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18 August 2026, Volume 30 Issue 23 Previous Issue   

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Mitophagy impairment mediated muscular atrophy: insights from the Drosophila model Li Zijing, Chen Xuwu, Ouyang Xinye, Wang Maoyuan 2026, 30 (23):  5897-5905.  doi: 10.12307/2026.346 Abstract ( 63 )   PDF (3208KB) ( 61 )   Save BACKGROUND: Muscular atrophy is a pathological process characterized by the progressive decline in muscle mass and function, which severely affects patients’ quality of life. In recent years, the role of mitophagy, as an important mitochondrial quality control mechanism for maintaining intracellular homeostasis, has attracted significant attention in the context of muscle atrophy. Drosophila, as a classical model organism, has become a crucial tool for studying the connection between muscle atrophy and mitophagy mechanism due to its conserved muscle functional structure and straightforward genetic manipulation. OBJECTIVE: To review the molecular mechanism of mitophagy dysfunction in muscular atrophy and to summarize the research progress of relevant Drosophila models in this field, with the aim of providing new insights and directions for the study of the pathological mechanism and the development of therapeutic strategies for muscular atrophy. METHODS: PubMed and China National Knowledge Infrastructure databases were screened, using the keywords “skeletal muscle, muscle regenerate, denervation muscle atrophy, muscle atrophy, sarcopenia, drosophila, drosophila melanogaster, mitophagy, mitochondrial dysfunction” in English and Chinese respectively, with literature tracing methods. The search covered the period from January 2001 to February 2025. After screening, 68 articles were included for review and analysis. RESULTS AND CONCLUSION: The studies on the Drosophila model indicate that mitophagy plays a pivotal role in the development of muscular atrophy. Mitophagy dysfunction leads to the accumulation of damaged mitochondria within muscle cells, subsequently triggers oxidative stress, energy metabolism disorders and etc., induces apoptosis, and exacerbates muscular atrophy. Furthermore, the Drosophila model exhibits significant advantages in screening potential therapeutic targets and identifying intervention strategies, which provides a new way to study the mechanism of muscle atrophy and develop therapeutic strategies in muscle atrophy. To summarize the research outcomes of the Drosophila model, the strategy of regulating mitophagy is emphasized to treat muscle atrophy; the unique advantages of the Drosophila model is highlighted in the study of the molecular mechanism of mitophagy and muscular atrophy. Future research should integrate translational medicine, high-throughput molecular screening technologies, and multi-omics approaches to further explore the unknown molecular mechanisms and novel therapeutic targets of mitophagy and muscle atrophy. Figures and Tables | References | Related Articles | Metrics

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Roles and mechanisms of mitochondrial dynamics in bone defect repair Zhou Fada, Long Zhisheng 2026, 30 (23):  5906-5914.  doi: 10.12307/2026.348 Abstract ( 67 )   PDF (1400KB) ( 20 )   Save BACKGROUND: Mitochondrial dynamic changes, such as fusion, fission and autophagy, are particularly important for maintaining mitochondrial health homeostasis and cellular balance. Increasing studies have shown that these mitochondrial dynamic changes play a significant role in the healing process of bone defects. In-depth research on mitochondrial dynamics creates new possibilities for the treatment of bone defects. OBJECTIVE: To explore the mechanism and principles of mitochondrial dynamics and its research and development in bone defect repair. METHODS: Relevant literature was retrieved from databases such as CNKI, WanFang Data, and PubMed published from 1990 to 2024 using the keywords of “mitochondrial dynamics, bone defect repair, mitochondrial fusion and fission, osteocytes” in Chinese and “mitochondrial dynamics, bone defect repair, mitochondrial dysfunction” in English. All retrieved documents were strictly screened, analyzed, and sorted one by one according to the inclusion criteria. A total of 77 documents were included for comprehensive analysis, consisting of 15 Chinese documents and 62 English documents.  RESULTS AND CONCLUSION: (1) The repair of bone defects is finely regulated by a variety of cells and molecular signaling pathways, which is a highly complex process. Mitochondrial dynamics play a particularly critical role in this process, as they can significantly influence bone cell function and bone metabolism, thereby further promoting the repair of bone defects. (2) Future research could focus on in-depth exploration of the molecular mechanisms of mitochondrial dynamics and development of novel nano-targeted particles and clinical mitochondrial drugs, thereby creating more possibilities for the clinical application of mitochondrial dynamics in bone defect repair. Figures and Tables | References | Related Articles | Metrics

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Biological mechanisms and future research trends of cartilaginous endplate degeneration Jiang Chao, Che Yanjun 2026, 30 (23):  5915-5924.  doi: 10.12307/2026.334 Abstract ( 58 )   PDF (1492KB) ( 119 )   Save BACKGROUND: The cartilaginous endplate is the bridge connecting the intervertebral disc to the vertebral body. Degeneration of the cartilaginous endplate is a central link in various degenerative spinal disorders.  OBJECTIVE: To conduct an in-depth analysis of the biological mechanisms of cartilaginous endplate degeneration and to reveal the key role of cartilaginous endplate degeneration in intervertebral disc degeneration. METHODS: Computerized searches were conducted in Web of Science, PubMed, CNKI, WanFang, and VIP databases. The search terms included “cartilaginous endplate degeneration, inflammatory factors, biomechanics, extracellular matrix” in Chinese and English. The literature search spanned from the inception of each database to August 2024. Based on predefined inclusion and exclusion criteria, a total of 68 articles were ultimately selected for review. RESULTS AND CONCLUSION: Intervertebral disc degeneration is a cascade reaction triggered by changes in the mechanical environment, leading to cell-mediated biochemical, mechanical, and structural changes. The cartilaginous endplate, as a dynamic mechanical barrier of the intervertebral disc, has biomechanical properties determined by the components of the extracellular matrix. The degeneration of the cartilaginous endplate is characterized by changes in the extracellular matrix components, including the degradation of type II collagen and proteoglycans, and the increase in type I collagen and type X collagen. These changes directly impact the attachment, proliferation, and differentiation of cartilaginous endplate cells. Maintaining and restoring a healthy extracellular matrix is the main direction for the treatment of intervertebral disc degeneration in the present and future. Cartilaginous endplate degeneration is a complex process involving multiple factors and mechanisms, involving multiple disciplines such as biomechanics, biochemistry, and cell biology. Through multidisciplinary collaboration, such as the combination of biomechanics and molecular biology, controlled immobilization and traction therapy could provide more effective treatment for patients with intervertebral disc degeneration through fully understanding the mechanisms by which traction promotes intervertebral disc regeneration. Figures and Tables | References | Related Articles | Metrics

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Application and progress of transcriptomics and proteomics techniques in the study of intervertebral disc degeneration Zhou Tianle, Wang Wei, Zhang Zhiwen, Liu Ximing 2026, 30 (23):  5925-5933.  doi: 10.12307/2026.787 Abstract ( 71 )   PDF (1300KB) ( 94 )   Save BACKGROUND: Intervertebral disc degeneration is a chronic spinal disease characterized by accelerated apoptosis of nucleus pulposus cells and decomposition of the extracellular matrix, which often leads to low back pain and spinal dysfunction. The molecular mechanism has not been fully understood, hindering the development of precision treatment strategies. Transcriptomics technology can be used to deeply analyze gene expression patterns, and proteomics technology can be used to identify protein function dynamics. The combined application of these two technologies provides an important means to elucidate the pathological mechanism of intervertebral disc degeneration. OBJECTIVE: To review the research progress of transcriptomics and proteomics technologies in intervertebral disc degeneration, and discuss the key roles of these two omics technologies in analyzing molecular mechanisms, screening diagnostic markers, and exploring therapeutic targets. METHODS: A computerized search of relevant literature published from January 1995 to April 2025 in PubMed, Web of Science, CNKI, and SinoMed databases was performed using the search terms “transcriptomics, ribonucleic acid sequencing, proteomics, intervertebral disc degeneration, nucleus pulposus, annulus fibrosus, cartilage endplate” in English and Chinese. A total of 24 articles were ultimately selected for relevant analysis after excluding duplicate and irrelevant literature. RESULTS AND CONCLUSION: Transcriptome studies have elucidated the dynamic evolution of gene expression in intervertebral disc degeneration, and revealed key regulatory networks involving apoptosis, inflammation, and matrix breakdown. Proteomics analysis provided insights into the dynamic changes of protein composition in the nucleus pulposus and annulus fibrosus, highlighting the key roles of matrix metalloproteinases and cytokines in matrix degradation. The combination of the two provides a multi-dimensional perspective on the molecular mechanism of intervertebral disc degeneration and enhances the depth of mechanism research. The comprehensive analysis revealed that the synergistic application of transcriptomics and proteomics has significant potential in revealing the molecular mechanism and potential therapeutic targets of intervertebral disc degeneration. Figures and Tables | References | Related Articles | Metrics

