Table of Content

Volume 31 Issue 1
26 January 2026

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Expert consensus on the value and strategies of precise drug administration for multi-ethnic populations in China

Yuan LIU, Cheng CUI, Miao YU, Wenyu JIN, Yinliang BAI, Yabin DUAN, Cao FANG, Jianchang HE, Yan HE, Hua HUANG, Shixia HUO, Yang JIN, Lin JIANG, Zhe JIANG, Zheng JIAO, Xuejun LI, Xiangyang LI, Hongjian LI, Lihong LIU, Yang LIU, Hongqiang QIU, Feng SUN, Jianjun SUN, Xuechang WANG, Jianhua WANG, Zhenlei WANG, Shijie WEI, Xiaowen YAN, Lei ZHANG, Xuenong ZHANG, Yuxin ZHANG, Jun ZHAO, Jiye YIN, Ru YAN, Xinchun WANG, Dongyang LIU

2026, 31(1):  1-13.  doi:10.12092/j.issn.1009-2501.2026.01.001

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The level of precision medication for multiple ethnic groups is crucial to the overall health and ethnic unity of our country, and is of vital importance to the realization of "Healthy China 2030" and the development and security of our country. To improve the health level of multiple ethnic groups, this article takes precision medication research as the core, elaborates on its significance in enhancing the rationality and safety of medication, and emphasizes the necessity of precision medication research for ethnic minorities. The aim is to establish a consensus on precision medication research based on the clinical pharmacokinetic and pharmacodynamic variations of multiple ethnic groups, in order to better ensure the efficacy and safety of medication for different ethnic groups. This consensus systematically reviews the general situation of clinical pharmacokinetic and pharmacodynamic variations in multiple ethnic groups, and analyzes the causes and mechanisms of variations from significant influencing factors such as genetic factors, intestinal flora, pathological and physiological states, high-altitude hypoxic environment, and dietary habits. Based on the existing evidence from clinical pharmacokinetics and pharmacodynamics studies of multi-ethnic populations, as well as the latest research techniques (physiologically pharmacokinetic virtual humans) strategies and considerations, the value and strategies of ethnic-specific drug use research are clarified. After thorough discussion, a consensus was reached, providing theoretical basis and practical guidance for the research on precise drug use in multi-ethnic populations.

Connectivity Map-based drug repositioning evaluation of verapamil as a therapeutic agent for Parkinson's disease

Jile XIN, Jing LIU, Xinyi ZHANG, Jiayuan GUO, Wenzhuo HAN, Yixin SUN, Le ZHAO, Weisheng FENG, Xiaoke ZHENG

2026, 31(1):  14-27.  doi:10.12092/j.issn.1009-2501.2026.01.002

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AIM: To screen small molecule compounds that modulate the expression of transcription factors related to hub genes in the pathogenesis of Parkinson's disease (PD). METHODS: Gene expression profiling data from PD patients were analyzed to find the hub genes for PD pathogenesis and the transcription factors that regulate their expression. Connectivity Map (CMap) was used to screen for potential small molecule drugs that could modulate transcription factors. 6-hydroxydopamine (6-OHDA)-injured PC12 cell and 6-OHDA-induced PD mice model were used to evaluate the potential role of the small molecule for modulating transcription factor expression and treating PD. RESULTS: The predicted results showed Verapamil (Ver) as a potential drug candidate. In vitro, Ver protected PC12 cells from 6-OHDA injury and regulated 6-OHDA-induced expressions of transcription factors such as PAX5, LEF1, MTF1, IKZF3, and SP140, as well as the expressions of PD pathogenic genes such as ITGA6, CDH1, CD40, ESR1, SMAD3, and CXCR4. In PD mice, Ver exerted inhibitory effects on α-Syn expression. However, Ver had weak effects on PD pathogenic genes and their transcription factors described above. CONCLUSION: Ver's therapeutic effect on PD partly depends on its regulatory effect on PD pathogenic genes and their related transcription factors.

