Background Hypertension, diabetes, and dyslipidemia are common chronic metabolic conditions and major risk factors for cardiovascular disease. These three conditions frequently coexist, presenting a significant public health challenge. Systematically evaluating the epidemiological characteristics and associated factors can be referred for early prevention and control strategies. Objective To systematically evaluate the prevalence and associated factors of the multimorbidity triad (hypertension, diabetes, and dyslipidemia) among Chinese adults. Methods CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Web of Science, and The Cochrane Library were systematically retrieved for studies published up to August 2025. Data were analyzed using Stata 18.0 software. Results Eighteen cross-sectional studies involving 625,718 participants were included. The meta-analysis indicated that the pooled prevalence of comorbid hypertension, diabetes, and dyslipidemia among Chinese adults was 6.2% (95%CI: 4.9%-7.4%). Significant factors associated with this multimorbidity triad included: family history of diabetes (OR=3.88, 95% CI: 1.57–9.58), obesity (OR=3.71, 95%CI: 2.85–4.81), central obesity (OR=2.47, 95%CI: 1.98–3.07), overweight (OR=2.02, 95%CI: 1.74–2.35), marital disruption (divorced, separated, or widowed) (OR=1.88, 95% CI: 1.55–2.27), male(OR=1.62, 95% CI: 1.35–1.96), smoking (OR=1.54, 95% CI: 1.259–1.884), and alcohol use (OR=1.45, 95% CI: 1.25–1.68) (P<0.05). Conclusion The prevalence of comorbid hypertension, diabetes, and dyslipidemia is substantial among Chinese adults. Key associated factors include adiposity (overweight, obesity, central obesity), male, lifestyle behaviors (smoking, alcohol consumption), family history of diabetes, and marital disruption(divorced, separated, widowed). Identifying and managing these modifiable risk factors is critical for clinicians to recognize high-risk individuals and reduce the burden of cardiovascular disease.

To determine how traditional Chinese manual therapy (Tuina) alleviates neuropathic pain (NPP) via central neuroplasticity. NPP was induced by chronic compression of the dorsal root ganglion (CCD) in male rats. From post-operative day 4 to day 28, Tuina (5 N, 2 Hz, 10 min/day) was applied at Weizhong acupoint (BL40). Behavioural tests (mechanical withdrawal threshold, MWT; paw withdrawal thermal latency, PWL) were performed on 2 and 1 day before CCD surgery and post-operative day 3, 7, 14, 21 and 28. Resting-state functional MRI was performed before CCD surgery and on postoperative days 7 and 28. CCD surgery induced persistent mechanical and thermal allodynia. Tuina reversed these deficits from day 14 onward. Compared with Sham group, the CCD group exhibited elevated regional homogeneity (ReHo) in the hippocampus, amygdala, brainstem and cerebellum. Tuina further increased ReHo in the amygdala, hippocampus, corpus callosum and temporal lobe between days 7 and 28. ReHo values in pain-related regions negatively correlated with MWT and PWL. Tuina may gradually relieve neuropathic pain by reshaping limbic and sensory-motor networks, offering a neuroplasticity-based rationale for its clinical use.

BackgroundLow back pain and lower extremity sensory and functional abnormalities are common symptoms of lumbar disc herniation (LDH), which can easily cause walking dysfunction and significantly impair the quality of life of patients. Tuina and traditional Chinese exercises (TCEs) are effective in relieving pain and restoring dysfunction, and both are often used in China as a combination of passive therapy and active exercise to ease symptoms in patients with LDH. However, the majority of current clinical trials on the treatment of LDH with Tuina or TCEs are single-centre clinical studies, and the quality of these studies is generally low. Furthermore, clear evidence of clinical efficacy as to whether Tuina combined with TCEs is superior to single TCEs for improving dysfunction and pain in patients with LDH is lacking.Methods/designThe design is a multicentre, assessor-blinded clinical randomised controlled trial. A total of 166 patients with LDH (aged 18–65 years) were recruited from four centres and randomly assigned at a 1:1 ratio to two groups: the TCE group and the Tuina combined with the TCE group. Each group received three treatments over the course of 1 week for a total of 4 weeks. The primary outcome indicator was the Oswestry Disability Index, whereas the secondary outcome indicators were the Short Form of Quality of Life Scale, the Short-Form McGill Pain Questionnaire Scale, and gait analysis. Assessments were made before the treatment, at the end of the treatment, and at the third and sixth months’ follow-ups. Gait analysis was only used for comparison between the two groups before and after treatment, and did not involve follow-up. Adverse events occurring during the trial were faithfully recorded.ConclusionThe results of this study are expected to provide a more effective research protocol for symptomatic LDH and an evidence-based rationale for the efficacy and safety of Tuina combined with TCEs in the treatment of symptomatic LDH.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=209956, identifier ChiCTR2300077361.