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Animal experimental study on the treatment of lumbar intervertebral disc degeneration with Chinese herbal compound: species selection, modeling method and drug administration Xie Ziying, Li Songbo, Li Jianwen, Yin Yuchao, Zheng Baichuan, Hu Chengshang 2026, 30 (23):  5934-5942.  doi: 10.12307/2026.311 Abstract ( 89 )   PDF (1459KB) ( 10 )   Save BACKGROUND: Chinese herbal compound has a unique curative effect on lumbar disc degeneration. In order to further understand the mechanism of its action, researchers have carried out many animal experiments in vivo, but there is no agreement on the animal model, the way of administration and the choice of observation indicators. OBJECTIVE: To review the progress in animal experimental studies on the treatment of lumbar disc degeneration with Chinese herbal compounds, focusing on the preparation of animal models of lumbar disc degeneration, the administration methods of Chinese herbal compounds and the evaluation indexes of efficacy, in order to provide a reference for related studies. METHODS: CNKI, WanFang, VIP, PubMed and Web of Science were retrieved by computer for relevant literature published from database inception to November 2024. The Chinese terms were “Chinese medicine, compound, Chinese medicine, herbal, drug combination, soup, formula, low back pain, degenerative disc disease, disc degeneration, disc injury, disc degeneration, disc disease, animal, rat, rabbit, canine, porcine, sheep, monkey, primate, model, modeling, experimental, research, progress, review.” The English search terms were “traditional Chinese medicine, Chinese herbal medicine, Chinese medicine formula, herbal formula, intervertebral disc degeneration, degenerative disc disease, disc degeneration, intervertebral disc injury, animal model, animal experiment, preclinical study, rat, mouse, rabbit, sheep, dog, pig, non-human primate, monkey, primate, treatment, therapy, effect, intervention.” A total of 789 relevant articles were retrieved, 139 of which met the inclusion criteria. RESULTS AND CONCLUSION: (1) Rats, gerbils, guinea pigs, mice or New Zealand rabbits are preferred as experimental animals for the treatment of intervertebral disc degeneration by using Chinese herbal compounds. (2) All kinds of intervertebral disc degeneration modeling methods have their own advantages and disadvantages, and the annulus fibropuncture model is the most widely used model in this kind of research. Combination of multiple modeling methods can better simulate the progression of intervertebral disc degeneration. (3) The mode of administration of Chinese herbal compounds in animal models is consistent with that in humans, and oral administration is the main method. (4) Chinese herbal compounds have a good effect on the treatment of disc degeneration, which is often verified by imaging, behavioral, molecular biology and histology. Figures and Tables | References | Related Articles | Metrics

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Traditional Chinese sports in the treatment of osteoporosis: potential biological mechanisms and clinical application progress Du Xingbin, Jiang Fugao, Kong Jianda 2026, 30 (23):  5943-5953.  doi: 10.12307/2026.320 Abstract ( 52 )   PDF (5557KB) ( 206 )   Save BACKGROUND: Although traditional drug therapy has achieved good results in the treatment of osteoporosis, long-term use often leads to adverse events. Currently, exercise intervention (including traditional Chinese sports) has gradually become a hot topic and a new choice for the prevention and treatment of osteoporosis. OBJECTIVE: To analyze the biological mechanisms and related clinical application progress of traditional Chinese sports (such as Tai Chi Chuan, Baduanjin, Wuqinxi, Yijinjing) in the prevention and treatment of osteoporosis, and to explore their potential mechanisms and effects in improving bone health in multiple aspects. METHODS: Relevant literature search was retrieved in the Web of Science, PubMed, CNKI, WanFang Database, and VIP Journal Database. The search terms included "Osteoporosis, Traditional Chinese Exercises, Tai Chi Chuan, Baduanjin, Wuqinxi, Yijinjing, Bone Mineral Density, Bone Metabolism, Blood Circulation, Anti-inflammatory, Antioxidant, Clinical Application” in English and Chinese. Finally, 59 articles were included for review. RESULTS AND CONCLUSION: Traditional Chinese exercises significantly improve bone mineral density and mitigate bone loss through the combined effects of multiple pathways, including mechanical loading to regulate bone metabolism, modulating the gut microbiota-bone axis, enhancing anti-inflammatory and antioxidant effects, and endocrine regulation. Clinical evidence has indicated that Tai Chi Chuan has particularly significant effects on improving lumbar spine and femoral neck bone mineral density in postmenopausal women. Baduanjin, when combined with medication, can markedly regulate glucose metabolism and bone turnover, whereas Wuqinxi indirectly reduces fracture risk by enhancing joint function. Yijinjing shows a significant advantage in maintaining bone mineral density related to men and women. Notably, traditional exercises exert their benefits through potential mechanisms involving immune cell modulation (e.g., Th1 cells and regulatory T cells) and oxidative stress pathways, thereby providing a theoretical foundation for developing novel exercise-based intervention strategies. Figures and Tables | References | Related Articles | Metrics

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Exercise interventions regulate thyroid hormones: effects on the liver, skeleton, muscle, heart, and brain Cheng Yang, Huang Qingqiang, Bu Shumin, Yi Yue 2026, 30 (23):  5954-5963.  doi: 10.12307/2026.304 Abstract ( 77 )   PDF (2819KB) ( 80 )   Save BACKGROUND: Thyroid hormones play a critical role in regulating growth, development, energy metabolism, and maintaining homeostasis in mammals. Exercise interventions can modulate thyroid hormones levels through various mechanisms. However, the regulatory effects of exercise on multiple organs via thyroid hormones have not yet been fully elucidated.  OBJECTIVE: To summarize thyroid hormones synthesis, metabolism, and its regulation through exercise, and explore its dynamic regulatory functions in the liver, bone, muscle, heart, and brain. METHODS: A comprehensive search was conducted in databases including China National Knowledge Infrastructure (CNKI), WanFang database, VIP, Web of Science, and PubMed for relevant articles published from database inception until February 2025. The search terms were “thyroid hormones, thyroxine, triiodothyronine, thyroid, hypothyroidism, hyperthyroidism, exercise, training, physical activity, liver, hepatic, muscle, bone, osteoporosis, osteoblasts, osteoclasts, heart, myocardium, cardiomyopathy, cardiac, myocardial infarction, brain, cognition, nervous” in Chinese and English. A total of 81 studies were included in this review. RESULTS AND CONCLUSION: Exercise can regulate thyroid hormones levels, reshape tissue-specific expression of deiodinases, or alter the sensitivity of thyroid hormone receptors in target organs, leading to dynamic multi-organ regulation. Exercise interventions have the potential to reverse pathological phenotypes of multiple organs associated with thyroid dysfunction, such as metabolic-related fatty liver disease, bone homeostasis imbalance, cognitive impairment, muscle and heart dysfunction. Although existing evidence reveals the regulatory effects of exercise on thyroid hormones, the molecular mechanisms and the regulatory roles of thyroid hormones in multiple organs still require further in-depth exploration. In addition, most of the current research is based on rodent models, primarily focusing on aerobic exercise, and more clinical evidence is needed to confirm its applicability to human metabolic diseases. Figures and Tables | References | Related Articles | Metrics

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Association between environmental exposure to endocrine disrupting chemicals and the risk of type 1 diabetes Wang Ting, Yang Yang, Li Yuping, Yang Lin 2026, 30 (23):  5964-5971.  doi: 10.12307/2026.349 Abstract ( 57 )   PDF (1820KB) ( 19 )   Save BACKGROUND: As a group of ubiquitous exogenous compounds in the environment, endocrine disrupting chemicals can interfere with endocrine system function and contribute to various diseases. In recent years, the correlation between exposure to endocrine disrupting chemicals and type 1 diabetes risk has become a research hotspot, but the exact underlying mechanisms remain unclear. OBJECTIVE: To review the research progress on the association between endocrine disrupting chemicals and type 1 diabetes in terms of epidemiological studies, animal experiments, and related mechanism studies. METHODS: The literature retrieval was conducted on CNKI and PubMed databases from January 2000 to January 2025 with the keywords of “endocrine disrupting chemicals; EDCs; type 1 diabetes; T1DM” in Chinese and English, respectively. A total of 55 articles were selected for the review. RESULTS AND CONCLUSION: Typical endocrine disrupting chemicals such as bisphenol A, pesticides and heavy metals can promote the development of type 1 diabetes through various pathways, including inducing immune dysregulation, activating oxidative stress, and epigenetic regulation. However, existing studies are limited by issues such as non-unified exposure assessment methods, an unclear dose-response relationship, and population heterogeneity. Future research should focus on identifying critical exposure windows and integrating multi-omics approaches to provide new strategies for the prevention of type 1 diabetes.  Figures and Tables | References | Related Articles | Metrics

