Advances of traditional Chinese medicine preclinical mechanisms and clinical studies on diabetic peripheral neuropathy.

CONTEXT: Diabetic peripheral neuropathy (DPN) results in an enormous burden and reduces the quality of life for patients. Considering there is no specific drug for the management of DPN, traditional Chinese medicine (TCM) has increasingly drawn attention of clinicians and researchers around the world due to its characteristics of multiple targets, active components, and exemplary safety. OBJECTIVE: To summarize the current status of TCM in the treatment of DPN and provide directions for novel drug development, the clinical effects and potential mechanisms of TCM used in treating DPN were comprehensively reviewed. METHODS: Existing evidence on TCM interventions for DPN was screened from databases such as PubMed, the Cochrane Neuromuscular Disease Group Specialized Register (CENTRAL), and the Chinese National Knowledge Infrastructure Database (CNKI). The focus was on summarizing and analyzing representative preclinical and clinical TCM studies published before 2023. RESULTS: This review identified the ameliorative effects of about 22 single herbal extracts, more than 30 herbal compound prescriptions, and four Chinese patent medicines on DPN in preclinical and clinical research. The latest advances in the mechanism highlight that TCM exerts its beneficial effects on DPN by inhibiting inflammation, oxidative stress and apoptosis, endoplasmic reticulum stress and improving mitochondrial function. CONCLUSIONS: TCM has shown the power latent capacity in treating DPN. It is proposed that more large-scale and multi-center randomized controlled clinical trials and fundamental experiments should be conducted to further verify these findings.

Optimization of the extraction process for Shenshou Taiyi powder based on Box-Behnken experimental design, standard relation, and FAHP-CRITIC methods.

BACKGROUND: Ancient classic prescription play a crucial role in the preservation and advancement of traditional Chinese medicine (TCM) theories. They represent a significant milestone in the ongoing development and transmission of TCM knowledge and practices and are considered one of the breakthroughs in the development of TCM inheritance. In the process of developing ancient classic prescriptions, many problems may still arise in ensuring quality consistency between traditional methods and modern production processes, among which the extraction process poses major challenges. This paper introduces a practical approach extracting an ancient classic prescription using a modern extraction process. The technique is demonstrated through the study of the extraction process of Shenshou Taiyi powder (STP). METHODS: This study focuses on optimising the STP extraction process to ensure consistency in the quality of the product obtained through ancient and modern processes using the standard relation and fuzzy analytic hierarchical process (FAHP) and criteria importance through intercriteria correlation (CRITIC) method integrated weights combined with the Box-Behnken response surface test. Using the contents of rosmarinic acid, isoimperatorin, puerarin, as well as the extract yield and fingerprint similarity as evaluation indexes of STP, the Box-Behnken response surface method was employed to examine the varying extraction parameters, including water addition ratio, extraction duration, and number of extractions. The weighted coefficients for each parameter were calculated by combining the benchmark correlation and FAHP-CRITIC method, deriving a comprehensive score. RESULTS: The optimal extraction process for STP consisted of a two extractions, each using at a tenfold quantity of water, performed for one hour. Process verification across three separate batches yielded a comprehensive score of 94.7, with a relative standard deviation of 0.76%. CONCLUSIONS: The application of the Box-Behnken response surface method combined with standard relation and FAHP-CRITIC approach proved to be stable and feasible for optimising the extraction process of STP.

Analysis of traditional Chinese medicine syndrome elements and clinical symptoms in prediabetes: A systematic review.

