Hypertension is a major contributor to cardiovascular morbidity and mortality, largely driven by oxidative stress, mitochondrial dysfunction, endothelial injury, and chronic vascular inflammation. Emerging evidence suggests that targeting vascular bioenergetics may provide complementary therapeutic strategies beyond conventional antihypertensive drugs. This review explores the mitochondrial protective mechanisms of Piper retrofractum and its major bioactive compounds in the context of hypertension and oxidative vascular injury. The phytochemical profile of P. retrofractum, particularly piperine, piplartine, pipernonaline, and retrofractamides, demonstrates significant antioxidant, anti-inflammatory, and metabolic regulatory activities. Mechanistically, these compounds may attenuate mitochondrial reactive oxygen species (mtROS), restore endothelial nitric oxide synthase (eNOS) coupling, activate AMPK–SIRT1–PGC-1α signaling, induce Nrf2–HO-1 antioxidant pathways, and modulate mitochondrial dynamics and mitophagy. Collectively, these effects contribute to improved endothelial function, reduced vascular remodeling, suppression of inflammatory cascades, and enhanced mitochondrial resilience. In addition, emerging omics technologies, network pharmacology, and AI-assisted nutraceutical discovery offer new opportunities to elucidate multitarget mechanisms and optimize P. retrofractum-based interventions. Despite promising preclinical evidence, important limitations remain, including insufficient clinical studies, limited mitochondrial-specific investigations, and challenges related to bioavailability and standardization. Overall, P. retrofractum represents a promising mitochondria-centered nutraceutical candidate for hypertension management and vascular protection, warranting further translational and clinical investigation.

INTRODUCTION:Decreased Cardiac Ejection Function (DCEF) is a critical manifestation of cardiotoxicity and has been increasingly recognized as a potential adverse effect of pharmacotherapy, particularly with antineoplastic and immunomodulating agents. This study conducted a comprehensive pharmacovigilance assessment of drug-induced DCEF using the FDA Adverse Event Reporting System (FAERS), focusing on high-risk drug identification, onset timing, and pharmacological classification. METHODS:FAERS reports from 2004 to 2024 were standardized using MedDRA and RxNorm. Disproportionality analysis with Reporting Odds Ratios (ROR) and 95% Confidence Intervals (CI) was used to detect drug-event associations. Time-to-Onset (TTO) analysis was performed for five clinically relevant agents, doxorubicin, docetaxel, rituximab, dabrafenib, and bevacizumab, selected based on frequency, signal strength, and clinical importance. Weibull modeling was used to characterize temporal risk patterns. RESULTS:A total of 86 drugs were significantly associated with DCEF. Frequently reported agents included trastuzumab (1,183 cases) and doxorubicin (465 cases). Notably, 50 drugs (e.g., clozapine, rofecoxib, docetaxel) were not previously labeled for DCEF, representing novel safety signals. Time-to-onset analysis showed that all five evaluated agents followed an "earlyfailure" pattern (β < 1), meaning the risk of DCEF was highest shortly after treatment initiation and declined thereafter. Median TTO ranged from 42 days for rituximab (β = 0.52, 95% CI: 0.41-0.63) to 140 days for doxorubicin (β = 0.83, 95% CI: 0.68-0.97; α = 277.8, 95% CI: 187.6-367.9), suggesting variable latency between drugs. Demographically, patients aged 65-85 years (22.9% of known cases) and those with body weight 70-89 kg (10.2%) were most frequently affected. CONCLUSION:This large-scale real-world analysis identifies both established and novel DCEF risk signals, highlights heterogeneity in onset timing, and emphasizes the predominance of antineoplastic agents. Clinically, these findings suggest the need for periodic echocardiographic monitoring of left ventricular ejection fraction, particularly in patients receiving high-risk drugs such as mitoxantrone, trastuzumab, doxorubicin, and pertuzumab. Early-phase monitoring is crucial for "early-failure" agents, while extended follow-up is warranted for drugs with delayed toxicity, such as doxorubicin. These results provide actionable evidence to support individualized risk management and regulatory label updates. .