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Glycocalyx: the new link between exercise and disease Ma Zhennan, Wang Yinfeng, Yao Lijuan, Chen Leqin 2026, 30 (23):  5972-5981.  doi: 10.12307/2026.347 Abstract ( 68 )   PDF (1846KB) ( 11 )   Save BACKGROUND: The glycocalyx serves as a selective permeability barrier that enables the controlled exchange of substances and maintains fluid balance between within and outside the blood vessels. It is also involved in various pathological processes, including inflammation, thrombus formation, and microcirculation disorders, and is significantly associated with the development and progression of diseases such as atherosclerosis, diabetes, and cancer.  OBJECTIVE: To correlate glycocalyx with exercise and disease.  METHODS: A literature search was conducted across international databases (MedReading, PubMed, and Web of Science) and Chinese databases (CNKI, WanFang, and VIP) to identify academic articles. The search terms used were “glycocalyx, physical exercise, disease” in Chinese and “glycocalyx, physical exercise, exercises, physical activity, acute exercise, isometric exercises, aerobic exercise, resistance training, exercise training, disease, diseases” in English. A total of 81 publications were included in the final analysis. RESULTS AND CONCLUSION: As a biological barrier of the vascular endothelium, the glycocalyx plays a key role in regulating vascular permeability, mediating inflammatory responses, sensing blood shear stress, and facilitating anticoagulation. The integrity of the glycocalyx is essential for maintaining stable normal blood circulation and ensuring the physiological functions of various organs in the body. Shedding of the glycocalyx can induce structural changes in the endothelial barrier, leading to an abnormal increase in endothelial permeability and accelerating the pathological processes associated with atherosclerosis. Research has confirmed that the extensive thickening and shedding of the glycocalyx on the surface of cancer cells promote tumor proliferation, metastasis, and disease progression. In traumatic diseases, the severity can be assessed by measuring the levels of debris resulting from glycocalyx injury. The glycocalyx is influenced by factors such as the duration of exercise, changes in exercise mode, and exercise intensity. Acute exercise can induce microvascular changes and increase glycocalyx thickness. The sensitivity of glycocalyx components to shedding during aerobic exercise varies by sex, age, and body mass index. Resistance exercise has a positive effect on the acute response of the endothelial glycocalyx, while long-term exercise training can provide protective benefits. As a potential intervention target for atherosclerosis, sepsis, and cancer, the glycocalyx offers theoretical support for the development of non-drug treatment strategies. However, the clinical application of glycocalyx injury markers has not yet been standardized, and the mechanisms linking glycocalyx, exercise, and disease still require further exploration.  Figures and Tables | References | Related Articles | Metrics

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Mitophagy regulates osteoclasts: a new perspective for osteoporosis treatment Gao Jiabin, Li Tianqi, Xu Kun, Zhu Hanmin, Zhou Xi, Li Wei 2026, 30 (23):  5982-5991.  doi: 10.12307/2026.366 Abstract ( 61 )   PDF (1548KB) ( 33 )   Save BACKGROUND: The development of osteoporosis is closely associated with the disruption of bone homeostasis, particularly due to the enhanced bone resorption activity of osteoclasts. Mitophagy, an autophagic pathway that selectively degrades damaged mitochondria, has recently been identified as being intricately linked to the pathogenesis and progression of osteoporosis. OBJECTIVE: To elucidate the mechanisms of mitophagy and its regulatory roles in osteoclasts and to investigate the potential mechanisms by which mitophagy influences bone homeostasis through the regulation of osteoclastogenesis and apoptosis. METHODS: The databases searched included PubMed, CNKI, WanFang Data, and VIP databases. The search terms were “mitophagy, bone metabolism, osteoclasts, bone homeostasis, bone resorption, bone loss” in Chinese and English. The search time frame was from January 2008 to April 2025. Based on the inclusion criteria, the search results were screened and excluded, and 101 articles were finally included for review and analysis. RESULTS AND CONCLUTION: Mitophagy is a crucial mitochondrial quality control mechanism within cells, primarily responsible for the selective elimination of damaged or dysfunctional mitochondria. The main pathways of mitophagy include the phosphatase and tensin homolog-induced kinase 1/E3 ubiquitin ligase pathway and the receptor-mediated mitophagy pathway. Mitophagy often exhibits dual beneficial and detrimental properties in the body. Excessive mitophagy can lead to imbalance of bone metabolism and subsequent osteoporosis by maintaining intracellular reactive oxygen species homeostasis, regulating energy metabolism, promoting osteoclast differentiation, inhibiting osteoclast apoptosis, and increasing bone resorption.  Figures and Tables | References | Related Articles | Metrics

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Association between immune cells and cardiovascular disease risk: a genome-wide association study in European populations Huang Zhe, Shang Baoling, Yao Gengzhen, Pan Guangming 2026, 30 (23):  5992-5999.  doi: 10.12307/2026.350 Abstract ( 56 )   PDF (1548KB) ( 46 )   Save BACKGROUND: Previous studies have linked immune cells to cardiovascular disease risk. As confounding factors are incompletely addressed, the causal relationship between them remains unclear. OBJECTIVE: To evaluate the potential causal relationship between immune cells and cardiovascular disease.  METHODS: The source of research data mainly involves three databases: Genome-Wide Association Study (GWAS) database (GWAS Catalog, jointly maintained by the National Institute of Human Genomics and the European Institute of Bioinformatics), UK biobank (a database of British population genomics, health and disease phenotype supported by the British government and Wellcome Foundation), and IEU OpenGWAS (a GWAS database developed by the MRC Epidemiology Unit of the University of Britos in the United Kingdom, which mainly focuses on European populations). All of them are open databases. The study has been approved by the institutional review board. It employed a two-sample Mendelian randomization approach with 731 immune cell phenotypes as exposure factors and seven types of cardiovascular diseases (atrial fibrillation, dilated cardiomyopathy, coronary atherosclerotic heart disease, heart failure, hypertrophic cardiomyopathy, hypertension, and valvular heart disease) as outcome factors. The primary methods used for Mendelian randomization analysis and sensitivity analysis were inverse variance weighting and weighted median, aiming to evaluate heterogeneity and pleiotropy. RESULTS AND CONCLUSION: (1) After false discovery rate correction, immunophenotypes exerted a statistically significant effect on atrial fibrillation and hypertension. Five types of cells were related to atrial fibrillation risk, including CD11c on monocytes [odds ratio (OR)=0.917; 95% confidence interval (CI): 0.876-0.960), FSC-A on myeloid dendritic cells (OR=0.942; 95% CI: 0.910-0.974), CX3CR1 on CD14+ CD16- monocytes (OR=1.045; 95% CI: 1.022-1.070), CX3CR1 on monocytes (OR=1.050; 95% CI: 1.024-1.076), and CX3CR1 on CD14+ CD16+ monocytes (OR=1.050; 95% CI: 1.024-1.077). Three immunophenotypes that exert a protective effect on hypertension were identified: CD19 on switched memory B cells (OR= 0.986, 95% CI: 0.980-0.993), CD25++ CD8+ T cells (OR=0.993; 95% CI: 0.990-0.997) and CD25++ CD8+ T cells (OR=0.993; 95% CI: 0.989-0.996). No underlying heterogeneity or horizontal pleiotropy was observed in the sensitivity analysis. (2) The study found a causal relationship between four types of monocytes and one type of myeloid dendritic cells and atrial fibrillation, and a potential causal relationship between one type of memory B cells and two types of T cells and hypertension, suggesting the necessity of considering immune cell phenotypes in monitoring and treating atrial fibrillation and hypertension. This study, based on public datasets, offers important implications for understanding the relationship between immune cell subtypes and cardiovascular disease in the Chinese population, with particular relevance for atrial fibrillation and hypertension management strategies in China. Figures and Tables | References | Related Articles | Metrics

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Sarcopenia and non-alcoholic fatty liver disease: analysis of the gut microbiota Zhang Zheng, Zhang Yibo, Xu Bin, Yan Shichao, Guo Hui 2026, 30 (23):  6000-6009.  doi: 10.12307/2026.318 Abstract ( 56 )   PDF (9270KB) ( 9 )   Save BACKGROUND: Previous studies have established a correlation between non-alcoholic fatty liver disease and sarcopenia; however, their causal relationship remains uncertain. The gut-muscle-liver axis hypothesis posits intricate interactions between the gut microbiota and both sarcopenia and non-alcoholic fatty liver disease, yet the precise pathogenic mechanisms underlying these interactions remain poorly elucidated. OBJECTIVE: To investigate the potential causal relationship between sarcopenia and non-alcoholic fatty liver disease using Mendelian randomization analysis and to delve into the potential role of the gut microbiota in mediating or influencing the interplay between non-alcoholic fatty liver disease and sarcopenia. METHODS: Sarcopenia data were sourced from the UK Biobank (the UK National-Level Biomedical Database, supported by the UK government and developed in 2006 in collaboration with institutions such as the University of Oxford and the University of Manchester, which encompasses multidimensional data including genes, imaging, and health records from 500 000 participants), with relevant traits including appendicular muscle mass, grip strength, and walking speed. The non-alcoholic fatty liver disease dataset was derived from a publicly accessible GWAS summary dataset compiled by Ghodsian et al., comprising aggregated statistics from GWAS cohorts including eMERGE and FinnGen, updated GWAS data of non-alcoholic fatty liver disease from the UK Biobank, and newly conducted GWAS data from the Estonian Biobank. Gut microbiota data for 211 taxa were obtained from the MiBioGen consortium’s large-scale human gut microbiota composition study. Analytical methods included inverse-variance weighted, weighted median, MR-Egger, weighted mode, and simple mode approaches to evaluate the interplay between non-alcoholic fatty liver disease, sarcopenia and gut microbiota-related traits.  RESULTS AND CONCLUSION: (1) The inverse-variance weighted analysis revealed a negative association between walking speed, appendicular muscle mass, and risk of non-alcoholic fatty liver disease, whereas no significant association was observed between left/right hand grip strength and non-alcoholic fatty liver disease. Reverse Mendelian randomization analysis indicated a negative causal relationship between non-alcoholic fatty liver disease and appendicular muscle mass, but no significant causal links were found between non-alcoholic fatty liver disease and walking speed or grip strength. Additionally, 39 gut microbiota taxa showed significant associations with sarcopenia onset, and causal relationships were identified between 6 gut microbiota taxa and non-alcoholic fatty liver disease. (2) The study suggests that the gut microbiota may regulate the “gut-liver-muscle axis” through the metabolism of short-chain fatty acids, which provides Chinese scholars with a new direction for the study of cross-organ mechanisms. Combined with the unique genetic background of the Chinese population (e.g., ALDH2 mutation and genes related to high salt diet), we can further analyze the race-specific pathways of metabolic-muscle co-morbidities, providing a scientific basis for the development of dietary recommendations that are consistent with the dietary structure of the Chinese population (e.g., high cereal intake).  Figures and Tables | References | Related Articles | Metrics