Objective To construct a clinical protocol for the intervention of lumbar disc herniation(LDH)with Tuina com-bined with Yijinjing based on expert questionnaire survey.Methods An expert consultation questionnaire was developed based on literature research.The Delphi method was used to conduct two rounds of expert consultations on the clinical protocol for the inter-vention of LDH with Tuina combined with Yijinjing.The participation and authority of experts were analyzed through indicators such as questionnaire response rate and expert authority coefficient(Cr).The concentration of expert opinions on the indicator sys-tem was analyzed through the mean(M),standard deviation(S),and full-mark ratio(K)of the items.The coefficient of variation(CV)and Kendall's harmony coefficient(Kendall's W)were used to evaluate the variation degree of expert scores and the coordina-tion and consistency of evaluation opinions.The clinical protocol was constructed using a comprehensive decision-making mecha-nism:(1)indicators that simultaneously satisfy the conditions of M<4 points,K<0.8,and CV>0.25 were deleted;(2)integrating expert opinions for item removal.Finally,a clinical protocol combining Tuina and Yijinjing for the intervention of LDH was formed.Results Expert consultation data showed a 100%questionnaire response rate in both rounds;the expert authority coefficients were 0.73 and 0.82,respectively.The final M values of the items after two rounds ranged from 4.42 to 4.87,with K values ranging from 0.54 to 0.88 and CV values ranging from 0.07 to 0.16.Kendall's W increased from 0.331 and 0.567 in the first round to 0.504 and 0.695 in the second round.The clinical protocol for the intervention of LDH with Tuina combined with Yijinjing requires the physi-cian to maintain mental focus during Tuina and perform holistic treatment on the waist,hips,and buttocks;Yijinjing should focus on practicing five core movements,including holding the heavens with palms,pulling nine cow tails backwards,pulling nine horse knives like a ghost,grasping with the dragon's claw,and pouncing like a tiger.Practice should be performed at least once a day,10-15 minutes a time for four weeks.Practice should integrate breath regulation,mental focus,and mindfulness.Conclusion The clinical protocol for the intervention of LDH with Tuina combined with Yijinjing provides a reference for clinical standardized treatment of LDH.

Gastric cancer (GC) is one deadly malignancy globally. The potential clinical values of circular RNAs (circRNAs) in cancer diagnosis, prognosis, and treatment have been demonstrated in increasing studies. This research aimed at delving into the specific role of circRNA hsa_circ_0007376 (circMAP2K2) in GC development. CircMAP2K2, miR-556-5p, and CREB5 levels in GC cells and tissues were tested by RT-qPCR. Subcellular fractionation assay was employed for determining the distribution of circMAP2K2 in GC cell cytoplasm and nucleus. The binding potentials between circMAP2K2 (or CREB5) and miR-556-5p were confirmed through luciferase reporter assay. GC cell viability, growth, and metastasis were examined via CCK-8, colony formation, and Transwell assays. CREB5 protein level was assessed via western blot analysis. CircMAP2K2 was upregulated in GC cells and tissues vs. normal controls. CircMAP2K2 depletion hindered GC cell growth, migration, and invasion. Mechanically, circMAP2K2 elevated CREB5 level by completely binding with miR-556-5p. Overexpressing CREB5 abrogated the suppression of circMAP2K2 silencing on GC cell malignant behaviors. CircMAP2K2/miR-556-5p/CREB5 axis plays an oncogenic role in GC tumorigenesis.