BACKGROUND:Patients with acute decompensated ischemic heart failure (ADIHF) often present with severe clinical symptoms and poor quality of life. In China, Yiqi Fumai lyophilized injection (YQFM) is widely used in the treatment of ADIHF. However, high-quality evidence is still needed to support its efficacy and safety. PURPOSE:This study aims to assess the therapeutic efficacy and safety of YQFM in patients with ADIHF. STUDY DESIGN AND METHODS:By conducting a multicenter, open-label, blinded-outcome, randomized controlled trial, we recruited patients with ADIHF from 37 hospitals in 20 regions of China from October 2015 to October 2018. Patients were allocated in a 1:1 ratio to either the YQFM group or the control group. Both groups received guideline-directed medical therapy (GDMT), with the YQFM group additionally receiving YQFM for 7 days. The primary outcome included the proportion of patients with a decrease from baseline B-type natriuretic peptide (BNP) value ≥ 30% on day 8 post-randomization. We evaluated the left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) functional class, Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, and composite endpoints. RESULTS:A total of 666 patients with ADIHF (332 in the YQFM group and 334 in the control group) were enrolled. The full analysis set (FAS) analysis revealed that the proportion of patients in the YQFM group with a reduction of at least 30% in BNP value on day 8 was higher than that in the control group (175 [55.21%] vs. 135 [41.93%], one-sided p < 0.001, two-sided p < 0.001; RR, 1.32 [95% CI, 1.12-1.56]). The YQFM group showed statistically significant improvements in LVEF, NYHA functional class, and MLHFQ scores compared to controls. There was no statistically significant difference between the two groups regarding composite endpoint events and adverse events during the follow-up period. CONCLUSIONS:Based on GDMT, the combined use of YQFM was associated with further reductions in BNP levels, improve quality of life and cardiac function in patients with ADIHF, without increasing safety risks. However, no significant differences were observed in clinical events, such as mortality or hospitalization, during the follow-up period.

Atherosclerosis (AS) is a complex cardiovascular disease characterized by endothelial dysfunction, dyslipidemia, and immune-inflammatory responses, leading to arterial plaque formation and potentially fatal complications such as myocardial infarction and stroke. Traditional treatments, such as statins, often pose challenges due to their side effects and limited efficacy. In this study, we explore a novel therapeutic approach utilizing engineered endothelial cells (ECs) targeting probiotic extracellular vesicles loaded with dihydrotanshinone I (DHT) (EC-BEVsDHT), a bioactive compound derived from Danshen (Salvia miltiorrhiza Bunge). With the characterization of EC-BEVsDHT by transmission electron microscope and nanoparticle tracking analysis, EC-BEVsDHT exhibited typical spherical morphology and particle size distribution. High-performance liquid chromatography coupled with tandem mass spectrometric confirmed the expression of the ECs-targeting peptide VSSSTPR in EC-BEVsDHT and EC-BEVsDHT. We further investigated the anti-atherosclerotic effects and molecular mechanisms of EC-BEVsDHT on human umbilical vein endothelial cells (HUVECs) and Apolipoprotein E-deficient (ApoE-/-) C57BL/6J mice. We found that EC-BEVsDHT attenuated oxidized low-density lipoprotein induced HUVECs injury in vitro and decreased AS in ApoE-/- mice in vivo. Our findings suggest that EC-BEVsDHT hold promise as a safe and effective therapeutic strategy for AS, offering potential advantages over traditional treatments.

BackgroundPrior research has established a correlation between immune cell activity and heart failure (HF), but the causal nature of this relationship remains unclear. Furthermore, the potential influence of metabolite levels on this interaction has not been comprehensively explored. To address these gaps, we employed a bidirectional Mendelian randomization (MR) approach in two stages to examine whether metabolite levels can mediate the causal relationship between immune cells and HF.MethodsGenetic information was extracted from summary data of genome-wide association studies. By applying a two-sample, two-step MR approach, we investigated the causal relationships among immune cells, metabolite levels, and HF, with a specific focus on the mediating effects of metabolites. Sensitivity analysis techniques were implemented to ensure the robustness of our findings.ResultsMR analysis revealed significant causal associations between HF and eight specific immune cells and five metabolites. Mediation analysis further identified three mediated relationships. Particularly, hexadecenedioate (C16:1-DC) mediated the influence of both the CD28- CD127- CD25++ CD8br%CD8br (mediation proportion: 19.2%) and CD28+ CD45RA + CD8br%T cells (mediation proportion: 11.9%) on HF. Additionally, the relationship between IgD + CD38br AC cells and HF appeared to be mediated by the phosphate to alanine ratio (mediation proportion: 16.3%). Sensitivity analyses validated that the used instrumental variables were free from pleiotropy and heterogeneity.ConclusionThis study provides evidence that certain immune cell levels are associated with the risk of HF and that metabolite levels may mediate these relationships. However, to strengthen these findings, further validation using MR analyses with larger sample sizes is essential.