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Application of patch-clamp technique in traditional Chinese medicine: a visual analysis of relevant literature Yang Jun, Li Bin, Xing Guogang, Cai Jie, Liu Lu, Chen Peng, Zhang Tao, Fu Yuanbo, Liu Huilin 2026, 30 (23):  6010-6020.  doi: 10.12307/2026.316 Abstract ( 46 )   PDF (9621KB) ( 8 )   Save BACKGROUND: In recent years, the interdisciplinary application potential of patch-clamp technique in traditional Chinese medicine research has gradually emerged, but a systematic summary of its applications in this field has not yet been conducted. OBJECTIVE: To visualize the application of patch-clamp technology in traditional Chinese medicine field through CiteSpace knowledge map analysis, and to reveal the progress and trends of this technology in the modernization research of traditional Chinese medicine. METHODS: The literature sources included CNKI, VIP, WanFang, PubMed and Web of Science Core Collection database. The computer-assisted literature search was conducted to build a database of patch-clamp technology applications in traditional Chinese medicine field from database inception to September 2024. The authors, institutions, and keywords were subjected to visual analysis and knowledge map drawing using CiteSpace 6.3.R1 software and bibliometric methods. RESULTS AND CONCLUSION: (1) A total of 819 articles were included, with 968 authors. The First Affiliated Hospital of Henan University of Chinese Medicine was the institution with the most publications in the Chinese database, while Harbin Medical University was the institution with the most publications in the English database. (2) The research directions, keyword clustering, and emergence analysis of each institution showed that patch-clamp technology in the field of traditional Chinese medicine mainly focused on cardiac electrophysiology, herbal pharmacology, and nervous system electrophysiology. (3) The development of patch-clamp technology in traditional Chinese medicine generally presents the evolution path of “basic mechanism → target deepening → clinical transformation,” reflecting the transformation from a single technical tool to a multidisciplinary cross-platform. (4) The core influence of the authors who published the articles needs to be further improved, and the cross-regional cooperation among research institutions needs to be enhanced. The current research relies on a single technical approach and lacks depth in content. Future research should integrate multiple technologies and interdisciplinary approaches to enrich the research content, expand research directions, and provide evidence-based support for in-depth exploration of the intrinsic mechanisms of traditional Chinese medicine. Figures and Tables | References | Related Articles | Metrics

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Visual analysis of shear wave elastography in skeletal muscle research Li Qian, Li Zhenxing, Qiao Pengyan, Wang Pingzhi 2026, 30 (23):  6021-6029.  doi: 10.12307/2026.364 Abstract ( 54 )   PDF (15303KB) ( 10 )   Save BACKGROUND: Shear-wave elastography is valuable for rehabilitation diagnosis and treatment, but it has not been sufficiently promoted in clinical practice. OBJECTIVE: To explore the trends and hotspots of ultrasound shear wave elastography in skeletal muscle research by visualizing and analyzing the international literature from the past 10 years, thereby providing a reference for clinical diagnosis and follow-up research. METHODS: Based on the Web of Science Core Collection database (2015-2024), the number of publications, countries/regions, institutions, authors, journals, cited literature, and key words from the 978 included articles were visualized and analyzed using CiteSpace software. RESULTS AND CONCLUSION: (1) With a 16.2% average annual growth in global publications, China has the highest number of publications worldwide (197), but its international collaborative network is relatively weak. The University of Nantes in France has the highest number of publications (50), and the University of Queensland has the most influential collaborative network. (2) Ultrasound in Medicine and Biology is the journal with the most publications (33). Noriaki Ichihashi is the most productive author. (3) The gastrocnemius muscle is one of the most frequently studied objects for shear wave elastography. Shear wave elastography shows significant clinical potential for central nervous system diseases and sports injuries. (4) The focus of shear wave elastography research has gradually shifted from basic biomechanical studies to dynamic assessment of clinical efficacy and therapeutic interventions. (5) In the future, diagnostic techniques should be more standardized and refined. Standardized data ranges can be established for muscle tissue; however, individual biological differences in elasticity values need to be considered. Figures and Tables | References | Related Articles | Metrics

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Association between sarcopenia and osteoporosis: a genome-wide data analysis in European populations Yin Xingxiao, Jiang Yang, Song Yanping, Yao Na, Shen Zhen, Li Yanqi, Song Yueyu, Peng Hao, Chen Qigang 2026, 30 (23):  6030-6039.  doi: 10.12307/2026.371 Abstract ( 51 )   PDF (9294KB) ( 8 )   Save BACKGROUND: Sarcopenia and osteoporosis have attracted significant attention in the academic community due to their high prevalence and severe adverse outcomes. Although existing studies have suggested a potential causal relationship between sarcopenia and osteoporosis, the evidence remains insufficient.  OBJECTIVE: Based on large-scale genome-wide data, to explore the causal relationship between genetically predicted sarcopenia and osteoporosis through a bidirectional Mendelian randomization approach.  METHODS: Genome-wide significant loci (P < 5×10-8) associated with sarcopenia-related traits were selected from the UK Biobank database (an open database jointly developed by the UK government, the Medical Research Council, and the Wellcome Trust), followed by linkage disequilibrium analysis. Osteoporosis data were obtained from the GEnetic Factors for OSteoporosis Consortium (GEFOS; an open database funded by the EU Framework Program for Research and Development, jointly led by Erasmus University Medical Center in the Netherlands), including 28 498 participants of European ancestry, with a focus on osteoporotic fracture-prone skeletal sites. The inverse-variance weighted method served as the primary analytical approach, supplemented by MR-Egger regression, weighted median method, and MR-RAPS for robustness validation. Multiple sensitivity analyses were conducted to ensure the reliability of the findings.  RESULTS AND CONCLUSION: The inverse-variance weighted analysis revealed bidirectional causal relationships between fat-free mass and bone mineral density (P < 0.05). Forward causality analysis indicated that fat-free mass was positively associated with lumbar spine bone mineral density [odds ratio (OR)=1.124, 95% confidence interval (CI): 1.008-1.253, P=0.035) but negatively associated with forearm bone mineral density (OR=0.821, 95% CI: 0.699-0.966, P=0.017). Reverse causality analysis demonstrated that forearm bone mineral density (OR=1.033, 95% CI: 1.002-1.066, P=0.036), lumbar spine bone mineral density (OR=1.054, 95% CI: 1.025-1.084, P < 0.001), and femoral neck bone mineral density (OR=1.059, 95% CI: 1.008-1.113, P=0.021) were all positively associated with fat-free mass. A reduction in fat-free mass may lead to decreased lumbar spine bone mineral density, while lower bone mineral density at various skeletal sites may further exacerbate the loss of fat-free mass. Although the study primarily utilized data from European populations, the generalizability of genome-wide association studies and shared genetic backgrounds suggest that these findings hold significant reference value for understanding the pathogenesis of sarcopenia and osteoporosis in Chinese populations, informing clinical intervention strategies, and assessing genetic risks. Figures and Tables | References | Related Articles | Metrics