BACKGROUND: Prediabetes mellitus (PDM) and impaired glucose regulation precedes diabetes and serve as early warning signals. A 2018 Chinese epidemiological survey reported prediabetes at 25.5% prevalence and type 2 diabetes at 10.8%, respectively. Untreated carries one-third of the risk of diabetes progression. This study aimed to understand traditional Chinese medicine syndromes in PDM to guide clinical practice and diabetes prevention. METHODS: We systematically searched the Chinese and English literature in PubMed, EMBASE, Sinomed, CNKI, VIP, Wanfang until March 31, 2023. We manually explored the Chinese prediabetes literature, trial registrations, and references, adhering to predefined criteria. The results were independently summarized by 2 researchers. Statistical analysis was performed using EXCEL, IBM SPSS 27.0, and IBM SPSS Modeler 18.0, with data mining techniques including association and cluster analysis. RESULTS: Analysis of 23 clinical trials (8943 patients) identified phlegm dampness syndrome as predominant, with qi deficiency, dampness, and phlegm as the principal pathogenic elements. Spleen syndrome elements dominated, with a priori correlation analysis favoring spleen dampness. The prevalent PDM clinical symptoms include amnesia, mental fatigue, limb fatigue, dizziness, and lumbar discomfort. CONCLUSION: Prediabetes is strongly associated with spleen dampness, highlighting its role. Common traditional Chinese medicine syndrome elements include qi deficiency, phlegm, and dampness. Clinical diagnosis and treatment should prioritize syndrome differentiation and emphasize spleen-focused approaches. Although limited research exists on prediabetes syndromes, further exploration of PDM and spleen dampness is crucial.

Analysis of the effectiveness and safety of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis: An observational study.

This study is for exploring the effectiveness and security of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis. This retrospective study collected 100 patients with gouty arthritis between February 2022 and February 2023. According to the different treatment methods, the data of patients were divided into control group and experimental group. The control group received routine treatment with benzbromarone, while the experimental group received additional treatment with Xuedu Xiezhuo Yishen Tang on the basis of the control group. The evaluation indicators for the effectiveness of treatment include serum levels of 8-hydroxydeoxyguanosine, 3-NT, interleukin-6, interleukin-10, interleukin-1ß, tumor necrosis factor-α, C-reactive protein, erythrocyte sedimentation rate, urea nitrogen, creatinine, evaluation of knee joint function and pain level, traditional Chinese medicine syndrome score, and safety evaluation. After treatment, the overall treatment effect of the experimental group reached 98%, while the control group was 78%. After treatment, the differences in various indicators possessed statistical significance (SS) (P < .05). In the Lysholm score, the improvement in the experimental group was markedly more excellent than the control group, and the difference possessed SS (P < .05). In the NRS score, the experimental group's NRS score decreased from 8.39 to 1.08 before and after treatment, while the control group only decreased to 3.61. In addition, both groups of patients showed significant improvement in the joint score in the Traditional Chinese medicine syndrome sub-items. The experimental group was able to effectively improve symptoms such as joint pain, joint redness and swelling, joint fever, and limited joint mobility. After treatment, the incidence of adverse reactions in the experimental group was only 8%, while the incidence of adverse reactions in the control group was 24%. After statistical analysis of the incidence of adverse reactions during treatment among the participants, it was found that the difference possessed SS (P < .001). The combination treatment of Jiedu Xiezhuo Yishen Tang and benbromarone can effectively improve oxidative stress response and significantly reduce blood uric acid levels. Meanwhile, this combination therapy can effectively inhibit inflammatory reactions, significantly alleviate knee joint pain, and promote the recovery of knee joint function. This treatment regimen has lower toxic side effects and higher safety.

Mechanism of drug-pairs Astragalus Mongholicus-Largehead Atractylodes on treating knee osteoarthritis investigated by GEO gene chip with network pharmacology and molecular docking.