BackgroundDuring severe acute pancreatitis (SAP), damage to the intestinal mucosal barrier and translocation of intestinal pathogenic bacteria are key mechanisms that accelerate the disease progression of SAP. Chaihuang Qingyi Huoxue Granule (CH) is a herbal formula used in the clinical treatment of SAP. This study aims to investigate the role of CH in regulating gut microbiota and intestinal mucosal barrier in SAP rats.MethodsSodium taurocholate (3.5%) was retrogradely perfused into the biliopancreatic duct to establish the model of SAP in rats. CH (4.4 g/kg) was administered by gavage. Serum amylase, lipase, and endotoxin levels were measured. Hematoxylin-eosin (HE) staining was used to observe morphological changes in the pancreas and colon. The expression of zona occludens-1 (ZO-1) and occludin in the colon was examined by immunohistochemistry (IHC) and western blot. 16S rDNA gene sequencing was used to analyze the gut microbiota of the rats. The content of short-chain fatty acids (SCFAs) in the intestinal contents of the rats was determined by gas chromatography-mass spectrometry (GC-MS).ResultsCH reduced serum amylase, lipase, and endotoxin levels in SAP rats, alleviated pathological damage in the pancreas and colon, and restored the expression of ZO-1 and occludin. Moreover, CH alleviated gut microbiota dysbiosis in SAP rats, with restored gut microbiota diversity and structure. At the phylum level, the relative abundance of Firmicutes and Bacteroidetes increased, while that of Proteobacteria decreased. At the genus level, the abundance of Ruminococcus 1, Parabacteroides, Prevotellaceae UCG-001, Lachnospiraceae NK4A136 group, and Lactobacillus increased, while that of Escherichia-Shigella, Enterococcus, and Enterobacter decreased. In addition, CH increased the levels of SCFAs in the intestinal contents of SAP rats.ConclusionCH ameliorates SAP by maintaining the homeostasis and diversity of the gut microbiota, increasing the levels of SCFAs, and repairing the intestinal mucosal barrier.

Background:Low back pain and leg pain are common symptoms of lumbar disc herniation (LDH), which predispose patients to walking dysfunction and affect their quality of life. Tuina and Traditional Chinese Exercises (TCEs) are often used in China as passive or active treatments to alleviate the symptoms of LDH in patients and to address disability. However, high-quality multicentre clinical trials evaluating the short- and long-term efficacy of Tuina combined with TCEs in the treatment of LDH are lacking. Methods:In a multicentre, randomised, controlled clinical trial, 166 patients with LDH were recruited from four centres and randomly assigned into two groups that were treated with TCEs and Tuina combined with TCEs. Each group received intervention 3 times in 1 week for 4 weeks, and efficacy was assessed at baseline, 4 weeks of treatment, 12 weeks of follow-up and 24 weeks of follow-up. The primary outcome indicator assessed was the Oswestry Disability Index (ODI), and the secondary outcome indicators were the Visual Analogue Scale (VAS), the Short Form of Quality of Life (SF-36) Scale, the Short-Form McGill Pain Questionnaire (SF-MPQ) Scale and gait analysis. Results:A total of 157 subjects completed the trial, and 9 were dislodged. After 4 weeks of intervention, the ODI mean value in the Tuina combined with TCE group was 16.31 (4.18), a decrease of 7.75 (95%, 6.88-8.62) from baseline. The mean value in the TCE group was 20.23 (3.43), a decrease of 3.79 (95%, 2.92-4.67) from baseline. The ODI scores were significantly lower in the Tuina combined with TCE group compared with the TCE group at weeks 4, 12 and 24, with mean differences of 3.92 (95%, 2.75-5.09, p < 0.001), 2.90 (95%, 1.63-4.18, p < 0.001) and 3.03 (95%, 1.70-4.36, p < 0.001), respectively. The Tuina combined with TCE group also performed significantly better than the TCE group in the VAS, SF-MPQ, SF-36 and gait analysis. Conclusion:Tuina combined with TCE therapy can effectively improve function disability, pain, quality of life and pace of step in patients with LDH, and the combined therapy is superior to single TCE therapy. Clinical trial registration:ChiCTR2300077361; https://www.chictr.org.cn/showproj.html?proj=209956.