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Osteoporotic vertebral compression fractures: a visual analysis of current status and emerging trends Qu Bolin, Ciren Lunzhu, Guo Jinyang, Meng Hanlu, Ding Guanxiang, Sang Hongpeng 2026, 30 (23):  6040-6050.  doi: 10.12307/2026.312 Abstract ( 55 )   PDF (3643KB) ( 12 )   Save BACKGROUND: Current literature primarily focuses on comparing the clinical efficacy and surgical safety of various operative approaches for osteoporotic vertebral compression fractures, while there is a notable lack of research addressing the current status, hotspots, and future trends in the treatment and prognosis of osteoporotic vertebral compression fractures. OBJECTIVE: To analyze the current status, hotspots and trends of research on osteoporotic vertebral compression fractures by bibliometric methods. METHODS: English articles related to the treatment and prognosis of osteoporotic vertebral compression fractures published between 1994 and 2023 were retrieved from the Web of Science Core Collection. Bibliometric and visualization analyses were conducted using CiteSpace and VOSviewer to evaluate publication volume, geographic distribution, institutional contributions, journal rankings, author productivity, keyword co-occurrence, research hotspots, and citation impact, thereby exploring the hotspots and trends of research on osteoporotic vertebral compression fractures. RESULTS AND CONCLUSION: A total of 2 275 publications were analyzed. Global research output of osteoporotic vertebral compression fractures demonstrated a steady upward trajectory, peaking in 2022 with 215 publications. Contributions spanned 68 countries/regions, with China leading in productivity (644 publications). Soochow University emerged as the most prolific institution (90 publications). European Spine Journal ranked first in publication volume (n=146), while Spine exhibited the highest citation count (n=1 923), citations per article (58.5), and H-index (45), ranked second in publication volume (n=106). Yang Huilin (China) was the most productive author (n=65), whereas Galibert P (France) received the highest citation count (n=300). Research themes evolved dynamically: early-stage focus centered on “vertebroplasty,” “balloon kyphoplasty,” and “polymethylmethacrylate (PMMA)”; mid-term shifts emphasized “surgical management” and “nonoperative treatment”; and recent expansion prioritized “safety” and “risk factors,” which will continue to gain sustained attention as a trend for future research. Figures and Tables | References | Related Articles | Metrics

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Molecular mechanism and natural drug screening for ferroptosis-targeted therapy in rheumatoid arthritis Zhou Wen, Yang Hongwei 2026, 30 (23):  6051-6061.  doi: 10.12307/2026.370 Abstract ( 53 )   PDF (2938KB) ( 11 )   Save BACKGROUND: Current research in rheumatoid arthritis focuses on iron metabolism-related proteins and the effects of ferroptosis on immune cells. This study proposes new approaches to target ferroptosis in the treatment of rheumatoid arthritis from the perspective of traditional Chinese medicine. These approaches include developing new traditional Chinese medicine therapies, creating individualized treatment plans based on patients’ genes and biomarkers, optimizing therapeutic strategies, and improving symptoms. These strategies aim to facilitate early treatment and improve prognosis. OBJECTIVE: Bioinformatics was applied to investigate the molecular mechanism of treating rheumatoid arthritis from the perspective of ferroptosis, and to screen potential traditional Chinese medicines and active ingredients, opening up a new way for the treatment of rheumatoid arthritis. METHODS: The Gene Expression Omnibus database, maintained by the National Center for Biotechnology Information, is primarily used to store and share high-throughput gene expression, microarray, and sequencing data. The Gene Expression Omnibus database enables researchers to search and analyze genomic data related to various diseases. This study is based on publicly available summary statistics databases and does not require ethical approval. The Gene Expression Omnibus database was searched for datasets related to rheumatoid arthritis that met the screening criteria. The Sanger sequencing platform was then used to obtain the transcriptome data of rheumatoid arthritis. Finally, the limma algorithm was applied to screen the differentially expressed genes. Meanwhile, the ferroptosis-related gene set was extracted from the FerrDb database. Through integration analysis, we obtained the intersection of the differentially expressed genes and the ferroptosis-related genes. We constructed a protein interaction network using this intersection to study the topological structure characteristics of the network. Then, the screened potential targets were analyzed using the online analysis tool DAVID Bioinformatics Resources 6.8 by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis to explore their biological functions and signaling pathway characteristics. Finally, the SymMap platform was used to locate natural drugs. Molecular docking analysis was performed to find small molecule compounds corresponding to natural drugs and their targets using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. RESULTS AND CONCLUSION: (1) The Gene Expression Omnibus database was screened to identify two datasets, GSE55457 and GSE55235, and 340 common differentially expressed targets were obtained after limma differential analysis. Through the FerrDb platform, 487 ferroptosis-related targets were collected and intersected with the above common differentially expressed targets, yielding a total of 17 co-targets related to ferroptosis and rheumatoid arthritis. (2) The protein interaction network was constructed using 17 co-targets, containing 16 target proteins and 33 protein interactions. Among them, core targets such as EGFR, AR, MAPK8, CDKN1A, JUN, ATM and EGR1 occupied important positions in the network, and 5 core co-targets related to ferroptosis and rheumatoid arthritis were screened out through the network topological features, namely EGFR, AR, MAPK8, CDKN1A, and JUN. (3) Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses showed that the treatment of rheumatoid arthritis through the ferroptosis pathway may be associated with DNA binding process, cytoplasmic and nuclear SMAD2/3 signaling pathway, etc. (4) The results of SymMap platform and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform show that natural small molecule compounds such as progesterone, estradiol and quercetin could form a good molecular docking with the core target, which provides a new direction for the development of a new direction for the development and research of new drugs for rheumatoid arthritis. Figures and Tables | References | Related Articles | Metrics

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Burn and multi-omic biomarkers: causal relationships with 41 inflammatory factors and 35 blood and urine markers Gao Minyi, Liu Pinghong, Lin Haixiong 2026, 30 (23):  6062-6070.  doi: 10.12307/2026.357 Abstract ( 40 )   PDF (10536KB) ( 14 )   Save BACKGROUND: Conventional observational studies are inadequate to reveal the potential causal relationship of biomarkers in burns patients. Mendelian randomization, leveraging genetic variation as an instrumental variable to mimic the advantages of randomized controlled trials, has emerged as a crucial tool for dissecting causal associations in complex diseases. OBJECTIVE: To explore the relationship of burn injury with 41 inflammatory cytokines and 35 blood and urinary biomarkers using Mendelian Randomization.  METHODS: (1) Burn-related data of genome-wide association studies were obtained from the IEU open GWAS project database, constructed by The University of Bristol, UK, including 218 131 samples and 16 380 465 single nucleotide polymorphisms were included in the study. (2) Data for 41 types of inflammatory cytokines were derived from a study involving 8 293 participants in the Finnish Young Cardiovascular Risk Study database, which is constructed by the Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku. (3) Data for 35 types of blood and urinary biomarkers were derived from a study involving 363 228 participants from the UK Biobank, which is a large biomedical database project jointly initiated by the UK government, the Wellcome Trust, and the Medical Research Council of the UK. Single nucleotide polymorphisms were employed as instrumental variables, and analyses were conducted using inverse variance weighted, Mendelian Randomization-Egger, weighted median, and weighted mode methods. Heterogeneity of results was assessed via Cochrane’s Q test. The reliability of exposure-outcome associations was evaluated using Mendelian Randomization-Egger intercept tests, Mendelian Randomization-Pleiotropy Residual Sum and Outlier (MR-PRESSO), and leave-one-out sensitivity analyses.  RESULTS AND CONCLUSION: The levels of interleukin-9 (odds ratio=0.97; 95% confidence interval, 0.949 to 0.997; P=0.030) and testosterone (odds ratio=0.997; 95% confidence interval, 0.995 to 0.999; P=0.025) were reduced in burn patients. No heterogeneity or horizontal pleiotropy demonstrated the robustness of the results. Through Mendelian randomization analysis, the study revealed the reduced interleukin-9 and testosterone levels following burns, suggesting that elevating these could potentially facilitate tissue repair and mitigate protein catabolism. Figures and Tables | References | Related Articles | Metrics

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Visual analysis of research hotspots in the field of gut microbiota in the elderly at home and abroad Li Yiguang, Guo Haonan, Ding Xiaotao, Yuan Mengyao, Jiang Lijin, Fan Xinfeng, Feng Yan 2026, 30 (23):  6071-6080.  doi: 10.12307/2026.341 Abstract ( 58 )   PDF (21805KB) ( 18 )   Save BACKGROUND: As the population ages, research on gut microbiota in the elderly is gaining attention. However, bibliometric analysis in this field is still lacking.  OBJECTIVE: To comprehensively analyze literature on gut microbiota in older adults from multiple databases, identify current research hotspots, predict future trends, and provide potential directions for subsequent research.  METHODS: CNKI was searched using the subject terms “gut microbiota in older adults,” “gut microecology in older adults,” and “intestinal flora in older adults.” The Web of Science database was searched using the search strategy of “TS=(elderly gut microbe OR elderly gut microbiome OR elderly gut microbiota OR elderly intestinal microbiome OR elderly intestinal microbiota).” Bibliometric tools VOSviewer and CiteSpace were employed to systematically analyze publication years, country distribution, research institutions, authors, and keywords in the retrieved literature. RESULTS AND CONCLUSION: A total of 250 and 604 eligible articles were obtained from the CNKI and Web of Science databases, respectively. From 2014 to 2023, the global publication volume in the field of gut microbiota in older adults showed a steady upward trend. Research interest and discussions in this field have increased significantly worldwide, with expanding depth and breadth through interdisciplinary collaboration. Notably, COVID-19, oxidative stress, depression, and cognitive impairment emerged as prominent keywords in the past 2 years. This bibliometric analysis visually illustrates the research status and developmental trends in the field of gut microbiota in older adults over the past decade. The field is currently in a growth phase, requiring further exploration of underlying mechanisms of gut microbiota and intervention strategies for related diseases. Figures and Tables | References | Related Articles | Metrics