Investigations into the therapeutic potential of Astragalus Mongholicus (AM, huáng qí) and Largehead Atractylodes (LA, bái zhú) reveal significant efficacy in mitigating the onset and progression of knee osteoarthritis (KOA), albeit with an elusive mechanistic understanding. This study delineates the primary bioactive constituents and their molecular targets within the AM-LA synergy by harnessing the comprehensive Traditional Chinese Medicine (TCM) network databases, including TCMSP, TCMID, and ETCM. Furthermore, an analysis of 3 gene expression datasets, sourced from the gene expression omnibus database, facilitated the identification of differential genes associated with KOA. Integrating these findings with data from 5 predominant databases yielded a refined list of KOA-associated targets, which were subsequently aligned with the gene signatures corresponding to AM and LA treatment. Through this alignment, specific molecular targets pertinent to the AM-LA therapeutic axis were elucidated. The construction of a protein-protein interaction network, leveraging the shared genetic markers between KOA pathology and AM-LA intervention, enabled the identification of pivotal molecular targets via the topological analysis facilitated by CytoNCA plugins. Subsequent GO and KEGG enrichment analyses fostered the development of a holistic herbal-ingredient-target network and a core target-signal pathway network. Molecular docking techniques were employed to validate the interaction between 5 central molecular targets and their corresponding active compounds within the AM-LA complex. Our findings suggest that the AM-LA combination modulates key biological processes, including cellular activity, reactive oxygen species modification, metabolic regulation, and the activation of systemic immunity. By either augmenting or attenuating crucial signaling pathways, such as MAPK, calcium, and PI3K/AKT pathways, the AM-LA dyad orchestrates a comprehensive regulatory effect on immune-inflammatory responses, cellular proliferation, differentiation, apoptosis, and antioxidant defenses, offering a novel therapeutic avenue for KOA management. This study, underpinned by gene expression omnibus gene chip analyses and network pharmacology, advances our understanding of the molecular underpinnings governing the inhibitory effects of AM and LA on KOA progression, laying the groundwork for future explorations into the active components and mechanistic pathways of TCM in KOA treatment.

[Research progress of traditional Chinese and Western medicine non-pharmacological prevention strategies for acute high altitude disease].

Acute high altitude disease (AHAD) is a general term for a series of clinical reactions that occur when the body fails to adapt to the low-pressure hypoxic environment of high altitudes. Mild cases can cause symptoms such as headache, nausea and vomiting, while more severe cases can lead to life-threatening conditions such as pulmonary edema, cerebral edema and other critical conditions that can be fatal. With the increasing demand for high altitudes deployment, understanding the common preventive measures of AHAD can reduce its morbidity or mortality to a certain extent, which is of great benefit to those who reside temporarily at high altitudes. In recent years, as people's health awareness has improved, there has been a growing attention towards non-pharmacological methods of disease prevention. At the same time, non-pharmacological therapy has significant therapeutic effects in preventing and treating high-altitude diseases, which has attracted the attention of researchers in this field. This review summarizes the major non-pharmacological preventive components of modern medicine and outlines the current non-pharmacological approaches to AHAD from the perspective of traditional Chinese medicine, intending to serve clinical purposes and improve the onset and prognosis of AHAD.

Advances in Research on the Effectiveness and Mechanism of Active Ingredients from Traditional Chinese Medicine in Regulating Hepatic Stellate Cells Autophagy Against Hepatic Fibrosis.

Hepatic fibrosis (HF) is a pathological process of structural and functional impairment of the liver and is a key component in the progression of chronic liver disease. There are no specific anti-hepatic fibrosis (anti-HF) drugs, and HF can only be improved or prevented by alleviating the cause. Autophagy of hepatic stellate cells (HSCs) is closely related to the development of HF. In recent years, traditional Chinese medicine (TCM) has achieved good therapeutic effects in the prevention and treatment of HF. Several active ingredients from TCM (AITCM) can regulate autophagy in HSCs to exert anti-HF effects through different pathways, but relevant reviews are lacking. This paper reviewed the research progress of AITCM regulating HSCs autophagy against HF, and also discussed the relationship between HSCs autophagy and HF, pointing out the problems and limitations of the current study, in order to provide references for the development of anti-HF drugs targeting HSCs autophagy in TCM. By reviewing the literature in PubMed, Web of Science, Embase, CNKI and other databases, we found that the relationship between autophagy of HSCs and HF is currently controversial. HSCs autophagy may promote HF by consuming lipid droplets (LDs) to provide energy for their activation. However, in contrast, inducing autophagy in HSCs can exert the anti-HF effect by stimulating their apoptosis or senescence, reducing type I collagen accumulation, inhibiting the extracellular vesicles release, degrading pro-fibrotic factors and other mechanisms. Some AITCM inhibit HSCs autophagy to resist HF, with the most promising direction being to target LDs. While, others induce HSCs autophagy to resist HF, with the most promising direction being to target HSCs apoptosis. Future research needs to focus on cell targeting research, autophagy targeting research and in vivo verification research, and to explore the reasons for the contradictory effects of HSCs autophagy on HF.