Objective To observe the clinical effect of Bushen Qishu Qiangxin granule on chronic heart failure.Methods A total of 120 inpatients admitted to Affiliated Hospital of Jiangxi University of Chinese Medicine from January 2019 to December 2020 were se-lected and divided into the treatment group and the control group by random number table,with 60 cases in each group.The control group received conventional Western medicine treatment,and the treatment group received Bushen Qishu Qiangxin granule on the ba-sis of conventional Western medicine treatment.The course of treatment was 8 weeks.The improvement of TCM syndrome score,left ventricular ejection fraction,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,cardiac function grading,brain natriuretic peptide(BNP)level,6-min walking distance and Minnesota Quality of Life scale score were observed and compared between the two groups.Results The therapeutic effect of the treatment group was significantly better than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Bushen Qishu Qiangxin granule has significant clinical effects in the treatment of chronic heart failure and is worthy of popularization and application.

目的 使用两样本孟德尔随机化研究克罗恩病(CD)与玫瑰痤疮之间的因果关系.方法 将来自全基因组关联研究(GWAS)的与克罗恩病密切相关的遗传位点作为工具变量,与来自不同的GWAS研究的玫瑰痤疮遗传数据进行双样本MR分析.主要采用随机效应模型的逆方差加权(IVW)方法进行分析,并以加权中位数法(WME)和MR-Egger回归法进行补充,结果以OR值进行呈现.结果 共获得了 18个与克罗恩病密切相关的SNPs作为工具变量,IVW结果[ OR=1.11(95％CI:1.01～1.22),P=0.03＜0.05]及 WME结果[OR=1.15(95％CI:1.00～1.31),P=0.04＜0.05] 均表明,基因预测克罗恩病与玫瑰痤疮的发病风险显著相关.MR-Egger回归结果(P=0.37)表明研究结果不存在基因水平多效性.结论 克罗恩病与玫瑰痤疮的发生存在因果关联,rs7517847变异可能是克罗恩病影响玫瑰痤疮发病的关键所在.

目的:探讨调肝活血稳压颗粒联合苯磺酸氨氯地平片对肝阳上亢型高血压的临床疗效及安全性.方法:纳入符合标准的100例肝阳上亢型高血压患者,随机分为观察组和对照组各50例.对照组给予苯磺酸氨氯地平片口服降压治疗,观察组在对照组的基础上联合调肝活血稳压颗粒口服,疗程为12 w,观察两组治疗前后的血压、中医证候积分、C反应蛋白(CRP)水平及疗效.结果:中医证候疗效方面,观察组的总有效率为86.00%,明显优于对照组的总有效率46.00%(P<0.05);两组患者治疗后的血压、CRP水平均较治疗前下降(P<0.05),且观察组治疗后的血压、CRP水平均低于对照组(P<0.05);观察组的降压有效率为84.00%,优于对照组的降压有效率68.00%(P<0.05).结论:调肝活血稳压颗粒治疗肝阳上亢型高血压,可有效改善患者血压、临床症状及血管炎症指标,且安全性较高.

冠状动脉粥样硬化性心脏病,临床上也称为冠心病,是一种发生率较高的心血管疾病类型,且年轻化趋势明显.从以往的临床实践结果来看,冠心病的常见影响因素包括吸烟、高血压病、糖尿病、高脂血症等.肠道菌群代谢产物氧化三甲胺(TMAO)也是近年来研究证实的一种冠心病影响因素.TMAO可以提升人体的巨噬细胞清道夫受体水平,进而增强血浆胆固醇以及炎症细胞因子的表达,这也是导致细胞热休克蛋白含量升高的原因,直接增加人体的冠心病发生风险,并持续诱发疾病的恶化.针对这一情况,医学领域更加倾向于结合TMAO检查结果开展冠心病的预防和治疗.不同的肠道菌群结构,对三甲胺(TMA)与相应的转化途径加以调节,有利于TMAO水平的抑制,最终起到抑制冠心病的作用.笔者从中医和西医 2 个维度,对肠道菌群及其代谢产物TMAO与冠心病的关系及相关技术方法的研究进展进行了论述分析.

目的:观察慢性心衰中医康复单元方案对心室重构及相关免疫指标的影响.方法:选取 60 例来自江西中医药大学附属医院 2021 年 6 月—2022 年 6 月心血管科慢性心衰住院患者.采用随机数字表法将其随机分为对照组 30例和 30 例.对照组常规西药治疗,治疗组在常规西药治疗基础上口服补肾启枢强心颗粒,外用热敏灸,练习呼吸静功妙诀,观察疗程 8 周.观察比较 2 组患者中医症候疗效和积分、心衰各指标、免疫功能、预后情况.结果:治疗组疗效明显优于对照组,P<0.05,具有可比性,差异有统计学意义.结论:慢性心衰中医康复单元方案能够显著改善患者临床症状,提升心脏功能水平,并能调节免疫,增强免疫功能,减少再住院率,提高生存质量,降低医疗成本,值得推广应用.