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Feng’s spinal manipulation for cervical spondylosis: kinematic changes Gu Jiangpeng, Guo Wei, Chen Xujing, Liu Xiaomin, Liu Hongbo, Sun Peng, Ye Chaoqun, Feng Wei, Wang Fei 2026, 30 (23):  6081-6091.  doi: 10.12307/2026.376 Abstract ( 48 )   PDF (18505KB) ( 48 )   Save BACKGROUND: Patients with cervical spondylosis often exhibit varying kinematic abnormalities due to degenerative structural changes and biomechanical imbalances in the cervical spine. Although previous studies have compared specific kinematic parameters between healthy individuals and cervical spondylosis patients, research on coupled motions and their associated ratios remains limited. OBJECTIVE: To investigate changes in kinematic parameters in cervical spondylosis patients before and after Feng’s spinal manipulation therapy. METHODS: Thirty patients with cervical spondylosis and 30 healthy controls were enrolled. Participants completed three standardized motion tasks: lateral flexion, flexion-extension, and axial rotation. Three-dimensional cervical spine kinematics were quantified using stereophotogrammetry upon admission and discharge. The following kinematic parameters were analyzed: primary range of motion, coupled range of motion, coupling patterns, movement symmetry, motion smoothness, and angular velocity. Comparative analyses were conducted between healthy controls and cervical spondylosis patients as well as between pre- and post-treatment kinematic changes in patients. RESULTS AND CONCLUSION: (1) Patients with cervical spondylosis exhibited significantly reduced maximal angular displacement compared with healthy controls during lateral flexion, flexion-extension, and axial rotation of the cervical spine (P < 0.05). Conversely, significant increases were observed in the following coupling ratios: flexion-extension during bending, axial rotation during bending, bending during extension, and bending during rotation (P < 0.05). (2) There were significant improvements in cervical spondylosis patients after treatment, with notable reductions in both Visual Analog Scale and Neck Disability Index scores (P < 0.05). Significant differences were also observed in kinematic parameters: maximal angular displacement during bending, bending symmetry, peak and mean bending velocities, maximal flexion-extension angle, peak and mean flexion-extension velocities, maximal axial rotation angles, rotational symmetry, peak rotational velocities, and mean left rotation velocity (P < 0.05). However, no significant differences were detected in coupling movement patterns (P > 0.05). Additionally, the axial rotation coupling ratio during bending, flexion-extension coupling ratio during right bending, bending coupling ratio during rotation and flexion-extension coupling ratio during right rotation showed significant post-treatment changes (P < 0.05). (3) Compared with healthy controls, patients with cervical spondylosis exhibited significantly higher coupling-to-primary motion ratios. Feng’s spinal manipulation not only markedly alleviated clinical symptoms but also effectively restored cervical spine mobility. Figures and Tables | References | Related Articles | Metrics

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Analysis of influencing factors and risk prediction model for spasticity severity in stroke patients with hemiplegia Cao Xinyan, Leng Xiaoxuan, Gao Shiai, Chen Jinhui, Liu Xihua 2026, 30 (23):  6092-6098.  doi: 10.12307/2026.344 Abstract ( 46 )   PDF (1209KB) ( 25 )   Save BACKGROUND: Spastic hemiplegia remains a challenging clinical problem that urgently needs to be addressed. Currently, most research primarily focuses on discussing the influencing factors of spasticity onset. This study, however, utilizes binary logistic regression to primarily explore the key factors affecting the severity of spasticity in stroke patients, providing a reliable basis for personalized treatment plans for patients. OBJECTIVE: To identify the influencing factors of spasticity severity in stroke patients with hemiplegia through univariate and multivariate logistic regression analyses, and to construct a risk prediction model.  METHODS: A total of 120 patients with post-stroke spasticity hospitalized at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from November 2024 to March 2025 were enrolled. A self-designed questionnaire was used for data collection. Logistic regression analysis was performed to screen the influencing factors of spasticity severity in hemiplegic patients, and a risk prediction model was constructed. The predictive performance of the model was evaluated via a receiver operating characteristic curve analysis. RESULTS AND CONCLUSION: Among 120 stroke spasticity patients, 66 had mild spasticity with Modified Ashworth Scale < 2 and 54 had severe spasticity with Modified Ashworth Scale ≥ 2. The results of logistic regression analysis showed that for stroke spasticity patients, advanced age, normal sensory function, higher Barthel index, and Fugl-Meyer motor function score were protective factors for the severity of spasticity; whereas negative emotions of depression and anxiety, poor sleep quality, and pain were risk factors for the severity of spasticity. The area under the receiver operating characteristic curve of the logistic regression model for spasticity severity in post-stroke hemiplegia patients was 0.969 [95% confidence interval (0.944, 0.994)], indicating that the predictive model constructed based on these factors has high predictive performance. Clinicians should actively prevent and reduce spasticity through multidimensional and individualized intervention strategies to improve patients' functional prognosis and quality of life. Figures and Tables | References | Related Articles | Metrics

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Performance of unstable barbell bench press and changes in electromyographic activity after transcranial direct current stimulation Wang Lejun, Chi Wenxin, Song Xiaoqian, Li Qian, Qiao Minjie, Tao Haifeng 2026, 30 (23):  6099-6109.  doi: 10.12307/2026.360 Abstract ( 42 )   PDF (2407KB) ( 15 )   Save BACKGROUND: Transcranial direct current stimulation can enhance human motor performance by modulating cortical excitability, but its impact on the performance of unstable resistance exercise remains unclear.  OBJECTIVE: To investigate the effects of transcranial direct current stimulation on unstable barbell bench press performance and electromyographic activity.  METHODS: A randomized, self-controlled crossover design was employed. Twenty-two male college students were randomly assigned to receive either active anodal transcranial direct current stimulation or sham stimulation. After transcranial direct current stimulation interventions, subjects performed a fatigue test involving the unstable barbell bench press. Performance during the unstable barbell bench press task was assessed by recording both the number of completed repetitions and barbell acceleration, serving as indicators of load capacity and movement stability control. In addition, surface electromyographic signals were collected from the right biceps brachii, triceps brachii, anterior deltoid, posterior deltoid, and pectoralis major during the exercise. A paired t-test was used to examine differences in repetition counts between true and sham stimulation conditions. Repeated measures analysis of variance was applied to analyze differences in triaxial acceleration, agonist muscle activation levels, and antagonist co-activation levels.  RESULTS AND CONCLUSION: (1) No significant difference in the number of barbell bench press repetitions was observed between the true and sham stimulation conditions. However, the mean amplitude of Y-axis acceleration was substantially lower in the true stimulation group than the sham stimulation group. (2) True transcranial direct current stimulation markedly increased the activation level of the anterior deltoid and the co-activation level of the posterior deltoid. Except for the posterior deltoid, the activation and co-activation levels of the tested muscles were markedly higher during the latter half of the exercise compared with the initial half. (3) There were no significant interaction effects between transcranial direct current stimulation intervention and exercise phase on the measured parameters. (4) These findings indicate that transcranial direct current stimulation has no significant impact on muscle endurance performance during unstable barbell bench press exercises, but can enhance movement stability. This improvement may be attributed to the significant increase in the activation levels of the anterior deltoid and the co-activation of the posterior deltoid, leading to greater shoulder joint stiffness and stability. In competitive sports and clinical rehabilitation training, transcranial direct current stimulation can be employed to modulate performance during unstable resistance exercise according to the training goals.  Figures and Tables | References | Related Articles | Metrics