Exploring the mechanism of Alpiniae Officinarum Rhizoma and two other Alpinia Roxb medicinal materials in treating gastric ulcer with cold syndrome based on network pharmacology, molecular docking and experimental validation

Zishuai WEN, Shengnan LIANG, Yuling RUAN, Wentao ZHANG, Mengying LI, Fangfang WU, Junhui LIU, Huazhen QIN

2026, 31(1):  28-39.  doi:10.12092/j.issn.1009-2501.2026.01.003

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AIM: Through network pharmacology and molecular docking technology, the mechanism of action of three kinds of Alpinia Roxb. Chinese medicinal materials such as Alpiniae Officinarum Rhizoma in the treatment of gastric ulcer with cold syndrome was explored and verified by experiments. METHODS: Through the commonly used technical means of network pharmacology, TCMSP, CNKI and other databases were used to screen the active components in three kinds of Alpinia Roxb. Chinese medicinal materials and related targets for the treatment of gastric ulcer diseases. Venn diagram and protein-protein interaction (PPI) were drawn. Pathway enrichment analysis was performed on key targets. The obtained data of “drug-active ingredient- target- pathway- disease” were imported into Cytoscape 3.10.2 for visualization, and some compounds with higher Degree ranking were selected for molecular docking by AutoDock software. A total of 72 SPF-grade SD rats were divided into nine groups, including a blank control group, a model group, a positive control group (Zingiberis Rhizoma, 10.8 g/kg), high and low dose groups of Alpiniae Officinarum Rhizoma (10.8 and 5.4 g/kg), high and low dose groups of Galangae Rhizoma (9 and 4.5 g/kg), and high and low dose groups of Galangae Fructus (10.8 and 5.4 g/kg). A gastric ulcer with cold syndrome model was induced using cold acetic acid and cold Anemarrhenae Rhizoma. The rats were administered decoctions at different doses by gavage at 1 mL/100 g body weight, twice daily for 4 consecutive days. By calculating the ulcer index and ulcer inhibition rate of rats, the pathological changes of gastric tissue in rats were observed by HE staining, the expression of AKT1, MAP2K1 and mTOR protein in gastric tissue was detected by ELISA, so as to confirm each other with the relevant results of network pharmacology. RESULTS: A total of 45 key components were screened from all the components of three kinds of Alpinia Roxb. Chinese medicinal materials, and 124 targets were intersected with the disease. The PPI network interaction map contained 124 nodes and 923 edges. A total of 138 signal pathways were obtained by KEGG enrichment. The molecular docking scores were less than -7.0 kcal/mol, that is the core components effectively acted on the core targets. The results of verification experiments showed that compared with the model group, the different doses of three kinds of Alpinia Roxb. Chinese medicinal materials groups significantly improved the gastric ulcer with cold syndrome, mucosal edema, congestion and other symptoms caused by the replication of iced Anemarrhenae Rhizoma decoction-glacial acetic acid method, and the ulcer surface and bleeding points were significantly reduced. Compared with the model group, the AKT1 protein expression level was significantly reduced in all drug - treated groups the except low - dose Galangae Fructus group (P<0.05 or P<0.01). The MAP2K1 protein expression level was significantly reduced in all drug - treated groups except the low - dose Alpiniae Officinarum Rhizoma group (P<0.05 or P<0.01). The mTOR protein expression level was significantly reduced in all drug - treated groups except the low - dose Alpiniae Officinarum Rhizoma and Galangae Rhizoma groups (P<0.05 or P<0.01). CONCLUSION: Three kinds of Alpinia Roxb. Chinese medicinal materials may play an anti-inflammatory and regulatory role in cell proliferation through multi-component, multi-target and multi-pathway network regulation and so on to treat gastric ulcer.

Metformin inhibits diabetes induced ferroptosis in renal proximal tubular epithelial cells by up-regulating Nrf2 expression

Ziyu WU, Ting YU, Mouwei ZHENG, Tailin GUO

2026, 31(1):  40-47.  doi:10.12092/j.issn.1009-2501.2026.01.004

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AIM: To investigate the mechanism of metformin in inhibiting ferroptosis of diabetic renal tubular epithelial cells by promoting the expression of Nrf2. METHODS: 8-week-old DBA2/J male mice were divided into normal control group, Met group, DM group and DM+Met group. HK-2 cells were divided into four groups: normal glucose group, Met group, high glucose group (30 mmmol/L) and HG+Met group. The changes of Scr, BUN, ROS, the protein and mRNA expression levels of Nrf2, GPX4 and FTH-1 were measured in the kidney of mice or HK-2 cells. The contents of MDA, Fe²⁺ and GSH were also detected in renal tissues or the HK-2 cells. RESULTS: Compared with the DM group, the levels of BUN, Scr and the score of renal pathological injury scores were significantly reduced and the protein expressions of Nrf2, GPX4 and FTH-1 were significantly increased in the kidney tissue of diabetes mice treated with metformin (all P<0.05). Compared with the HG group, the expression levels of Nrf2, GPX4, FTH-1 protein and mRNA were significantly promoted, the GSH content was increased and intracellular ROS, MDA, and Fe²⁺ content were decreased in high glucose-induced HK-2 cells treated with metformin (all P<0.05). CONCLUSION: Metformin can suppress ferroptosis induced by high glucose and alleviate diabetic tubulopathy. The mechanism may be through up-regulating the expression of Nrf2 in renal tubular epithelial cells.