Despite improvements in therapeutic approaches, the mortality rate of gastric cancer (GC) remains unacceptably high. Evidence suggests that FXYD domain containing ion transport regulator 6 (FXYD6) is downregulated in GC. However, its exact function and the molecular mechanism in GC are still unclear. FXYD6 expression in different cell lines was estimated using RT-qPCR. Western blotting was employed for protein expression detection. Cell counting kit-8 assay, colony formation assay, and flow cytometry were implemented to assess GC cell viability, proliferation, and apoptosis, respectively. Bioinformatics analysis as well as chromatin immunoprecipitation and luciferase reporter assays were utilized for verifying FXYD6 interaction with the transcription factor Krüppel-like factor 10 (KLF10). The results showed that FXYD6 displayed a decreased level in GC cell lines. Impaired proliferative ability and enhanced apoptotic capacity were observed in GC cells overexpressing FXYD6. KLF10 expression is positively correlated with FXYD6 expression in GC samples. KLF10 binds to the FXYD6 promoter to enhance its transcription. FXYD6 depletion counteracted KLF10 upregulation-triggered reduction in GC cell proliferation and elevation in apoptosis. In conclusion, KLF10 activates FXYD6 transcription, thereby impeding GC cell proliferation and promoting cell apoptosis.

Traditional Chinese medicine has long acknowledged the therapeutic potential of Tetradium ruticarpum (A.Juss.) T.G.Hartley together with Coptis chinensis Franch in managing metabolic disorders. However, their combined anti-obesity effects and the underlying mechanisms remain poorly characterized. This study investigates the synergistic anti-obesity effects and mechanisms of a combined berberine and evodiamine treatment (BBE) in high-fat diet (HFD)-induced C57BL/6J mice and 3T3-L1 cells. In vitro, cell viability was evaluated using the Cell Counting Kit-8 (CCK-8), while lipid accumulation was assessed through Oil Red O staining and triglyceride content determination. Molecular docking simulations performed with AutoDockTools 1.5.6 software Vina predicted interactions between BBE and key proteins. The analysis of genes and proteins involved in browning and thermogenesis was conducted using quantitative reverse transcription polymerase chain reaction and Western blotting. In vivo, HFD-induced mice were assessed for serum lipids profiles, glucose, insulin, adipocytokines, fat tissue morphology (Hematoxylin and eosin staining), mitochondrial activity (flow cytometry), and protein expression (immunofluorescence). Molecular docking analysis revealed strong binding affinities between BBE and key target proteins, including UCP1, PGC-1α, PRDM16, CIDEA, FGF21, and FGFR1c. BBE significantly reduced lipid accumulation in 3T3-L1 cells, upregulated the mRNA expression of Prdm16, Cidea, Ucp1, and Dio2, elevated UCP1 and PGC-1α protein levels, and activated the FGF21/PGC-1α signaling pathway. In HFD-induced mice, BBE administration led to reduced body weight, smaller adipocyte size, increased adipocyte number, and alleviated hepatic steatosis. Furthermore, it lowered serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and levels of triglycerides (TG), while simultaneously increasing concentrations of high-density lipoprotein cholesterol (HDL-C). BBE also improved glucose tolerance, reduced fasting insulin levels, and modulated adipocytokine levels (reduced leptin, increased adiponectin), while promoting browning gene and protein expression. Overall, the combination of berberine and evodiamine mitigates obesity by enhancing browning and activating the FGF21/PGC-1α signaling pathway.

ObjectiveBaduanjin, a traditional Chinese exercise for health enhancement and chronic disease prevention, has been practiced for millennia. However, studies on the exercise intensity of Baduanjin are limited. Most existing studies focus on its general health benefits rather than quantifying its specific intensity levels. This study aims to measure and compare the exercise intensity indices of long-term Baduanjin practitioners and beginners, providing insights into its mechanisms for disease prevention and treatment and supporting the scientific formulation of clinical exercise prescriptions.MethodsTwenty healthy adults aged 35–45 years old and the mean BMI was 24.45 were recruited and divided into a beginner group (A group, no prior practice, 10 participants) and a skilled group (B group, practice duration ≥3 years, 10 participants). The Italian Cosmed/K5 wireless portable cardiopulmonary testing system was used to measure indicators during the practice.ResultsWithin-group analysis revealed statistically significant differences in oxygen consumption (VO2), oxygen consumption per kilogram of body weight (VO2/kg), metabolic equivalent (METs), heart rate (HR), oxygen pulse (VO2/HR), respiratory rate (RR), and minute ventilation (VE) between exercise and resting states in both the B and A groups (P < 0.001). In between-group comparisons, resting HR was significantly lower in the B group compared to the A group (P < 0.01). During Baduanjin practice, significant between-group differences were found in METs, HR (P < 0.01), and RR (P < 0.05), with the A group exhibiting higher values for METs, HR, and RR than the B group.ConclusionBaduanjin positively impacts cardiovascular function and exercise performance, with long-term practitioners showing significantly better cardiovascular recovery and overall function.