[Textual research on the evolution of therapeutic indications of Fenglong (ST 40): discussion on the related articles for "Fenglong (ST 40) for phlegm" published in Chinese Acupuncture and Moxibustion].

Based on Huangdi Neijing (Yellow Emperor's Internal Classic), combined with the Huangdi Mingtang Jing JiJiao (Compilation and Correction of Yellow Emperor's Mingtang Classic) and unearthed Tianhui Yijian (Tianhui Medical Bamboo Slips), it is recognized that the therapeutic indications of Fenglong (ST 40) were recorded repeatedly in many medical works of the Qin and Han dynasties; and the treatments mostly focus on "upward reversion of qi ". In Huangdi Mingtang Jing (Yellow Emperor's Mingtang Classic), a part of symptoms were re-described textually, which affects the understanding on the indications of Fenglong (ST 40) in the medical works of the later generations. On the basis of the construction of phlegm theory in the Sui and Tang dynasties, the scholars of Song, Jin and Yuan dynasties had placed the emphasis on the relationship between phlegm and qi movement. In acupuncture works by Dou Hanqing, Fenglong (ST 40) was selected in treatment of phlegm dampness and phlegm-induced asthma, which is also based on the pathogenesis, "upward reversion of qi ", rather than "phlegm" itself. This view can be understood by the proof of "reducing Zusanli (ST 36) for eliminating wind". The relationship between Fenglong (ST 40) and phlegm was emphasized in Yulong Ge (Jade Dragon Verse) and Zhenfang Liuji (Six Sets of Acupuncture Methods), after which, the understanding, " Fenglong (ST 40), the key point for phlegm disorders", had been formed gradually since the Ming dynasty. The formation and evolution of the therapeutic indications of Fenglong (ST 40) are influenced comprehensively by the errors in textual duplication, cultural background, changes in the term expressions of disorders, and the clinical experience of medical practitioners.

[Xuezheng Quanji, the earliest monograph on blood disorder].

Xuezheng Quanji(«¼) written by Sun Guangyu, a doctor in the Ming Dynasty, is the first known book on blood disorders in China. The book mainly deals with bleeding. The book begins with a collection of the Neijing and the treatises of the sages, focusing on systematically summarizing the theories and experiences of the past dynasties in the treatment of bleeding, interspersed with Sun's own opinions.The main part discusses four types of bleeding, summarizing Sun's profound experience in clinical practice, and many of his personal creative opinions.In terms of causes,Sun believed that there are three causes of bleeding and more due to heat. In terms of treatment,he opposed the abuse of bitter cold and attached great importance to nourishing yin and strengthening kidney and proposed four treatment methods of dispelling stasis, nourishing Yin and suppressing Yang, regulating Qi and blood, and tonifying deficiency. He advocated that bleeding should not be treated quickly, and emphasized that the disease should be judged according to the bleeding location and bleeding color to use herbs flexibly.Special attention should be paid to daily life care during and after illness as well.

[The annotation and compilation of Shennong Classic of Materia Medica in the period of the Republic of China].

A variety of books on the annotation and compilation of Shennong Classic of Materia Medica (Shen Nong Ben Cao Jing) appeared in the Ming and Qing Dynasties. In the period of the Republic of China at the beginning of the last century, a total of eight annotated and compiled books on Shennong Classic of Materia Medica were published. This paper discusses the authors of these books, their contents and their academic features. It was found that the research on Shennong Classic of Materia Medica in the period of the Republic of China was basically divided into two main sections: the continuation of reverence for classical texts with extensive commentary and the 'scientific' transformation of traditional materia medica in the context of Sino-Western medicine integration.

[The origin and development of Huanglong Decoction].