刘中勇教授基于多年临证经验,认为心悸的产生与脾的功能失调关系紧密,临床治疗心悸应从脾入手,具体治法有益气健脾养心、疏肝健脾宁心、清热化痰稳心,收效显著,其经验值得学习与借鉴.

Objective To explore the effect of Yajie Yizai(Xin)Recipe on blood lipid,inflammation,oxidation factors,and the possible mechanism of anti AS in atherosclerosis model rats.Methods The AS model was established by intraperitoneal injection of VD3+high-fat feed,and was randomly divided into control group,model group,simvastatin group,and Yajie Yizai(Xin)recipe high-dose and low-dose groups.Detect the levels of TG,LDL-C,and HDL-C in serum of rats,use ELISA method to detect the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-PX)and the influence of malondialdehyde(MDA)content in serum of rats in each group,and detect the levels of IL-6 and TNF in serum-α Content.Results Compared with the model group,the high and low dose Yajie Yizai(Xin)groups showed a decrease in serum TG and rat LDL content,while the HDL content increased.The difference between the two groups was statistically significant(P＜0.01 or P＜0.05).Compared with the mod-el group,both high-dose and low-dose Yajie Yizai(Xin)groups were able to increase GSH-PX,SOD,CAT activity,and reduce MDA content,with statistical significance(P＜0.05 or P＜0.01);Compared with the model control group,the Yajie Yizai(Xin)high-dose group,Yajie Yizai(Xin)low-dose group,and simvastatin group had TNF-a、The content of IL-6 significantly de-creased,and the differences were statistically significant(P＜0.01 or P＜0.05).Conclusion Yajie Yizai(Xin)has a significant anti AS effect.The mechanism of action may be that it can reduce the lipid peroxidation damage of arterial endothelial cells,improve the inflammato-ry reaction,reduce the inflammatory reaction,and inhibit the atherosclerosis process by regulating the lipid metabolism of rat models.

Abstract Background: The potential relationship between IBD and COPD remains uncertain. necessitating further exploration of their causal relationship. To address this, we employed Mendelian randomization in the present study to investigate the potential causal link between IBD and COPD and provide valuable insights into their interconnectedness. Methods: We performed a comprehensive two-sample Mendelian randomization analysis utilizing extensive genetic summary data obtained from genome-wide association studies (GWAS).Our study utilized a comprehensive dataset comprising a substantial cohort, including 12,366 ulcerative colitis (UC) cases and 33,609 controls, 25,042 IBD cases and 34,915 controls, and 12,194 Crohn's disease (CD) cases and 28,072 controls. The COPD dataset consisted of 58,925 individuals from various GWAS studies. Our main analyses utilized the IVW method with a random-effects model, complemented by WME and MR-Egger approaches. Results: Our study demonstrated a significant correlation between genetic predisposition to IBDand the risk of developing COPD, as evidenced by the IVW(odds ratio [OR] = 1.02, 95% CI = 1.00-1.04, p = 0.013). Consistent results were obtained using the WME (OR = 1.02, 95% CI = 1.00-1.04, p = 0.032) and MR-Egger (OR = 1.02, 95% CI = 1.00-1.04, p = 0.032) methods. Importantly, our analysis did not reveal any evidence of directional pleiotropy between IBD and rosacea, as confirmed by both funnel plots and MR-Egger intercepts. Subgroup analysis further indicated a robust association between Crohn's disease (CD) and rosacea (IVW: OR = 1.01, 95% CI = 1.00-1.02, p = 0.008), while the causal association between ulcerative colitis (UC) and rosacea did not reach statistical significance (IVW: OR = 1.01, 95% CI = 0.99-1.02, p = 0.169). These findings provide compelling evidence supporting the link between IBD and COPD, shedding light on potential pathogenic mechanisms underlying these conditions. Conclusions: Our comprehensive MR analysis provides robust evidence of a unidirectional positive association between IBD and COPD, with varying degrees of association observed among different subtypes of IBD. Notably, variations in the SMAD3 gene may play a pivotal role in the increased risk of COPD among individuals with IBD. Recognizing the elevated occurrence of COPD in IBD patients holds significant clinical implications, highlighting the importance of early identification, monitoring, patient education, preventive measures, and collaborative treatment approaches involving healthcare professionals. The TGF-β1/SMAD3 pathway could serve as a promising therapeutic target for managing IBD complicated with COPD.