High-fat diet (HFD)-induced dyslipidemia is frequently accompanied by gut microbiota dysbiosis and a compromised gut barrier. Enhancing the intestinal barrier function emerges as a potential therapeutic approach for dyslipidemia. The ILC3-IL22-IL22R pathway, which responds to dietary and microbial signals, has not only attracted attention for its crucial role in maintaining the intestinal barrier, but recent reports have also suggested its potential in regulating lipid metabolism. Limonin is derived from the Chinese herb Evodiae fructus, which has shown potential in ameliorating dysbiosis of serum lipids. However, its underlying mechanisms remain elusive. Consequently, targeting the ILC3-IL22-IL22R pathway to enhance intestinal barrier function holds promise as a therapeutic approach for dyslipidemia. In this study, male C57BL/6 mice were subjected to a 16-week HFD to induce dyslipidemia and concurrently administered oral limonin. We discovered that limonin supplementation dramatically reduced serum lipid profiles in HFD-fed mice, significantly curbing HFD-induced weight gain and epididymal fat accumulation. Ileal histopathological evaluation indicated limonin's ameliorative effects on HFD-induced intestinal barrier impairment. Limonin also moderated the intestinal microbiota dysbiosis, which is characterized by the elevation of Firmicutes in HFD mice, and notably amplified the abundance of probiotic Lactobacillus. In addition, supported by flow cytometry and other analyses, we observed that limonin upregulated the ILC3-IL22-IL22R pathway, enhancing phosphorylated STAT3 (pSTAT3) in intestinal epithelial cells (IECs), thereby reducing lipid transporter expression. In conclusion, our study revealed that limonin exerted a promising preventive effect against HFD-induced dyslipidemia by the mitigation of the intestinal barrier function and intestinal microbiota, and its mechanism was related to the upregulation of the ILC3-IL22-IL22R pathway.

AIM:The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide, but there are currently limited treatment options available. Therefore, it is necessary to research new treatment strategies. Zhuyu Pill (ZYP) is a well-known herbal recipe consisting of Huanglian (Coptidis rhizoma) and Wuzhuyu (Evodiae Fructus) that has been clinically used to treat NAFLD. This study aimed to investigate the impact of ZYP on NAFLD induced by a high-fat diet (HFD) and to identify its potential mechanism.METHODS:In this investigation, we used ZYP to treat a mouse model of NAFLD induced by an HFD. We conducted various analyses including assessment of serum biochemical indices, histological evaluation, fecal metabonomics analysis, western blot, and quantitative real-time polymerase chain reaction.RESULTS:ZYP effectively improved blood lipid levels and reduced inflammatory response in HFD mice, while also alleviating liver cell damage and lipid accumulation. Additionally, ZYP influenced the fecal bile acid (BA) metabolism profiles of HFD mice by inhibiting the signal transduction of ileal farnesoid X receptor (FXR) fibroblast growth factor 15 (FGF15), enhancing the expression of cytochrome P450 family 7 subfamily A member 1(CYP7A1), promoting BA synthesis and increasing the metabolic elimination of cholesterol.CONCLUSION:ZYP shows promise as a potential treatment for alleviating NAFLD by modulating BA metabolism through the FXR-FGF15-CYP7A1 pathway.

