoangiogenesis, and enhance granulation growth and epithelial crawling. Furthermore, it can maintain a moist environment within the wound. It is hypothesized that ulcer oil can accelerate the healing of diabetic foot ulcers via a combination of these effects. These observations indicate that ulcer oil has the potential to prevent diabetic foot ulcers and treat high‐risk diabetic foot conditions. In this article, we provide a comprehensive analysis of the utilization of ulcer oil in the management of diabetic foot conditions. Its indications, contraindications, and other pertinent aspects are described to establish a foundation for the clinical application of this therapeutic modality.
The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working-age adults not yet age-eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working-age adults with a history of cancer and compare them with estimates among working-age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer.
The integrated treatment with Chinese and Western medicine plays an important role in the treatment of ankylosing spondylitis (AS), which can significantly relieve the patient's symptoms and improve quality of life. However, as a result of the lack of standardization of clinical management in some regions, the quality of AS treatment in China remains unoptimistic. In 2021, initiated by the Center for Integrative Medicine of China‐Japan Friendship Hospital, led by the traditional Chinese medicine department of rheumatology of China‐Japan Friendship Hospital, relying on the rheumatology branch of the Beijing Association of the integrating of traditional and Western medicine, and using the Delphi method, an expert consensus on “Quality Control Indicators for Integrative Medicine in Ankylosing Spondylitis” was established (Beijing Association of the Integrating of Traditional and Western Medicine Standardization Expert Consensus Filing Number: 2021Z031A2). The consensus revision updates the 2021 version by adding four items, which will provide a reference for the quality control of integrated traditional Chinese and Western medicine for AS in China and help improve the current diagnosis and treatment status of AS.
AXL belongs to the TAM receptor tyrosine kinase family. Relying on binding its high‐affinity ligand—growth arrest‐specific protein 6 (Gas6)—AXL plays an important role in tumor initiation and progression. Traditional Chinese Medicine (TCM) has been clinically used in tumor treatment for a long time, and remarkable therapeutic efficacy has been achieved. Recent studies pointed out that some natural products derived from TCM could inhibit tumor growth by targeting AXL. The potential antitumor mechanisms of natural products targeting AXL still need to be understood. In this review, we discussed the relationship between the AXL axis and tumor malignant phenotype, including migration, invasion, drug resistance, and immunosuppression. The effects and mechanisms of natural products on targeting AXL in tumors also have been systematically summarized.
Psoriasis is a chronic, inflammatory skin condition characterized by its recurrent nature, often accompanied by various systemic comorbidities. It may not fully satisfy the precise diagnostic and therapeutic demands for psoriasis by the theory of syndrome differentiation and treatment of traditional Chinese medicine (TCM). Guided by Academician Tong Xiaolin's “theory of state‐target differentiation and treatment,” psoriasis can be divided into “early stage, middle stage, and late stage,” and “constraint state, excess state, and deficiency state.” Defining the target prescription and targeted Chinese materia medcia of psoriasis in each stage and establishing the system of state‐target differentiation and treatment of psoriasis could provide a new model for clinical diagnosis and treatment.
Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus and the leading cause of mortality. The complex pathogenesis and various clinical manifestations of this disease increase the difficulty of the treatments. The current treatments with Western medicine including glucocorticoids, mycophenolate mofetil and other immunosuppressants, and biological agents have greatly improved the patients' survival. However, frequent recurrence occurred and LN remained an important cause of end stage renal disease. The increasing adverse effects with the prolongation of treatment also restrained the efficacy of Western medicine. Increasing evidence has demonstrated the therapeutic efficacy of traditional Chinese medicine (TCM) which provides a theoretical basis for the integrative therapy of TCM and Western medicine for LN. We previously established a unique comprehensive treatment strategy for LN with the combination of TCM and Western medicine based on the TCM theory and achieved good clinical efficacy. This review will summarize the single‐center experience that integrative therapy of TCM, represented by Lupus Recipe and artesunate, and Western medicine for LN treatment, and elucidate the potential mechanism, with the purpose to provide reliable evidence for developing more effective personalized treatment strategies in the future.