Shikonin restrains TGF-β1/Smad signaling pathway to improve renal fibrosis

Tao WANG, Xiaowen CHENG, Zhirui ZHANG, Hao JIAO

2026, 31(1):  48-54.  doi:10.12092/j.issn.1009-2501.2026.01.005

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AIM: To explore the effect of shikonin (SK) in the treatment of renal fibrosis in mice. METHODS: C57BL/6 mice were randomly divided into sham group, UUO group, shikonin low-dose group (5 mg·kg^?1·d^?1) and high-dose group (20 mg·kg^?1·d^?1), with 8 mice in each group. Mice in the experimental group were given different concentrations of shikonin, sham group and UUO group were given equal volume of normal saline, continuous intervention for 10 days. Serum urea nitrogen (BUN), creatinine (Cr) and uric acid (UA) levels were detected by automatic differentiation analyzer, serum inflammatory factors IL-6, IL-1β and TNF-α levels were detected by enzyme-linked immunosorbent assay (ELISA), and renal tissue damage and collagen deposition were detected by HE staining, Masson staining and qRT-PCR. Use protein blotting to detect the expression levels of TGF-β1, p-Smad2, Smad2, p-Smad3, Smad3. RESULTS: Compared with the sham group, the levels of inflammatory factors, renal function indexes, fibrosis-related proteins and TGF-β1/Smad signaling pathway proteins in UUO group were significantly increased (P<0.05), and the degree of renal fibrosis was aggravated. Compared with UUO group, the levels of inflammatory factors, renal function indexes, fibrosis-related proteins and TGF-β1/Smad signaling pathway proteins in the SK group were significantly decreased, and the degree of renal fibrosis was improved, and the improvement was more obvious in the SK high-dose group, with statistical significance (P<0.05). CONCLUSION: Shikonin may alleviate renal inflammation and fibrosis by inhibiting the TGF-β1/Smad signaling pathway, improve renal function and kidney injury status, and play a role in alleviating the progression of renal fibrosis.

Study on bioequivalence evaluation of daclatasvir hydrochloride tablets in healthy Chinese subjects

Jing XIE, Xiaoni WANG, Jie MIN, Min LIU, Xu ZHU, Wang HU, Chang LU, Ran ZHANG, Huan ZHOU, Jian GONG

2026, 31(1):  55-62.  doi:10.12092/j.issn.1009-2501.2026.01.006

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AIM: To evaluate the bioequivalence and safety of the test formulation of daclatasvir hydrochloride tablets and the reference formulation of daclatasvir hydrochloride tablets (DAKLINZA^TM) in healthy Chinese subjects. METHODS: A single-dose, randomized, open-label, two-cycle, double-crossover design was used, and 60 healthy subjects were enrolled. The subjects were randomly divided into two groups, with 30 subjects in the fasting group and 30 subjects in the fed group. In the first cycle, one tablet (60 mg) of the test or reference formulation was taken orally as a single dose, and cross-administration was conducted on the 8th day. RESULTS: The main pharmacokinetic parameters of the test and reference formulations of daclatasvir hydrochloride tablets in the fasting group were as follows: C_max (1 102.690±311.345) and (1 174.800±361.642) ng/mL; AUC_0-t (13 517.051±3 576.349) and (13 503.448±4 022.914) h·ng·mL^?1; AUC_0-∞ (13 672.052±3 626.297) and (13 669.602±4 059.563) h·ng·mL^?1. The main pharmacokinetic parameters of the test and reference formulations of daclatasvir hydrochloride tablets in the fed group were as follows: C_max (791.733±230.334) and (872.000±303.921) ng/mL; AUC_0-t (10 974.708±3 213.564) and (11 217.253±4 060.319) h·ng·mL^?1; AUC_0-∞ (11 140.018±3 261.934) and (11 396.162±4 143.077) h·ng·mL^?1. The 90% confidence intervals for the geometric mean ratios of the main pharmacokinetic parameters (C_max, AUC_0-t and AUC_0-∞) of daclatasvir in plasma after oral administration of 60 mg of the test and reference formulations of daclatasvir hydrochloride tablets under fasting and fed conditions fell within the 80.00%–125.00% equivalence interval. There were no serious adverse events in both groups. CONCLUSION: The test and reference formulations of daclatasvir hydrochloride tablets were determined to be bioequivalent and safe under fasting or fed conditions.