目的 观察健脾化浊调脂颗粒在动脉粥样硬化(AS)治疗中的效果.方法 选取100例AS患者,以随机数字表法分成对照组(阿托伐他汀钙片与阿司匹林肠溶片治疗)和观察组(对照组基础上联合健脾化浊调脂颗粒),每组50例.比较2组疗效.结果 治疗后,观察组TC、TG、LDL-C指标低于对照组,HDL-C指标高于对照组;IMT、斑块数量及斑块厚度低于对照组;TMAO指标高于对照组;CRP、IL-6、TNF-ɑ指标低于对照组;临床治疗有效率高于对照组,差异均有统计学意义(P<0.05).结论 AS疾病使用健脾化浊调脂颗粒治疗,有助于改善患者脂代谢指标,缩小斑块厚度,优化血清指标,治疗效果突出.

目的 通过网络药理学探讨益气活血通脉颗粒治疗冠心病心绞痛的活性成分、作用靶点、信号通路.方法 使用中药系统药理学分析平台(TCMSP)、BATMAN-TCM等数据库查询益气活血通脉颗粒成分及药物作用靶点,筛选出其活性成分并且搜集靶点.通过GeneCards、OMIM数据库搜集冠心病心绞痛的作用靶点.运用Cytoscape 3.8.1软件构建靶点蛋白-蛋白相互作用(PPI)网络图,并进行基因本体论(GO)和京都基因与基因组百科全书(KEGG)富集分析.结果 本研究共筛选得到益气活血通脉颗粒主要活性成分共163个,药物与疾病共同作用靶点263个.GO和KEGG通路富集分析分别得到2880个生物过程和160条通路.结论 益气活血通脉颗粒可以通过降低心肌耗氧量、改善血流动力学等方式来改善冠心病心绞痛.

通过搜集整理与浊、浊邪相关的古今中医学文献,追溯浊邪理论的历史发展,总结其在不同时代的发展情况.以朝代划分,从浊与浊邪概念的出现,到分科论治浊病,专篇阐述浊邪为病的机理及病脉证治,到今人对于浊邪的实质研究及致病机理、临床运用发展,浅析浊邪理论的历史源流.

介绍运用疏肝健脾化浊法治疗心律失常的体会.结合长期临床经验和当今社会环境特点,发现肝郁脾虚型心律失常较为常见.认为肝郁脾虚、浊邪闭阻为心律失常的主要病机,其中脾虚为发病之本,肝郁为直接诱因,瘀浊、痰浊、湿浊、脂浊等浊邪为重要致病因素.提出疏肝健脾化浊法为主要治法,并自拟疏肝健脾化浊方作为治疗心律失常的有效验方.

目的 研究益气活血通脉颗粒治疗冠心病心绞痛(心血瘀阻型)的疗效及对患者内皮功能和相关生化指标的影响.方法 选取2018年11月—2020年2月因冠心病(心血瘀阻型)来江西中医药大学第二附属医院院治疗的患者(曾有心绞痛病史)80例,以随机原则分为观察组与对照组,每组各40例.其中对照组给予常规降血脂药,突发心绞痛时舌下含服硝酸甘油,观察组在其基础上给予益气活血通脉颗粒.以患者治疗前后的血管内皮功能与相关生化指标作为治疗评测标准.结果 治疗2周后、2组患者病情均有所改善,但观察组各项心脏生化指标下降幅度高于对照组(P<0.05),血管内皮功能恢复更佳(P<0.05),总有效率达92.5％(37/40),高于对照组的70％(28/40)(P<0.05).结论 益气活血通脉颗粒有利于改善冠心病患者血管内皮功能,增加冠张动脉有效灌注,降低心绞痛突发概率,提高治疗效果.

白血病细胞在化疗后继发的多药耐药(MDR)是化疗失败和白血病复发的主要原因.目前寻求安全、有效的MDR逆转剂,探索治疗过程中产生MDR的机理,提高白血病细胞对化疗药物的敏感性,是科研工作者和临床医生共同奋斗的目标.由于西药价格昂贵且副作用大,而中药以其多靶点,多阶段,毒副作用小,安全有效的优势成为白血病MDR研究领域的热点.本文从中药作用于白血病MDR相关作用机制入手,就这一方面研究进展做一综述.

以"浊"理论为基础,从痰浊、瘀浊、和浊毒3个阶段论述高脂血症的病理发生、发展过程及其诊治,通过探索传统中医文献对"浊"的论述,联系有关临床实践或研究,阐明"浊"是高脂血症形成及发展过程中的重要因素,为"浊"理论运用于高脂血症的临床防治提供相关依据.