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Mechanisms by which mitochondria-endoplasmic reticulum interaction stress mediates activation of inflammatory vesicles in nerve roots of lumbar intervertebral disc herniation rabbits modulated by acupotomy Jiang Qiang, Ding Yu, Ding Zhili, Han Jiaheng 2026, 30 (23):  6110-6121.  doi: 10.12307/2026.319 Abstract ( 75 )   PDF (40947KB) ( 13 )   Save BACKGROUND: Acupotomy, as one of the representative therapies of minimally invasive interventional therapy, has been applied to the clinical treatment of lumbar disc herniation, which can antagonize nerve root inflammatory response in lumbar disc herniation with precise curative effects, but its potential mechanism of action remains to be explored. OBJECTIVE: To investigate how acupotomy intervention affects the mitochondrial-mitochondria-associated endoplasmic reticulum membranes-endoplasmic reticulum interaction stress-mediated NLRP3 inflammasome activation in the microenvironment of nerve roots in the model rabbits of lumbar disc herniation. METHODS: Forty healthy adult New Zealand white rabbits were randomly divided into a blank control group (10 rabbits) and a model group (30 rabbits). Animal models were established in the model group through a standard autologous nucleus pulposus transplantation method. Once the model was successfully created, the model group was randomly subdivided into a model control group (10 rabbits), an electroacupuncture intervention group (positive control group) (10 rabbits), and an acupotomy intervention group (10 rabbits). Acupotomy and electroacupuncture interventions were performed 1 week after modeling. Rabbit dorsal root ganglion neurons were isolated and cultured at 3 weeks after intervention. TUNEL staining was used to detect cell apoptosis. Western blot assay was used to measure the expression levels of NLRP3, MAMs-related proteins, endoplasmic reticulum stress marker protein GRP78, specific marker protein CHOP, and the key pathway PERK axis TXNIP protein. Fluorescent probe staining (Mito Tracker and ER Tracker) and transmission electron microscopy were used to observe mitochondrial-endoplasmic reticulum structural coupling. Flow cytometry was used to detect Ca2+ levels, and reactive oxygen species content was measured using reactive oxygen probes. RESULTS AND CONCLUSION: (1) Compared with the model control group, the acupotomy group had a significant reduction in apoptosis rate (P=0.000 2), the protein expressions of NLRP3 (P=0.014 4), IP3R (P=0.013 2), GRP75 (P=0.009 9), VDAC1 (P=0.000 3), GRP78 (P=0.006 5), CHOP (P=0.008 5), and TXNIP (P=0.001 5) and the levels of Ca2+ (P < 0.000 1) and reactive oxygen species (P=0.039 2) as well as a significant increase in the protein expression of MFN2 (P=0.010 8). (2) Fluorescent probe staining results showed that the co-localization level of mitochondria and endoplasmic reticulum was highest in the model control group and lowest in the blank control group; the co-localization level of mitochondria and endoplasmic reticulum in the acupotomy group was higher than that in the blank control group but lower than the model control group. (3) Transmission electron microscopy observations revealed enhanced contact between mitochondria and endoplasmic reticulum in the model control group and less contact in the blank control group, and there was increased contact in the acupotomy intervention group compared with the blank control group, but lower than in the model control group. To conclude, acupotomy intervention can help manage the stress between mitochondria and the endoplasmic reticulum, modulate mitochondria-endoplasmic reticulum contact sites, reduce Ca²⁺ influx, reactive oxygen species generation, and mitochondrial dysfunction, thereby inhibiting the formation of the NLRP3 inflammasome. This explains the upstream mechanism by which acupotomy inhibits NLRP3 inflammatory vesicle assembly by modulating mitochondria-endoplasmic reticulum interaction stress, revealing the deep action targets of acupotomy in treating lumbar intervertebral disc herniation, and providing a certain theoretical basis for the treatment of lumbar intervertebral disc herniation by acupotomy. Figures and Tables | References | Related Articles | Metrics

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Potential targets of glucagon-like peptide 1 receptor agonist ticagrelor in the treatment of Alzheimer’s disease Zhang Xiaomin, Du Pengyang, Zhang Xiuping, Xue Guofang 2026, 30 (23):  6122-6133.  doi: 10.12307/2026.355 Abstract ( 56 )   PDF (2137KB) ( 21 )   Save BACKGROUND: Glucagon-like peptide 1 receptor agonists, as novel drug candidates for the treatment of neurodegenerative diseases, have achieved breakthrough progress in clinical research on Alzheimer’s disease, with drugs such as Semaglutide advancing to phase III clinical trials. However, there remains a significant knowledge gap regarding the molecular mechanism of neuroprotective effects of these drugs. OBJECTIVE: To innovatively integrate multi-omics analysis techniques and network pharmacology methods, to systematically analyze the intersection network between the gene lineage related to Alzheimer’s disease pathology and the potential targets of ticagrelor, to identify key regulatory genes, and to verify their molecular mechanisms through in vitro and in vivo experiments. METHODS: A multi-dimensional research strategy was adopted: (1) Constructing the differential expression gene profile of Alzheimer’s disease using the DisGeNET database that covers various disease-related genomics. (2) Obtaining the structure of Tirzepatide from PubChem database with bioactive molecules and screening potential targets. (3) Conducting Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis using the DAVID database. (4) Constructing a protein-protein interaction network by combining the STRING database with Cytoscape 3.9.1, and screening key genes through topological network analysis. (5) Cell level verification: HT22 cells were divided into control group, and model group in which treatment with β-amyloid 1-42 oligomers for 36 hours was performed to develop an Alzheimer’s disease in vitro model in HT22 cells, and drug administration group in which the cells were pretreated with β-amyloid 1-42 oligomers for 24 hours, followed by co-treatment with ticrepotide for 12 hours. The expression of angiotensin II type 2 receptor protein was analyzed by western blot assay, and the expression levels of synaptic function markers such as synapse protein 1 and postsynaptic dense substance 95 were detected by ELISA. (6) Animal experiment verification: The experiment was divided into three groups. The control group, consisting of WT-type C57BL/6 mice, received intraperitoneal injection of physiological saline; the model group, consisting of 3xTg mice that were Alzheimer’s disease-mimicking mice, received intraperitoneal injection of physiological saline; and the drug administration group, consisting of 3xTg mice, received intraperitoneal injection of 20 nmol/L ticrepotide. All treatments were administered once every other day for a total of 15 times. The cognitive behavior improvement in the Alzheimer’s disease mouse model was analyzed using the water maze technique; the expression of β-amyloid (6E10) and phosphorylated Tau protein (P-tau-181) was quantitatively analyzed by western blot assay. RESULTS AND CONCLUSION: (1) A total of 3 397 genes associated with Alzheimer's disease were screened from the DisGeNET database. Based on protein connectivity, 10 key genes with the highest connectivity were identified: AGTR2, NTSR1, NTSR2, GHSR, C5AR1, C3AR1, OPRM1, SSTR2, OPRD1, and STAT3. GO enrichment analysis and KEGG pathway analysis suggested that ticagrelor may improve Alzheimer’s disease by enhancing neuroreceptor-ligand function. (2) Cell experiments suggested that ticagrelor may exert therapeutic effects by improving synaptic function in Alzheimer’s disease. The angiotensin II type 2 receptor may be a potential target for Ticagrelor in the treatment of Alzheimer’s disease. (3) Animal experiments indicated that ticagrelor can improve cognitive ability in 3xTg mice and alleviate abnormal β-amyloid deposition and tau protein phosphorylation in the brains of 3xTg mouse models. To conclude, the angiotensin II type 2 receptor is revealed as a key molecular target for ticagrelor in the pathological process of Alzheimer's disease. Ticagrelor may treat Alzheimer's disease by regulating synaptic function mediated by the angiotensin II type 2 receptor. Figures and Tables | References | Related Articles | Metrics

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Tetramethylpyrazine improves iron metabolism disorders in a rat model of spinal cord injury via the Keap-1/Nrf2 signaling pathway Zheng Peng, Jia Xiaoning, Tao Jingwei, Fan Xiao 2026, 30 (23):  6134-6141.  doi: 10.12307/2026.352 Abstract ( 36 )   PDF (2375KB) ( 6 )   Save BACKGROUND: The clinical management of spinal cord injury remains a global medical challenge, with no currently available ideal treatment. Traditional Chinese medicine has therapeutic advantages for spinal cord injury. Notably, tetramethylpyrazine, an active component of Chuanxiong rhizome, has been shown to significantly suppress pathological responses including neuroinflammation and apoptosis after spinal cord injury, exhibiting promising therapeutic potential. However, its mechanisms require further elucidation. OBJECTIVE: To investigate the regulatory effects of tetramethylpyrazine on the Kelch-like ECH-associated protein 1/nuclear factor-erythroid 2-related factor 2 (Keap-1/Nrf2) signaling pathway and iron metabolism following spinal cord injury, and to elucidate its neuroprotective mechanisms. METHODS: Thirty-six Sprague-Dawley rats were randomly allocated into: sham group (laminectomy+saline, n=12), model group (spinal cord injury+saline, n=12), and tetramethylpyrazine group (spinal cord injury+tetramethylpyrazine, n=12). At 4 weeks post-injury, tissues were collected for analysis. Neuronal morphology was assessed via Nissl staining; iron deposition detected by Prussian blue staining; iron content in the spinal cord measured using an iron assay kit; protein expression of Keap-1, ferritin heavy polypeptide 1, and ferritin light chain detected by immunohistochemistry; Nrf2 expression detected via immunofluorescence; and protein levels of Nrf2, ferritin heavy polypeptide 1, and ferritin light chain measured using western blot assay. RT-PCR was used to quantify the mRNA expression of Nrf2, Keap-1, ferritin light chain, and ferritin heavy polypeptide 1. RESULTS AND CONCLUSION: Nissl staining demonstrated preserved neuronal morphology in the sham group, while the model group exhibited disorder of neuronal structure and tetramethylpyrazine administration substantially improved these pathological morphological changes. Quantitative assessment of iron metabolism showed that both the model and tetramethylpyrazine groups displayed significantly elevated average absorbance values for Prussian blue staining (P < 0.01) and iron content in the spinal cord tissue (P < 0.01) compared with the sham group, while the iron content in the tetramethylpyrazine group was significantly lower than that in the model group (P < 0.01). Immunohistochemical analysis revealed that the model and tetramethylpyrazine groups showing markedly increased average absorbance values for Keap-1 expression but decreased average absorbance values for ferritin light chain and ferritin heavy chain 1 levels compared with the sham group (all P < 0.01). Importantly, tetramethylpyrazine treatment reversed these patterns, demonstrating significantly lower average absorbance values for Keap-1 and higher average absorbance values for ferritin light chain/ferritin heavy chain 1 expression compared with the model group (P < 0.01). Immunofluorescence results showed that the average absorbance values for Nrf2 expression in the model and tetramethylpyrazine groups were significantly lower than those in the sham group (P < 0.01), while the average absorbance value for Nrf2 expression in the tetramethylpyrazine group was significantly higher than that in the model group (P < 0.01). Western blot analysis confirmed these trends at the protein level, showing decreased relative protein expression of Nrf2, ferritin heavy chain 1 and ferritin light chain in the model and tetramethylpyrazine groups compared with the sham group (P < 0.01) but increased relative protein expression of Nrf2, ferritin heavy chain 1 and ferritin light chain in the tetramethylpyrazine group compared with the model group (P < 0.01). Molecular analysis via RT-PCR showed that the relative mRNA expression of Keap-1 in the model and tetramethylpyrazine groups was significantly higher than that in the sham group (P < 0.01), while the relative mRNA expression of Nrf2, ferritin heavy chain 1, and ferritin light chain mRNA was significantly lower than that in the sham group (P < 0.01); the relative mRNA expression of Keap-1 in the tetramethylpyrazine group was significantly lower than that in the model group (P < 0.01). To conclude, tetramethylpyrazine modulates the Keap-1/Nrf2 pathway and ferritin light chain/ferritin heavy chain 1 expression after spinal cord injury, ameliorating iron metabolism dysregulation and exerting neuroprotective effects. Figures and Tables | References | Related Articles | Metrics