"Different prescriptions with the same name" is a common phenomenon clinically in traditional Chinese medicine prescriptions. Huanglong Decoction can be regarded as a representative example of this phenomenon with many changes to the contents of the decoction during its development. To clarify and identify the typology of Huanglong Decoction, this paper attempts to explore the origins and evolution of almost all types of Huanglong Decoction with an archival method examining data before 1911. It was found that Huanglong Decoction has at least seven main types: Fecal Liquid, Xiaochaihu Decoction Plus or Minus, Tao's, Taiping Shenghui Fang, Shengji Zonglu, Fu's and Zhulin Gynecology Treatment. Xiaochaihu Decoction Plus or Minus (Xiao Chai Hu Tang Jia Jian) includes four subcategories: Yao's Huanglong Decoction, Gujin Luyan Huanglong Decoction, Leizheng Huorenshu Huanglong Decoction, and Qian's Huanglong Decoction. It was also found that Xinjia Huanglong Decoction is derived from Tao's Huanglong Decoction.

[The first translation on pediatrics: Er Ke Cuo Yao].

Er Ke Cuo Yao(The Pediatric Summary) is the first monograph on pediatrics of Western medicine translated and introduced in the late Qing Dynasty. It occupies an important position in the history of the development of modern pediatrics and modern Western medicine in China. Edited by American missionary Mary Hannah Fulton and translated by Chinese Western medicine scholar Yin Duanmo, the book consists of 2 volumes and 14 books, including general discussion of pediatrics, diagnosis of pediatric diseases, and discussion on teething, throat diseases, gastrointestinal diseases, worms, liver diseases, abdominal epimesis, and new infectious diseases, etc. covering the diagnosis, treatment, maintenance and other knowledge of Western medical pediatrics. The source of Er Ke Cuo Yao is not yet available, but it may be a synthesis of various materials, and the translation uses paraphrasing, transliteration, and traditional Chinese medicine terminology, and the language is easy to understand. Er Ke Cuo Yao reflects the level of development of pediatrics in Western medicine in the early modern period, makes up for the lack of pediatrics knowledge of traditional Chinese medicine, and plays an active role in the diagnosis and treatment of common pediatric diseases, epidemiological diseases, surgical diseases, and malnutrition prevention.

[Jing Xiao Chan Bao collected by the Waseda university library].

The current version of Jing Xiao Chan Bao is believed to be the earliest medical book on gynecology remaining in China. It has three problems: formulae missing, lack of fluency in the text, and thus difficulties in proofreading and editing. These problems are still there because there are very few versions of Jing Xiao Chan Bao left in China and so it is difficult to do further studies to make comparisons. The Waseda University Library announced that the version they held was a handwritten. It provides a new version for further research of this book. This version was believed to be compiled and edited by Japanese scholars based on Medical Prescription Analogues (Yi Fang Lei Ju) and therefore appears to be similar to the South Song Dynasty version. Using archival research, it was found that in the version at Waseda University Library, the content organisation, the number of formulas, and the use of taboo words is different from those in the current version in China. In this sense, it is believed that this version is valuable and meaningful for archival and clinical research for traditional Chinese medicine.

[Medical related content in Macao Newsprint in the Late Qing Dynasty].

Macao Newsprint, which was an important tool for Lin Zexu to get acquainted with foreign affairs, was the first translated newspaper in Chinese history. The translation and compilation of news information related to Western medicine in Macao Newsprint was an active attempt by Chinese people to open their eyes to Western medicine. The two pieces of news related to Western medicine in Macao Newsprint, which presented the medical ethics, medical skills and doctor-patient relationship in the Western medicine, are precious historical materials on the exchange of Chinese and Western medicine. The expressions in the two pieces of translated news in which the foreigners might have praised their own medicine had a certain influence on the medical views of the late Qing scholars represented by Lin Zexu, and thus had a positive impact on the dissemination of Western medicine in China.

S5Utis: Structured State-Space Sequence SegNeXt UNet-like Tongue Image Segmentation in Traditional Chinese Medicine.