The optimal cultivation conditions and chemical components of Poria cocos fruiting bodies were examined by employing the single factor and response surface methods to screen for optimal conditions for artificial cultivation. The differences in chemical composition among the fruiting bodies, fermented mycelium, and sclerotia of P. cocos were compared using UV spectrophotometry and high-performance liquid chromatography (HPLC). The optimal growth conditions for P. cocos fruiting bodies were 28.5°C temperature, 60% light intensity, and 2.5 g pine sawdust, which resulted in the production of numerous basidiocarps and basidiospores under microscopic examination. Polysaccharides, triterpenoids, and other main active components of P. cocos were found in the fruiting bodies, sclerotia, and fermented mycelium. The triterpenoid components of the fruiting bodies were consistent with those of the sclerotia. The content of pachymic acid in the fruiting bodies was significantly higher than that in the sclerotia, with a value of 33.37 ± 0.1902 mg/g. These findings provide novel insights into the sexual breeding and comprehensive development and utilization of P. cocos.

Endometrial cancer (EC) is a prevalent epithelial malignancy in the uterine corpus's endometrium and myometrium. Regulating apoptosis of endometrial cancer cells has been a promising approach for treating EC. Recent in-vitro and in-vivo studies show that numerous extracts and monomers from natural products have pro-apoptotic properties in EC. Therefore, we have reviewed the current studies regarding natural products in modulating the apoptosis of EC cells and summarized their potential mechanisms. The potential signaling pathways include the mitochondria-dependent apoptotic pathway, endoplasmic reticulum stress (ERS) mediated apoptotic pathway, the mitogen-activated protein kinase (MAPK) mediated apoptotic pathway, NF-κB-mediated apoptotic pathway, PI3K/AKT/mTOR mediated apoptotic pathway, the p21-mediated apoptotic pathway, and other reported pathways. This review focuses on the importance of natural products in treating EC and provides a foundation for developing natural products-based anti-EC agents.

Background: Atherosclerosis (AS) is an immunoinflammatory disease associated with dyslipidemia.Zhuyu Pill (ZYP) is a classic Chinese herbal compound that has been shown to exhibit anti-inflammatory and lipid-lowering effects on AS in our previous studies.However, the underlying mechanisms by which ZYP ameliorates atherosclerosis have not yet been fully investigated.In this study, network pharmacology and in vivo experiments were conducted to explore the underlying pharmacological mechanisms of ZYP on ameliorating AS.Methods: The active ingredients of ZYP were acquired from our previous study.The putative targets of ZYP relevant to AS were obtained from TCMSP, SwissTargetPrediction, STITCH, DisGeNET, and GeneCards databases.Protein-protein interactions (PPI) network, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were conducted using the Cytoscape software.Furthermore, in vivo experiments were carried out for target validation in apolipoprotein E (ApoE) -/-mice.Results: Animal experiments revealed that ZYP ameliorated AS mainly through lowering blood lipids, alleviating vascular inflammation, and decreasing the levels of vascular cell adhesion molecule-1 (VCAM1), intercellular adhesion molecule-1 (ICAM1), monocyte chemotactic protein-1 (MCP-1), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α).Additionally, the results of Real-Time quantitative PCR revealed that ZYP inhibited the gene expressions of mitogen-activated protein kinase (MAPK) p38, extracellular regulated protein kinases (ERK), c-Jun N-terminal kinase (JNK), and nuclear factor kappa-B (NF-κB) p65.The Immunohistochemistry and Western blot assays showed the inhibitory effect of ZYP on the proteins level of p38, p-p38, p65, and p-p65. Conclusion:This study has provided valuable evidence on the pharmacological mechanisms of action of ZYP in ameliorating AS that will be useful for forming the rationale of future research studying the cardio-protection and anti-inflammation effects of ZYP.