Effect of esketamine on postoperative fatigue syndrome in elderly patients undergoing posterior lumbar fusion

Congli ZHANG, Yan YAN, Nannan SONG, Di LIU, Yang ZHANG, Pinghui ZHOU, Li REN, Fangtian FAN

2026, 31(1):  63-71.  doi:10.12092/j.issn.1009-2501.2026.01.007

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AIM: To investigate the effects of esketamine on postoperative fatigue syndrome (POFS), recovery quality and cellular immunity in elderly patients undergoing posterior lumbar fusion. METHODS: A total of 128 elderly patients scheduled for posterior lumbar fusion were randomly divided into esketamine group (Esk group, n=64) and normal saline group (NS group, n=64). Both groups underwent MTLIP block under ultrasound guidance before surgery. In the Esk group, 0.25 mg/kg esketamine was injected intravenously during anesthesia induction, followed by continuous infusion at 0.125 mg·kg^?1·h^?1 until 10 min before the end of surgery. In the NS group, equal-volume normal saline was injected in the same way. The concise perioperative Fatigue Rating Scale (ICFS-10) and Quality of Recovery Scale (QoR-15) were scored 1 day before surgery (D0), 1 day after surgery (D1), 3 days after surgery (D3), 7 days after surgery (D7) and 30 days after surgery (D30), respectively, and the incidence of POFS was analyzed. Peripheral venous blood samples were collected before anesthesia induction (T0), immediately after surgery (T1), 12 hours after surgery (T2), 24 hours after surgery (T3), 48 hours after surgery (T4) and 72 hours after surgery (T5), and the serum levels of IL-6, IL-10, CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ were detected. The intraoperative anesthetic drug consumption, extubation time, PACU stay time, postoperative hospital stay, postoperative nausea/vomiting and pain were recorded. RESULTS: Compared with the NS group, the incidence of POFS in the Esk group was significantly decreased on day 1 after surgery (53.3% vs. 32.8%, P=0.022), the ICFS-10 scores of the Esk group were significantly decreased at 1, 3 and 7 days after surgery (P<0.05), the QoR-15 score was significantly increased (P<0.01). The levels of IL-6 and CD8⁺ were significantly decreased at T1-T2 (P<0.05). The level of IL-10 was significantly increased at T1-T3 (P<0.05). The levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ increased significantly at T1-T4 (P<0.05). The consumption of sufentanil, remifentanil and propofol during operation and the end-tidal concentration of sevoflurane were significantly reduced. The incidence of nausea/vomiting was significantly decreased 48 hours after surgery (P<0.05). The duration of postoperative ventilator assistance, PACU stay and postoperative hospitalization were significantly shortened. CONCLUSION: Esketamine can reduce the incidence of POFS and improve the quality of recovery in elderly patients with posterior lumbar fusion, and its mechanism may be related to inhibiting inflammatory response and improving cellular immune function.

Comparison of postoperative awakening between ciprofol and propofol in elderly patients undergoing hip replacement under BIS monitoring