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Intervention with Compound Kidney-Invigorating Granules in a mouse model of osteoporosis: role of the TRIB3/beta-catenin axis Wang Yan, Lyu Hao, Hu Zhimu, Zhou Yao, Liu Qiang, Yang Yuxiang, Yi Hairu, Wang Jiuxiang, Jiang Ting 2026, 30 (23):  6142-6149.  doi: 10.12307/2026.353 Abstract ( 39 )   PDF (2502KB) ( 16 )   Save BACKGROUND: Previous studies have shown that knockdown of β-catenin can inhibit the osteogenic differentiation of human bone marrow mesenchymal stem cells and reduce the expression of TRIB3. Serum containing Compound Kidney-Invigorating Granules can promote the expression of β-catenin and TRIB3 in human bone marrow mesenchymal stem cells, and induce human bone marrow mesenchymal stem cells to differentiate into osteogenic cells. OBJECTIVE: To further explore the mechanism of Compound Kidney-Invigorating Granules in a mouse model of osteoporosis based on the TRIB3/β-catenin axis.  METHODS: 8-week-old female C57BL/6 mice were randomly divided into the following experimental groups: blank control group, sham surgery group, model group, low-, medium-, and high-dose groups of Compound Kidney-Invigorating Granules, and a positive drug group. Except for the blank control and sham surgery groups, the bilateral ovaries of mice were removed to construct osteoporosis models. One week after model preparation, mice were given 7.05, 14.1 and 28.2 g/kg Compound Kidney-Invigorating Granules in the low-, medium- and high-dose Compound Kidney-Invigorating Granule groups, respectively. Mice in the positive drug group were given 1.53 mg/kg alendronate sodium by intragastric administration, and those in the blank control group and sham surgery group were given an equal volume of normal saline, once a day. After 12 weeks of intragastric administration, the bone microstructures of mice in different groups were observed by Micro-CT. The pathological changes in the femur were detected by hematoxylin-eosin staining and Masson staining; and expressions of TRIB3, β-catenin and osteogenic proteins (alkaline phosphatase and osteopontin) in the femur were detected by western blot assay.   RESULTS AND CONCLUSION: Compared with the blank control group and sham surgery group, the bone trabecular arrangement in the model group was sparse, and the number of empty bone lacunae was significantly increased. The expression levels of TRIB3, β-catenin, alkaline phosphatase and osteopontin were significantly decreased (P < 0.05). Compared with the model group, bone trabeculae in the medium- and high-dose groups of Compound Kidney-Invigorating Granules showed more intact morphology and regular arrangement. The protein expression levels of TRIB3, β-catenin, alkaline phosphatase and osteopontin were significantly up-regulated (P < 0.05). Therefore, these findings indicate that Compound Kidney-Invigorating Granules have a therapeutic effect on osteoporosis model mice, and its mechanism may be generated through the TRIB3/β-catenin axis.  Figures and Tables | References | Related Articles | Metrics

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Effect of blood flow restriction training on the magnitude and temporal characteristics of post-activation performance enhancement: a systematic review and meta-analysis Li Yanfeng, Zhang Yilin, Kong Hao, Zheng Hang, Liu Jiajun, Yin Mingyue, Qiu Bopeng, Huang Kongyun, Liu Hengxian, Zhong Yuming, Chen Jun, Xu Kai 2026, 30 (23):  6150-6146.  doi: 10.12307/2026.387 Abstract ( 60 )   PDF (3866KB) ( 26 )   Save OBJECTIVE: Multi-level meta-analysis was used to systematically compare the acute effects of blood flow restriction combined with conditioning activity (that is used to induce post-activation performance enhancement) versus conditioning activity alone, conditioning activity plus blood flow restriction versus seated rest, low-intensity conditioning activity plus blood flow restriction versus high-intensity conditioning activity, and seated rest plus blood flow restriction versus seated rest on exercise performance.  METHODS: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we systematically searched the Web of Science, PubMed, SPORTDiscus, and CNKI databases from their inception to May 24, 2025. The inclusion criteria were: (1) participants were at least physically active and healthy; (2) those reported at least one of the following four comparisons: blood flow restriction+conditioning activity versus conditioning activity alone, conditioning activity+blood flow restriction versus seated rest, low-intensity conditioning activity+blood flow restriction versus high-intensity conditioning activity, and seated rest+blood flow restriction versus seated rest alone; (3) exercise performance (e.g., jump height, sprint time, and bench throw) reported as the primary outcome; (4) randomized or non-randomized crossover/parallel intervention designs; and (5) relevant articles published in peer-reviewed English or Chinese journals. Risk of bias was assessed using ROB-2, and evidence quality was evaluated via Grading of Recommendations Assessment Development and Evaluation (GRADE). Data were synthesized using cluster-robust variance estimation and three-level mixed-effects models with small-sample adjustments. Subgroup analyses and meta-regression were conducted to explore moderators and heterogeneity sources. RESULTS: A total of 12 studies involving 196 participants (12 females and 184 males) were included. The main findings were: (1) conditioning activity+blood flow restriction was more effective than conditioning activity alone in acutely enhancing performance (ES=0.21, 95% confidence interval [CI]=0.01-0.40, GRADE=low), with optimal effects at 4-12 minutes of recovery and 50% arterial occlusion pressure (ES=1.49); (2) conditioning activity+blood flow restriction showed no significant difference compared with seated rest (ES=0.52, 95% CI=-0.12 to 1.15, GRADE=very low), but the conditioning activity+140 mmHg blood flow restriction outperformed conditioning activity alone (ES=1.21, 95% CI=0.14-2.28); (3) low-intensity conditioning activity+blood flow restriction had similar effects to high-intensity conditioning activity (ES=-0.10, 95% CI=-0.84 to 0.64, GRADE=low); and (4) seated rest+blood flow restriction did not differ from seated rest alone (ES=0.24, 95% CI=-0.03-0.52, GRADE=very low). Notably, the latter two comparisons showed performance declines over recovery time (β=-0.04, P < 0.01 and β=-0.04, P=0.02). CONCLUSION: A preliminary suggestion is that blood flow restriction combined with conditioning activity can enhance post-activation performance enhancement more than conditioning activity alone, with 50% arterial occlusion pressure and a recovery period of 4-12 minutes being potentially optimal. However, conditioning activity+blood flow restriction does not appear to outperform seated rest, possibly due to limited studies. In addition, low-intensity conditioning activity+blood flow restriction can achieve similar post-activation performance enhancement as high-intensity conditioning activity, while the potential benefits of seated blood combined with blood flow restriction on exercise performance may diminish over time. Overall, the preliminary recommendation is to use low-intensity conditioning activity (e.g., 30% of one-repetition maximum squat or body weight exercises) combined with 50% arterial occlusion pressure or 140 mmHg blood flow restriction with a recovery period of 4-12 minutes for subsequent exercise performance testing. Figures and Tables | References | Related Articles | Metrics