Background: Berberine has been widely used for the adjuvant therapy of several cardiovascular diseases (CVDs). However, evidence for its efficacy remains controversial. Purpose: This study aimed to evaluate the efficacy and safety of berberine in CVDs. Study design: A systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: We searched ten electronic databases for articles from inception to December 23, 2022. RCTs comparing berberine alone or combined with statins versus statins or routine for CVDs were included. Meta-analysis was performed according to the Cochrane Handbook. Results: Forty-four RCTs were included with 4606 patients. There were no differences between berberine alone and routine or statins in improving total cholesterol (TC) (SMD, 0.43; 95% CI,-0.39 to 1.24; p = 0.30; I-2 = 95%), triglyceride (TG) (SMD,-0.14; 95% CI,-0.49 to 0.21; p = 0.44; I-2 = 76%), low-density lipoprotein cholesterol (LDL-C) (SMD, 0.69; 95% CI,-0.23 to 1.60; p = 0.14; I-2 = 96%), high-density lipoprotein cholesterol (HDL-C) (SMD, 0.55; 95% CI,-0.48 to 1.57; p = 0.30; I-2 = 96%), and Crouse score levels. Berberine alone significantly reduced National Institute of Health Stroke Scale (NIHSS) score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and intima-media thickness (IMT) levels than routine therapy. Berberine plus statins significantly reduced TC, TG, LDL-C, NIHSS score, hs-CRP, TNF-alpha, IMT, Crouse score, and number of unstable plaques levels than routine or statins. However, no differences were found be-tween groups in improving HDL-C and IL-6 levels. There were no significant differences between groups in the incidence of adverse reactions. Conclusion: This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions. However, our results may be limited by the quality of existing research. High-quality RCTs are needed to provide more convinced evidence.

Subgroup analysis Subgroup analysis will be performed to investigate the possible sources of heterogeneity based on emodin dose, duration of intervention, NAFLD model, and species.Sensitivity analysis Sensitivity analysis will be performed to ascertain the results of the metaanalysis by excluding each of the individual studies. Language restriction No language restrictions.Country(ies) involved China.

Nonalcoholic steatohepatitis (NASH), a progression of nonalcoholic fatty liver disease (NAFLD), is a clinical syndrome characterized by liver steatosis, inflammation, and hepatocellular damage. Ganlu powder (GLP) is a classic traditional Chinese medicine prescription that has shown favorable treatment effects on NASH. However, the underlying therapeutic mechanisms are still poorly understood. This study is aimed at exploring the potential mechanism of GLP in the treatment of NASH via network pharmacology and molecular docking. PubMed and CNKI databases were used to identify the components of GLP. Swiss and STITCH databases were employed to obtain corresponding drug targets. NASH targets were adopted from the Therapeutic Target Database (TTD), DisGeNET, DrugBank, GeneCards, and MalaCards databases. Cytoscape software was utilized to construct “drug-ingredient-target-disease” networks and the protein-protein interaction (PPI) network of GLP in NASH. AKT1 was identified as the key target. The GO functional enrichment analysis revealed that GLP might treat NASH by modulating the inflammatory response and regulating phosphatidylinositol 3-kinase signaling. The KEGG analysis showed that GLP might treat NASH by regulating the tumor necrosis factor (TNF) signal pathway by affecting the role of AKT1. According to the network pharmacology results, a virtual docking of active compounds with AKT1 was carried out, and the results indicated that the 7 components, berberine, epiberberine, jatrorrhizine, coptisine, palmatine, evodiamine, and rutecarpine, can bind stably with AKT1 and have higher binding energy than AKT1 inhibitors. The overall study findings suggest that GLP may treat NASH by regulating AKT1.

Background . Ai-Tong-An-Gao-Ji (ATAGJ) has been extensively applied for acute bone cancer pain treatment with a satisfactory efficacy, while the specific mechanisms remain unclear and require further investigation. Methods . Overlapped genes of ATAGJ and CIBP obtained from SwissTargetPrediction website and GeneCards database were presented as a Venn diagram. A network diagram of drug-component-target was further established using the Cytoscape 3.6.0 software. The effect of fisetin on Walker 256 cell proliferation was observed by clone formation assay and EDU assay, and the interaction between fisetin and AKT was revealed using the immunoprecipitation assay. Effects of fisetin on AKT/HIF-1 α signaling pathway in Walker 256 cells were ultimately detected using Western blot and qPCR assays. Results . The key component fisetin and core target gene AKT were sorted out using the drug-component-target network with a binding energy between fisetin and AKT less than −5 kcal/mol. Clone formation assay and EDU assay showed that fisetin substantially suppressed the proliferation of Walker 256 cells. Immunoprecipitation assay results revealed that the combination of fisetin and AKT decreased the level of AKT/HIF-1 α signaling pathway of Walker 256 cells. Conclusions . The fisetin of ATAGJ can markedly suppress Walker 256 cells, and the mechanisms may be intimately associated with the combination of fisetin and AKT. Furthermore, fisetin decreased the level of p-AKT and inhibited the expression of the AKT/HIF-1 α signaling pathway.