Jianyou ZHANG, Yi GONG, Luyu SUN, Suhong TANG, Dawei YANG, Jie ZHOU

2026, 31(1):  72-77.  doi:10.12092/j.issn.1009-2501.2026.01.008

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AIM: To compare the difference between ciprofol and propofol continuous infusion for postoperative awakening in elderly patients undergoing hip replacement. METHODS: A total of 68 patients aged 65-85 years, who underwent elective hip replacement surgery were randomly assigned into two groups (n=34 each): group C and group P. In group C, anesthesia was induced with ciprofol 0.3 mg/kg, sufentanil 0.3 μg/kg and cisatracurium 0.15 mg/kg. Anesthesia was then maintained with a continuous infusion of ciprofol at a rate of 0.8 mg·kg^?1·h^?1 and remifentanil at 1.2 to 12 μg·kg^?1·h^?1. The Bispectral Index (BIS) value was kept between 40 and 60, and blood pressure was maintained within ±20% of the baseline. In group P, ciprofol was replaced by propofol at an induction dose of 1.5 mg/kg and a maintenance dose of 5.0 mg·kg^?1·h^?1. Record amount of intraoperative anesthetic dosage, blood loss, volume of fluid input, urine volume, vasoactive drugs usage and intraoperative hemodynamic indexes, postoperative awakening time, spontaneous breathing recovery time, extubation time, and the time required to achieve a modified Aldrete score ≥9, and MOAA/S scores and adverse reactions at 0, 5, 15, and 30 minutes after extubation. RESULTS: Compared to group P, group C exhibited significantly prolonged awakening time, spontaneous breathing recovery time, and extubation time (P<0.05). Additionally, the volume of intraoperative fluid infusion was significantly reduced (P<0.05), urine volume was significantly increased (P<0.05), and the utilization of vasoactive drugs was significantly decreased (P<0.05) in group C. No significant differences were observed between the two groups in terms of the time for modified Aldrete score ≥9, MOAA/S score at 0, 5, 15 and 30 min after extubation, as well as adverse reactions (P>0.05). The dosage of remifentanil in group C showed a significant increase (P<0.05), while the intraoperative maintenance dose of ciprofol was determined to be at a rate of 0.849 mg·kg^?1·h^?1 (range: 0.456 to 1.222 mg·kg^?1·h^?1). CONCLUSION: Compared with propofol, the postoperative awakening time, spontaneous breathing recovery time and extubation time of ciprofol in elderly patients undergoing hip replacement are prolonged, and the intraoperative hemodynamics is more stable. The maintenance dose of ciprofol in elderly patients is 0.849 mg·kg^?1·h^?1.

The latest progress in the pathogenesis of multiple sclerosis and drug therapy

Yayan SHI, Yu WANG, Wei KUANG, Shouyang YU

2026, 31(1):  78-87.  doi:10.12092/j.issn.1009-2501.2026.01.009

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Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). As a global health concern, MS manifests with motor symptoms such as muscle weakness and ambulatory dysfunction, along with non-motor symptoms including cognitive impairment, neuropsychological manifestations, and pain. The pathogenesis of MS remains intricate and not fully elucidated. In recent years, pharmacological treatments have remained the first-line therapeutic approach for MS. This review summarizes current understanding of potential pathogenic mechanisms and advances in pharmacotherapeutic interventions for MS, while proposing potential future research directions to provide novel perspectives for investigating the pathogenesis and treatment of this disease.

Progress in the study of interleukin-17A-mediated signaling network regulating airway remodeling in asthma

Zhiwang WANG, Yue ZHANG, Ping QUAN, Yue ZHAO, Bei TIAN, Haijing DUAN, Ruiqiong WANG

2026, 31(1):  88-95.  doi:10.12092/j.issn.1009-2501.2026.01.010

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Asthma is an immune inflammatory disease. Repeated inflammatory responses cause "damage-repair" to reshape the airway structure (known as "airway remodeling"), and airway remodeling is the main cause of irreversible reduction in lung function in asthma patients. Interleukin-17A (IL-17A), as a special subtype of IL-17, plays a key regulatory role in the pathological changes of airway remodeling, such as airway inflammation, goblet cell (GC) metaplasia, high expression of mucin (Muc), and smooth muscle (ASM) thickening in asthma. Therefore, IL-17A regulation of the signal network related to airway remodeling in asthma has become a new research hotspot in recent years. This article reviews the mechanism of IL-17A regulating airway remodeling in asthma from the perspective of signal networks such as retinoic acid-related orphan receptor γt (RORγt), signal transducer and activator of transcription 3 (STAT3), transforming growth factor-β1 (TGF-β1), nuclear factor-κB (NF-κB), and p38 mitogen-activated protein kinase (p38 MAPK), providing a theoretical basis for the study of the mechanism of airway remodeling in asthma and the development of new drugs.

Potential role and therapeutic prospects of glycolysis-lactylation modification in asthma

Xiaoping SHEN, Dong WU, Lili YU, Bin WU

2026, 31(1):  96-106.  doi:10.12092/j.issn.1009-2501.2026.01.011

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Asthma is a heterogeneous disease characterized by chronic airway inflammation, airway hyperresponsiveness, and remodeling. Its pathological mechanisms involve complex interactions between multiple immune and structural cells. Recent studies reveal that glycolysis is closely associated with the pathogenesis and severity of asthma. Dysregulated glycolytic metabolism in various immune cells promotes asthmatic pathogenesis by inducing dysfunctions in both innate and adaptive immune responses. Lactate, the end-product of glycolysis, directly mediates lactylation modifications that regulate epigenetic processes and signaling pathways. This mechanism plays critical roles in Th2 inflammation, macrophage activation, and airway remodeling, potentially serving as a regulatory hub in asthma pathology. In this review, we discuss the potential roles and mechanisms of glycolysis-lactylation in asthma, analyze the feasibility of targeting the glycolysis-lactylation axis as a novel therapeutic approach for asthma, and provide references and directions for future research.