Intelligent Traditional Chinese Medicine can provide people with a convenient way to participate in daily health care. The ease of acceptance of Traditional Chinese Medicine is also a major advantage in promoting health management. In Traditional Chinese Medicine, tongue imaging is an important step in the examination process. The segmentation and processing of the tongue image directly affects the results of intelligent Traditional Chinese Medicine diagnosis. As intelligent Traditional Chinese Medicine continues to develop, remote diagnosis and patient participation will play important roles. Smartphone sensor cameras can provide irreplaceable data collection capabilities in enhancing interaction in smart Traditional Chinese Medicine. However, these factors lead to differences in the size and quality of the captured images due to factors such as differences in shooting equipment, professionalism of the photographer, and the subject's cooperation. Most current tongue image segmentation algorithms are based on data collected by professional tongue diagnosis instruments in standard environments, and are not able to demonstrate the tongue image segmentation effect in complex environments. Therefore, we propose a segmentation algorithm for tongue images collected in complex multi-device and multi-user environments. We use convolutional attention and extend state space models to the 2D environment in the encoder. Then, cross-layer connection fusion is used in the decoder part to fuse shallow texture and deep semantic features. Through segmentation experiments on tongue image datasets collected by patients and doctors in real-world settings, our algorithm significantly improves segmentation performance and accuracy.

The evolution of ancient healing practices: From shamanism to Hippocratic medicine: A review.

In the ever-evolving healthcare landscape, ancient healing traditions cast a profound shadow, offering insights and inspirations that resonate with modern medical practice. This paper explores the enduring influence of shamanic and Hippocratic healing traditions on contemporary healthcare, examining their contributions to holistic health approaches, diagnostic techniques, and ethical standards. The Hippocratic emphasis on observation, clinical experience, and ethical principles laid the foundation for modern Western medicine, while shamanic practices highlight the importance of spiritual and psychological dimensions in healing. The comparative analysis reveals both commonalities and distinctions among various ancient practices, such as Ayurveda, Traditional Chinese Medicine, and indigenous healing systems, emphasizing their holistic understanding of health and the use of natural remedies. Cross-cultural exchanges, from the Silk Road to the Islamic Golden Age and beyond, facilitated the integration and dissemination of medical knowledge, enriching global medical traditions. The paper also discusses the impact of these ancient practices on contemporary healthcare systems, highlighting the resurgence of holistic and integrative medicine, the validation and incorporation of herbal remedies, and the challenges of cultural appropriation and scientific validation. By embracing the wisdom of ancient healing traditions and fostering collaboration between traditional and modern medicine, contemporary healthcare can enhance therapeutic options, promote patient-centered care, and address global health challenges with a more inclusive and compassionate approach. This integration holds promise for the future of healthcare, benefiting individuals and communities worldwide.

[Potential action mechanism of Yishen Tongluo Prescription on male infertility: An analysis based on network pharmacology].

OBJECTIVE: To analyze the main active components and potential molecular mechanism of Yishen Tongluo Prescription (YTP) in the treatment of male infertility based on network pharmacological technology. METHODS: We searched and sorted the main active components of YTP and their individual potential targets in the databases of Systematic Pharmacology of Traditional Chinese Medicine (TCM) and Bioinformatics Analysis Tool of the Molecular Mechanism of TCM, and screened the targets related to male infertility diseases in the databases of Genecards, DisGeNET and OMIM. We made a Venn diagram by intersecting the predicted targets of YTP and those of male infertility diseases, constructed visualized networks for the association of the intersection targets and protein-protein interaction (PPI) using the Cytoscape software and STRING platform respectively, and conducted gene ontology (GO) and KEGG enrichment analyses using the DAVID database and R language "Cluster Profiler" software package respectively. RESULTS: A total of 99 active components, 250 targets of YTP, 4 397 targets of male infertility and 127 common targets were identified. GO analysis revealed that the biological processes of the common targets mainly included transcriptional regulation of RNA polymerase promoter Ⅱ, regulation of gene expressions, regulation of apoptosis, responses to estrogen, and cell responses to hypoxia. KEGG analysis showed significant enrichment of the common targets in the estrogen signaling pathway, cell apoptosis pathway, AGE-RAGE signaling pathway in diabetic complications, and TNF signaling pathway. CONCLUSION: Through network pharmacology, we identified the main active components of YTP and its multi-target and multi-pathway mechanism in the treatment of male infertility, which has paved the ground for animal and cell experiments in verifying the action mechanism of YTP on male infertility.

Assembly and evolutionary analysis of the complete mitochondrial genome of Trichosanthes kirilowii, a traditional Chinese medicinal plant.