Research progress of tirofiban in the treatment of ruptured intracranial aneurysms

Li YANG, Zhi ZHENG, Xufeng MENG, Qian LIU, Yunfei HAO

2026, 31(1):  107-115.  doi:10.12092/j.issn.1009-2501.2026.01.012

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Ruptured intracranial aneurysm is a cerebrovascular emergency with high mortality and morbidity. Although stent-assisted coil embolization is effective, complications such as intraoperative thrombosis and postoperative bleeding remain prominent issues. Tirofiban, a potent platelet aggregation inhibitor, with its rapid onset, short half-life, and quick recovery of platelet function, shows potential in the treatment of ruptured intracranial aneurysms. This review summarizes the pharmacological mechanisms of tirofiban and its clinical applications, analyzes its efficacy and safety at different doses, and explores its rational use in preoperative prophylaxis and intraoperative salvage therapy. Furthermore, the review discusses the challenges and limitations of using tirofiban in the treatment of ruptured intracranial aneurysms and proposes future research directions. The goal is to provide evidence-based support for the standardized application of tirofiban and enhance its value in neurointerventional therapy.

Advances in the modulation of Nrf2 signaling by natural compounds for the treatment of intervertebral disc degeneration

Jianqiang DU, Qi ZHANG, Enpeng GU, Chen XU, Yuan GUO, Menglong ZHANG, Jinke GUO, Si WU, Haibo XIE

2026, 31(1):  116-124.  doi:10.12092/j.issn.1009-2501.2026.01.013

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Intervertebral disc degeneration (IDD) is a major cause of chronic low back pain, yet there is a lack of effective and safe targeted drugs. Studies have shown that the pathogenesis of IDD is closely related to oxidative stress, inflammation, extracellular matrix degradation, autophagy and apoptosis, and the nuclear factor E2-related factor 2 (Nrf2) signaling pathway is widely involved in the abovementioned activities, which plays a key role in slowing down the progression of IDD. According to recent literature, some natural products can target the Nrf2 signaling pathway to intervene in IDD and have achieved certain results, however, their specific molecular mechanisms still need to be further elaborated. Based on this, this article introduces the structure and function of Nrf2 signaling and its specific role in IDD, and discusses the progress of the intervention of natural products of traditional Chinese medicine, with the aim of providing a theoretical basis for the therapeutic strategy based on the targeting of Nrf2 signaling to prevent and control IDD.

Progress in research on macrophage polarization, intestinal flora and their metabolites in organ injury

Yiru WEN, Jinlamu YANG, Ga MEI, Na LI, Yapeng LU, Yan ZHANG, Jieting LIU

2026, 31(1):  125-132.  doi:10.12092/j.issn.1009-2501.2026.01.014

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Macrophage polarization, intestinal flora and their metabolites have emerged as research hotspots in recent years. Several published studies have shown that there is a certain correlation between macrophage polarization and intestinal flora as well as their metabolites. Intestinal flora and their metabolites can induce macrophages to polarize into M1 or M2 phenotypes, thereby triggering pro-inflammatory or anti-inflammatory responses, which are closely related to organ injury. This review summarizes the relevant research on macrophage polarization, intestinal flora, and their metabolites in organ injury. It elaborates on the mechanisms and related pathways of macrophage polarization, explores the regulatory effects of intestinal flora and their metabolites on macrophage polarization, and discusses their roles in related diseases and organ injury. The aim is to provide new insights for the research on the mechanisms of organ injury and corresponding protective strategies.

Cefiderocol: a novel siderophore cephalosporin

Shifeng ZHAO, Hengbin CAO, Ronghua WANG, Yumei YUAN

2026, 31(1):  133-144.  doi:10.12092/j.issn.1009-2501.2026.01.015

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Cefiderocol is the first-in-class siderophore cephalosporin. With its unique mechanism of action and high stability independent of β-lactamase inhibitor, Cefiderocol exhibits potent activity against multidrug-resistant gram-negative bacilli or carbapenem-resistant gram-negative bacilli, making it an important choice for the treatment of such pathogens in current clinical practice. This article provides a review of its mechanism of action, antibacterial activity, pharmacokinetics/pharmacodynamics, clinical research, safety, and resistance mechanisms, in order to provide reference for clinical anti drug-resistance gram-negative bacilli infections.