Trichosanthes kirilowii (T. kirilowii) is a valuable plant used for both medicinal and edible purposes. It belongs to the Cucurbitaceae family. However, its phylogenetic position and relatives have been difficult to accurately determine due to the lack of mitochondrial genomic information. This limitation has been an obstacle to the potential applications of T. kirilowii in various fields. To address this issue, Illumina and Nanopore HiFi sequencing were used to assemble the mitogenome of T. kirilowii into two circular molecules with sizes of 245,700 bp and 107,049 bp, forming a unique multi-branched structure. The mitogenome contains 61 genes, including 38 protein-coding genes (PCGs), 20 tRNAs, and three rRNAs. Within the 38 PCGs of the T. kirilowii mitochondrial genome, 518 potential RNA editing sites were identified. The study also revealed the presence of 15 homologous fragments that span both the chloroplast and mitochondrial genomes. The phylogenetic analysis strongly supports that T. kirilowii belongs to the Cucurbitaceae family and is closely related to Luffa. Collinearity analysis of five Cucurbitaceae mitogenomes shows a high degree of structural variability. Interestingly, four genes, namely atp1, ccmFC, ccmFN, and matR, played significant roles in the evolution of T. kirilowii through selection pressure analysis. The comparative analysis of the T. kirilowii mitogenome not only sheds light on its functional and structural features but also provides essential information for genetic studies of the genus of Cucurbitaceae.

Promoting the development of ethnic medicine in China: policy evaluation and optimization countermeasures.

Background: The coordinated development of ethnic medicine is a basic necessity for steady construction of a healthy China. This process includes closely following domestic and foreign policies, including changes, through the optimization of policies; shaping the new direction of the development of national medicine; and achieving comprehensive technological and industrial upgrades. As such, ensuring the all-round development of national medicine in China remains a great challenge. Methods: This paper takes the relevant policies of national and local ethnic medicine issued by the government as the research object, and, through the full interpretation of the policy-issuing body, policy content, and policy effectiveness, deeply analyzes the current situation of the policy's role in ethnic medicine and explores the distribution of policy types, subject-cooperation modes, and scoring levels in various dimensions. Results: This study found that, in the new era of pharmaceutical reform, the State lacks a variety of special policies on ethnomedicine, and there is also an imbalance in the use of policy tools at both the central and local levels as well as synergies in the implementation of policies that need to be further strengthened. Discussion: There remains a need to continue to improve the policy-evaluation system, optimize the structure for the use of policy tools, and improve the rates of application and implementation of the national medicine policy by strengthening cross-provincial and multisectoral cooperation to promote the revitalization of the national medicine industry in China.

Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews.

BACKGROUND: Knee osteoarthritis (KOA) has become a public health issue. Several systematic reviews (SRs) and meta-analyses (MAs) indicate that traditional Chinese exercise (TCE) may be an effective treatment for reducing pain and stiffness and improving physical function in people with knee osteoarthritis (KOA). OBJECTIVES: To evaluate the literature quality and evidence for the systematic reviews of TCE for KOA and provide evidence to support the clinical application of TCE for KOA. METHODS: Eight databases were searched from their inception to January 3, 2023, to retrieve relevant literature, including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), China Biology Medical literature database (CBM), PubMed, Embase, Web of Science and Cochrane Library, without restrictions on publication date or language. AMSTAR-2 and PRISMA 2020 assessed the methodological and reporting quality of included SRs/MAs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to evaluate the quality of evidence. RESULTS: A total of 18 SRs/MAs were included. The methodological quality was "very low" based on AMSTAR-2. The overall reporting quality was deficient based on PRISMA 2020. The quality of Chinese and English literature differed, with English literature being superior in methodological and reporting quality. Among 93 pieces of evidence obtained, 46 (49.46%) were of very low quality, 34 (36.56%) were of low quality, 13 (13.98%) were of moderate quality, and none were of high quality. TCE was supported by 76 pieces of evidence (81.72%). CONCLUSION: TCE appears beneficial and safe for managing KOA. However, due to the relatively low methodological and evidentiary quality of included SRs/MAs, clinicians should interpret these findings cautiously.